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Research Article
Child Abuse Incidences Per Child Year Predicted from the Available Average Incidence Combined with Foreign Incidences Per Child Year: Towards a New Policy
Marianne Vlaming*,
Martin J. C. Van Gemert,
Pieter J. J. Sauer
Issue:
Volume 10, Issue 4, December 2024
Pages:
163-168
Received:
24 July 2024
Accepted:
2 September 2024
Published:
18 October 2024
Abstract: Child abuse is a worldwide recognized serious problem. Reliable child abuse incidences, preferably per child year, are fundamental for a sound detection and prevention program. Unfortunately, in most countries where child abuse data is available, incidences are not determined per child year but as an average over the child age range. In this paper we suggest a possible "next-best" solution for deriving child abuse incidences per child year when only an average value is available in an area or country. As method, we combined the country's measured average incidence with available (foreign) incidences per child year. The country's next-best incidences per child year will be estimated from its average, multiplied by the foreign incidences per child year divided by the foreign average. As results, we calculated the next-best Dutch age-dependent incidences by combining the Dutch average value with US and Ontario age-related incidences. We found comparable results for infants above 1 year and marked differences for children <1 year, likely due to cultural differences between the US and Ontario. In conclusion, next-best age-related child abuse incidences are obtainable in large areas or countries by choosing a smaller but representative region, the latter estimated from Ontario-data as ≥210,000 inhabitants, and establishing as perfectly as possible the optimal infra structure. A future perspective towards a new policy could be to initiate and stimulate this approach in the various European Union and United Nations Convention on the Rights of the Child member states.
Abstract: Child abuse is a worldwide recognized serious problem. Reliable child abuse incidences, preferably per child year, are fundamental for a sound detection and prevention program. Unfortunately, in most countries where child abuse data is available, incidences are not determined per child year but as an average over the child age range. In this paper ...
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Research Article
Correlation Between Feeding Pattern and Duration of Hospital Stay in Pneumonia of Infants Below 6 Months of Age
Issue:
Volume 10, Issue 4, December 2024
Pages:
169-174
Received:
2 October 2024
Accepted:
23 October 2024
Published:
12 November 2024
DOI:
10.11648/j.ajp.20241004.12
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Abstract: Introduction: Pneumonia is the most common respiratory disorder among infants and one of the leading causes of hospital admission. Various feeding patterns have multiple impacts on pneumonia and recovery from it. Breast milk provides some protective properties against respiratory tract and gastrointestinal illness to protect infants during the first year of life. This study aimed to find an association between feeding patterns and duration of hospital stay due to pneumonia in infants below 6 months of age. Methodology: This cross-sectional study was conducted in the Department of Paediatrics, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh from February, 2019 to August, 2020. In our study, 200 infants below 6 months of age admitted with pneumonia in the Department of Paediatrics in Shaheed Suhrawardy Medical College Hospital, Dhaka were enrolled according to selection criteria. Result: Maximum incidence was seen in the 3 to 4 months of age, e.g.40.0% & 36.30% in girls and boys respectively, mean age of the pneumonia patient was 2.9±1.5 months. Out of 200 cases, 55.0% cases were male and 45.0% were female. Among all infants 93.75% of exclusively breastfed infants needed ≤10 days, and 27.88% of non-exclusive breastfed infants needed>10 days in the hospital for recovery from pneumonia. In both cases, the p-value was 0.001. Conclusion: Exclusive breastfed infants have shorter and non-exclusive breastfed infants have longer hospital stays due to pneumonia below 6 months of age.
Abstract: Introduction: Pneumonia is the most common respiratory disorder among infants and one of the leading causes of hospital admission. Various feeding patterns have multiple impacts on pneumonia and recovery from it. Breast milk provides some protective properties against respiratory tract and gastrointestinal illness to protect infants during the firs...
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Review Article
Difficulty of Announcing Congenital Heart Disease in a Child in a Hospital Setting in our Context
Soundousse Salimi,
Angela Kibangou*,
Nisrine EL Marzouki,
Chrislaine Moboula,
Salima Hajjaji
Issue:
Volume 10, Issue 4, December 2024
Pages:
175-178
Received:
26 September 2024
Accepted:
4 November 2024
Published:
28 November 2024
Abstract: Congenital heart disease (CHD) is synonymous with a frequent, serious, very long-lasting disease. It is necessary throughout the child's development phase and conditions his or her lifestyle. This is due on the one hand to the physical health problem, but also to the appearance of secondary psychological and social disorders, the possible course of the child's life conditions the quality of it, his future autonomy is therefore the total success of the treatment. The problems of the child and his or her family must be addressed in a comprehensive manner by the paediatrician and the attending physician, who must accompany them in facing the obstacles of society. The pediatric cardiotrician and the attending physician must inform the parents of the diagnosis, although it is difficult, and endeavour to give all the required information and clear, precise recommendations, adapted to the specific situation of the child. In this work we report a prospective study on a series of 51 children and their parents over a period of 5 months in a hospital setting, while performing a bibliographic search in the main search engines and research in the field of psychology.
