Journal of tropical pediatrics
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Pneumonia is a significant cause of death for children, particularly those in developing countries. The records of children who were hospitalized because of pneumonia between January 2003 and December 2015 were retrospectively reviewed, and patients who met the recurrent pneumonia criteria were included in this study. During this 13-year period, 1395 patients were hospitalized with pneumonia; of these, 129 (9.2%) met the criteria for recurrent pneumonia. ⋯ These results demonstrate that underlying diseases can cause recurrent pneumonia in children. Viruses are also commonly seen in recurrent pneumonia. Appropriate treatments should be chosen based on an analysis of the underlying disease, the patient's clinical condition and the laboratory and radiological data.
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Early detection of malnutrition in hospitalized children helps reduce length of hospital stay and morbidity. A validated nutrition tool is essential to correctly identify children at risk of malnutrition or who are already malnourished. This study compared the use of the Subjective Global Nutrition Assessment (SGNA, nutrition assessment tool) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP, nutrition screening tool) with objective nutritional parameters to identify malnutrition in hospitalized children. ⋯ SGNA is a valid nutrition assessment tool in diagnosing malnutrition status among hospitalized children in Malaysia. The discrepancy in specificity values between the two methods explains the distinguished roles between SGNA and STAMP. The use of STAMP will have to be followed up with a more valid tool such as SGNA to verify the actual nutrition status of the paediatric population.
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We assessed the accuracy of the Nelson, Best Guess and Advanced Pediatric Life Support (APLS) formulae in estimating weight in a suburban Cameroonian pediatric population, by conducting a cross-sectional study using 544 children aged 1 month to 12 years. Agreement between measured and estimated weight was poor for Nelson [concordance correlation coefficient (CCC) 0.89 (95% confidence interval (CI) 0.87-0.90)] and Best Guess [CCC 0.88 (95% CI 0.86-0.90)] formulae, and moderate for the APLS formula [CCC 0.92 (95% CI 0.90-0.93)]. On Bland-Altman analysis, all three methods had limits of agreement (APLS -42.2 to -45.6%, Best Guess -42.7 to -55.1%, Nelson -36.4 to -42.4%) above the -10 to -10% set as criteria for clinical agreement. Conclusively, the accuracy of all three formulae was clinically unacceptable in our study population, suggesting the need for studies aimed at deriving more accurate formulae adapted for use in our context.
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Observational Study
Prevalence and Outcome of Sepsis-induced Myocardial Dysfunction in Children with 'Sepsis' 'With' and 'Without Shock'-A Prospective Observational Study.
To estimate the prevalence and effects of sepsis-induced myocardial dysfunction (SIMD) in children with septic shock. ⋯ SIMD, especially diastolic dysfunction, is common in septic shock and may increase inotrope requirement. It is reversible in majority. Sepsis patients may have asymptomatic underlying SIMD. cTnI does not correlate with the degree of SIMD.
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This study was designed to examine the rates of HIV serostatus disclosure in a sample of HIV-infected children in the state of Karnataka in South India, their reactions to learning their HIV-positive status and the reasons for and barriers to disclosure from the point of view of their caregivers. We enrolled 233 HIV-infected children, aged 5-18 years and their caregivers between July 2011 and February 2013 at HIV clinics in three tertiary care centers. Caregiver interviews included information about demographic characteristics, medical history, type of disclosure to the child and other related factors, including disclosure barriers. ⋯ The majority of children who learned their status had been informed by a health-care provider, possibly reflecting the difficulty for a caregiver of having this conversation. The caregivers reported multiple disadvantages of disclosure, mostly because of fears of stigma and discrimination. Despite some evidence from the literature that disclosure can have positive effects on a child's health, it is thus clear that we need to develop, implement and evaluate community-based stigma reduction programs to reduce the social barriers to disclosure.