A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center

Abstract Purpose To report characteristics of microbial keratitis in pediatric patients under five years. Methods Patients with infectious keratitis under the age of 5 years were included in this retrospective cross-sectional study for ten years. All patients were admitted and corneal scraping was performed in 81 children. Fortified empiric antibiotic eye drops including cefazolin (50 mg/cc) and amikacin (20 mg/cc) were started and the antibiotic regimen was continued or changed according to culture results. In the case of fungal keratitis, topical voriconazole (10 mg/cc) or natamycin (50 mg/cc) and topical chloramphenicol (5 mg/cc) were started. A tectonic procedure was done when corneal thinning or perforation was present. Results Ninety-Three Patients between 1 to 60 months with a mean age of 33 ± 18 months old with corneal ulcer were included in the study. The most common risk factor was trauma (40.9%) followed by contact lens use (8.6%). Cultures were negative for microbial growth in 28 (30.1%) patients. The most common pathogens were S. epidermidis (10.8%) and P. aeruginosa (10.8%). Fluoroquinolone antibiotics (ciprofloxacin; 93.8% sensitivity) were the most potent antibiotic against bacterial pathogens. Forty-one patients underwent tectonic procedures, which the most common ones were cyanoacrylate glue 18.3% followed by keratoplasty 16.1%. Conclusion This study emphasizes the role of trauma as the primary cause and S. epidermidis as the most frequent microorganism in pediatric keratitis; according to antibiogram results and poor cooperation of patients under five years, monotherapy with fluoroquinolones could be a good regimen in small non-central lesions without thinning.

Download Full-text

Suppurative Infections in Hospitalized Patients – An Ongoing MRSA Threat

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd9-1/012 ◽

2020 ◽

Author(s):

Sadaf Razzak

Keyword(s):

Staphylococcus Aureus ◽

Medical Science ◽

Great Influence ◽

Antibiotic Sensitivity ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Inducible Clindamycin Resistance ◽

Empiric Antibiotic ◽

Medical Wards

Background: Penicillin resistance among Staphylococcus aureus commonly encountered in the hospital admitted patients. Detection of antibiotic sensitivity in hospital acquired methicillin resistant Staphylococcus aureus infections is important as it has great influence on empiric antibiotic prescription, successful control of infection, prevention of spread of disease and successful patient management. This study aimed to detect the frequency of HA-MRSA from pus samples in a hospital setup with assessment of their antibiotic susceptibility patterns. Method: A cross-sectional study was conducted in the Microbiology department of Basic Medical Science Institute, JPMC, Karachi from January 2015 until December 2015. Pus samples from surgical site wounds, skin lesions, abscesses from surgical and medical wards and ICUs were collected. According to the standards given by CLSI 2014, MRSA testing of the samples was done and susceptibility testing for antibiotics was performed. Inducible clindamycin resistance was detected by D-Test; E Test. determined MIC (minimum inhibitory concentration) for vancomycin. The data was analyzed by SPSS version 16. Result: Out of the 149 MRSA identified from the pus samples, 106 (71.14%) samples were HA-MRSA. The number of male patients was more than the female patients (67.66%). Out of the 106 HA-MRSA, 91(85.8%) were sensitive to TMP/SMX, 98(92.5%) to rifampicin, 12(11.6%) to gentamicin, 85(80.2%) to tetracycline, 11(10.4%) to erythromycin, 37(34.9%) to clindamycin, 20(18.9%) to ciprofloxacin, 106 (100%) to both vancomycin and linezolid. Conclusion: HA-MRSA showed sensitivity to TMP/SMX and vancomycin making them effective drugs to use in combination in superficial infections. The drug linezolid also showed 100% sensitivity.

Download Full-text

Determinants of Screen Time Among Children Under Five Years: A Cross Sectional Study (Preprint)

10.2196/preprints.23506 ◽

2020 ◽

Author(s):

Diana Raj ◽

Norliza Ahmad ◽

Nor Afiah Mohd. Zulkefli ◽

Zalilah Mohd Shariff

Keyword(s):

Screen Time ◽

Well Being ◽

Cross Sectional Study ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Health Clinics ◽