Abstract: Congenital heart disease (CHD) is synonymous with a frequent, serious, very long-lasting disease. It is necessary throughout the child's development phase and conditions his or her lifestyle. This is due on the one hand to the physical health problem, but also to the appearance of secondary psychological and social disorders, the possible course of...
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Research Article
Glycaemic Status Among Neonates in Perinatal Asphyxia with Hypoxic Ischaemic Encephalopathy (Stage II and Stage III) in a Tertiary Level Hospital
Issue:
Volume 10, Issue 4, December 2024
Pages:
179-184
Received:
28 October 2024
Accepted:
11 November 2024
Published:
28 November 2024
Abstract: Background: Perinatal asphyxia is major cause of neonatal mortality and morbidity. Hypoxic ischaemic brain injury is the most important consequences of perinatal asphyxia which ultimately results in immediate and delayed form of neuronal death. The aim of this study was to find a relationship between glycaemic status and immediate outcomes of perinatal asphyxia. Methods: This prospective study was carried out in Department of Paediatrics, Shaheed Suhrawardy Medical College Hospital, from 16th April 2019 to 15th October 2019. Total 100 term asphyxiated newborn babies with HIE (Stage II and III) admitted within 24 hours were enrolled according to selection criteria, Blood glucose level and other relevant tests were done in all included patients. Results: The mean age of the neonates was 6.31±0.91 hours. Among the patients, 60% were male and 40% were female. Most cases (65%) had normal birth weight, while 35% were low birth weight. Common clinical features included respiratory distress (59%), poor feeding (75%), lethargy (33%), grunting (48%), and petechiae (6%). Moderate encephalopathy (Stage II) was observed in 63% of cases, and severe asphyxia (Stage III) in 37%. Hypoglycaemia was present in 26% of neonates, hyperglycaemia in 3%, and 71% had normal glucose levels. Hypoglycaemia was significantly associated with severe asphyxia, occurring in 45.9% of severe cases compared to 14.2% of moderate cases (p<0.05). Conclusion: There was significant association between glycaemic abnormalities with severity of perinatal asphyxia and immediate outcome of the asphyxiated newborn.
Abstract: Background: Perinatal asphyxia is major cause of neonatal mortality and morbidity. Hypoxic ischaemic brain injury is the most important consequences of perinatal asphyxia which ultimately results in immediate and delayed form of neuronal death. The aim of this study was to find a relationship between glycaemic status and immediate outcomes of perin...
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Research Article
An Assessment of KAP Towards LTBI in Under-5 Children among Physicians Treating Adult/Adolescent TB Patients in Dhaka City
Issue:
Volume 10, Issue 4, December 2024
Pages:
185-192
Received:
24 October 2024
Accepted:
11 November 2024
Published:
29 November 2024
Abstract: Introduction: LTBI is the precursor to TB, making early detection and treatment of infected children vital to preventing pediatric morbidity and mortality. This study assesses the knowledge, attitudes, and practices of physicians treating adult and adolescent TB patients in managing LTBI among under-5 children in Dhaka. Aim of the study: The aim of the study was to evaluate the knowledge, attitude, and practices of physicians treating adult and adolescent tuberculosis patients in Dhaka City regarding the diagnosis and management of latent tuberculosis infection (LTBI) in under-5 children. Methods: This six-month cross-sectional, semi-qualitative study was conducted from January to June 2020 at the Department of Paediatrics in five Dhaka hospitals, involving 50 physicians treating adult and adolescent TB patients. Data were collected through standardized questionnaires, with consent obtained, and qualitative responses categorized and scored using SPSS Version 25.0. Result: Among 50 physicians, most were aged 30-39, and 62% had recent TB training. Knowledge of latent tuberculosis infection (LTBI) was limited, with only 14% accurately defining it, while 88% acknowledged isoniazid preventive therapy (IPT) availability. Only 12% inquired about family members of pulmonary TB patients, and 10% asked about under-five children. A significant 80% had no involvement in managing LTBI in children, with just 6% prescribing IPT. Additionally, 84% believed IPT could cause drug resistance, and those with recent training scored higher in knowledge. Conclusion: This KAP study identifies key barriers to LTBI tracing and IPT/TPT implementation in children under five, emphasizing the need for structured training to enhance physician practices.
