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Sample records for infected kenyan children

  1. High-Risk Enteric Pathogens Associated with HIV-Infection and HIV-Exposure in Kenyan Children with Acute Diarrhea

    PubMed Central

    PAVLINAC, PB; JOHN-STEWART, GC; NAULIKHA, JM; ONCHIRI, FM; DENNO, DM; ODUNDO, EA; SINGA, BO; RICHARDSON, BA; WALSON, JL

    2015-01-01

    Objective HIV-infection is an established risk for diarrheal severity, less is known about specific enteric pathogens associated with HIV status. We determined associations of selected enteric pathogens with HIV-infection and HIV-exposure among Kenyan children. Design Cross-sectional study among 6 months to 15 year olds presenting to two Western Kenya District hospitals with acute diarrhea between 2011–2013. Methods Stool was tested using standard bacterial culture and microscopy for ova and parasites. HIV testing was obtained on children and mothers. Enteric pathogen prevalence was compared between HIV-infected and HIV-uninfected children and between HIV-exposed uninfected (HEU) and HIV-unexposed. Unadjusted and adjusted prevalence ratios (PR) for selected pathogens by HIV-status were estimated using relative risk (RR) regression and P-values. Age, site, income, household crowding, water source/treatment, anthropometrics, cotrimoxazole use, and breastfeeding history were accounted for in multivariable models. Results Among 1,076 children, median age was 22 months (interquartile range: 11–42), 56 (5.2%) were HIV-infected, and 10.3%(105/1020) of HIV-uninfected children were HIV-exposed. The following organisms were most frequently isolated from stool: enteroaggregative Escherichia coli (13.3%), Giardia spp. (11.1%) Campylobacter (6.3%), enteropathogenic Escherichia coli (EPEC) (6.1%) and Cryptosporidium spp. (3.7%). Accounting for age, HIV-infection was associated with EPEC infection (PR: 3.70, P=0.002) while HIV-exposure was associated with Cryptosporidium among HIV-uninfected children (PR: 2.81, P=0.005). Conclusion EPEC and Cryptosporidium infections were more common in HIV-infected and HIV-exposed children, respectively. This could explain the increased mortality attributed to these pathogens in other studies. Interventions targeting EPEC and Cryptosporidium may reduce morbidity and mortality in high HIV-prevalence settings. PMID:25028987

  2. Partnering Parasites: Evidence of Synergism between Heavy Schistosoma haematobium and Plasmodium Species Infections in Kenyan Children

    PubMed Central

    Florey, Lia S.; King, Charles H.; Van Dyke, Melissa K.; Muchiri, Eric M.; Mungai, Peter L.; Zimmerman, Peter A.; Wilson, Mark L.

    2012-01-01

    Background Residents of resource-poor tropical countries carry heavy burdens of concurrent parasitic infections, leading to high rates of morbidity and mortality. This study was undertaken to help identify the social and environmental determinants of multiple parasite infection in one such community. Methodology/Principal Findings Residents of Kingwede, Kenya aged 8 years and older were tested for presence and intensity of S. haematobium and Plasmodium spp. infections in a cross-sectional, household-based, community survey. Using General Estimating Equation (GEE) models, social and environmental determinants associated with patterns of co-infection were identified, with age being one of the most important factors. Children had 9.3 times the odds of co-infection compared to adults (95%CI = 5.3–16.3). Even after controlling for age, socio-economic position, and other correlates of co-infection, intense concomitant infections with the two parasites were found to cluster in a subset of individuals: the odds of heavy vs. light S. haematobium infection increased with increasing Plasmodium infection intensity suggesting the importance of unmeasured biological factors in determining intensity of co-infection. Conclusions/Significance Children in this community are more likely to be infected with multiple parasites than are adults and should therefore be targeted for prevention and control interventions. More importantly, heavy infections with multiple parasite species appear to cluster within a subset of individuals. Further studies focusing on these most vulnerable people are warranted. PMID:22848765

  3. High-nutrition biscuits to increase animal protein in diets of HIV-infected Kenyan women and their children: A study in progress

    PubMed Central

    Ernst, Judith; Ettyang, Grace; Neumann, Charlotte G.

    2015-01-01

    Background Preliminary evidence suggests that improved nutrition early in HIV infection may delay progression to AIDS and delay the initiation or improve the effectiveness of antiretroviral drug therapy. There are few studies that evaluate food-based interventions in drug-naïve, HIV-infected women and their children. Meat provides several nutrients identified as important in maintaining immune function and lean body mass. Objective To design supplemental meat and soybean biscuits for use in a randomized trial examining the effect of meat in the diet of drug-naïve, HIV-infected rural Kenyan women on changes in weight, lean body mass, morbidity, nutritional status, and activities of daily living of the women and growth and development of their children. Methods We designed three supplemental biscuits: one with added dried beef, another with added soybean flour, and a wheat biscuit to serve as a control biscuit to be used in a randomized feeding intervention in drug-naïve, HIV-infected rural Kenyan women and their children. The nutritional contents of the different types of biscuit were examined and compared. Results The three biscuits were isocaloric. Meat biscuits provided more lysine, vitamin B12, and bioavailable zinc. Soybean biscuits provided more total and absorbable iron; however, higher fiber and phytate contents may inhibit nutrient absorption. Data analysis for clinical outcomes of the trial is ongoing. Conclusions The “biscuit model” is useful for nutrition supplementation studies because it can be provided in a blinded and randomized fashion, safely and privately in a home under directly observed consumption by a highly stigmatized population. It is well received by adults and children, and the biscuits can be produced locally with available, simple, affordable technology. PMID:25639139

  4. Accidental paraffin poisoning in Kenyan children.

    PubMed

    Lang, T; Thuo, N; Akech, S

    2008-06-01

    A serious and common accident in rural Kenyan homesteads is accidental ingestion of paraffin when it has been mistaken for water and offered to a young child. Here we report the incidence, parental practices and outcome of severe paraffin poisoning, requiring admission at Kilifi District Hospital, Kenya. Over a 2-year period, 48 children (0.5% of all admissions) were admitted with kerosene poisoning, constituting 62% of all poisoning cases. All cases were accidental. Ten per cent had induced vomiting. One child (2%) died. We suggest these data support assessment followed by implementation of practical and affordable measures to prevent paraffin poisoning. PMID:18363584

  5. Philosophy for Children Kenyan Style

    ERIC Educational Resources Information Center

    Odierna, Rebecca

    2012-01-01

    It was the last day of Philosophy 492, the author's college course dedicated to teaching the principles and strategies of philosophy for children (p4c) Hawai'i. Months before she joined the Philosophy 492 class, she was asked to join Emerging Humanity as a volunteer in a project that focused on enhancing the classroom environments at the…

  6. Comparison of HIV-1 nef and gag Variations and Host HLA Characteristics as Determinants of Disease Progression among HIV-1 Vertically Infected Kenyan Children

    PubMed Central

    Saina, Matilda Chelimo; Bi, Xiuqiong; Lihana, Raphael; Lwembe, Raphael; Ishizaki, Azumi; Panikulam, Annie; Palakudy, Tresa; Musoke, Rachel; Owens, Mary; Songok, Elijah Maritim; Ichimura, Hiroshi

    2015-01-01

    Objectives Disease progression varies among HIV-1-infected individuals. The present study aimed to explore possible viral and host factors affecting disease progression in HIV-1-infected children. Methods Since 2000, 102 HIV-1 vertically-infected children have been followed-up in Kenya. Here we studied 29 children (15 male/14 female) who started antiretroviral treatment at <5 years of age (rapid progressors; RP), and 32 (17 male/15 female) who started at >10 years of age (slow progressors; SP). Sequence variations in the HIV-1 gag and nef genes and the HLA class I-related epitopes were compared between the two groups. Results Based on nef sequences, HIV-1 subtypes A1/D were detected in 62.5%/12.5% of RP and 66.7%/20% of SP, with no significant difference in subtype distribution between groups (p = 0.8). In the ten Nef functional domains, only the PxxP3 region showed significantly greater variation in RP (33.3%) than SP (7.7%, p = 0.048). Gag sequences did not significantly differ between groups. The reportedly protective HLA-A alleles, A*74:01, A*32:01 and A*26, were more commonly observed in SP (50.0%) than RP (11.1%, p = 0.010), whereas the reportedly disease-susceptible HLA-B*45:01 was more common in RP (33.3%) than SP (7.4%, p = 0.045). Compared to RP, SP showed a significantly higher median number of predicted HLA-B-related 12-mer epitopes in Nef (3 vs. 2, p = 0.037), HLA-B-related 11-mer epitopes in Gag (2 vs. 1, p = 0.029), and HLA-A-related 9-mer epitopes in Gag (4 vs. 1, p = 0.051). SP also had fewer HLA-C-related epitopes in Nef (median 4 vs. 5, p = 0.046) and HLA-C-related 11-mer epitopes in Gag (median 1 vs. 1.5, p = 0.044) than RP. Conclusions Compared to rapid progressors, slow progressors had more protective HLA-A alleles and more HLA-B-related epitopes in both the Nef and Gag proteins. These results suggest that the host factor HLA plays a stronger role in disease progression than the Nef and Gag sequence variations in HIV-1-infected Kenyan children

  7. Bacteremia in Kenyan children presenting with malaria.

    PubMed

    Were, T; Davenport, G C; Hittner, J B; Ouma, C; Vulule, J M; Ong'echa, J M; Perkins, D J

    2011-02-01

    Since the etiologies and clinical outcomes of bacteremia in children with Plasmodium falciparum infections, particularly in areas of holoendemic malaria transmission, are largely unexplored, blood cultures and comprehensive clinical, laboratory, hematological, and nutritional parameters for malaria-infected children (aged 1 to 36 months, n = 585 patients) were investigated at a rural hospital in western Kenya. After the exclusion of contaminant microorganisms, the prevalence of bacteremia was 11.7% in the cohort (n = 506), with nontyphoidal Salmonella spp. being the most common isolates (42.4%). Bacteremia was found to occur in a significantly higher proportion of females than males and was associated with elevated blood glucose concentrations and lowered malaria parasite and hemoglobin (Hb) levels compared to those in abacteremic participants. In addition, the incidences of respiratory distress and severe malarial anemia (SMA; Hb level of <6.0 g/dl) were nonsignificantly greater in children with bacteremia. Mortality was 8.5-fold higher in children with bacteremia. Multivariate logistic regression analyses revealed that bacteremia was significantly associated with reduced incidences of high-density parasitemia (HDP; ≥ 10,000/μl) and increased incidences of malnutrition (i.e., underweight; weight-for-age Z score of <-2 using the NCHS system). Since previous studies showed that bacteremia caused by Gram-negative organisms is associated with enhanced anemia and mortality, multivariate logistic regression was also performed separately for randomly age- and gender-matched children with bacteremia caused by Gram-negative organisms (n = 37) and for children found to be abacteremic (n = 74). These results revealed that the presence of bacteremia caused by Gram-negative organisms was significantly associated with reduced HDP, enhanced susceptibility to respiratory distress, SMA (Hb level of <6.0 g/dl), and being underweight (Z score, <-2). Data presented here from a

  8. The Kenyan Political Conflict and Children's Adjustment

    ERIC Educational Resources Information Center

    Kithakye, Mumbe; Morris, Amanda Sheffield; Terranova, Andrew M.; Myers, Sonya S.

    2010-01-01

    This study examined pre- and postconflict data from 84 children, ages 3-7 years, living in Kibera, Kenya, during the December 2007 political conflict. Results indicate that children's disaster experiences (home destruction, death of a parent, parent and child harm) are associated with adjustment difficulties and that emotion regulation is an…

  9. Children's Emotion Regulation across and within Nations: A Comparison of Ghanaian, Kenyan, and American Youth

    ERIC Educational Resources Information Center

    Morelen, Diana; Zeman, Janice; Perry-Parrish, Carisa; Anderson, Ellen

    2012-01-01

    This research examined national, regional, developmental, and gender differences in children's reported management of anger and sadness. Participants (8-15 years) were 103 Ghanaian children from a village setting, 142 Ghanaian children from a middle-class urban context, 106 Kenyan children from an impoverished urban context, and 170 children from…

  10. Targets and Mechanisms Associated with Protection from Severe Plasmodium falciparum Malaria in Kenyan Children

    PubMed Central

    Sondén, Klara; Llewellyn, David; Rono, Josea; Guleid, Fatuma; Williams, Andrew R.; Ogada, Edna; Thairu, Amos; Färnert, Anna; Marsh, Kevin; Draper, Simon J.; Osier, Faith H. A.

    2016-01-01

    Severe malaria (SM) is a life-threatening complication of infection with Plasmodium falciparum. Epidemiological observations have long indicated that immunity against SM is acquired relatively rapidly, but prospective studies to investigate its immunological basis are logistically challenging and have rarely been undertaken. We investigated the merozoite targets and antibody-mediated mechanisms associated with protection against SM in Kenyan children aged 0 to 2 years. We designed a unique prospective matched case-control study of well-characterized SM clinical phenotypes nested within a longitudinal birth cohort of children (n = 5,949) monitored over the first 2 years of life. We quantified immunological parameters in sera collected before the SM event in cases and their individually matched controls to evaluate the prospective odds of developing SM in the first 2 years of life. Anti-AMA1 antibodies were associated with a significant reduction in the odds of developing SM (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.15 to 0.90; P = 0.029) after adjustment for responses to all other merozoite antigens tested, while those against MSP-2, MSP-3, Plasmodium falciparum Rh2 [PfRh2], MSP-119, and the infected red blood cell surface antigens were not. The combined ability of total IgG to inhibit parasite growth and mediate the release of reactive oxygen species from neutrophils was associated with a marked reduction in the odds of developing SM (OR = 0.07; 95% CI = 0.006 to 0.82; P = 0.03). Assays of these two functional mechanisms were poorly correlated (Spearman rank correlation coefficient [rs] = 0.12; P = 0.07). Our data provide epidemiological evidence that multiple antibody-dependent mechanisms contribute to protective immunity via distinct targets whose identification could accelerate the development of vaccines to protect against SM. PMID:26787721

  11. Targets and Mechanisms Associated with Protection from Severe Plasmodium falciparum Malaria in Kenyan Children.

    PubMed

    Murungi, Linda M; Sondén, Klara; Llewellyn, David; Rono, Josea; Guleid, Fatuma; Williams, Andrew R; Ogada, Edna; Thairu, Amos; Färnert, Anna; Marsh, Kevin; Draper, Simon J; Osier, Faith H A

    2016-04-01

    Severe malaria (SM) is a life-threatening complication of infection with Plasmodium falciparum Epidemiological observations have long indicated that immunity against SM is acquired relatively rapidly, but prospective studies to investigate its immunological basis are logistically challenging and have rarely been undertaken. We investigated the merozoite targets and antibody-mediated mechanisms associated with protection against SM in Kenyan children aged 0 to 2 years. We designed a unique prospective matched case-control study of well-characterized SM clinical phenotypes nested within a longitudinal birth cohort of children (n= 5,949) monitored over the first 2 years of life. We quantified immunological parameters in sera collected before the SM event in cases and their individually matched controls to evaluate the prospective odds of developing SM in the first 2 years of life. Anti-AMA1 antibodies were associated with a significant reduction in the odds of developing SM (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.15 to 0.90; P= 0.029) after adjustment for responses to all other merozoite antigens tested, while those against MSP-2, MSP-3, Plasmodium falciparum Rh2 [PfRh2], MSP-119, and the infected red blood cell surface antigens were not. The combined ability of total IgG to inhibit parasite growth and mediate the release of reactive oxygen species from neutrophils was associated with a marked reduction in the odds of developing SM (OR = 0.07; 95% CI = 0.006 to 0.82;P= 0.03). Assays of these two functional mechanisms were poorly correlated (Spearman rank correlation coefficient [rs] = 0.12;P= 0.07). Our data provide epidemiological evidence that multiple antibody-dependent mechanisms contribute to protective immunity via distinct targets whose identification could accelerate the development of vaccines to protect against SM. PMID:26787721

  12. Speech and Language Disorders in Kenyan Children: Adapting Tools For Regions With Few Assessment Resources

    PubMed Central

    Carter, Julie Anne; Murira, Grace; Gona, Joseph; Tumaini, Judy; Lees, Janet; Neville, Brian George; Newton, Charles Richard

    2013-01-01

    This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama. Data were collected from 303 children admitted to hospital with severe malaria and 206 age-matched children recruited from the village communities. The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools. PMID:24294109

  13. Urinary tract infection - children

    MedlinePlus

    UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children ... They may occur often around age 3, as children begin toilet training. Boys who are not circumcised ...

