Health Status Of Children Research Articles

Prediction of cyanotic and acyanotic congenital heart disease using machine learning models.

Congenital heart disease is most commonly seen in neonates and it is a major cause of pediatric illness and childhood morbidity and mortality. To identify and build the best predictive model for predicting cyanotic and acyanotic congenital heart disease in children during pregnancy and identify their potential risk factors. The data were collected from the Pediatric Cardiology Department at Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan from December 2017 to October 2019. A sample of 3900 mothers whose children were diagnosed with cyanotic or acyanotic congenital heart disease was taken. Multivariate outlier detection methods were used to identify the potential outliers. Different machine learning models were compared, and the best-fitted model was selected using the area under the curve, sensitivity, and specificity of the models. Out of 3900 patients included, about 69.5% had acyanotic and 30.5% had cyanotic congenital heart disease. Males had more cases of acyanotic (53.6%) and cyanotic (54.5%) congenital heart disease as compared to females. The odds of having cyanotic was 1.28 times higher for children whose mothers used more fast food frequently during pregnancy. The artificial neural network model was selected as the best predictive model with an area under the curve of 0.9012, sensitivity of 65.76%, and specificity of 97.23%. Children having a positive family history are at very high risk of having cyanotic and acyanotic congenital heart disease. Males are more at risk and their mothers need more care, good food, and physical activity during pregnancy. The best-fitted model for predicting cyanotic and acyanotic congenital heart disease is the artificial neural network. The results obtained and the best model identified will be useful for medical practitioners and public health scientists for an informed decision-making process about the earlier diagnosis and improve the health condition of children in Pakistan.

Diarrhea and associated factors among under-five children in open defecation free and open defecation rural households of Degem district, Oromia, Ethiopia

IntroductionDiarrheal diseases are the top cause of preventable death, particularly among children under the age of five in developing countries like Ethiopia. Despite the national level of latrine coverage being 61%, diarrhea is responsible for the deaths of half a million children under 5 years annually. Therefore, this study aimed to assess diarrhea and its associated factors among children in open defecation free (ODF) and open defecation (OD) households of Degem district, Oromia, Ethiopia.MethodsA comparative cross-sectional study was conducted within the community, involving 398 participants (200 from open defecation free [ODF] and 198 from open defecation [ODF] households). The selection of study participants from OD and ODF households was done using a multistage sampling approach. Data input was carried out using Epi Data 3.1, while data analysis would be performed using Statistical Package for Social Sciences (SPSS) version 26 software, employing appropriate testing methods. Statistical significance and the strength of relationships were assessed using odds ratios with a 95% confidence interval.ResultsThe prevalence of diarrhea among children in open defecation free and open defecation households was 26 and 38%, respectively. Factors such as children who were not vaccinated for rotavirus, mothers or caregivers did not have diarrhea, mothers or caregivers did not wash their hands at critical times, and individuals with poor latrine utilization were significantly associated with diarrhea among children in ODF households. On the other hand, children who were not vaccinated for rotavirus, not received vitamin A supplementation, mothers or caregivers did not wash their hands at critical times, children lacking access to latrines and children whose their families practice open field solid waste disposal were significantly associated with diarrhea among children in open defecation free households.ConclusionThe study results indicated that the prevalence of diarrhea among children under five in open defecation areas was notably higher compared to those residing in open defecation free areas. Consequently, it is imperative for all responsible bodies to focus on evidence-based strategies to combat childhood diarrhea and to ensure child health status.

Analysis of urban–rural differences in the relationship between grandparenting and the nutrition and health status of children aged 0–3 in China