Abstract: Introduction: LTBI is the precursor to TB, making early detection and treatment of infected children vital to preventing pediatric morbidity and mortality. This study assesses the knowledge, attitudes, and practices of physicians treating adult and adolescent TB patients in managing LTBI among under-5 children in Dhaka. Aim of the study: The aim of...
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Research Article
Effects of Prolonged Screen Time on Children Aged 1-5 Years – A Cross-sectional Study
Issue:
Volume 10, Issue 4, December 2024
Pages:
193-199
Received:
4 November 2024
Accepted:
18 November 2024
Published:
29 November 2024
Abstract: Introduction: With the advancement of digital technology, people are enjoying the benefits of it in the context of information gathering, entertainment, saving physical time, and advertisement. Yet with good outcomes many undesirable side effects happen not only in adults but also in children. The prolonged use of screen time for children's physical, mental, and social health and development has now become a concern. Therefore, this study aimed to evaluate the effects of prolonged screen time and its impact on children aged 1-5 years. Methods: This was a cross-sectional study conducted in the Department of Pediatrics, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh from January, 2020 to July, 2020. This study included 150 children aged between 1 -5 years who used various screen devices daily. Children were divided into two groups – Group A (Children used screen time >2 hours/day) and Group B (Children used screen time <2 hours/day). Result: The mean age was 3.6 ±0.04 years and most of the children were male (60%). During meal time, 86% of children showed adverse effects like aggressiveness and stopped eating in group A, and 28 (37%) & 21 (28%) children demanded devices at sleep time in groups A & B respectively. Regarding nutritional effects, 26(35%) children of group A were overweight and 16(21%) were underweight. In group B, it is 28% and 20% respectively. Conclusion: The findings showed that using devices for more than 2 hours per day by children aged 1-5 years, was detrimental in regards to sleep disturbance, eating behavior, and nutritional condition.
Abstract: Introduction: With the advancement of digital technology, people are enjoying the benefits of it in the context of information gathering, entertainment, saving physical time, and advertisement. Yet with good outcomes many undesirable side effects happen not only in adults but also in children. The prolonged use of screen time for children's physica...
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Research Article
Exclusive Breast-Feeding Practices in Bangladesh: An Observational Study
Issue:
Volume 10, Issue 4, December 2024
Pages:
200-205
Received:
5 October 2024
Accepted:
29 October 2024
Published:
29 November 2024
Abstract: Exclusive breastfeeding practices contribute to the overall well-being and development of child. In spite of Bangladesh has National Breastfeeding Policy and also Baby-Friendly Hospital Initiative the exclusive breastfeeding rate in Bangladesh remains below. However, establishing EBF remains a significant problem not only in Bangladesh but in other developing nations. The aim of the study was to observe the actual scenario of exclusive breast feeding (EBF) practices in Bangladesh. A descriptive cross-sectional study was conducted among 32 government health care facilities of Bangladesh for five months. Multi stage stratified sampling design was followed for selection of study places and mothers whom visited health care facilities having a child with below one year of age was selected purposively. Data collection was conducted by using a structured questionnaire by face-face interview. Data coding and analysis or statistical analysis done by SPSS version 26. Among 320 respondents, Socio demographic characteristics of respondents revealed 92.2% were house wife; most of them had primary to higher secondary level education. Among them 75.9% of the mother delivered their baby at hospital and mode of the delivery percentage was almost similar which was 50%. Two third of the mother exclusively breast fed their child (74%) and know about benefits of colostrum (78.1%). Foster multidisciplinary teamwork, continuous leadership support, and enforce national or institutional policies, focusing on the National Breastfeeding Policy and Regulation of Breast Milk Substitutes Act can increase the practices.
Abstract: Exclusive breastfeeding practices contribute to the overall well-being and development of child. In spite of Bangladesh has National Breastfeeding Policy and also Baby-Friendly Hospital Initiative the exclusive breastfeeding rate in Bangladesh remains below. However, establishing EBF remains a significant problem not only in Bangladesh but in other...