  14. Classes of Psychotic Experiences in Kenyan Children and Adolescents

    ERIC Educational Resources Information Center

    Mamah, Daniel; Owoso, Akinkunle; Mbwayo, Anne W.; Mutiso, Victoria N.; Muriungi, Susan K.; Khasakhala, Lincoln I.; Barch, Deanna M.; Ndetei, David M.

    2013-01-01

    Psychotic-like experiences (PLEs) have been observed worldwide in both adults and children outside the context of a clinical disorder. In the current study, we investigate the prevalence and patterns of PLEs among children and adolescents in Kenya. Among 1,971 students from primary and secondary schools around Nairobi (aged 8-19), 22.1 % reported…

  15. Turkana Children's Sociocultural Practices of Pastoralist Lifestyles and Science Curriculum and Instruction in Kenyan Early Childhood Education

    ERIC Educational Resources Information Center

    Ng'asike, John Teria

    2010-01-01

    This dissertation discusses the findings of an ethnographic exploratory study of Turkana nomadic pastoralist children's sociocultural practices of their everyday lifestyles and science curriculum and instruction in Kenyan early childhood curriculum. The study uses the findings from Turkana elders to challenge the dominant society in Kenya that…

  16. Concomitant infections of Plasmodium falciparum and Wuchereria bancrofti on the Kenyan coast

    PubMed Central

    Muturi, Ephantus J; Mbogo, Charles M; Mwangangi, Joseph M; Ng'ang'a, Zipporah W; Kabiru, Ephantus W; Mwandawiro, Charles; Beier, John C

    2006-01-01

    Background Anopheles gambiae s.l. and An. funestus are important vectors of malaria and bancroftian filariasis, which occur as co-endemic infections along the Kenyan Coast. However, little is known about the occurrence and prevalence of concomitant infections of the two diseases in mosquito and human populations in these areas. This study reports the prevalence of concomitant infections of Plasmodium falciparum and Wuchereria bancrofti in mosquito and human populations in Jilore and Shakahola villages in Malindi, Kenya. Methods Mosquitoes were sampled inside houses by pyrethrum spray sheet collection (PSC) while blood samples were collected by finger prick technique at the end of entomological survey. Results A total of 1,979 female Anopheles mosquitoes comprising of 1,919 Anopheles gambiae s.l and 60 An. funestus were collected. Concomitant infections of P. falciparum sporozoites and filarial worms occurred in 1.1% and 1.6% of An. gambiae s.l collected in Jilore and Shakahola villages respectively. Wuchereria-infected mosquitoes had higher sporozoite rates compared to non-infected mosquitoes, but multiple infections appeared to reduce mosquito survivorship making transmission of such infections rare. None of the persons examined in Shakahola (n = 107) had coinfections of the two parasites, whereas in Jilore (n = 94), out of the 4.3% of individuals harbouring both parasites, 1.2% had P. falciparum gametocytes and microfilariae and could potentially infect the mosquito with both parasites simultaneously. Conclusion Concerted efforts should be made to integrate the control of malaria and bancroftian filariasis in areas where they co-exist. PMID:16723020

  17. Algorithms for verbal autopsies: a validation study in Kenyan children.

    PubMed Central

    Quigley, M. A.; Armstrong Schellenberg, J. R.; Snow, R. W.

    1996-01-01

    The verbal autopsy (VA) questionnaire is a widely used method for collecting information on cause-specific mortality where the medical certification of deaths in childhood is incomplete. This paper discusses review by physicians and expert algorithms as approaches to ascribing cause of deaths from the VA questionnaire and proposes an alternative, data-derived approach. In this validation study, the relatives of 295 children who had died in hospital were interviewed using a VA questionnaire. The children were assigned causes of death using data-derived algorithms obtained under logistic regression and using expert algorithms. For most causes of death, the data-derived algorithms and expert algorithms yielded similar levels of diagnostic accuracy. However, a data-derived algorithm for malaria gave a sensitivity of 71% (95% Cl: 58-84%), which was significantly higher than the sensitivity of 47% obtained under an expert algorithm. The need for exploring this and other ways in which the VA technique can be improved are discussed. The implications of less-than-perfect sensitivity and specificity are explored using numerical examples. Misclassification bias should be taken into consideration when planning and evaluating epidemiological studies. PMID:8706229

  18. Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

    PubMed Central

    Ngwiri, Thomas; Were, Fred; Predieri, Barbara; Ngugi, Paul; Iughetti, Lorenzo

    2015-01-01

    Background. Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children and adolescents worldwide. While data about prevalence, treatment, and complications are recorded in many countries, few data exist for Sub-Saharan Africa. The aim of this study was to determine the degree of control in patients with T1DM aged 1–19 years over a 6-month period in 3 outpatient Kenyan clinics. It also sought to determine how control was influenced by parameters of patient and treatment. Methods. Eighty-two children and adolescents with T1DM were included in the study. Clinical history regarding duration of illness, type and dose of insulin, and recent symptoms of hypoglycemia/hyperglycemia were recorded. Glycaemia, HbA1c, and ketonuria were tested. HbA1c of 8.0% and below was defined as the cut-off for acceptable control. Results. The median HbA1c for the study population was 11.1% (range: 6.3–18.8). Overall, only 28% of patients had reasonable glycemic control as defined in this study. 72% therefore had poor control. It was also found that age above 12 years was significantly associated with poor control. Conclusions. African children and with T1DM are poorly controlled particularly in adolescents. Our data strongly support the necessity of Kenya children to receive more aggressive management and follow-up. PMID:26494998

  19. Polymorphism in a lincRNA Associates with a Doubled Risk of Pneumococcal Bacteremia in Kenyan Children.

    PubMed

    Rautanen, Anna; Pirinen, Matti; Mills, Tara C; Rockett, Kirk A; Strange, Amy; Ndungu, Anne W; Naranbhai, Vivek; Gilchrist, James J; Bellenguez, Céline; Freeman, Colin; Band, Gavin; Bumpstead, Suzannah J; Edkins, Sarah; Giannoulatou, Eleni; Gray, Emma; Dronov, Serge; Hunt, Sarah E; Langford, Cordelia; Pearson, Richard D; Su, Zhan; Vukcevic, Damjan; Macharia, Alex W; Uyoga, Sophie; Ndila, Carolyne; Mturi, Neema; Njuguna, Patricia; Mohammed, Shebe; Berkley, James A; Mwangi, Isaiah; Mwarumba, Salim; Kitsao, Barnes S; Lowe, Brett S; Morpeth, Susan C; Khandwalla, Iqbal; Blackwell, Jenefer M; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden; Duncanson, Audrey; Jankowski, Janusz; Markus, Hugh S; Mathew, Christopher G; Palmer, Colin N A; Plomin, Robert; Sawcer, Stephen J; Trembath, Richard C; Viswanathan, Ananth C; Wood, Nicholas W; Deloukas, Panos; Peltonen, Leena; Williams, Thomas N; Scott, J Anthony G; Chapman, Stephen J; Donnelly, Peter; Hill, Adrian V S; Spencer, Chris C A

    2016-06-01

    Bacteremia (bacterial bloodstream infection) is a major cause of illness and death in sub-Saharan Africa but little is known about the role of human genetics in susceptibility. We conducted a genome-wide association study of bacteremia susceptibility in more than 5,000 Kenyan children as part of the Wellcome Trust Case Control Consortium 2 (WTCCC2). Both the blood-culture-proven bacteremia case subjects and healthy infants as controls were recruited from Kilifi, on the east coast of Kenya. Streptococcus pneumoniae is the most common cause of bacteremia in Kilifi and was thus the focus of this study. We identified an association between polymorphisms in a long intergenic non-coding RNA (lincRNA) gene (AC011288.2) and pneumococcal bacteremia and replicated the results in the same population (p combined = 1.69 × 10(-9); OR = 2.47, 95% CI = 1.84-3.31). The susceptibility allele is African specific, derived rather than ancestral, and occurs at low frequency (2.7% in control subjects and 6.4% in case subjects). Our further studies showed AC011288.2 expression only in neutrophils, a cell type that is known to play a major role in pneumococcal clearance. Identification of this novel association will further focus research on the role of lincRNAs in human infectious disease. PMID:27236921

  20. The Unrecognized Burden of Influenza in Young Kenyan Children, 2008-2012.

    PubMed

    McMorrow, Meredith L; Emukule, Gideon O; Njuguna, Henry N; Bigogo, Godfrey; Montgomery, Joel M; Nyawanda, Bryan; Audi, Allan; Breiman, Robert F; Katz, Mark A; Cosmas, Leonard; Waiboci, Lilian W; Duque, Jazmin; Widdowson, Marc-Alain; Mott, Joshua A

    2015-01-01

    Influenza-associated disease burden among children in tropical sub-Saharan Africa is not well established, particularly outside of the 2009 pandemic period. We estimated the burden of influenza in children aged 0-4 years through population-based surveillance for influenza-like illness (ILI) and acute lower respiratory tract illness (ALRI). Household members meeting ILI or ALRI case definitions were referred to health facilities for evaluation and collection of nasopharyngeal and oropharyngeal swabs for influenza testing by real-time reverse transcription polymerase chain reaction. Estimates were adjusted for health-seeking behavior and those with ILI and ALRI who were not tested. During 2008-2012, there were 9,652 person-years of surveillance among children aged 0-4 years. The average adjusted rate of influenza-associated hospitalization was 4.3 (95% CI 3.0-6.0) per 1,000 person-years in children aged 0-4 years. Hospitalization rates were highest in the 0-5 month and 6-23 month age groups, at 7.6 (95% CI 3.2-18.2) and 8.4 (95% CI 5.4-13.0) per 1,000 person-years, respectively. The average adjusted rate of influenza-associated medically attended (inpatient or outpatient) ALRI in children aged 0-4 years was 17.4 (95% CI 14.2-19.7) per 1,000 person-years. Few children who had severe laboratory-confirmed influenza were clinically diagnosed with influenza by the treating clinician in the inpatient (0/33, 0%) or outpatient (1/109, 0.9%) settings. Influenza-associated hospitalization rates from 2008-2012 were 5-10 times higher than contemporaneous U.S. estimates. Many children with danger signs were not hospitalized; thus, influenza-associated severe disease rates in Kenyan children are likely higher than hospital-based estimates suggest. PMID:26379030

  1. Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

    PubMed Central

    Talbert, Alison; Thuo, Nahashon; Karisa, Japhet; Chesaro, Charles; Ohuma, Eric; Ignas, James; Berkley, James A.; Toromo, Christopher; Atkinson, Sarah; Maitland, Kathryn

    2012-01-01

    Background Severe acute malnutrition (SAM) accounts for two million deaths worldwide annually. In those hospitalised with SAM, concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital. Methods A 4-year prospective descriptive study involving 1,206 children aged 6 months to 12 years, hospitalized with SAM and managed in accordance with WHO guidelines. Data on clinical features, haematological, biochemical and microbiological findings for children with diarrhoea (≥3 watery stools/day) were systematically collected and analyzed to identify risk factors associated with poor outcome. Results At admission 592 children (49%) had diarrhoea of which 122 (21%) died compared to 72/614 (12%) deaths in those without diarrhoea at admission (Χ2 = 17.6 p<0.001). A further 187 (16%) children developed diarrhoea after 48 hours of admission and 33 died (18%). Any diarrhoea during admission resulted in a significantly higher mortality 161/852 (19%) than those uncomplicated by diarrhoea 33/351 (9%) (Χ2 = 16.6 p<0.001). Features associated with a fatal outcome in children presenting with diarrhoea included bacteraemia, hyponatraemia, low mid-upper arm circumference <10 cm, hypoxia, hypokalaemia and oedema. Bacteraemia had the highest risk of death (adjusted OR 6.1; 95% C.I 2.3, 16.3 p<0.001); and complicated 24 (20%) of fatalities. Positive HIV antibody status was more frequent in cases with diarrhoea at admission (23%) than those without (15%, Χ2 = 12.0 p = 0.001) but did not increase the risk of death in diarrhoea cases. Conclusion Children with SAM complicated by diarrhoea had a higher risk of death than those who did not have diarrhoea during their hospital stay. Further operational and clinical research is needed to reduce mortality in children with SAM in the given setting. PMID:22675542

  2. Zinc, iron and calcium are major limiting nutrients in the complementary diets of rural Kenyan children.

    PubMed

    Ferguson, Elaine; Chege, Peter; Kimiywe, Judith; Wiesmann, Doris; Hotz, Christine