BackgroundThe practice of grandparents taking on the role of primary caregivers for their grandchildren is widespread across both urban and rural regions in China. Yet, the existing body of research offered limited clarity on how grandparenting associated with nutrition as well as health of children aged 0–3 years, particularly in terms of potential differences between urban and rural areas in China. Therefore, this study aims to delve into the association between grandparenting and nutrition as well as health status of children aged 0–3 and its urban–rural differences in China.MethodsThis study draws on data from 1,028 children aged 0 to 3 years and their families, collected through the China Family Panel Studies (CFPS) in 2020. Nutrition and health status of children aged 0–3 was assessed based on the indicators of malnutrition, medical consultations due to illness and developmental delay. Parental reports were used to determine the extent of grandparenting, which any caregiving arrangement involving grandparents, whether during daytime, nighttime, or both, were categorized as grandparenting. Multivariate regression analyses were conducted to explore the association between grandparenting and nutrition as well as health outcomes of children aged 0–3.ResultsRegression analysis results indicated that grandparenting is positively associated with malnutrition (OR 1.323; 95% CI 1.008, 1.735), medical consultation for illness (OR 1.382; 95% CI 1.058, 1.804), and developmental delay (OR 1.502; 95% CI 1.508, 2.134) in children aged 0–3 years. The above association has been proven to be evident in rural settings, whereas it was not significant in urban environments.ConclusionGrandparenting exhibits a negative association with nutrition and health status of children aged 0–3. It is imperative for parents to consider their children’s caregiving arrangements carefully, and foster nutrition and health status of children from birth to 3 years old actively.

Sensory and Motor Function, Pain, and Health Status in Children with Arthrogryposis and Myelomeningocele

Background/Objectives: Proprioception and sensory disorders have been reported in children with arthrogryposis multiplex congenita (AMC) and myelomeningocele (MMC), but valid and reliable assessment tools are limited in accurately identifying the sensory aspects of motor disorders. This study aimed to investigate the somatosensory status in the feet and legs. An additional purpose of this study was to explore pain, skin irritations, and health status. Methods: Nineteen children with AMC, twenty-three with MMC, and twenty-two typically developing (TD) children (7–18 years old) were tested using a somatosensory test battery in ankle kinesthesia and in identifying four different types of floors. Results: In the AMC and MMC groups, the threshold to perceive the somatosensory stimuli was not achieved by all participants. MMC participants perceived somatosensory stimuli less than TD participants in all tests, with a higher level of the lesion and more affected ambulation. The MMC group identified one floor significantly less often than the TD group. The AMC group performed better than the MMC group in two-point discrimination, vibration sensation, and some light-touch pressure tests. There were no differences among the TD, AMC, and MMC groups in ankle kinesthesia. Pain was reported by four (21%) subjects in the AMC group and five (22%) in the MMC group, and skin irritations were reported by three (13%) participants in the MMC group. There was no difference among the TD, AMC, and MMC groups in health status as reported using the EQ-5D-Y visual analog scale. Conclusions: Although differences in sensory aspects were the most evident between the groups, assessments of activity and participation levels in the rehabilitation of children with disabilities are also recommended.

Oral Health Status of Korean Students and Associated Fasting Plasma Glucose in Overweight/Obese Individuals

This study aimed to evaluate the current oral health status of Korean children and adolescents and investigate the correlation between fasting plasma glucose levels and oral health in individuals with overweight and obesity. A total of 121,682 participants were selected from the Survey of School Health Examination data provided by the Ministry of Education over the last 5 years to assess recent oral health status and related factors. Among them, 18,105 students with overweight or obesity who had their fasting plasma glucose levels measured were assessed for blood glucose-related analysis. Based on fasting blood glucose levels, the participants were categorized into normal, impaired fasting glucose, and diabetes groups. The associations of these groups with dental caries, oral hygiene, and periodontal diseases were investigated. There were significant associations between demographic factors, health-related behaviors, and blood glucose levels with oral health. Increased fasting blood glucose levels were associated with poor oral health. These results suggest that glycemic management is important in enhancing the oral health of overweight and obese children and adolescents.

The influence of parents’ oral health literacy and behavior on oral health of preschool children aged 3–6 years- evidence from China