Age Appropriate ◽

Cross Sectional Design ◽

Time Future

BACKGROUND Excessive screen time is detrimental to the child’s health. However, screen time situation among Malaysian children is poorly understood. OBJECTIVE This study aims to identify the prevalence and determinants of screen time among children under five years old using the latest WHO guidelines. METHODS A cross sectional design was used to randomly select 489 children from nine government health clinics. Total screen time and factors were assessed using validated self-administered questionnaires and analyzed using multiple logistic regression. RESULTS Results show an overall prevalence of 91.4% with a median of 3.00 hours (IQR: 1.36-5.04). Majority of children watched television (66%), followed by mobile phones (30%) and computers (4%). The determinants of screen time were Malay ethnicity, (AOR 3.56, 95% CI: 1.65-7.68), parental age of 30 years or more (AOR 3.12, 95% CI: 1.58-6.16), parental screen time exceeding 2 hours a day (AOR 2.42, 95% CI: 1.24-4.73), parent’s moderate self-efficacy to influence child’s physical activity (AOR 2.29, 95% CI: 1.01-5.20) and parent’s positive perception on influence of screen time on child’s cognitive well-being (AOR 1.15, 95% CI:1.01-1.32). CONCLUSIONS Parents played an important role in determining their child’s screen time. Future interventions that focus on the parents may ensure age appropriate screen time for their children.

Download Full-text

Impact of Community-Led Total Sanitation and Hygiene on Prevalence of Diarrheal Disease and Associated Factors among Under-Five Children: A Comparative Cross-Sectional Study in Selected Woredas of Gamo Gofa Zone, Southern Ethiopia

Advances in Public Health ◽

10.1155/2020/8237101 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Agune Ashole Alto ◽

Wanzahun Godana ◽

Genet Gedamu

Keyword(s):

Drinking Water ◽

Diarrheal Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Sanitation And Hygiene ◽

The Impact ◽

Gamo Gofa

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

Download Full-text

Prevalence of SARS-CoV-2 infection in Italian pediatric population: a regional seroepidemiological study

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01074-9 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Manola Comar ◽

Simone Benvenuto ◽

Marzia Lazzerini ◽

Giorgio Fedele ◽

Egidio Barbi ◽

...

Keyword(s):

Pediatric Population ◽

Cross Sectional Study ◽

Nasopharyngeal Swab ◽

Strongly Correlated ◽

Igg Antibodies ◽

Cross Sectional ◽

Equal Distribution ◽

Chemiluminescent Immunoassay ◽

Italian National Institute ◽

Friuli Venezia Giulia

Abstract Background Data on the effective burden of the SARS-CoV-2 pandemic in pediatric population are very limited, mostly because of the higher rate of asymptomatic or paucisymptomatic cases among children. Updated data on COVID-19 prevalence are needed for their relevance in public health and for infection control policies. In this single-centre cross-sectional study we aimed to assess prevalence of SARS-CoV-2 infection through IgG antibodies detection in an Italian pediatric cohort. Methods The study was conducted in January 2021 among both inpatients and outpatients referring to Research Institute for Maternal and Child Health “Burlo Garofolo” in Trieste, Friuli Venezia-Giulia, Italy, who needed for blood test for any reason. Collected samples were sent to Italian National Institute of Health for analysis through chemiluminescent immunoassay (CLIA). Results One hundred sixty-nine patients were included in the study, with a median age of 10.5 ± 4.1 years, an equal distribution for sex (49.7% female patients), and a 55.6% prevalence of comorbidities. Prevalence of anti-SARS-CoV-2 trimeric Spike protein IgG antibodies was 9.5% (n = 16), with a medium titre of 482.3 ± 387.1 BAU/mL. Having an infected cohabitant strongly correlated with IgG positivity (OR 23.83, 95% CI 7.19–78.98, p < 0.0001), while a cohabitant healthcare worker wasn’t associated with a higher risk (OR 1.53, 95% CI 0.4–5.86, p 0.46). All of the 5 patients who had previously tested positive to a nasopharyngeal swab belonged to the IgG positive group, with a 3-month interval from the infection at most. Conclusion We assessed a 9.5% SARS-CoV-2 seroprevalence in a pediatric cohort from Friuli Venezia-Giulia region in January 2021, showing a substantial increase after the second peak of the pandemic occurred starting from October 2020, compared to 1% prevalence observed by National Institute of Statistics (ISTAT) in July 2020.

Download Full-text

Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

BMC Pediatrics ◽

10.1186/s12887-020-02379-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shuichi Ito ◽

Tomoko Torii ◽

Akihiro Nakajima ◽

Takeshi Iijima ◽

Hiroshi Murano ◽

...

Keyword(s):

Uric Acid ◽

Health Insurance ◽

Pediatric Population ◽

Gouty Arthritis ◽

Cross Sectional Study ◽

Sectional Study ◽

Insurance Claims ◽

Cross Sectional ◽

Total Prevalence ◽

Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

Download Full-text

The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

BioMed Research International ◽

10.1155/2016/7042947 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Turki M. AlHarbi ◽

Abdullaziz AlGarni ◽

Fasial AlGamdi ◽

Mona Jawish ◽

Tariq Ahmad Wani ◽

...