    2015-12-01

    Poor quality infant and young child (IYC) diets contribute to chronic under-nutrition. To design effective IYC nutrition interventions, an understanding of the extent to which realistic food-based strategies can improve dietary adequacy is required. We collected 24-h dietary recalls from children 6-23 months of age (n = 401) in two rural agro-ecological zones of Kenya to assess the nutrient adequacy of their diets. Linear programming analysis (LPA) was used to identify realistic food-based recommendations (FBRs) and to determine the extent to which they could ensure intake adequacy for 12 nutrients. Mean nutrient densities of the IYC diets were below the desired level for four to nine of the 10 nutrients analysed, depending on the age group. Mean dietary diversity scores ranged from 2.1 ± 1.0 among children 6-8 months old in Kitui County to 3.7 ± 1.1 food groups among children 12-23 months old in Vihiga County. LPA confirmed that dietary adequacy for iron, zinc and calcium will be difficult to ensure using only local foods as consumed. FBRs for breastfed children that promote the daily consumption of cows'/goats' milk (added to porridges), fortified cereals, green leafy vegetables, legumes, and meat, fish or eggs, 3-5 times per week can ensure dietary adequacy for nine and seven of 12 nutrients for children 6-11 and 12-23 months old, respectively. For these rural Kenyan children, even though dietary adequacy could be improved via realistic changes in habitual food consumption practices, alternative interventions are needed to ensure dietary adequacy at the population level. PMID:26778799

  3. Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria

    PubMed Central

    Idro, Richard; Otieno, Godfrey; White, Steven; Kahindi, Anderson; Fegan, Greg; Ogutu, Bernhards; Mithwani, Sadik; Maitland, Kathryn; Neville, Brian GR; Newton, Charles RJC

    2005-01-01

    Background Abnormal motor posturing is often observed in children with cerebral malaria, but the aetiology and pathogenesis is poorly understood. This study examined the risk factors and outcome of posturing in Kenyan children with cerebral malaria. Methods Records of children admitted to Kilifi district hospital with cerebral malaria from January, 1999 through December, 2001 were reviewed for posturing occurring on or after admission. The clinical characteristics, features of raised intracranial pressure, number of seizures and biochemical changes in patients that developed posturing was compared to patients who did not. Results Of the 417 children with complete records, 163 (39.1%) had posturing: 85 on admission and 78 after admission to hospital. Decorticate posturing occurred in 80, decerebrate in 61 and opisthotonic posturing in 22 patients. Posturing was associated with age ≥ 3 years (48.1 vs 35.8%, p = 0.01) and features of raised intracranial pressure on funduscopy (adjusted OR 2.1 95%CI 1.2–3.7, p = 0.009) but not other markers of severity of disease. Unlike decorticate posturing, decerebrate (adjusted OR 1.9 95%CI 1.0–3.5) and opisthotonic posturing (adjusted OR 2.9 95%CI 1.0–8.1) were, in addition, independently associated with recurrence of seizures after admission. Opisthotonus was also associated with severe metabolic acidosis (OR 4.2 95%CI 3.2–5.6, p < 0.001). Thirty one patients with posturing died. Of these, 19 (61.3%) had features suggestive of transtentorial herniation. Mortality and neurological deficits on discharge were greatest in those developing posturing after admission. Conclusion Abnormal motor posturing is a common feature of cerebral malaria in children. It is associated with features of raised intracranial pressure and recurrence of seizures, although intracranial hypertension may be the primary cause. PMID:16336645

  4. The Unrecognized Burden of Influenza in Young Kenyan Children, 2008-2012

    PubMed Central

    McMorrow, Meredith L.; Emukule, Gideon O.; Njuguna, Henry N.; Bigogo, Godfrey; Montgomery, Joel M.; Nyawanda, Bryan; Audi, Allan; Breiman, Robert F.; Katz, Mark A.; Cosmas, Leonard; Waiboci, Lilian W.; Duque, Jazmin; Widdowson, Marc-Alain; Mott, Joshua A.

    2015-01-01

    Influenza-associated disease burden among children in tropical sub-Saharan Africa is not well established, particularly outside of the 2009 pandemic period. We estimated the burden of influenza in children aged 0–4 years through population-based surveillance for influenza-like illness (ILI) and acute lower respiratory tract illness (ALRI). Household members meeting ILI or ALRI case definitions were referred to health facilities for evaluation and collection of nasopharyngeal and oropharyngeal swabs for influenza testing by real-time reverse transcription polymerase chain reaction. Estimates were adjusted for health-seeking behavior and those with ILI and ALRI who were not tested. During 2008–2012, there were 9,652 person-years of surveillance among children aged 0–4 years. The average adjusted rate of influenza-associated hospitalization was 4.3 (95% CI 3.0–6.0) per 1,000 person-years in children aged 0–4 years. Hospitalization rates were highest in the 0–5 month and 6–23 month age groups, at 7.6 (95% CI 3.2–18.2) and 8.4 (95% CI 5.4–13.0) per 1,000 person-years, respectively. The average adjusted rate of influenza-associated medically attended (inpatient or outpatient) ALRI in children aged 0–4 years was 17.4 (95% CI 14.2–19.7) per 1,000 person-years. Few children who had severe laboratory-confirmed influenza were clinically diagnosed with influenza by the treating clinician in the inpatient (0/33, 0%) or outpatient (1/109, 0.9%) settings. Influenza-associated hospitalization rates from 2008–2012 were 5–10 times higher than contemporaneous U.S. estimates. Many children with danger signs were not hospitalized; thus, influenza-associated severe disease rates in Kenyan children are likely higher than hospital-based estimates suggest. PMID:26379030

  5. Prevalence and Correlates of Helminth Co-infection in Kenyan HIV-1 Infected Adults

    PubMed Central

    Walson, Judd L.; Stewart, Barclay T.; Sangaré, Laura; Mbogo, Loice W.; Otieno, Phelgona A.; Piper, Benjamin K. S.; Richardson, Barbra A.; John-Stewart, Grace

    2010-01-01

    Background Deworming HIV-1 infected individuals may delay HIV-1 disease progression. It is important to determine the prevalence and correlates of HIV-1/helminth co-infection in helminth-endemic areas. Methods HIV-1 infected individuals (CD4>250 cells/ul) were screened for helminth infection at ten sites in Kenya. Prevalence and correlates of helminth infection were determined. A subset of individuals with soil-transmitted helminth infection was re-evaluated 12 weeks following albendazole therapy. Results Of 1,541 HIV-1 seropositive individuals screened, 298 (19.3%) had detectable helminth infections. Among individuals with helminth infection, hookworm species were the most prevalent (56.3%), followed by Ascaris lumbricoides (17.1%), Trichuris trichiura (8.7%), Schistosoma mansoni (7.1%), and Stongyloides stercoralis (1.3%). Infection with multiple species occurred in 9.4% of infections. After CD4 count was controlled for, rural residence (RR 1.40, 95% CI: 1.08–1.81), having no education (RR 1.57, 95% CI: 1.07–2.30), and higher CD4 count (RR 1.36, 95% CI: 1.07–1.73) remained independently associated with risk of helminth infection. Twelve weeks following treatment with albendazole, 32% of helminth-infected individuals had detectable helminths on examination. Residence, education, and CD4 count were not associated with persistent helminth infection. Conclusions Among HIV-1 seropositive adults with CD4 counts above 250 cells/mm3 in Kenya, traditional risk factors for helminth infection, including rural residence and lack of education, were associated with co-infection, while lower CD4 counts were not. Trial Registration ClinicalTrials.gov NCT00130910 PMID:20361031

  6. Analysis of dental casts of 6-8- and 12-year-old Kenyan children.

    PubMed

    Hassanali, J; Odhiambo, J W

    2000-04-01

    Dental plaster casts of 97 6-8-year-old and 173 12-year-old Maasai, Kikuyu, and Kalenjin children were studied. The Kikuyu are Bantu, while Maasai and Kalenjin are Nilo-Hamitic subjects. The variables measured were palatal depth (PD) and length (PL); maxillary and mandibular anterior arc circumferences (AC1) and (AC2), respectively; posterior arc circumferences (PC1) and (PC2), inter-canine (CC1), and (CC2); inter-molar (MM1) and (MM2) distances, and mandibular length (ML). The data were analysed using SPSS package. The mean values of all the variables were generally higher in the males compared with the females and significant sex differences in the means (P < 0.01) were found in AC1, PC1, PC2, CC1, CC2, MM1, and MM2 in the 12-year-old subjects. The means of all variables, except PL, ML, PC2, and CC2, increased from 6 to 12 years of age and significant differences in the means for age were found in ML, AC1, PC2, PD, MM1, MM2, and CC1. Mean maxillary inter-molar distance increased with age by 0.17-0.34 mm in the three groups. Mean values of mandibular variables were highest in the Kikuyu, while maxillary variables were highest in the Maasai. The Maasai casts showed a marked decrease in CC2, PC2, AC2, and ML compared with the Kikuyu and Kalenjin. Ethnic and sex differences in the dental arches may be masked by anterior tooth positions that are influenced by the dento-alveolar complex and soft tissues. Corresponding mandibular and maxillary variables were strongly correlated and anterior and posterior arc circumferences were correlated with inter-canine and intermolar distances. Details of the norms for dental arch dimensions and changes with age may allow for appropriate assessment of dental occlusion and treatment planning for Kenyan children. PMID:10822886

  7. Increasing Coverage and Decreasing Inequity in Insecticide-Treated Bed Net Use among Rural Kenyan Children

    PubMed Central

    Noor, Abdisalan M; Amin, Abdinasir A; Akhwale, Willis S; Snow, Robert W

    2007-01-01

    Background Inexpensive and efficacious interventions that avert childhood deaths in sub-Saharan Africa have failed to reach effective coverage, especially among the poorest rural sectors. One particular example is insecticide-treated bed nets (ITNs). In this study, we present repeat observations of ITN coverage among rural Kenyan homesteads exposed at different times to a range of delivery models, and assess changes in coverage across socioeconomic groups. Methods and Findings We undertook a study of annual changes in ITN coverage among a cohort of 3,700 children aged 0–4 y in four districts of Kenya (Bondo, Greater Kisii, Kwale, and Makueni) annually between 2004 and 2006. Cross-sectional surveys of ITN coverage were undertaken coincidentally with the incremental availability of commercial sector nets (2004), the introduction of heavily subsidized nets through clinics (2005), and the introduction of free mass distributed ITNs (2006). The changing prevalence of ITN coverage was examined with special reference to the degree of equity in each delivery approach. ITN coverage was only 7.1% in 2004 when the predominant source of nets was the commercial retail sector. By the end of 2005, following the expansion of heavily subsidized clinic distribution system, ITN coverage rose to 23.5%. In 2006 a large-scale mass distribution of ITNs was mounted providing nets free of charge to children, resulting in a dramatic increase in ITN coverage to 67.3%. With each subsequent survey socioeconomic inequity in net coverage sequentially decreased: 2004 (most poor [2.9%] versus least poor [15.6%]; concentration index 0.281); 2005 (most poor [17.5%] versus least poor [37.9%]; concentration index 0.131), and 2006 with near-perfect equality (most poor [66.3%] versus least poor [66.6%]; concentration index 0.000). The free mass distribution method achieved highest coverage among the poorest children, the highly subsidised clinic nets programme was marginally in favour of the least poor

  8. Longevity of Genotype-Specific Immune Responses to Plasmodium falciparum Merozoite Surface Protein 1 in Kenyan Children from Regions of Different Malaria Transmission Intensity.

    PubMed

    Bowman, Natalie M; Juliano, Jonathan J; Snider, Cynthia J; Kharabora, Oksana; Meshnick, Steven R; Vulule, John; John, Chandy C; Moormann, Ann M

    2016-09-01

    Naturally acquired immunity to Plasmodium falciparum presents a changing landscape as malaria control programs and vaccine initiatives are implemented. Determining which immunologic indicators remain surrogates of past infection, as opposed to mediators of protection, led us to compare stability of immune responses across regions with divergent malaria transmission intensities. A repeat cross-sectional study of Kenyan children from a malaria-holoendemic area and an epidemic-prone area was used to examine longitudinal antibody and interferon-gamma (IFN-γ) responses to the 3D7 and FVO variants of merozoite surface protein 1 (MSP1). Antibodies to MSP1 were common in both study populations and did not significantly wane over a 21-month time period. IFN-γ responses were less frequent and rapidly disappeared in children after a prolonged period of no malaria transmission. Antibody and IFN-γ responses rarely correlated with each other; however, MSP1-specific IFN-γ response correlated with lack of concurrent P. falciparum parasitemia of the same genotype, though only statistically significantly in the malaria-holoendemic region (odds ratio = 0.31, 95% confidence interval = 0.12-0.84). This study affirms that antimalarial antibodies are informative for evaluation of history of malaria exposure within individuals, whereas cell-mediated immunity, though short lived under natural exposure conditions, might provide an assessment of recent infection and protection from parasitemia. PMID:27481054

  9. Repeated Infections in Children

    MedlinePlus

    ... cause of an infection, such as being in day-care centers. Children in day-care centers give infections to each other. They drool ... winter, you could move your child out of day care, where so many other children would have colds. ...

  10. Impact of Plasmodium falciparum Coinfection on Longitudinal Epstein-Barr Virus Kinetics in Kenyan Children.

    PubMed

    Reynaldi, Arnold; Schlub, Timothy E; Chelimo, Kiprotich; Sumba, Peter Odada; Piriou, Erwan; Ogolla, Sidney; Moormann, Ann M; Rochford, Rosemary; Davenport, Miles P

    2016-03-15

    Endemic Burkitt lymphoma is associated with Epstein-Barr virus (EBV) and Plasmodium falciparum coinfection, although how P. falciparum exposure affects the dynamics of EBV infection is unclear. We have used a modeling approach to study EBV infection kinetics in a longitudinal cohort of children living in regions of high and low malaria transmission in Kenya. Residence in an area of high malaria transmission was associated with a higher rate of EBV expansion during primary EBV infection in infants and during subsequent episodes of EBV DNA detection, as well as with longer episodes of EBV DNA detection and shorter intervals between subsequent episodes of EBV DNA detection. In addition, we found that concurrent P. falciparum parasitemia also increases the likelihood of the first and subsequent peaks of EBV in peripheral blood. This suggests that P. falciparum infection is associated with increased EBV growth and contributes to endemic Burkitt lymphoma pathogenesis. PMID:26531246

  11. Co-Infection Burden of Hepatitis C Virus and Human Immunodeficiency Virus among Injecting Heroin Users at the Kenyan Coast

    PubMed Central

    Mwatelah, Ruth S.; Lwembe, Raphael M.; Osman, Saida; Ogutu, Bernhards R.; Aman, Rashid; Kitawi, Rose C.; Wangai, Laura N.; Oloo, Florence A.; Kokwaro, Gilbert O.; Ochieng, Washingtone

    2015-01-01

    Background Injection drug use is steadily rising in Kenya. We assessed the prevalence of both human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infections among injecting heroin users (IHUs) at the Kenyan Coast. Methods A total of 186 IHUs (mean age, 33 years) from the Omari rehabilitation center program in Malindi were consented and screened for HIV-1 and HCV by serology and PCR and their CD4 T-cells enumerated by FACS. Results Prevalence of HIV-1 was 87.5%, that of HCV was 16.4%, co-infection was 17.9% and 18/152 (11.8%) were uninfected. Only 5.26% of the HIV-1 negative injectors were HCV positive. Co-infection was higher among injectors aged 30 to 40 years (20.7%) and among males (22.1%) than comparable groups. About 35% of the injectors were receiving antiretroviral treatment (ART). Co-infection was highest among injectors receiving D4T (75%) compared to those receiving AZT (21.6%) or TDF (10.5%) or those not on ART (10.5%). Mean CD4 T-cells were 404 (95% CI, 365 - 443) cells/mm3 overall, significantly lower for co-infected (mean, 146; 95% CI 114 – 179 cells/mm3) than HIV mono infected (mean, 437, 95% CI 386 – 487 cells/mm3, p<0.001) or uninfected (mean, 618, 95% CI 549 – 687 cells/mm3, p<0.001) injectors and lower for HIV mono-infected than uninfected injectors (p=0.002). By treatment arm, CD4 T-cells were lower for injectors receiving D4T (mean, 78; 95% CI, 0.4 – 156 cells/mm3) than TDF (mean 607, 95% CI, 196 – 1018 cells/mm3, p=0.005) or AZT (mean 474, 95% CI -377 – 571 cells/mm3, p=0.004). Conclusion Mono and dual infections with HIV-1 and HCV is high among IHUs in Malindi, but ART coverage is low. The co-infected IHUs have elevated risk of immunodeficiency due to significantly depressed CD4 T-cell numbers. Coinfection screening, treatment-as-prevention for both HIV and HCV and harm reduction should be scaled up to alleviate infection burden. PMID:26208212

  12. Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children.