BackgroundDirect and indirect associations have been identified among health literacy, health behavior, and health status. Thus, we aimed to investigate the influence of oral health literacy and behaviors in parents on their children's oral health status. Moreover, we aimed to analyze the mentioned mediating effects through oral health behavior management.MethodsOral health information of 1,102 preschool children aged 3 to 6 years was collected from five primary schools in Jinjiang District, Chengdu City, Sichuan Province, China. The decay-missing-filled teeth (DMFT) index and soft scale plaque index (PI) were used by professional dentists aided by school teachers to assess caries and periodontal health among the children. Simultaneously, we conducted a questionnaire-based survey among the parents to determine their oral health literacy and health behavior and their children's oral health behavior. The probit model, instrumental variables, and mediation effect model were used to evaluate the association of parents' oral health literacy and behavior with their children's oral health status.ResultsThe DFMT index was 1.58 among the children, with zero caries in 646 (58.6%) children. The PI was 0.68, with zero gum disease in 517 (46.9%). The univariate analysis suggested that the parents' health literacy and behavior were correlated with their children's oral health status (P < 0.01). Parents' oral health behavior significantly affected their children's oral health status. Simultaneously, a stronger correlation was observed upon using parents' health literacy as an instrumental variable to assess the endogeneity, indicating endogeneity problems. Parents' health-related behaviors exerted a mediating effect on children's oral health, with parents helping children brush their teeth demonstrating the strongest effect.ConclusionParents' oral health-related behaviors can affect their children's oral health status. We recommend enhancing parents' oral health literacy to improve children's oral health status.

Evaluation of Oral Health Status among Children of Halba Tribe in Bastar Division of Chhattisgarh, India.

The Halba tribe owes its nomenclature term "Hal" which locally means plowing or farming. Bastariya Halba is Dravidian tribe from Warangal. They speak Indo-European language Halbi. There are no population-based studies till date evaluating the oral health status among Halba children in Chhattisgarh. To evaluate the oral health status of Halba tribe children in the Bastar division of Chhattisgarh by assessing the prevalence of dental caries and periodontal conditions. A cross-sectional study was conducted to determine the dental caries and periodontal status in Halba tribe children. Children aged between 6 and 12 years (N = 1,050) were randomly selected from Halba community of Chhattisgarh. Dental caries status was recorded by using the decayed missing filled teeth (DMFT/dmft) index and papillary marginal attached (PMA) index for periodontal status. The statistical software namely Statistical Package for the Social Sciences (SPSS) version 17.0 was used for the analysis of the data. The study population was 1,050 children from the Halba tribal community. Among the subjects, 545 (51.9%) were boys and 505 (48.1%) were girls. The overall mean dmft/DMFT was found to be 2.25 ± 2.71. In this study, boys had significantly higher values for overall dmft/DMFT (2.55 ± 2.74) than girls. It was observed that mild, moderate, and severe gingivitis significantly increased with increasing age. The population examined was characterized by high prevalence of dental caries as well as unmet treatment needs. Factors like poverty, illiteracy, poor awareness, and lack of oral health services may be a reason for poor oral health in these children. Pathivada L, Prabhat SK, Garg N, et al. Evaluation of Oral Health Status among Children of Halba Tribe in Bastar Division of Chhattisgarh, India. Int J Clin Pediatr Dent 2024;17(10):1121-1123.

Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study.

Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children. The present study included mother-reported health assessments for 621 children aged 5-7years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression. Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL. Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.

Meta-Analysis of the Heritability of Childhood Height From 560 000 Pairs of Relatives Born Between 1929 and 2004.

Childhood height is commonly used to measure children's health and nutritional status. It is used to define stunting, where a child is considered stunted if their height is shorter than two standard deviations below the Child Growth Standards median. Studies have shown that genetic and environmental factors contribute to childhood height, so understanding these contributions is important for stunting research. This systematic review and meta-analysis examined the contribution of these factors across study designs and ancestries. A systematic search found 28 twin and 26 family studies spanning from birth to 17 years. We identified 162 293 twin, 380 195 parent-offspring, and 19 965 sibling pairs born between 1929 and 2004. These datasets were meta-analyzed using a random effects model. The review is registered in PROSPERO (ID CRD42023432550). The estimated heritability (h2) of height from twin design increased from birth to 17 years. For children under 5 years, the estimated heritability was 0.57 (95%CI, 0.52-0.61) for European, 0.48 (0.39-0.57) for Asian, and 0.46 (0.40-0.51) for multi ancestries. Heritability estimated from parent-offspring design was 0.46 (95%CI, 0.28-0.62) at birth and 0.76 (95%CI, 0.70-0.80) at 17 years. Meanwhile, the estimated heritability from sibling design remained constant across ages at 0.70 (95%CI, 0.52-0.83). The heritability estimates of childhood height were slightly higher in European ancestries, but in general, they did not significantly differ across ancestry groups. While the shared environmental effects on height peak in early childhood, the estimated heritability increase in late teens. Unique environmental factors play a small, but significant role throughout childhood.