Keyword(s):

Body Weight ◽

Pediatric Population ◽

Body Height ◽

Age Groups ◽

Cross Sectional Study ◽

The Body ◽

Accurate Estimation ◽

Cross Sectional ◽

Actual Weight ◽

Medical City

Objective.To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population.Methods.A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child’s height produce an estimated weight, which was compared with the actual weight.Results.A total of 3537 children were recruited. The height (cm) of the subjects was97.7±24.1and the actual weight (kg) was16.07±8.9, whereas the estimated weight determined by BT 2007 was15.87±7.56and by BT 2011 was16.38±7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms.Conclusions.Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight.

Download Full-text

Knowledge, Practice, and Associated Factors of Home-Based Management of Diarrhea among Caregivers of Children Attending Under-Five Clinic in Fagita Lekoma District, Awi Zone, Amhara Regional State, Northwest Ethiopia, 2016

Nursing Research and Practice ◽

10.1155/2017/8084548 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Bogale Kassahun Desta ◽

Nega Tezera Assimamaw ◽

Tesfaye Demeke Ashenafi

Keyword(s):

Primary Education ◽

Associated Factors ◽

Good Practice ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Cross Sectional ◽

Under Five ◽

Adequate Knowledge ◽

Home Based ◽

Knowledge Practice

Introduction. In Ethiopia, it is the second cause for clinical presentation among under five-year child population. Objective. The main aim of this study was to assess knowledge, practice, and associated factors of home-based management of diarrhea among caregivers of children attending the under-five clinic. Methods. Institution based quantitative cross-sectional study was carried out from March 1, 2016, to April 22, 2016. Results. Two hundred eight (56.2%) of them had good knowledge and one hundred thirty-nine (37.6%) of them had the good practice of home management of diarrhea, specifically, primary education (AOR: 5.384, 95% CI: 2.008, 14.438), secondary and above education (AOR: 11.769, 95% CI: 3.527, 39.275), daily laborer (AOR: 0.208, 95% CI: 0.054, 0.810), and no information about diarrhea (AOR: 0.139, 95% CI: 0.054, 0.354). Moreover, age range of 25–35 (AOR: 4.091, 95% CI: 1.741, 9.616) and 36–45 (AOR: 3.639, 95% CI: 1.155, 11.460), being single (AOR: 0.111, 95% CI: 0.013, 0.938), being divorced (AOR: 0.120, 95% CI: 0.024, 0.598), illiteracy (AOR: 0.052, 95% CI: 0.017, 0.518), primary education (AOR: 0.143, CI: 0.046, 0.440), and no information about diarrhea (AOR: 0.197, 95% CI: 0.057, 0.685) were significantly associated variables with the outcome variables in multivariate regression. Conclusion. Caregivers had slightly adequate knowledge but poor practice.

Download Full-text

Pattern of Thalassemia and Hemoglobinopathies Among Anemic Under-Five Children of Northern Bangladesh: A Hospital Based Cross Sectional Study

10.21203/rs.3.rs-157764/v1 ◽

2021 ◽

Author(s):

Md. Abdur Rafi ◽

M. Morsed Zaman ◽

Md. Golam Hossain

Keyword(s):

Cross Sectional Study ◽

Severe Form ◽

Health Concern ◽

Sectional Study ◽

Cross Sectional ◽

Hemoglobin E ◽

Under Five ◽

Under Five Children ◽

Thalassemia Minor ◽

Different Types

Abstract Background Congenital hemoglobin defects are significant global health concern affecting more than 330,000 newborns every year. In Bangladesh more than half of the under-five children are anemic, but the contribution of hemoglobin disorders to childhood anemia is quite unexplored. Hence, the objective of the present study was to investigate the prevalence and pattern of hemoglobinopathies among anemic under-five (age 6–59 months) children visiting the hematology department of Rajshahi Medical College Hospital (RMCH). Methods This was a retrospective cross-sectional study among anemic patients aged between 6 to 59 months conducted in the hematology department of RMCH from July 2018 to June 2020. The guideline of WHO was used to define the severity of anemia. Hemoglobinopathies was measured using standard methods. Chi-square test was used to find the association between two categorical factors. Results Female and younger children included in the study were more likely to suffer from moderate to severe form of anemia compared to their counterparts. Out of 534 patients 183 were suffering from different types of hemoglobinopathies (prevalence 34.3%). E-β-Thalassemia was the most common type of hemoglobinopathy (14%) followed by Hemoglobin E trait (11%) and β-Thalassemia minor (5.6%). Prevalence of these hemoglobin disorders was comparatively higher among female and older children (p < 0.05). Patients with E-β-Thalassemia and β-Thalassemia major of our study were mostly suffering from severe form of anemia while patients with hemoglobin E trait and β-Thalassemia minor were mostly suffering from mild anemia (p < 0.01). Conclusions A remarkable number of children were suffering from severe anemia and different types of hemoglobinopathies. Gender and age group were the risk factors of anemia and hemoglobinopathies among under-five children. Health authorities of Bangladesh should especially take care of anemic children in this country.