    PubMed

    Grillenberger, Monika; Neumann, Charlotte G; Murphy, Suzanne P; Bwibo, Nimrod O; Weiss, Robert E; Jiang, Luohua; Hautvast, Joseph G A J; West, Clive E

    2006-02-01

    Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth. PMID:16469157

  13. Worm Infections in Children.

    PubMed

    Weatherhead, Jill E; Hotez, Peter J

    2015-08-01

    • On the basis of research evidence, worm infections are important global child health conditions causing chronic disability that lasts from childhood into adulthood (Table 1). (2)(3) Evidence Quality: B • On the basis of research evidence, the major worm infections found in developing countries include ascariasis, trichuriasis, hookworm infection, and schistosomiasis; toxocariasis, enterobiasis, and cysticercosis are also found in poor regions of North America and Europe. (4)(9)(13) Evidence Quality: B • On the basis of expert consensus, children and adolescents are often vulnerable to acquiring large numbers of worms, ie, high-intensity infections (Fig 1)(21)(22)(23) Evidence Quality: D • On the basis of expert consensus and research evidence, moderate and heavy worm burdens cause increased morbidity because of growth and intellectual stunting in children and adolescents. Many of these effects may result from helminth-induced malnutrition. (21)(22)(23) Evidence Quality: C • On the basis of expert consensus and research evidence, worm infections are also commonly associated with eosinophilia. (48) (49) Evidence Quality: B • On the basis of research evidence as well as consensus, helminthes can cause inflammation in the lung (asthma), gastrointestinal tract (enteritis and colitis), liver (hepatitis and fibrosis), and urogenital tract. (7)(21)(22)(23)(27)(28)(40)(41)(43) Evidence Quality: B • On the basis of research evidence, microscopy techniques for diagnosis of worm infections in children often exhibit suboptimal sensitivities and specificities, necessitating new or improved diagnostic modalities such as polymerase chain reaction. (54)(55) Evidence Quality: A • On the basis of research evidence and expert consensus, mass drug administration (“preventive chemotherapy”) has becomea standard practice for ministries of health in low- and middle-income countries to control intestinal helminth infections and schistosomiasis. (67)(68) Evidence

  14. Correlates of objectively measured overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-Kenya

    PubMed Central

    2014-01-01

    Background Childhood overweight/obesity and inadequate physical activity burden Western countries, and now, pose a growing threat to the health of children in low and middle income countries. Behavioural transitions toward more sedentary lifestyles coupled with increased consumption of high calorie foods has resulted in rising proportions of overweight/obesity and decreasing levels of physical activity in school-aged children. The objective of this study was to determine the prevalence and to investigate factors associated with overweight/obesity and physical activity in Kenyan children aged 9 to 11 years. Methods Body composition and physical activity measures of participating children were accomplished by anthropometric assessment, accelerometry, and administration of questionnaires related to diet and lifestyle, and the school and neighbourhood environments. Data collection was conducted in the city of Nairobi as part of a larger International Study of Childhood Obesity, Lifestyle and Environment. Results A total of 563 participants (46.5% boys, 53.5% girls) were included in the analyses. Of these, 3.7% were underweight, 14.4% were overweight, and 6.4% were obese based on WHO cut-points. Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in moderate-to-vigorous physical activity was 36 minutes based on activity cut-points developed by Treuth et al. Only 12.6% of participating children were meeting the recommendation of ≥ 60 minutes of daily moderate-to-vigorous physical activity, and 45.7% of participants used active transportation to/from school. Increasing parental education level, total annual household income, and attending a private rather than public school were associated positively with being overweight/obese and negatively with meeting physical activity guidelines. Conclusions This study provided the evidence for an existing prevalence of childhood overweight/obesity in Nairobi

  15. Aflatoxin exposure is inversely associated with IGF1 and IGFBP3 levels in vitro and in Kenyan school children

    PubMed Central

    Castelino, Jovita M.; Routledge, Michael N.; Wilson, Shona; Dunne, David W.; Mwatha, Joseph K.; Gachuhi, Kimani; Wild, Christopher P.; Gong, Yun Yun

    2014-01-01

    Scope This study explores the relationship between aflatoxin and the insulin-like growth factor (IGF) axis and its potential effect on child growth. Methods and results 199 Kenyan schoolchildren were studied for aflatoxin-albumin adduct (AF-alb), IGF1 and IGFBP3 levels using ELISA. AF-alb was inversely associated with IGF1 and IGFBP3 (P<0.05). Both IGF1 and IGFBP3 were significantly associated with child height and weight (P<0.01). Children in the highest tertile of AF-alb exposure (> 198.5 pg/mg) were shorter than children in the lowest tertile (< 74.5 pg/mg), after adjusting for confounders (P=0.043). Path analysis suggested that IGF1 levels explained ~16% of the impact of aflatoxin exposure on child height (P=0.052). To further investigate this putative mechanistic pathway, HHL-16 liver cells were treated with AFB1 (0.5, 5 and 20 μg/ml for 24–48 hours). IGF1 and IGFBP3 gene expression measured by qPCR and protein in culture media showed a significant down-regulation of IGF genes and reduced IGF protein levels. Conclusion Aflatoxin treatment resulted in a significant decrease in IGF gene and protein expression in vitro. IGF protein levels were also lower in children with the highest levels of AFB-alb adducts. The data suggest that aflatoxin-induced changes in IGF protein levels could contribute to growth impairment where aflatoxin exposure is high. PMID:24668606

  16. Turkana Children's Sociocultural Practices of Pastoralist Lifestyles and Science Curriculum and Instruction in Kenyan Early Childhood Education

    NASA Astrophysics Data System (ADS)

    Ng'asike, John Teria

    This dissertation discusses the findings of an ethnographic exploratory study of Turkana nomadic pastoralist children's sociocultural practices of their everyday lifestyles and science curriculum and instruction in Kenyan early childhood curriculum. The study uses the findings from Turkana elders to challenge the dominant society in Kenya that draws from Western education ideology to unfairly criticize Turkana traditional nomadic cultural practices as resistant to modern education. Yet Turkana people have to rely on the cultural knowledge of their environment for survival. In addition, the community lives in abject poverty caused by the harsh desert environment which has contributed to parents' struggle to support their children's education. Cultural knowledge of Turkana people has received support in research demonstrating the role cultural lifestyles such as nomadic pastoralism play as important survival strategy that enable people to adapt to the harsh desert environment to ensure the survival of their livestock critical for their food security. The study documented ways in which the Kenya national education curriculum, reflecting Western assumptions about education, often alienates and marginalises nomadic children, in its failure to capture their cultural Indigenous knowledge epistemologies. The research investigated the relationships between Turkana children's sociocultural practices of pastoralist lifestyles and the national science curriculum taught in local preschools and first grade science classrooms in Kenya and the extent to which Turkana children's everyday life cultural practices inform science instruction in early childhood grades. Multiple ethnographic methods such as participant and naturalistic observation, focus group interviews, analysis of documents, archival materials, and cultural artifacts were used to explore classrooms instruction and Indigenous sociocultural practices of the Turkana nomads. The findings from the elders' narratives

  17. Fertility intentions among HIV-infected, sero-concordant Kenyan couples in Nyanza Province, Kenya

    PubMed Central

    Dworkin, Shari; Harrington, Elizabeth; Kwena, Zachary; Onono, Maricianah; Bukusi, Elizabeth; Cohen, Craig R.; Grossma, Daniel; Newmann, Sara J.

    2013-01-01

    Research in sub-Saharan Africa has shown significant diversity in how HIV influences infected couples’ fertility intentions. Supporting HIV-infected, sero-concordant couples in sub-Saharan Africa to make informed choices about their fertility options has not received sufficient attention. In-depth interviews were conducted among 23 HIV-positive, sero-concordant married couples in Kenya, to better understand how HIV impacted fertility intentions. HIV compelled many to reconsider fertility plans, sometimes promoting childbearing intentions in some individuals but often reducing fertility plans among most, largely due to fears of early death, health concerns, stigma, perinatal HIV transmission and financial difficulties (particularly in men). Preferences for sons and large families influenced some couples’ intentions to continue childbearing, although none had discussed their intentions with health care providers. Additional support and services for HIV-infected, sero-concordant couples are needed. Family planning counselling should be tailored to the unique concerns of HIV-infected couples, addressing perinatal transmission but also individual, couple-level, and socio-cultural fertility expectations. Community-level programmes are needed to reduce stigma and make HIV-infected couples more comfortable in discussing fertility intentions with health care providers. PMID:23885924

  18. Oral hygiene habits and dental health awareness of Kenyan children aged 9-15 years in a peri-urban and urban school.

    PubMed

    Kaimenyi, J T; Ndungu, F L; Maina, S W; Chindia, M

    1993-02-01

    The oral hygiene habits and dental health awareness of 541 Kenyan children from a peri-urban and urban school and aged 9-15 years, were investigated. 80.2% of the urban children and 43.1% of the peri-urban children had visited a dentist before. 12.4% of the urban children and 9.2% of the peri-urban children knew that bacteria cause dental caries. Over 87% of the children from either school knew that dental caries and periodontitis can be prevented. The main reason for visiting a dentist was to have tooth extraction. Failure to brush teeth was believed to be the cause of gingival bleeding by 38.9% of the peri-urban children and 37.6% of the urban children. 67.2% of the peri-urban children and 39.5% of the urban children brushed their teeth thrice daily. 21.1% of the peri-urban children and 2% of the urban children used a chewing stick to brush their teeth. More urban children (96.5%) used a toothbrush than peri-urban children (64.8%). None of the children from either school admitted using traditional cleaning aids such as the finger and charcoal. It is concluded that there were no consistent differences in oral hygiene habits and dental health awareness between peri-urban and urban children. PMID:8513743

  19. Prevalence and Risk Factors of Human Papillomavirus Infection by Penile Site in Uncircumcised Kenyan Men

    PubMed Central

    Smith, Jennifer S.; Backes, Danielle M.; Hudgens, Michael G.; Bailey, Robert C.; Veronesi, Giovanni; Bogaarts, Martijn; Agot, Kawango; Ndinya-Achola, J.O.; Maclean, Ian; Agingu, Walter; Meijer, Chris J.L.M.; Moses, Stephen; Snijders, Peter J.F.

    2009-01-01

    Human papillomavirus (HPV) prevalence was estimated from 2,705 sexually active, uncircumcised, human immunodeficiency virus seronegative men aged 17–28 years in Kisumu, Kenya. HPV prevalence was 51.1% (95% confidence interval: 49.2 – 53.0%) in penile cells from the glans/coronal sulcus and/or shaft. HPV prevalence varied by anatomical site, with 46.5% positivity in the glans/coronal sulcus compared with 19.1% in the shaft (p<.0001). High-risk HPV was detected in 31.2% of glans and 12.3% of shaft samples (p<.0001). HPV16 was the most common type and 29.2% of men were infected with more than one HPV type. Risk factors for HPV infection included presence of C. trachomatis, N. gonorrhea, self-reported sexually transmitted infections, and less frequent bathing. Lifetime number of sexual partners and herpes simplex virus type-2 seropositivity were also marginally associated with HPV infection. PMID:19626601

  20. Stress, diabetes, and infection: Syndemic suffering at an urban Kenyan hospital.

    PubMed

    Mendenhall, Emily; Omondi, Gregory Barnabas; Bosire, Edna; Isaiah, Gitonga; Musau, Abednego; Ndetei, David; Mutiso, Victoria

    2015-12-01

    The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and health problems become syndemic. Increasingly diabetes and other non-communicable diseases (NCDs) are emerging among low-income populations that also are most afflicted by social stress and infection. This article examines how social stress, psychological distress, and physical illness among patients in a public hospital in Nairobi, Kenya, produce syndemic suffering, defined by lived experiences of syndemic clustering such as diabetes with depression and infection. We recruited 100 urban public hospital patients, of which half were women, and half had type 2 diabetes from June to August 2014. We administered written informed consent and collected anthropometrics and blood samples before we conducted lengthy mixed qualitative and survey interviews. We analyzed social stress in narrative interviews using content analysis and evaluated social and physical contributors to mental distress with frequency tables and logistic regression. We found that people experienced diabetes through a complex social and medical framework, where social problems were cause and consequence to psychological and physical suffering. Women's narratives revealed more social suffering as well as more mental distress and somatic symptoms, including multi-morbidities, than men's. People with diabetes reported not only concurrent anxiety and depression but also common infections, including malaria, tuberculosis, and HIV/AIDS. Narratives reveal how NCDs concurrent with infections, and HIV in particular, produce financial challenges for patients, especially when HIV treatment is free and patients must pay out-of-pocket for diabetes care. Future studies should investigate syndemic clustering of infections and NCDs among low-income populations at the population-level. PMID:26476849