Peningkatan Kapasitas Ibu Hamil Melalui Buku KIA Kelas Ibu Hamil Tahun 2024

Health development programs in Indonesia are currently prioritized towards improving the health status of mothers and children, particularly in the most vulnerable groups such as pregnant women, mothers giving birth, perinatal infants, toddlers, and women of reproductive age. In response to this, a community service activity titled "Enhancing the Capacity of Pregnant Women through the Maternal and Child Health (MCH) Handbook in Pregnant Women's Classes in the Working Area of Puskesmas Cempaka, Banjarbaru City, in 2024" was conducted. This initiative aims to reduce child mortality rates and improve maternal health. The use of the MCH Handbook is considered a strategic step to enhance community independence. The target of this community service activity was 12 pregnant women attending the Pregnant Women's Class facilitated by Midwife Maulida. The implementation methods included preparation and execution of activities in June 2024 in Bangkal, Cempaka Subdistrict, Banjarbaru City. Evaluations were conducted through pre-test and post-test assessments of the mothers' knowledge about the MCH Handbook. The results showed that 83% of the participants always brought the MCH Handbook during antenatal visits, 41.6% had read the handbook in its entirety, and 58.3% only read the sections related to examinations. Therefore, further evaluations of pregnant women's knowledge about pregnancy through the MCH Handbook are needed to broaden their insights and enable effective implementation.

Oral health status of children with intellectual and developmental disabilities in India: a systematic review and meta-analysis

IntroductionIndia has committed to the Sustainable Development Goals (SDGs) 2030 principle of “Leave No One Behind”, which seeks to reduce disparities and vulnerabilities. The dearth of data on the oral health conditions of children with intellectual and developmental (IDD) disabilities in India is significant. Our systematic review intended to collate and synthesise data on the oral health status of children with IDD.MethodsOnline electronic databases such as PubMed-MEDLINE, Embase, and Scopus were searched using appropriate keywords from the earliest available data until 31st March 2024, with no language restriction. Cross-sectional studies conducted amongst individuals below 18 years of age with intellectual, or developmental disabilities, in India were included. Quality assessment and meta-analysis using a random-effects model for variables reported from four or more studies and a prediction interval was calculated.ResultsOut of 2388 studies, a total of 15 studies were included. Our study showed that 91% (95% [confidence interval] CI: 0.80–0.96) of IDD children use toothbrushes regularly. However, poor oral hygiene was found among 38% (95% CI = 0.21–0.59) of IDD children. The pooled prevalence of dental caries among children was found to be 64% (95% CI: 0.45–0.79). Periodontal disease was reported in only one study among 54.20% of IDD children.ConclusionsOur findings suggest that despite brushing regularly the incidence of caries and poor oral hygiene in children with IDD is high. Flexible, tailored interventions that go beyond a uniform approach must be implemented to effectively address oral health requirements of children with IDD. Specific Health Programmes should be established for their preventive oral care.

The Impact of Fermentation on Aflatoxin and Fumonisin Levels in Sorghum Kernels and Flour Used to Prepare Complementary Food in Kerio Valley, Kenya

ABSTRACTSorghum is a major ingredient used in the production of complementary foods in Kenya's drylands, particularly in areas like Kerio Valley. However, it is known to be susceptible to aflatoxin and fumonisin contamination, which have adverse effects on human health. The current study aimed to assess the levels of aflatoxin and fumonisin in sorghum kernels and flour from Kerio Valley and to investigate whether fermentation (spontaneous or innoculum facilated) could reduce the levels of toxins. The sorghum samples were obtained through a cross‐sectional survey and subjected to ELISA analysis for quantification of aflatoxin and fumonisin levels. The aflatoxin levels ranged from 0 to 119.91 ppb for sorghum kernels and from 2.70 to 89.36 ppb in the flour, while fumonisin concentrations ranged from 0 to 30.65 ppm in sorghum kernels and 0.22 to 27.27 ppm in the flour. Fermentation significantly reduced the levels of the toxins in sorghum samples (p ≤ 0.05). The type of fermentation (p = 0.001), sample fermented (kernels or flour) (p = 0.004), and duration of fermentation (p = 0.037) significantly impacted the reduction of both toxins. Therefore, there is a need to integrate the adoption of fermentation with other effective postharvest practices to mitigate mycotoxin contamination in sorghum and other cereal‐based foods. In addition to the customary health and nutrition messages, promoting proper food handling, storage, and processing can significantly contribute to improving food safety and the overall health and nutritional status of young children.