Download Full-text

Relationship Between Hand-washing Habit and Toilet Use with Diarrhea Incidence in Children Under Five Years

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v5i12017.95-106 ◽

2017 ◽

Vol 5 (1) ◽

pp. 95

Author(s):

Nikmatur Rohmah ◽

Fariani Syahrul

Keyword(s):

Public Health ◽

Public Health Problem ◽

Cross Sectional Study ◽

Hand Washing ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Children Under Five ◽

Under Five ◽

Before And After

Diarrhea is still a public health problem in the world and the mostly occur in children under five years. At the moment the number of diarrhea-caused mortality was 3.8 per 1000 per year by 3.2 episodes per year in children under five years. This research aims to analyze the association between hand-washing habits and toilet use with the incidence of diarrhea in children under five years. This is an observational analytic with cross sectional study. Population of the research was a children's mother took her children to the public health center of Sekardangan Sidoarjo Subdistrict. The number of samples taken as many as 58 mother of children under five years. Data collection was done with interviews to parents of children and the observations of the toilets. Technique of data analysis using chi-square test or Fisher's exact test. On the results of the research there is a significant association the habit of hand washing (p = 0.006) and toilet use(p = 0.014) with the incidenceof diarrhea in children under five years. Conclusions of the research is the habit of hand washing and toilet use had a significant association with the incidenceof diarrhea in children under five years. Advice that can be given to the mother of a children under five years is to wash the hands before and after defecating and before preparing food for children. Keywords: diarrhea, hand washing, toilet use, observational, children under five years

Download Full-text

Predictors of Parental Barriers to Reduce Excessive Child’s Screen Time Among Parents of Children Under Five Years of Age in Selangor: A Cross-Sectional Study (Preprint)

10.2196/preprints.25219 ◽

2020 ◽

Author(s):

Elliza Mansor ◽

Norliza Ahmad ◽

Nor Afiah Mohd. Zulkefli

Keyword(s):

Young Children ◽

Screen Time ◽

Parental Attitudes ◽

Cross Sectional Study ◽

Sectional Study ◽

Parental Attitude ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Parental Barriers

BACKGROUND Globally, there is an increasing prevalence of excessive screen time exposure among young children, including Malaysia. Parents are advised to limit this exposure but there are barriers for many of them to follow this recommendation. To date, there is a lack of studies on the factors that cause these parental barriers. OBJECTIVE This study aimed to determine the parental barrier towards the reduction of excessive child’s screen time and its predictors among parents of children under five years old in Petaling District, Selangor. METHODS A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in Petaling District, Selangor. Validated self-administered questionnaires were used to capture information on sociodemographic factors, parental influences, child-related factors, environmental factors, and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analysed with IBM SPSS version 25. Descriptive analysis and bivariate analysis were performed before multiple linear regression was used to identify the predictors of parental barriers. RESULTS The overall mean score of parental barriers was 3.51 ± 0.83, indicating that the average numbers of barriers experienced by parents were more than three. The multivariate analysis showed that the predictors of parental barriers included monthly household income (adjusted β: -0.031, 95% CI: -0.048 to -0.015), parents who worked in public sectors (adjusted β: 0.178, 95% CI: 0.063 to 0.292), positive parental attitude on screens (adjusted β: 0.684, 95% CI: 0.576 to 0.793), parents’ low self-efficacy to influence child’s physical activity (adjusted β: -0.318, 95% CI: -0.432 to -0.204), and child’s screen time (adjusted β: 0.042, 95% CI: 0.024 to 0.061). CONCLUSIONS The strongest predictor of the parental barriers to reduce excessive child’s screen time was the positive parental attitude on screen time. Thus, future intervention strategies should aim to foster correct parental attitudes towards screen time activities among young children.

Download Full-text