  1. Use of combined measures from capillary blood to assess iron deficiency in rural Kenyan children.

    PubMed

    Shell-Duncan, Bettina; McDade, Thomas

    2004-02-01

    Community-based surveys of iron deficiency (ID) require simple, accurate methods that can be used in remote areas. The objective of this study was to assess iron status in rural Kenya using "field-friendly" methods for capillary blood, including an improved dried blood spot assay for transferrin receptor (TfR). A single finger stick was used to obtain capillary blood from 275 school-age children. Whole blood was applied directly to filter paper, dried, and later analyzed for TfR, as well as C-reactive protein (CRP), an acute-phase protein that serves as a general marker of inflammation. Capillary blood was also used to measure hemoglobin (Hb) concentration and the ratio of zinc protoporphyrin to heme (ZPP:H). The Hb concentration alone provides the lowest estimate of the prevalence of ID (8.0%). Because ZPP:H is reported to be elevated in the presence of inflammation, we constructed a preliminary diagnostic model based on elevated ZPP:H and normal CRP level, estimating the prevalence of ID at 25.9%. When TfR is added to a multiple criteria model (elevated ZPP:H in the absence of elevated CRP and/or elevated TfR level) the prevalence of ID is estimated to be 31.2%. This study demonstrates the diagnostic utility of combining TfR with other indexes of iron status, enabling the detection of ID in both the presence and absence of infection. Furthermore, this study is the first field application of TfR blood-spot methods, and it demonstrates their feasibility in remote field settings. PMID:14747676

  2. The Kenyan runners.

    PubMed

    Larsen, H B; Sheel, A W

    2015-12-01

    Today the Kenyan dominance in middle- and long-distance running is so profound that it has no equivalence to any other sport in the world. Critical physiological factors for performance in running include maximal oxygen consumption (VO2max), fractional VO2max utilization and running economy (energetic cost of running). Kenyan and non-Kenyan elite runners seem to be able to reach very high, but similar maximal oxygen uptake levels just as there is some indication that untrained Kenyans and non-Kenyans have a similar VO2max. In addition, the fractional utilization of VO2max seems to be very high but similar in Kenyan and European runners. Similarly, no differences in the proportion of slow muscle fibers have been observed when comparing Kenyan elite runners with their Caucasian counterparts. In contrast, the oxygen cost of running at a given running velocity has been found to be lower in Kenyan elite runners relative to other elite runners and there is some indication that this is due to differences in body dimensions. Pulmonary system limitations have been observed in Kenyan runners in the form of exercise-induced arterial hypoxemia, expiratory flow limitation, and high levels of respiratory muscle work. It appears that Kenyan runners do not possess a pulmonary system that confers a physiological advantage. Additional studies on truly elite Kenyan runners are necessary to understand the underlying physiology which permits extraordinary running performances. PMID:26589124

  3. Correcting for Inflammation Changes Estimates of Iron Deficiency among Rural Kenyan Preschool Children123

    PubMed Central

    Suchdev, Parminder S.; Flores-Ayala, Rafael; Cole, Conrad R.; Ramakrishnan, Usha; Ruth, Laird J.; Martorell, Reynaldo

    2015-01-01

    The assessment of iron status where infections are common is complicated by the effects of inflammation on iron indicators and in this study we compared approaches that adjust for this influence. Blood was collected in 680 children (aged 6–35 mo) and indicators of iron status [(hemoglobin (Hb), zinc protoporphyrin (ZP), ferritin, transferrin receptor (TfR), and TfR/ferritin index)] and subclinical inflammation [(the acute phase proteins (APP) C-reactive protein (CRP), and α-1-acid glycoprotein (AGP)] were determined. Malaria parasitemia was assessed. Subclinical inflammation was defined as CRP >5 mg/L and/or AGP>1 g/L). Four groups were defined based on APP levels: reference (normal CRP and AGP), incubation (raised CRP and normal AGP), early convalescence (raised CRP and AGP), and late convalescence (normal CRP and raised AGP). Correction factors (CF) were estimated as the ratios of geometric means of iron indicators to the reference group of those for each inflammation group. Corrected values of iron indicators within inflammation groups were obtained by multiplying values by their respective group CF. CRP correlated with AGP (r = 0.65; P < 0.001), ferritin (r = 0.38; P < 0.001), Hb (r = −0.27; P < 0.001), and ZP (r = 0.16; P < 0.001); AGP was correlated with ferritin (r = 0.39; P < 0.001), Hb (r = −0.29; P < 0.001), and ZP (r = 0.24; P < 0.001). Use of CF to adjust for inflammation increased the prevalence of ID based on ferritin < 12 µg/L by 34% (from 27 to 41%). Applying the CF strengthened the expected relationship between Hb and ferritin (r = 0.10; P = 0.013 vs. r = 0.20; P < 0.001, before and after adjustment, respectively). Although the use of CF to adjust for inflammation appears indicated, further work is needed to confirm that this approach improves the accuracy of assessment of ID. PMID:22157541

  4. Nevirapine Resistance in Previously Nevirapine-Unexposed HIV-1-Infected Kenyan Infants Initiating Early Antiretroviral Therapy.

    PubMed

    Chohan, Bhavna H; Tapia, Kenneth; Benki-Nugent, Sarah; Khasimwa, Brian; Ngayo, Musa; Maleche-Obimbo, Elizabeth; Wamalwa, Dalton; Overbaugh, Julie; John-Stewart, Grace

    2015-08-01

    Nevirapine (NVP) resistance occurs frequently in infants following NVP use in prevention of mother-to-child transmission (PMTCT) regimens. However, among previously NVP-unexposed infants treated with NVP-antiretroviral therapy (ART), the development and impact of NVP resistance have not been well characterized. In a prospective clinical trial providing early ART to HIV-infected infants <5 months of age in Kenya (OPH03 study), we followed NVP-unexposed infants who initiated NVP-ART for 12 months. Viral loads were assessed and resistance determined using a population-based genotypic resistance assay. Of 99 infants screened, 33 had no prior NVP exposure, 22 of whom were initiated on NVP-ART. Among 19 infants with follow-up, seven (37%) infants developed resistance: one at 3 months and six at 6 months after ART initiation. The cumulative probability of NVP resistance was 5.9% at 3 months and 43.5% at 6 months. Baseline HIV RNA levels (p=0.7) and other characteristics were not associated with developing resistance. Post-ART, higher virus levels at visits preceding the detection of resistance were significantly associated with increased detection of resistance (p=0.004). Virus levels after 6 and 12 months of ART were significantly higher in infants with resistance than those without (p=0.007, p=0.030, respectively). Among infants without previous NVP exposure, development of NVP resistance was frequent and was associated with virologic failure during the first year of ART. Earlier development of NVP resistance in infants than in adults initiating NVP-ART may be due to longer viremia following ART or inadequate NVP levels resulting from NVP lead-in dosing. The development of NVP resistance may, in part, explain the superiority of protease inhibitor-based ART in infants. PMID:25819584

  5. Comparison of indicators of iron deficiency in Kenyan children1–6

    PubMed Central

    Grant, Frederick KE; Martorell, Reynaldo; Flores-Ayala, Rafael; Cole, Conrad R; Ruth, Laird J; Ramakrishnan, Usha; Suchdev, Parminder S

    2015-01-01

    Background In the absence of a feasible, noninvasive gold standard, iron deficiency (ID) is best measured by the use of multiple indicators. However, the choice of an appropriate single iron biomarker to replace the multiple-criteria model for screening for ID at the population level continues to be debated. Objective We compared ID defined as ≥2 of 3 abnormal ferritin (<12 μg/L), soluble transferrin receptor (TfR; >8.3 mg/L), or zinc protoporphyrin (ZP; >80 μmol/mol) concentrations (ie, multiple-criteria model) with ID defined by abnormal concentrations of any of the independent candidate iron biomarkers (ferritin alone, TfR alone, or ZP alone) and TfR/ferritin index (ID, >500). Values either were adjusted for inflammation [as measured by C-reactive protein (>5 mg/L) and α1-acid glycoprotein (>1 g/L) before applying cutoffs for ID] or were unadjusted. Design In this community-based cluster survey, capillary blood was obtained from 680 children (aged 6–35 mo) for measurement of iron status by using ferritin, TfR, and ZP. Results On the basis of the multiple-criteria model, the mean (±SE) prevalence of ID was 61.9 ± 2.2%, whereas the prevalences based on abnormal ferritin, TfR, or ZP concentrations or an abnormal TfR/ferritin index were 26.9 ± 1.7%, 60.9 ± 2.2%, 82.8 ± 1.6%, and 43.1 ± 2.3%, respectively, for unadjusted values. The prevalences of ID were higher for adjusted values only for low ferritin and an elevated TfR/ferritin index compared with the unadjusted values. The κ statistics for agreement between the multiple-criteria model and the other iron indicators ranged from 0.35 to 0.88; TfR had the best agreement (κ = 0.88) with the multiple-criteria model. Positive predictive values of ID based on the other iron indicators in predicting ID based on the multiple-criteria model were highest for ferritin and TfR. Receiver operating characteristic curve analysis indicated that TfR (AUC = 0.94) was superior to the other indicators in diagnosing ID

  6. Prevalence of enteropathogens in stools of rural Maasai children under five years of age in the Maasailand region of the Kenyan Rift Valley.

    PubMed

    Joyce, T; McGuigan, K G; Elmore-Meegan, M; Conroy, R M

    1996-01-01

    Stool samples were collected during August 1994 from seventy rural Maasai children under the age of five years who were living in the Maasailand region of the Kenyan Rift Valley. Microbiological analysis was carried out on these samples to identify which intestinal pathogens were present among the infant population of the Maasai. Of the samples studied 54% were pathogen positive. The most common pathogen isolated was Giardia lamblia which was detected in 31% of the samples. Other pathogens that were detected include: Entamoeba histolytica (23%), Enteropathogenic Escherichia coli (13%), Strongyloides stercoralis (4%), Blastocystis hominis (3%) and Cryptosporidium sp (3%). Although all samples were screened for Campylobacter and rotavirus, neither pathogen was detected. Water samples were taken from all the water sources in the study area and analysed microbiologically. Results showed that all the sources were contaminated with the faecal E. coli whose populations ranged from 14 CFU/100 ml to greater than 1800 CFU/100ml. PMID:8625866

  7. Factors influencing survival among Kenyan children diagnosed with endemic Burkitt lymphoma between 2003 and 2011: A historical cohort study.

    PubMed

    Buckle, Geoffrey; Maranda, Louise; Skiles, Jodi; Ong'echa, John Michael; Foley, Joslyn; Epstein, Mara; Vik, Terry A; Schroeder, Andrew; Lemberger, Jennifer; Rosmarin, Alan; Remick, Scot C; Bailey, Jeffrey A; Vulule, John; Otieno, Juliana A; Moormann, Ann M

    2016-09-15

    Discovering how to improve survival and establishing clinical reference points for children diagnosed with endemic Burkitt lymphoma (eBL) in resource-constrained settings has recaptured international attention. Using multivariate analyses, we evaluated 428 children with eBL in Kenya for age, gender, tumor stage, nutritional status, hemoglobin, lactate dehydrogenase (LDH), Epstein-Barr virus (EBV) and Plasmodium falciparum prior to induction of chemotherapy (cyclophosphamide, vincristine, methotrexate and doxorubicin) to identify predictive and prognostic biomarkers of survival. During this 10 year prospective study period, 22% died in-hospital and 78% completed six-courses of chemotherapy. Of those, 16% relapsed or died later; 31% achieved event-free-survival; and 31% were lost to follow-up; the overall one-year survival was 45%. After adjusting for covariates, low hemoglobin (<8 g/dL) and high LDH (>400 mU/ml) were associated with increased risk of death (adjusted Hazard Ratio (aHR) = 1.57 [0.97-2.41]) and aHR = 1.84, [0.91-3.69], respectively). Anemic children with malaria were 3.55 times more likely to die [1.10-11.44] compared to patients without anemia or malarial infection. EBV load did not differ by tumor stage nor was it associated with survival. System-level factors can also contribute to poor outcomes. Children were more likely to die when inadvertently overdosed by more than 115% of the correct dose of cyclophosphamide (a HR = 1.43 [0.84-2.43]) or doxorubicin (a HR = 1.25, [0.66-2.35]), compared with those receiving accurate doses of the respective agent in this setting. This study codifies risk factors associated with poor outcomes for eBL patients in Africa and provides a benchmark by which to assess improvements in survival for new chemotherapeutic approaches. PMID:27136063

  8. Urinary tract infection in children.

    PubMed Central

    McKerrow, W; Davidson-Lamb, N; Jones, P F

    1984-01-01

    During 1968-77, 572 consecutive children with one or more positive urine cultures who were referred by their family doctors to one paediatric surgical outpatient clinic were investigated and prospectively recorded. An abnormality requiring treatment was found in 45%. The yield of positive findings and need for operation were greater in those referred after one infection than in those with recurrent infection. Among those under 2 years old 90% had an abnormality. One third of children with vesicoureteric reflux showed renal scarring at the time of first attendance. The results of medical and surgical treatment over five to 15 years of follow up were analysed. They emphasised the importance of culturing the urine whenever there may be urinary infection in a child and of investigating immediately those with a positive urine culture. PMID:6430447

  9. A study of the efficacy and safety of albendazole (Zentel) in the treatment of intestinal helmenthiasis in Kenyan children less than 2 years of age.

    PubMed

    Pamba, H O; Bwibo, N O; Chunge, C N; Estambale, B B

    1989-03-01

    One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index. PMID:2591328

  10. Serum adiponectin in HIV-1 and hepatitis C virus mono- and co-infected Kenyan injection drug users

    PubMed Central

    Ndombi, Eric M; Budambula, Valentine; Webale, Mark K; Musumba, Francis O; Wesongah, Jesca O; Mibei, Erick; Ahmed, Aabid A; Lihana, Raphael; Were, Tom

    2015-01-01

    Adiponectin is an important marker of anthropometric profiles of adipose tissue. However, association of adiponectin and adiposity in HIV mono- and co-infected and hepatitis (HCV) injection drug users (IDUs) has not been elucidated. Therefore, the relationship of total adiponectin levels with anthropometric indices of adiposity was examined in HIV mono-infected (anti-retroviral treatment, ART-naive, n=16 and -experienced, n=34); HCV mono-infected, n=36; HIV and HCV co-infected (ART-naive, n=5 and -experienced, n=13); uninfected, n=19 IDUs; and healthy controls, n=16 from coastal Kenya. Anthropometric indices of adiposity were recorded and total circulating adiponectin levels were measured in serum samples using enzyme-linked immunosorbent assay. Adiponectin levels differed significantly amongst the study groups (P<0.0001). Post-hoc analyses revealed decreased levels in HIV mono-infected ART-naive IDUs in comparison to uninfected IDUs (P<0.05) and healthy controls (P<0.05). However, adiponectin levels were elevated in HCV mono-infected IDUs relative to HIV mono-infected ART-naive (P<0.001) and -experienced (P<0.001) as well as HIV and HCV co-infected ART-naive (P<0.05) IDUs. Furthermore, adiponectin correlated with weight (ρ=0.687; P=0.003) and BMI (ρ=0.598; P=0.014) in HIV mono-infected ART-naive IDUs; waist circumference (ρ=−0.626; P<0.0001), hip (ρ=−0.561; P=0.001) circumference, and bust-to-waist ratio (ρ=0.561; P=0.001) in HIV mono-infected ART-experienced IDUs; waist girth (ρ=0.375; P=0.024) in HCV mono-infected IDUs; and waist-to-hip ratio (ρ=−0.872; P=0.048) in HIV and HCV co-infected ART-naive IDUs. Altogether, these results suggest suppression of adiponectin production in treatment-naive HIV mono-infected IDUs and that circulating adiponectin is a useful surrogate marker of altered adiposity in treatment-naive and -experienced HIV and HCV mono- and co-infected IDUs. PMID:26306727

  11. The effect of sucrose on plaque pH in the primary and permanent dentition of caries-inactive and -active Kenyan children.