Measuring resilience in young children: The Child and Youth Resilience Measure- Early Childhood (CYRM-EC)

Early childhood is a particularly important time to nurture resilience. Strengthening measurement of resilience processes for young children is essential to advancing resilience science and application. The current study provides an initial validation of the Child and Youth Resilience Measure (CYRM) for parent/caregiver-report during early childhood (CYRM-EC). Participants included 265 children in the U.S. ages 4–5 years (M = 5.07 years) in the spring prior to kindergarten. The sample varied substantially by annual household income (36% earning ≤ $35,000; 43% ≥ $75,000) and Adverse Childhood Experiences (ACEs; 47% had ≥ 1; 17% had ≥ 3). Diversity in child race/ethnicity was limited (69.5% White/Caucasian, 17.9% more than one race, 9.4% Latinx/Hispanic, 1.6% Asian, 0.4% Native American/Alaska Native, and 1.2% other races/ethnicities). The 11-item Child and Youth Resilience Measure-Early Childhood demonstrated strong internal reliability (α = .81) and a single factor structure. This measure also exhibited concurrent validity with both individual (children's self-regulation and social skills) and relational (positive parenting) promotive and protective factors and processes, accounting for covariates including child age, gender, race/ethnicity, ACEs, parent education, and nesting by classroom. Findings further indicated evidence for predictive (concurrent) validity of the Child and Youth Resilience Measure-Early Childhood to better overall child health status and fewer teacher-rated externalizing behaviors, but not to early literacy or math scores. Longitudinal research with young children of varying ages and from more diverse racial/ethnic backgrounds is needed to advance understanding of the Child and Youth Resilience Measure-Early Childhood and to inform application for preventive interventions.

Impact of Consumer Wearables Data on Pediatric Surgery Clinicians' Management: Multi-Institutional Scenario-Based Usability Study.

At present, parents lack objective methods to evaluate their child's postoperative recovery following discharge from the hospital. As a result, clinicians are dependent upon a parent's subjective assessment of the child's health status and the child's ability to communicate their symptoms. This subjective nature of home monitoring contributes to unnecessary emergency department (ED) use as well as delays in treatment. However, the integration of data remotely collected using a consumer wearable device has the potential to provide clinicians with objective metrics for postoperative patients to facilitate informed longitudinal, remote assessment. This multi-institutional study aimed to evaluate the impact of adding actual and simulated objective recovery data that were collected remotely using a consumer wearable device to simulated postoperative telephone encounters on clinicians' management. In total, 3 simulated telephone scenarios of patients after an appendectomy were presented to clinicians at 5 children's hospitals. Each scenario was then supplemented with wearable data concerning or reassuring against a postoperative complication. Clinicians rated their likelihood of ED referral before and after the addition of wearable data to evaluate if it changed their recommendation. Clinicians reported confidence in their decision-making. In total, 34 clinicians participated. Compared with the scenario alone, the addition of reassuring wearable data resulted in a decreased likelihood of ED referral for all 3 scenarios (P<.01). When presented with concerning wearable data, there was an increased likelihood of ED referral for 1 of 3 scenarios (P=.72, P=.17, and P<.001). At the institutional level, there was no difference between the 5 institutions in how the wearable data changed the likelihood of ED referral for all 3 scenarios. With the addition of wearable data, 76% (19/25) to 88% (21/24 and 22/25) of clinicians reported increased confidence in their recommendations. The addition of wearable data to simulated telephone scenarios for postdischarge patients who underwent pediatric surgery impacted clinicians' remote patient management at 5 pediatric institutions and increased clinician confidence. Wearable devices are capable of providing real-time measures of recovery, which can be used as a postoperative monitoring tool to reduce delays in care and avoidable health care use.