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Research Article
Diagnostic Role of Urinary Nitrites and Leukocyte Esterase in Detection of UTI in Children
Issue:
Volume 10, Issue 4, December 2024
Pages:
206-214
Received:
11 November 2024
Accepted:
26 November 2024
Published:
16 December 2024
DOI:
10.11648/j.ajp.20241004.18
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Abstract: Background: Urinary tract infections (UTI) are common in children and pose a significant public health concern, particularly in low-resource settings like Bangladesh. Rapid, cost-effective diagnostic tools such as urinary nitrite and leukocyte esterase dipstick tests offer an alternative to traditional urine culture, which is often time-consuming and resource-intensive. This study aimed to evaluate the diagnostic accuracy of urinary nitrite and leukocyte esterase tests in detecting UTI in children. Methods: This cross-sectional study was conducted at Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, from July 2019 to December 2019. A total of 200 children, including 100 cases with proven UTI by culture or microscopy and 100 controls, were enrolled. Urinary nitrite and leukocyte esterase tests were performed on urine samples, with urine culture used as the gold standard. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess diagnostic performance. Results: The urinary nitrite test demonstrated a sensitivity of 75.56% and a specificity of 97.00%, with an overall accuracy of 90.34%. The PPV was 91.89%, and the NPV was 89.81%. The leukocyte esterase test showed a sensitivity of 88.89% and a specificity of 82.00%, with an accuracy of 84.14%, PPV of 68.97%, and NPV of 94.25%. Compared with urine R/E, the urinary nitrate test had strong specificity (97.00%) but moderate sensitivity (47.78%), while the leukocyte esterase test maintained high sensitivity (86.67%) and reliable NPV (87.23%). Conclusion: Both urinary nitrite and leukocyte esterase dipstick tests are effective rapid screening tools for diagnosing UTI in children, with high specificity and sensitivity, respectively. Their combined use can enhance diagnostic accuracy, particularly in settings where access to culture testing is limited. These findings support the implementation of dipstick tests as a reliable first-line diagnostic method for pediatric UTI.
Abstract: Background: Urinary tract infections (UTI) are common in children and pose a significant public health concern, particularly in low-resource settings like Bangladesh. Rapid, cost-effective diagnostic tools such as urinary nitrite and leukocyte esterase dipstick tests offer an alternative to traditional urine culture, which is often time-consuming a...
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Research Article
Pediatric Tuberculosis Characteristic in West Nusa Tenggara Regional General Hospital During COVID-19 Pandemic 2019-2021
Luh Made Indrasuari*
,
Sang Ayu Kompiyang Indriyani
Issue:
Volume 10, Issue 4, December 2024
Pages:
215-219
Received:
16 November 2024
Accepted:
29 November 2024
Published:
16 December 2024
DOI:
10.11648/j.ajp.20241004.19
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Abstract: Tuberculosis (TB) infection is still an important health problem worldwide, especially in children. The Coronavirus Disease (COVID-19) pandemic has affected the priority of healthcare including TB services. Many health services reported a significant decrease in TB detection, notification, treatment and prevention due to COVID-19 policies. Therefore, we conducted a study to determine the characteristics of pediatric TB patients in West Nusa Tenggara Province General Hospital during COVID-19 pandemic. This study was a retrospective study using registry data from the Pediatric Respirology Division, Department of Child Health, West Nusa Tenggara Province General Hospital from March 2019 to December 2021. Of 225 children with TB disease, there were 66.2% outpatient and 33.8% inpatient. Thirty point seven percents (69/225) were in ages group 5 to 11 years old and mostly were males (69.8%). West Lombok Regency was the district with highest number of subjects (37.3%). Majority of subjects were visited in March-December 2019, nearly before pandemic. Polymerase Chain Reaction (PCR) test for TB were performed in 172 (76.5%) subjects and showed positive result in 22/172 (9.8%). Most of them were pulmonary TB (72.9%) and 9.8% bacteriologically confirmed. Only 4 (1.8%) of children were died. Pulmonary TB is the most common TB disease among pediatric TB patients in this study. During study period, the number of hospital visit was decreased due to COVID-19 policies. This findings can guided healthcare providers to improve detection, treatment and prevention of TB disease post COVID-19 pandemic.
Abstract: Tuberculosis (TB) infection is still an important health problem worldwide, especially in children. The Coronavirus Disease (COVID-19) pandemic has affected the priority of healthcare including TB services. Many health services reported a significant decrease in TB detection, notification, treatment and prevention due to COVID-19 policies. Therefor...