    PubMed

    Fejerskov, O; Scheie, A A; Manji, F

    1992-01-01

    The hypothesis that the Stephan pH responses of dental plaque would be different in caries-active and -inactive individuals was tested in 20 seven-year-old and 19 14-year-old Kenyan children. In each age group, half the children had greater than or equal to 2 dentin cavities; the other half had no such lesions. With a palladium-touch microelectrode, interdental plaque pH was monitored between m1/m2 in each quadrant in the primary dentition and in the four molar/premolar regions in the permanent dentition. pH was also monitored in caries cavities in the occlusal surfaces of lower first molars and on the tongue. pH was measured before and up to 60 min after the children rinsed with 10 mL of 10% sucrose. Caries status of the individual was unrelated to plaque pH in comparable non-carious sites in both of the age groups. The pH minimum in the maxilla was about 0.5 pH units lower than that in the mandible. Active occlusal caries lesions had a resting pH value of about 5.5, about 1 pH unit lower than that of sound surfaces. The pH dropped to about 4.5 in caries lesions and recovered slowly. In sound occlusal sites, a pH drop to about 6.0 was followed by a relatively rapid return to the resting value. Thus, when the mean values were considered, the classic Stephan curve response was evident. However, when the pH changes at single sites were considered at various time intervals, a substantial, erratic fluctuation was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1740552

  12. Anaerobic Infections in Children with Neurological Impairments.

    ERIC Educational Resources Information Center

    Brook, Itzhak

    1995-01-01

    Children with neurological impairments are prone to develop serious infection with anaerobic bacteria. The most common anaerobic infections are decubitus ulcers; gastrostomy site wound infections; pulmonary infections (aspiration pneumonia, lung abscesses, and tracheitis); and chronic suppurative otitis media. The unique microbiology of each of…

  13. Fusobacterial head and neck infections in children.

    PubMed

    Brook, Itzhak

    2015-07-01

    Fusobacterium species are increasingly recognized as a cause of head and neck infections in children. These infections include acute and chronic otitis, sinusitis, mastoiditis, and tonsillitis; peritonsillar and retropharyngeal abscesses; Lemierre syndrome; post-anginal cervical lymphadenitis; and periodontitis. They can also be involved in brain abscess and bacteremia associated with head and neck infections. This review describes the clinical spectrum of head and neck fusobacterial infection in children and their management. PMID:25980688

  14. Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections.

    PubMed

    Chersich, M F; Luchters, S M F; Malonza, I M; Mwarogo, P; King'ola, N; Temmerman, M

    2007-11-01

    This study examined patterns of alcohol use and its association with unsafe sex and related sequelae among female sex workers in Mombasa, Kenya. A community-based cross-sectional study was conducted using snowball sampling. Binge drinkers (> or =5 alcoholic drinks on > or =1 occasion in the previous month) were compared with non-binge drinkers. Of 719 participants, 22.4% were lifetime-alcohol abstainers, 44.7% non-binge and 33.0% binge drinkers. Compared with non-binge drinkers, binge drinkers were more likely to report unprotected sex (adjusted odds ratio (AOR)=1.59, 95% confidence interval [CI]=1.00-2.53; P=0.047) and sexual violence (AOR=1.85, 95% CI=1.27-2.71; P=0.001) and to have either syphilis, Neisseria gonorrhoeae or Trichomonas vaginalis infection (AOR=1.56, 95% CI=1.00-2.41; P=0.048). HIV prevalence was higher among women having ever drunk (39.9%) than lifetime abstainers (23.2%; P<0.001), but was not associated with drinking patterns. Interventions are needed to assist female sex workers adopt safer drinking patterns. Investigation is needed for the effectiveness of such interventions in reducing unprotected sex, sexual violence and sexually transmitted infections. PMID:18005511

  15. Imaging in acute renal infection in children

    SciTech Connect

    Sty, J.R.; Wells, R.G.; Starshak, R.J.; Schroeder, B.A.

    1987-03-01

    Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc-glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor.

  16. Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children.

    PubMed

    Newton, V E; Macharia, I; Mugwe, P; Ototo, B; Kan, S W

    2001-03-01

    In developing countries, there is a lack of trained personnel and testing equipment to facilitate the early detection of hearing impairment in children. A questionnaire offers a low cost option and the value of this for detecting hearing impairment in pre-school children was determined in several districts in Kenya. The questionnaire was completed by either teachers, parents/carers or community nurses. The children were subsequently tested using pure tone audiometry and visual examination of the ear by ENT Clinical Officers, who were not given prior access to the results of the questionnaire. A total of 757 (88%) questionnaires were completed. Of the 735 children, who could be tested using pure tone audiometry, four were found to have a unilateral hearing impairment and one was detected by the questionnaire. A total of 13 children had a bilateral hearing impairment >40 dB HL. All were detected using the questionnaire. There were eight males and five females with ages ranging from 4.2 to 6.9 years, mean age 5.7 years and median age 5.8 years. Eight had a sensorineural hearing impairment and two a mixed hearing impairment. Three of the children with a sensorineural hearing loss had a family history of hearing impairment. No question detected all children with a hearing impairment and some questions were more discerning than others. There was 100% sensitivity for the questionnaire when a hearing loss of >40 dB was considered, but specificity was lower at 75%. Negative predictive value was 100%, but the positive predictive value was low, 6.75%. It was concluded that a questionnaire of this nature could be usefully applied at Primary Health Care level for detecting hearing impairment at the pre-school stage. There would be need for services available for diagnosis, treatment and habilitation before a screening programme was introduced. PMID:11223455

  17. Red blood cell complement receptor one level varies with Knops blood group, α+thalassaemia and age among Kenyan children

    PubMed Central

    Opi, D H; Uyoga, S; Orori, E N; Williams, T N; Rowe, J A

    2016-01-01

    Both the invasion of red blood cells (RBCs) by Plasmodium falciparum parasites and the sequestration of parasite-infected RBCs in the microvasculature are mediated in part by complement receptor one (CR1). RBC surface CR1 level can vary between individuals by more than 20-fold and may be associated with the risk of severe malaria. The factors that influence RBC CR1 level variation are poorly understood, particularly in African populations. We studied 3535 child residents of a malaria-endemic region of coastal Kenya and report, for the first time, that the CR1 Knops blood group alleles Sl2 and McCb, and homozygous HbSS are positively associated with RBC CR1 level. Sickle cell trait and ABO blood group did not influence RBC CR1 level. We also confirm the previous observation that α+thalassaemia is associated with reduced RBC CR1 level, possibly due to small RBC volume, and that age-related changes in RBC CR1 expression occur throughout childhood. RBC CR1 level in malaria-endemic African populations is a complex phenotype influenced by multiple factors that should be taken into account in the design and interpretation of future studies on CR1 and malaria susceptibility. PMID:26844958

  18. Oral Human Papillomavirus Infection in Children.

    PubMed

    Ilea, Aranka; Boşca, Bianca; Miclăuş, Viorel; Rus, Vasile; Băbţan, Anida Maria; Mesaros, Anca; Crişan, Bogdan; Câmpian, Radu Septimiu

    2016-02-01

    Oral human papillomavirus infection is rare in children, but the presence of a villous lesion with slow but continuous growth concerns parents, who need information and therapeutic solutions from the physician. All these aspects are discussed based on a case report of a 9-year-old child with an oral human papillomavirus infection. PMID:26588443

  19. [Associated infections in acute bronchopulmonary infections in children].

    PubMed

    Lykova, E A; Vorob'ev, A A; Bokovoĭ, A G; Karazhas, N V; Evseeva, L F

    2003-01-01

    A total of 189 children with bacterial complications of the acute respiratory viral infection (ARVI)--primarily with pneumonia and bronchitis--were dynamically examined for typical and atypical pneumotropic causative agents of the infection process (Mycoplasma pneumoniae, Chlamydia spp., Streptococcus pneumoniae, Haemophilus influenzae, Pneumocystis carini, and Citomegalovirus). A high frequency rate of the associative infection involving mycoplasmas and pneumocysts was registered (45-50%); it was lower in the cases involving Chlamydias, hemophilic bacteria, pneumococcus, and cytomegalovirus--up to 25-30%. No sharp difference was found between the indices of an infection degree and those of an active clinical infectious process involving the same pneumotropic agent: the biggest difference was observed in Chlamydia infections (9.4%) and the lowest one--in mycoplasma infections (3%). A dynamic comparison of different classes of immunoglobulins revealed that, in acute bronchitis and pneumonias, the Chlamydia and cytomegalovirus infections are, primarily, of the persistent nature; the hemophilic and pneumocystic infections are of a mixed nature; and the pneumococcus one is of the acute nature. The Mycoplasma infection, which is more often encountered in pre-school children, is of the primary type with a trend towards a prolonged clinical course. All pneumonias had a typical clinical course; the clinical picture was compared in 128 patients with the etiological factor (including a description of characteristic symptoms). PMID:12861708

  20. Travel-related infections in children.

    PubMed

    Fox, Thomas G; Manaloor, John J; Christenson, John C

    2013-04-01

    Malaria, diarrhea, respiratory infections, and cutaneous larva migrans are common travel-related infections observed in children and adolescents returning from trips to developing countries. Children visiting friends and relatives are at the highest risk because few visit travel clinics before travel, their stays are longer, and the sites they visit are more rural. Clinicians must be able to prepare their pediatric-age travelers before departure with preventive education, prophylactic and self-treating medications, and vaccinations. Familiarity with the clinical manifestations and treatment of travel-related infections will secure prompt and effective therapy. PMID:23481114

  1. Burden of HIV Infection Among Children Aged 18 Months to 14 Years in Kenya: Results From a Nationally Representative Population-Based Cross-sectional Survey

    PubMed Central

    Ng’eno, Bernadette; Mwangi, Ann; Ng’ang’a, Lucy; Kim, Andrea A.; Waruru, Anthony; Mukui, Irene; Ngugi, Evelyn W.; Rutherford, George W.

    2016-01-01

    Backgrounds In Kenya, mathematical models estimate that there are approximately 220,000 children aged less than 15 years infected with HIV. We analyzed data from the second Kenya AIDS Indicator Survey (KAIS 2012) to estimate the prevalence of HIV infection among children aged 18 months to 14 years. Methods KAIS 2012 was a nationally representative 2-stage cluster sample household survey. We studied children aged 18 months to 14 years whose parents or guardians answered questions pertaining to their children by interview. Blood specimens were collected for HIV serology and viral load measurement. Results We identified 5162 children who were eligible for the study. Blood was obtained for 3681 (71.3%) children. Among child participants, 16.4% had been tested for HIV infection in the past, and among children with parents or guardians who self-reported HIV-positive status, 52.9% had been tested for HIV infection. Twenty-eight (0.9%) children tested HIV-positive in the survey. Of these, 11 had been previously diagnosed with HIV infection before the survey. All 11 children were in HIV care and receiving cotrimoxazole; 8 were on antiretorivral therapy (ART). Among those on ART, 4 were virologically suppressed. Conclusions HIV causes a substantial burden of disease in the Kenyan pediatric population. Although most children who had been diagnosed with HIV before the survey were engaged in care and treatment, they represented less than half of HIV-infected children identified in the survey. Future efforts should focus on identifying infected children and getting them into care and on suppressive ART as early as possible. PMID:24732823

  2. Consequences of Helicobacter pylori infection in children

    PubMed Central

    Pacifico, Lucia; Anania, Caterina; Osborn, John F; Ferraro, Flavia; Chiesa, Claudio

    2010-01-01

    Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent abdominal pain, chronic idiopathic thrombocytopenia, and poor growth. There is evidence of the role of H. pylori in childhood iron deficiency anemia, but the results are not conclusive. The possibility of an inverse relationship between H. pylori and gastroesophageal reflux disease, as well as childhood asthma, remains a controversial question. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. PMID:21049552

  3. Removal of deciduous canine tooth buds in Kenyan rural Maasai.

    PubMed

    Hassanali, J; Amwayi, P; Muriithi, A

    1995-04-01

    The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase. PMID:7621751

  4. Acute Respiratory Infections in Children

    PubMed Central

    Laxdal, O. E.; Evans, G. E.; Braaten, V.; Robertson, H. E.

    1964-01-01

    A new polyvalent respiratory virus vaccine has been evaluated in a double-blind trial involving infants and children. Five hundred and sixteen healthy infants and children were given either nine-strain polyvalent respiratory virus vaccine or placebo. The vaccine contained four Influenza strains, three Adenovirus strains and two Parainfluenza strains. Serologic studies revealed that persistent protective antibody levels were achieved with only the Asian Influenza component. The children were followed up clinically for a one-year period and each respiratory illness was recorded. No protection appeared to have been conferred by the vaccine, and indeed a significantly greater number of respiratory illnesses occurred among the vaccinated group. PMID:14105010

  5. Clostridial Infections in Children: Spectrum and Management.

    PubMed

    Brook, Itzhak

    2015-11-01

    Clostridia can cause unique histotoxic syndromes produced by specific toxins (e.g., gas gangrene and food poisoning) as well as non-syndromic infections (e.g., abscess, local infections, and blood born infection). Clostridia can also be recovered from various body sites as part of polymicrobial aerobic-anaerobic infection. These include intra-abdominal (peritonitis and abscess), biliary tract, female genital tract, abscess (rectal area and oropharyngeal), pleuropulmonary, central nervous system, and skin and soft-tissue infections. Clostridia were recovered from children with bacteremia of gastrointestinal origin, necrotizing enterocolitis, and sickle cell disease. They have also been isolated in acute and chronic otitis media, chronic sinusitis and mastoiditis, peritonsillar abscesses, and neonatal conjunctivitis. Early and aggressive surgical debridement, decompression, and drainage of affected tissues are critical to successful outcome of histotoxic infections. Effective antimicrobials include penicillin, clindamycin, chloramphenicol, third-generation cephalosporins, carbapenems, and vancomycin. PMID:26431956

  6. Cryptococcal Disease in HIV-Infected Children.

    PubMed

    Kao, Carol; Goldman, David L

    2016-09-01

    Cryptococcus neoformans is an encapsulated fungal pathogen that is remarkable for its tendency to cause meningoencephalitis, especially in patients with AIDS. While disease is less common in children than adults, it remains an important cause of morbidity and mortality among HIV-infected children without access to anti-retroviral therapy. This review highlights recent insights into both the biology and treatment of cryptococcosis with a special emphasis on the pediatric literature. PMID:27443557

  7. [Tuberculosis infection and disease in immigrant children].