Using School-Based Teleconsultation Services to Make Community Health Services Accessible in Semirural Settings of Pakistan: Sequential Explanatory Mixed Methods Study.

In Pakistan's remote areas, quality health care and experienced professionals are scarce. Telehealth can bridge this gap by offering innovative services like teleconsultations. Schools can serve as effective platforms for introducing these services, significantly improving health service access in semirural communities. This study aims to explore the feasibility of introducing school-based teleconsultation services (TCS) to strengthen community health in a semirural area of Karachi, Pakistan. This study used a mixed methods design. A total of 393 students were enrolled for the quantitative component, while 35 parents, teachers, and community stakeholders participated in the qualitative arm (focused group discussion). Proportional computation for the quantitative data was done using SPSS (version 24; IBM Corp), while qualitative data underwent thematic analysis. A total of 1046 successful teleconsultations were provided for 393 students over 28 months. The demographic data showed that the mean age of the students availing TCS was 9.24 (SD 3.25) years, with the majority being males (59.3%, 233/393). Only 1.24% (13/1046) of cases required referrals. The qualitative analysis yielded three themes: (1) transformation of the health care experience, (2) escalating demands for teleconsultation, and (3) the psychological aspect of care. This study demonstrated the efficacy of integrating TCS in a semiurban school in Karachi to address health care accessibility gaps. Implementing TCS through the school platform improved the overall health status of school children while reducing school absences and financial burdens on families. The study highlighted TCS's cost-effectiveness, time efficiency, and quality, with community support for 24/7 availability, expansion to adults, and a reimbursement model. School health nurse-led TCS offers a scalable solution to health care challenges, enhancing health outcomes for school-going children in Pakistan and globally, particularly in low- and middle-income countries, where accessibility is a major issue.

Inequalities and Differences in Health Status of Pre- and Perinatal Periods in Hungarian Long-Term Series Analysis (1997-2019).

The main goal of this study is to publish findings on the lifestyle factors of pregnant women in Hungary and their impact on early childhood health status by examining changes over time and regional/geographical disparities. The source of the data is the raw indicators reported by health visitors as per mandatory annual report data for the period of 1997-2019. To examine the association, we used indicators of pregnant women's states as explanatory variables (for example, pregnant women in very late care, prenatal smoking habits, and pregnant women without care), and the outcome indicators were prematurity, intrauterine malnutrition, and newborn babies with developmental disorders. A univariate Poisson regression was used to examine the correlations. Our results show a decreasing trend in the proportion of pregnant women who smoke and of pregnant women who apply late for care (after 28 weeks of pregnancy), with an increasing indicator of regional differences. The research results of the prenatal and perinatal indicators show that the counties Borsod-Abaúj-Zemplén and Szabolcs-Szatmár-Bereg are the most critical areas in terms of health status in Hungary. The number of pregnancies attended very late (after 28 weeks) and the number of women who gave birth without health visitor care are associated with the number of preterm births (R2 = 0.7313; p < 0.001; R2 = 0.5519; p < 0.001) and intrauterine growth restrictions (R2 = 0.3306; p < 0.001; R2 = 0.2632; p < 0.001). Interventions to improve early childhood health in some counties of Hungary are urgently needed to reduce regional disparities. Such counties include Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg, Heves, Somogy, Bács-Kiskun, and Nógrád. Health education for pregnant women and activities to strengthen the compliance of pregnant women are key to improving early childhood health outcomes.

Exploring the oral health status of children living with hypoxic ischemic encephalopathy (HIE): A caregiver described self-report.

Hypoxic Ischemic Encephalopathy (HIE) is a birth complication due to loss of oxygen flow, resulting in a wide range of physical and cognitive differences often requiring support from multidisciplinary healthcare teams. Despite this population's increased need, little is known about their oral health status and the role of the dentist as a member of the care team. A 32-item oral health questionnaire was shared to 8700 members within the patient advocacy non-profit, Hope for HIE's, Facebook group. The survey assessed caregiver-reported oral health status and facilitators and barriers to receiving dental care. Two hundred sixty-two individuals responded to the survey. The majority were white (90%, 177/196) parents of children with HIE (99%, 259/262) that lived in the U.S. (76%, 148/195) and cared for children under 3 (42%, 106/251). 36% (85/236) reported cavity experience, 81% (180/223) reported visiting the dentist for a dental check-up, however, 58% (147/255) considered the dentist to be a member of their child's care team. Children diagnosed with HIE likely experience similar oral health status as their peers, however, qualitative developmental work is necessary to assess facilitators and barriers to receiving dental care, and how to integrate the dentist into the care team.