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Case Report
Management of Quadruplet Infants at the General Hospital of West Nusa Tenggara Province, Indonesia: A Case Report
Luh Made Indrasuari*,
I Ketut Adi Wirawan,
Agus Rusdhy Hariawan Hamid
Issue:
Volume 10, Issue 4, December 2024
Pages:
220-228
Received:
16 November 2024
Accepted:
29 November 2024
Published:
16 December 2024
DOI:
10.11648/j.ajp.20241004.20
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Abstract: Multiple pregnancies with more than two fetuses significantly increase maternal and infant complications. Almost all multiple pregnancies with more than two fetuses result in preterm birth. Prematurity is the main consequence of multiple pregnancies with more than two fetuses. Early provision of optimal nutrition is crucial for the growth and immunity of premature infants. We report our first-hand experience as the primary referral hospital in West Nusa Tenggara Province, Indonesia, in providing multidisciplinary care for the birth of quadruplet premature infants. A 39-year-old woman, gravida 3, para 2, living 2, nulliparous, was referred to the General Hospital of West Nusa Tenggara Province from Bima District Hospital due to a quadruplet pregnancy at 28-29 weeks gestation. A multidisciplinary team consisting of obstetricians, pediatricians, and nurses was assembled. All four infants were diagnosed with hyaline membrane disease (HMD) and immediately transferred to the Neonatal Intensive Care Unit (NICU). Premature infants received parenteral and enteral nutrition support. Family-centered care approach was implemented for the care of the premature infants and their families. All infants were discharged at 35 weeks postmenstrual age (PMA). Spontaneous quadruplet pregnancies are rare cases, and this particular case represents the first experience of our hospital in managing quadruplet infants. A well-coordinated multidisciplinary approach, coupled with good preparedness for delivery, is essential and has proven to yield favorable outcomes for both the mother and the infants.
Abstract: Multiple pregnancies with more than two fetuses significantly increase maternal and infant complications. Almost all multiple pregnancies with more than two fetuses result in preterm birth. Prematurity is the main consequence of multiple pregnancies with more than two fetuses. Early provision of optimal nutrition is crucial for the growth and immun...
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Case Report
Miliary Tuberculosis with Tuberculous Meningoencephalitis in Children Under Two Years of Age with a Missed Opportunity of Immunization: A Case Report
Luh Made Indrasuari*,
Sang Ayu Kompiyang Indriyani
Issue:
Volume 10, Issue 4, December 2024
Pages:
229-233
Received:
16 November 2024
Accepted:
29 November 2024
Published:
16 December 2024
DOI:
10.11648/j.ajp.20241004.21
Downloads:
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Abstract: Miliary TB is one of the manifestations of TB with incidence 3-7% among all TB cases and 13% can spread to brain as Tuberculous Meningitis (TBM). This case report discusses a case of miliary TB complicated with meningoencephalitis in children under two years of age without history of BCG vaccination. A 23-month-old girl with severe malnutrition, came to outpatient clinic with fever for 6 months, cough for 3 months, gland enlargement in the neck, no history of BCG and no history of TB contact. Because the chest x-ray showed miliary TB, we decided to hospitalized the patient. Suddenly she had loss of consciousness and seizures in the way to pediatric ward. After being managed and stabilized, we decided do head CT scan with contrast and found multiple rim enhancing lesions, with a smooth inner outer layer. Mycobacterium Tuberculosis was detected without rifampicin resistance by Polymerase Chain Reaction (PCR) TB from sputum speciment, but not detected in liquor cerebro spinal (LCS). Cerebrospinal fluid analysis showed mononuclear cell dominant (87%). The patient was given broad spectrum antibiotic, anti-seizures drug, and intensive phase anti-tuberculosis drugs with RHZE and steroid. The patient was discharged with clinical improvement after 3 weeks of treatment but had sequelae of cerebral palsy. Early detection and appropriate management are crucial in pediatric patients with miliary TB to reduce mortality rate and prevent TBM, which can lead to permanent neurological disabilities.
Abstract: Miliary TB is one of the manifestations of TB with incidence 3-7% among all TB cases and 13% can spread to brain as Tuberculous Meningitis (TBM). This case report discusses a case of miliary TB complicated with meningoencephalitis in children under two years of age without history of BCG vaccination. A 23-month-old girl with severe malnutrition, ca...
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