    PubMed

    Giacchino, Raffaella; di Martino, Lucio; Losurdo, Giuseppe; Pisanti, Antonello

    2003-06-01

    From the second half of the eighties, the cases of tuberculosis (TBC) in Italy have been constantly increasing. The increase in TBC cases in developed countries is related to different factors, including HIV epidemic and increased number of immigrants from countries with high TBC incidence and important socio-economic problems. Compared with adults few children with TBC were homeless or coinfected with HIV, nonetheless the children lived frequently in low socioeconomic status and consequently high risk of being uninsured and with adults at risk for tuberculosis (immediate relative, household members, or recently immigrated). An epidemiologic study was carried out, in order to evaluate the impact of TBC infection in immigrant children. From January 2001 to December 2002, Mantoux test (5 IU) was performed in immigrant children hospitalized or followed in two children hospitals. They included 228 children: mean age 4 years (range 1 month to 15 years). The patients came from: South America (44%) (especially from Ecuador), from Africa (20%), from Eastern Europe (19%), (especially from Middle East and North Africa), from Far East (17%). In 30 cases (13,2%) Mantoux test was positive. Among these latter, 21 presented latent infection, whereas another 9 had tuberculous disease with pulmonary localization and one of them associated with cervical adenopathy. In the study period, among all children (4426) admitted the two Units, the prevalence of tuberculous disease was 2,5% in immigrant children compared 0.2% in native children. Accurate epidemiologic monitoring, further clinical studies aimed at highlighting TBC peculiar aspects in children, and adequate therapy can lead to TBC control in the immigrant children. PMID:15020852

  8. Human papillomavirus infections in nonsexually active perinatally HIV infected children.

    PubMed

    Moscicki, Anna-Barbara; Puga, Ana; Farhat, Sepideh; Ma, Yifei

    2014-02-01

    Although human papillomavirus (HPV) infections are common in HIV-infected adults, little is known about children. Our objective was to examine the prevalence of and risks for HPV of the oral mucosal and external genital areas in nonsexually active (NSA) perinatally (P) HIV+ children and compare with HIV-exposed but uninfected (HEU) children. A convenience sample attending a pediatric clinic were enrolled. Samples for HPV were obtained from the oral and anogenital areas and tested for one of 37 HPV types. The mean age of the 48 PHIV+ children was 14.3±3.9 years vs. 6.2±4.8 for the 52 HEU (p<0.001). Of the 23 PHIV+ girls, 30.4% had anogenital and 17% had oral HPV, and of the 27 HEU girls, 2 (7.4%) anogenital and 0 had oral HPV. Of the boys, 4/23 (17.4%) and 1/25 (4%) PHIV+ had anogenital and oral HPV, respectively, and 3/24 (12.5%) and 1/25 (4%) HEU had anogenital and oral HPV, respectively. Rates of HPV did not differ by age among the PHIV+, whereas older HEU were more likely to have HPV than younger HEU (p=0.07). This large age gap precluded statistical comparison by HIV status. The presence of HPV in NSA PHIV+ children may have implications regarding HPV vaccination efficacy. PMID:24460009

  9. Immunocompromised Children with Severe Adenoviral Respiratory Infection

    PubMed Central

    Tylka, Joanna C.; McCrory, Michael C.; Gertz, Shira J.; Custer, Jason W.; Spaeder, Michael C.

    2016-01-01

    Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children's hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p = 0.015), multiple organ dysfunction syndrome (p = 0.001), requirement of renal replacement therapy (p = 0.01), ICU admission severity of illness score (p = 0.011), and treatment with cidofovir (p = 0.005). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p = 0.01), require renal replacement therapy (p = 0.02), and not survive to hospital discharge (p = 0.004). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children. PMID:27242924

  10. Ear Infections in Autistic and Normal Children. Brief Report.

    ERIC Educational Resources Information Center

    Konstantareas, M. Mary; Homatidis, Soula

    1987-01-01

    Evaluation of the frequency of ear infections, ear tube drainage, and deafness for 51 autistic children (ages 2-18) indicated that autistic children had a greater incidence of ear infections than matched normal peers and lower functioning children had an earlier onset of ear infections than higher functioning autistic peers. (Author)

  11. [Virological diagnosis of HIV infection in children].

    PubMed

    Muñoz Fernández, M A

    1998-01-01

    The laboratory diagnosis of HIV-1 infection in newborns should be carried out using virological methods, viral isolation or molecular methods for the detection of proviral DNA by PCR. Serological methods have poor sensitivity in the first months of life because the IgG of the seropositive mother crosses the placenta. Once HIV-1 infection is diagnosed, other assays are available which indicate the clinical progression of the infection, the genetic variability of the virus, its biological behavior and sensitivity to different antiretroviral medications. These studies can be used independently of the clinical manifestations in order to assess disease progression. Different immunological markers and virological markers of disease progression have been described, but the CD4+ T lymphocyte count is used routinely as an immunological marker and as a virological marker of the virus load. In HIV-1 newborns and children, the largest decrease in the number of CD4+ T lymphocytes is due to the combined effect of infection progression and a natural decrease in CD4+ T lymphocytes with age. In newborns, low viral load levels suggest that the infection was acquired shortly before birth or that maternal and/or placental factors inhibited viral replication before birth, or that the child was infected at birth. In children, viral loads are greater than in adult patients during the primary infection and throughout their evolution. Because of advances in the treatment of HIV-1 infection, the study of resistance to antiretroviral agents by phenotypical and genotypical methods is important. Increased viral load suggests the loss of effectiveness of a treatment and should be monitored. PMID:9675394

  12. Maize porridge enriched with a micronutrient powder containing low-dose iron as NaFeEDTA but not amaranth grain flour reduces anemia and iron deficiency in Kenyan preschool children.

    PubMed

    Macharia-Mutie, Catherine W; Moretti, Diego; Van den Briel, Natalie; Omusundi, Agnes M; Mwangi, Alice M; Kok, Frans J; Zimmermann, Michael B; Brouwer, Inge D

    2012-09-01

    Few studies have evaluated the impact of fortification with iron-rich foods such as amaranth grain and multi-micronutrient powder (MNP) containing low doses of highly bioavailable iron to control iron deficiency anemia (IDA) in children. We assessed the efficacy of maize porridge enriched with amaranth grain or MNP to reduce IDA in Kenyan preschool children. In a 16-wk intervention trial, children (n = 279; 12-59 mo) were randomly assigned to: unrefined maize porridge (control; 4.1 mg of iron/meal; phytate:iron molar ratio 5:1); unrefined maize (30%) and amaranth grain (70%) porridge (amaranth group; 23 mg of iron/meal; phytate:iron molar ratio 3:1); or unrefined maize porridge with MNP (MNP group; 6.6 mg iron/meal; phytate:iron molar ratio 2.6:1; 2.5 mg iron as NaFeEDTA). Primary outcomes were anemia and iron status with treatment effects estimated relative to control. At baseline, 38% were anemic and 30% iron deficient. Consumption of MNP reduced the prevalence of anemia [-46% (95% CI: -67, -12)], iron deficiency [-70% (95% CI: -89, -16)], and IDA [-75% (95% CI: -92, -20)]. The soluble transferrin receptor [-10% (95% CI: -16, -4)] concentration was lower, whereas the hemoglobin (Hb) [2.7 g/L (95% CI: 0.4, 5.1)] and plasma ferritin [40% (95% CI: 10, 95)] concentrations increased in the MNP group. There was no significant change in Hb or iron status in the amaranth group. Consumption of maize porridge fortified with low-dose, highly bioavailable iron MNP can reduce the prevalence of IDA in preschool children. In contrast, fortification with amaranth grain did not improve iron status despite a large increase in iron intake, likely due to high ratio of phytic acid:iron in the meal. PMID:22810982

  13. Infections Associated with Streptococcus intermedius in Children.

    PubMed

    Faden, Howard S

    2016-09-01

    Streptococcus intermedius is a viridans Streptococcus belonging to the Anginosus group. In the past 7 years, it has been associated with abscesses in 48 children, 40% of whom had complicated and/or life-threatening illness. It was the sole pathogen in 35 cases. Seventy-five percent of the infections occurred in winter and spring. None occurred in infants younger than 1 year. PMID:27294306

  14. Spinal infections in children: A review.

    PubMed

    Tyagi, Rahul

    2016-12-01

    Spinal infections are uncommon but significant causes of morbidity and hospitalization in the paediatric population. These infections encompass a broad range of conditions, from discitis to osteomyelitis and spinal epidural and intramedullary abscesses. Paediatric spinal infections can be caused by a range of bacterial, viral, fungal and parasitic agents. Ultrastructural differences of the vertebrae and associated structures result in distinct mechanisms of pathogenesis of spinal infections in children compared to adults. The non-specific nature of symptoms produced by them can cause considerable diagnostic delays. Magnetic Resonance (MR) imaging can facilitate early identification of the disease, and distinguish it from other spinal pathologies. The association of antimicrobial resistant bacterial strains from some of the cases appears worrisome; as is the increasing incidence of Kingella kingae infections causing spinal infections. Rest and immobilization are the general treatment, and prompt initiation of antimicrobial therapy is warranted to ensure optimal clinical outcome. Most patients generally have a good prognosis; however, early identification and prompt initiation of antimicrobial therapy is essential to achieve the best therapeutic response. PMID:27408498

  15. Characteristics of mild dengue virus infection in Thai children.

    PubMed

    Yoon, In-Kyu; Srikiatkhachorn, Anon; Hermann, Laura; Buddhari, Darunee; Scott, Thomas W; Jarman, Richard G; Aldstadt, Jared; Nisalak, Ananda; Thammapalo, Suwich; Bhoomiboonchoo, Piraya; Mammen, Mammen P; Green, Sharone; Gibbons, Robert V; Endy, Timothy P; Rothman, Alan L

    2013-12-01

    A four-year longitudinal cohort and geographic cluster study in rural Thailand was conducted to characterize the clinical spectrum of dengue virus (DENV) infection. Symptomatic DENV infections in the cohort were detected by active school absence-based surveillance that triggered cluster investigations around ill cohort children. Data from 189 cohort children with symptomatic DENV infection and 126 contact children in the clusters with DENV infection were analyzed. Of infected contacts, only 19% were asymptomatic; 81% were symptomatic, but only 65.9% reported fever. Symptom-based case definitions were unreliable for diagnosis. Symptomatic infections in contacts were milder with lower DENV RNA levels than the cohort. Infections in contacts with fever history were more likely to have detectable DENV RNA than infections without fever history. Mild infections identified by cluster investigations account for a major proportion of all DENV infections. These findings are relevant for disease burden assessments, transmission modeling, and determination of vaccine impact. PMID:24127167

  16. [Secrecy in children with HIV infection].

    PubMed

    Champion, M; Lefebvre Des Noëttes, A; Taboulet, P; Lemerle, S

    1999-10-01

    The secrecy surrounding the disease of parents and children infected with HIV leads to psychic and affective isolation and difficulties of communication within the family. Psychological management may possibly help to resolve the problem of secrecy between parents and children. We analyzed the organization and dynamics of the secret surrounding children contaminated by their mothers. The analysis was prospective and was based on semi-directive interviews and drawings. We followed up, over a period of two years, ten children (mean age: 4 years, range: 4 months to 12 years) with different ethnic and socio economic backgrounds. In each family, the child was the target of the secret, the pediatrician the guardian, and the mother (or her substitute) the keeper. The organization of the secret around the other potential guardians varied from one family to another. Two modes of intra-family communication were observed: the secret (reserved for the youngest children) and the tacit. One child suffered from a disorder related to the secret, the others had depressive and reactional symptoms. At the end of the study, the manner of approaching, and especially dealing with, the question of the secret had changed appreciably in each family: disclosure to the family circle (three cases), passage of the child from the secret to the tacit (two cases), and easier questioning of the pediatrician in all of the cases. Nonetheless, in no case had the secret been completely lifted for the child. Four children asked to continue psychological management. The changes in the dynamics of the secret and the appeasement observed in the families suggest that psychotherapeutic aid should be offered to families where a child has been contaminated with HIV by the mother. PMID:10544788

  17. Management of Developmentally Disabled Children with Chronic Infections.

    ERIC Educational Resources Information Center

    Andersen, Richard D.

    1988-01-01

    The nature of chronic infections in developmentally disabled children is reviewed, along with appropriate management strategies for care providers and implications for other children. Discussed are herpes simplex virus, cytomegalovirus, hepatitis B virus, and human immunodeficiency virus. (Author/JDD)

  18. Prevalence of urinary tract infection in severely malnourished preschool children.

    PubMed

    Banapurmath, C R; Jayamony, S

    1994-06-01

    Eighty eight severely malnourished preschool children (Grade III or Grade IV, IAP classification) were studied to find out the prevalence of urinary tract infection (UTI). Fifty three well nourished preschool children served as controls. Urine samples were collected by suprapubic aspiration in children below 3 years and in older children a clean catch midstream sample of urine was collected. The urine samples were subjected to direct microscopic examination, Gram's stain and culture. UTI was detected in 7 (8%) of the 88 malnourished children. Besides UTI, the other associated infections included respiratory tract infection (31.8%), diarrhea (27.2%) and tuberculous meningitis (12.7%). PMID:7896393

  19. Anaerobic infections in children: a prospective survey.

    PubMed Central

    Thirumoorthi, M C; Keen, B M; Dajani, A S

    1976-01-01

    Over an 18-month period, cultures from 95 infants and children yielded 146 anaerobic organisms in 110 clinical specimens. Bacteroides was the most frequently isolated anaerobe, followed by Propionibacterium and Clostridium species. Intra-abdominal sources, soft tissues, and blood were the three major sources (82%) of isolation of anaerobes. Whereas most patients (58%) were over 5 years of age and only 11% were newborns, anaerobic infections constituted a rather uniform proportion of all infections, regardless of sources, in all age groups. Anaerobes accounted for only 2.9% of all positive cultures encountered from the various sources. Rates of recovery of anaerobes from intra-abdominal sources were significantly the highest, and from soft-tissue infections they were significantly the lowest. The anaerobic bacteremias observed were of no clinical significance when Propionibacterium species were isolated; however, recovery of other anaerobes from the blood, and primarily Bacteroides species, was usually associated with clinical disease. Except in blood cultures, anaerobes almost invariably coexisted with facultative bacteria. PMID:1270594

  20. Entamoeba moshkovskii Infections in Children in Bangladesh

    PubMed Central

    Ali, Ibne Karin M.; Hossain, Mohammad Bakhtiar; Roy, Shantanu; Ayeh-Kumi, Patrick F.; Petri, William A.; Haque, Rashidul

    2003-01-01

    Entamoeba moshkovskii cysts are morphologically indistinguishable from those of the disease-causing species E. histolytica and the nonpathogenic E. dispar. Although sporadic cases of human infection with E. moshkovskii have been reported, the organism is considered primarily a free-living ameba. No simple molecular detection tool is available for diagnosing E. moshkovskii infections. We used polymerase chain reaction (PCR) to detect E. moshkovskii directly in stool. We tested 109 stool specimens from preschool children in Bangladesh by PCR; 17 were positive for E. histolytica (15.6%) and 39 were positive for E. dispar (35.8%). In addition, we found that 23 (21.1%) were positive for E. moshkovskii infection, and 17 (73.9%) of these also carried E. histolytica or E. dispar. The high association of E. moshkovskii with E. histolytica and E. dispar may have obscured its identification in previous studies. The high prevalence found in this study suggests that humans may be a true host for this ameba. PMID:12737742

  1. Additional diagnostic yield of adding serology to PCR in diagnosing viral acute respiratory infections in Kenyan patients 5 years of age and older.