Understanding Parental Decision-Making and Determinants of COVID-19 Vaccination for Children in Vietnam: A Cross-Sectional Online Survey.

In Vietnam, COVID-19 vaccination campaigns for children have encountered numerous challenges due to acceptance issues among parents. This study aimed to assess parental decision-making and identify factors influencing their decision to vaccinate their children against COVID-19. This was a cross-sectional online survey conducted between April and May 2023 among parents of children aged 6-17 years enrolled in urban and rural schools in Thai Nguyen province, Vietnam. Data on parental and child demographics, vaccination decision-making, COVID-19 experiences, and health beliefs based on the Health Belief Model were collected and analyzed, using univariate and multivariable multinomial regression analyses. Among 4235 respondents (median age 41 years, 80.4% female), 81.3% had accepted all vaccine doses for their children, 9.7% had accepted some doses, 4.6% had rejected all doses, and 4.5% had not vaccinated their children for reasons unrelated to vaccine acceptance. Factors influencing parental decision-making included parental age, educational status, area of residence, health beliefs, prior experience with COVID-19 vaccination, and their child's age and health status. We found overall high levels of parental acceptance for COVID-19 vaccination for children in Thai Nguyen province. To enhance COVID-19 vaccination acceptance, targeted communication strategies should focus on younger parents, those living in urban areas, parents with higher educational levels, and those with children who are younger or have underlying medical conditions. Trusted sources such as healthcare workers, teachers, and official health websites are essential for disseminating accurate information and fostering trust in vaccination programs.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages

BackgroundIn many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.MethodsWe carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization’s HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.ResultsA total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children’s health as poor. Many factors were associated with perceived children’s health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.ConclusionThis study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.

Regional Disparities, Economic Development, and Neonatal Mortality and Hospital Delivery in China

A negative association between neonatal mortality and hospital delivery has been found in some low- and lower-middle-income countries but not in rural settings characterized by poor quality of maternal and child health care. To examine the association between neonatal mortality and hospital delivery in China across urban and rural regions, regional disparities, and varying levels of economic development. This retrospective cohort study used county-level data from 2008 to 2020 from the National Maternal & Child Health Statistics across mainland China. Statistical analysis was conducted from March to December 2023. Since 2008, China has strategically leveraged hospital deliveries with national subsidies to diminish neonatal mortality, particularly in rural areas. Neonatal mortality and hospital delivery rates were calculated, and their association was estimated using multivariable fixed-effects linear models of county-level cohort data to adjust for time-invariant differences across counties and controls for gross domestic product (GDP) per capita, women's years of education, hospital beds, and health workers. The analysis included data from 2930 counties, with 198.7 million live births across 36 255 county-year records between 2008 and 2020. The mean (SD) neonatal mortality rate per 1000 live births decreased in rural areas from 12.3 (7.5) in 2008 to 3.9 (2.7) in 2020 and decreased in urban areas from 5.0 (3.1) in 2008 to 2.0 (1.3) in 2020. Hospital delivery rates increased in rural areas from a mean (SD) of 93.4% (11.8%) in 2008 to 99.9% (0.6%) in 2020 and increased in urban areas from 97.7% (6.1%) in 2008 to 100.0% (0.1%) in 2020. In rural areas, an increase of 10 percentage points in hospital deliveries was associated with a neonatal mortality rate of -1.4 (95% CI, -1.9 to -1.0; P < .001) per 1000 live births, whereas this negative association was not observed in urban areas. When the analysis was stratified by regions and incomes, the negative association became considerably stronger in the western and central regions of China, as well as in counties with lower GDP per capita. This cohort study of more than 2900 counties in China suggests that an increase in hospital deliveries was associated with reduced neonatal mortality in rural and economically underdeveloped areas in China. To further reduce neonatal mortality and improve newborn health, it is imperative to increase the accessibility of hospital delivery services.