    PubMed

    Feikin, Daniel R; Njenga, M Kariuki; Bigogo, Godfrey; Aura, Barrack; Gikunju, Stella; Balish, Amanda; Katz, Mark A; Erdman, Dean; Breiman, Robert F

    2013-01-01

    The role of serology in the setting of PCR-based diagnosis of acute respiratory infections (ARIs) is unclear. We found that acute- and convalescent-phase paired-sample serologic testing increased the diagnostic yield of naso/oropharyngeal swabs for influenza virus, respiratory syncytial virus (RSV), human metapneumovirus, adenovirus, and parainfluenza viruses beyond PCR by 0.4% to 10.7%. Although still limited for clinical use, serology, along with PCR, can maximize etiologic diagnosis in epidemiologic studies. PMID:23114699

  2. Hyponatremia, hypochloremia, and hypoalbuminemia predict an increased risk of mortality during the first year of antiretroviral therapy among HIV-infected Zambian and Kenyan women.

    PubMed

    Dao, Christine N; Peters, Philip J; Kiarie, James N; Zulu, Isaac; Muiruri, Peter; Ong'ech, John; Mutsotso, Winfred; Potter, Dara; Njobvu, Lungowe; Stringer, Jeffrey S A; Borkowf, Craig B; Bolu, Omotayo; Weidle, Paul J

    2011-11-01

    Early mortality rates after initiating antiretroviral therapy (ART) are high in sub-Saharan Africa. We examined whether serum chemistries at ART initiation predicted mortality among HIV-infected women. From May 2005 to January 2007, we enrolled women initiating ART in a prospective cohort study in Zambia and Kenya. We used Cox proportional hazards models to identify risk factors associated with mortality. Among 661 HIV-infected women, 53 (8%) died during the first year of ART, and tuberculosis was the most common cause of death (32%). Women were more likely to die if they were both hyponatremic (sodium <135 mmol/liter) and hypochloremic (chloride <95 mmol/liter) (37% vs. 6%) or hypoalbuminemic (albumin <34 g/liter, 13% vs. 4%) when initiating ART. A body mass index <18 kg/m(2) [adjusted hazard ratio (aHR) 5.3, 95% confidence interval (CI) 2.6-10.6] and hyponatremia with hypochloremia (aHR 4.5, 95% CI 2.2-9.4) were associated with 1-year mortality after adjusting for country, CD4 cell count, WHO clinical stage, hemoglobin, and albumin. Among women with a CD4 cell count >50 cells/μl, hypoalbuminemia was also a significant predictor of mortality (aHR=3.7, 95% CI 1.4-9.8). Baseline hyponatremia with hypochloremia and hypoalbuminemia predicted mortality in the first year of initiating ART, and these abnormalities might reflect opportunistic infections (e.g., tuberculosis) or advanced HIV disease. Assessment of serum sodium, chloride, and albumin can identify HIV-infected patients at highest risk for mortality who may benefit from more intensive medical management during the first year of ART. PMID:21417949

  3. Strongyloides stercoralis infection and re-infection in a cohort of children in Cambodia.

    PubMed

    Khieu, Virak; Hattendorf, Jan; Schär, Fabian; Marti, Hanspeter; Char, Meng Chuor; Muth, Sinuon; Odermatt, Peter

    2014-10-01

    Information on Strongyloides stercoralis re-infection after ivermectin treatment is scarce in S. stercoralis endemic countries. In semi-rural Cambodia, we determined S. stercoralis infection and re-infection rates among schoolchildren, two years after ivermectin treatment (2×100 μg/kg PO, 24 h apart). The study was conducted among 484 children from four primary schools in semi-rural villages in Kandal province from 2009 to 2011, using Koga agar plate culture and the Baermann method on two stool samples per child. Complete data were available for 302 participants. We observed infections in 24.2% and 22.5% of the children at baseline and at follow-up, respectively. At baseline, 73 children were treated for S. stercoralis infection. At follow-up, one-third of those treated for S. stercoralis infection had been reinfected, while 19.6% of the 229 healthy children (at baseline) had been newly infected with S. stercoralis. Possession of shoes and defecation in toilet were negatively associated with S. stercoralis infection at follow-up. Infection and re-infection rates of S. stercoralis among schoolchildren are considerably high. However, 68.5% of infected children remained free of infection for at least two years. A large-scale cohort study is required to understand age-specific infection and re-infection dynamics in endemic countries. PMID:24970767

  4. Prime-boost vaccination with chimpanzee adenovirus and modified vaccinia Ankara encoding TRAP provides partial protection against Plasmodium falciparum infection in Kenyan adults.

    PubMed

    Ogwang, Caroline; Kimani, Domtila; Edwards, Nick J; Roberts, Rachel; Mwacharo, Jedidah; Bowyer, Georgina; Bliss, Carly; Hodgson, Susanne H; Njuguna, Patricia; Viebig, Nicola K; Nicosia, Alfredo; Gitau, Evelyn; Douglas, Sandy; Illingworth, Joe; Marsh, Kevin; Lawrie, Alison; Imoukhuede, Egeruan B; Ewer, Katie; Urban, Britta C; S Hill, Adrian V; Bejon, Philip

    2015-05-01

    Protective immunity to the liver stage of the malaria parasite can be conferred by vaccine-induced T cells, but no subunit vaccination approach based on cellular immunity has shown efficacy in field studies. We randomly allocated 121 healthy adult male volunteers in Kilifi, Kenya, to vaccination with the recombinant viral vectors chimpanzee adenovirus 63 (ChAd63) and modified vaccinia Ankara (MVA), both encoding the malaria peptide sequence ME-TRAP (the multiple epitope string and thrombospondin-related adhesion protein), or to vaccination with rabies vaccine as a control. We gave antimalarials to clear parasitemia and conducted PCR (polymerase chain reaction) analysis on blood samples three times a week to identify infection with the malaria parasite Plasmodium falciparum. On Cox regression, vaccination reduced the risk of infection by 67% [95% confidence interval (CI), 33 to 83%; P = 0.002] during 8 weeks of monitoring. T cell responses to TRAP peptides 21 to 30 were significantly associated with protection (hazard ratio, 0.24; 95% CI, 0.08 to 0.75; P = 0.016). PMID:25947165

  5. Seroprevalence of asymptomatic dengue infection in children in Lahore.

    PubMed

    Mohsin, S N; Ghafoor, F; Saleem, M; Ghous, R; Aasim, M

    2016-08-01

    Dengue has become a global problem in past few decades, with half of the world's population at risk of infection. For some countries of Asia and Latin America, severe dengue is a major cause of serious illness and even death in children. Pakistan has been reported as a hyperendemic area for dengue infection. Our study aimed to find seroprevalence of past dengue infection in asymptomatic children of Lahore with no previous history of dengue infection. A total of 400 samples were collected from children aged 1-12 years in Lahore using random sampling. The inclusion criteria were children aged 1-12 years, who had no previous symptoms of dengue fever during their lives. Children with known immunodeficiency status or fever at the time of recruitment were excluded from the study. Commercially available ELISA kits were used to determine the IgG status in sera of children. The data obtained was entered and analysed using SPSS v. 20.0. The overall prevalence of asymptomatic dengue infection was found to be 25%. There was no statistically significant difference between prevalence of infection in male and female children. There was, however, a strong relationship between increasing age of the child and number of cases with infection, with low incidence in children aged ⩽5 years. PMID:27019361

  6. The Experience of Children with Hemophilia and HIV Infection.

    ERIC Educational Resources Information Center

    Hall, Christopher S.

    1994-01-01

    Children with hemophilia and Human Immunodeficiency Virus (HIV) infection are not a transmission risk to other children, and they can help enact best practices for school attendance by other such children. The article examines the National Hemophilia Foundation's work to promote appropriate inclusion of students with hemophilia and HIV in all…

  7. Prophylactic antibiotics for children with recurrent urinary tract infections

    PubMed Central

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2015-01-01

    Prophylactic antibiotics for urinary tract infections are no longer routinely recommended. A large number of children must be given prophylaxis to prevent one infection and antibiotic resistance is a major concern when treating community-acquired urinary tract infections. The results of three recent significant studies are examined, with focus on the efficacy of prophylaxis, and recommendations are made. PMID:25722643

  8. Parents’ and Professionals’ Perceptions on Causes and Treatment Options for Autism Spectrum Disorders (ASD) in a Multicultural Context on the Kenyan Coast

    PubMed Central

    Gona, Joseph K.; Rimba, Kenneth; Mapenzi, Rachel; Kihara, Michael

    2015-01-01

    Objective To explore parents’ and professionals’ perceived causes and treatment of Autism Spectrum Disorders (ASD) on the Kenyan Coast. Methods In-depth interviews and focus group discussions using guiding questions were utilized in data collection. One hundred and three participants, who included parents of children with ASD, special needs teachers, clinicians, and social workers from diverse cultural background, participated in this study. The interviews and focus groups were recorded, transcribed verbatim and then translated to English. Themes were generated using content analysis. Results Preternatural causes were mentioned and included evil spirits, witchcraft, and curses. Biomedical causes comprised infections, drug abuse, birth complications, malnutrition, and genetic related problems. Treatment varied from traditional and spiritual healing to modern treatment in health facilities, and included consultations with traditional healers, offering prayers to God, and visits to hospitals. Conclusions The results suggest that regardless of cultural backgrounds, people on the Kenyan Coast have similar views on perceived causes and treatment of ASD. These findings provide valuable conceptual understanding for professionals when planning and implementing community based rehabilitation interventions targeting children with ASD within a local context. PMID:26267668

  9. Diversity in Education: Kenyan Sign Language as a Medium of Instruction in Schools for the Deaf in Kenya

    ERIC Educational Resources Information Center

    Mweri, Jefwa G.

    2014-01-01

    In Kenya, the only official document that deals with the use of mother tongue (MT) in Schools is the 1967 Gachathi report. The report has clear-cut guidance and policy regarding MT use by the hearing children. However, for deaf children, no such policy exists; therefore, the use of the deaf child's MT (Kenyan Sign Language (KSL)) in schools…

  10. [H. pylori infections in children: clinical, diagnostic and treatment implications].

    PubMed

    Iwańczak, Franciszek; Iwańczak, Barbara

    2013-10-01

    Helicobacter pylori is the most widespread infection all over the Word. The rate of this infection varies, depending on age, geographic region, socioeconomic and hygienic conditions. Most infected children live in the poor, developing countries without adequate living and hygienic conditions. Prevalence of H. pylori infections in children in Poland was 32.01%. The course of infection in children depends on individual predisposition, environmental factors and virulence of H. pylori. In children in Poland infection with cagA+s1m1 genotype occurs most frequently. In children, a connection of H. pylori infection to ulcer disease of the duodenum was demonstrated. Additionally, the diagnostic tests of infection and diagnostic assessing eradication were discussed in the work. Recommendations on the treatment of H. pylori taking into account the necessity of the assessment of bacteria sensitivity to antibiotics were outlined. It is particularly important in the regions with high resistance of H. pylori to clarythromycin, which in children can exceed 20%. PMID:24340886

  11. Unresolved antiretroviral treatment management issues in HIV-infected children.

    PubMed

    Heidari, Shirin; Mofenson, Lynne M; Hobbs, Charlotte V; Cotton, Mark F; Marlink, Richard; Katabira, Elly

    2012-02-01

    Antiretroviral therapy in children has expanded dramatically in low-income and middle-income countries. The World Health Organization revised its pediatric HIV guidelines to recommend initiation of antiretroviral therapy in all HIV-infected children younger than 2 years, regardless of CD4 count or clinical stage. The number of children starting life-long antiretroviral therapy should therefore expand dramatically over time. The early initiation of antiretroviral therapy has indisputable benefits for children, but there is a paucity of definitive information on the potential adverse effects. In this review, a comprehensive literature search was conducted to provide an overview of our knowledge about the complications of treating pediatric HIV. Antiretroviral therapy in children, as in adults, is associated with enhanced survival, reduction in opportunistic infections, improved growth and neurocognitive function, and better quality of life. Despite antiretroviral therapy, HIV-infected children may continue to lag behind their uninfected peers in growth and development. In addition, epidemic concurrent conditions, such as tuberculosis, malaria, and malnutrition, can combine with HIV to yield more rapid disease progression and poor treatment outcomes. Additional studies are required to evaluate the long-term effects of antiretroviral therapy in HIV-infected infants, children, and adolescents, particularly in resource-limited countries where concomitant infections and conditions may enhance the risk of adverse effects. There is an urgent need to evaluate drug-drug interactions in children to determine optimal treatment regimens for both HIV and coinfections. PMID:22138766

  12. [Helicobacter pylori infection in children: a new focus].

    PubMed

    Yee, K-C

    2014-03-01

    Helicobacter pylori (Hp) is a high prevalence of chronic infectious pathogens, though not necessarily lead to symptoms, but it can affect the immune system. More than of the world's population harbors the bacterium, and most adult Hp infection was obtained in childhood. Hp infection is a major cause of peptic ulcer, although children rarely suffer from peptic ulcer disease. Hp infection is closely related to chronic gastritis, dyspepsia, chronic diarrhea and recurrent abdominal pain in children. In recent years, Hp infection may also participate in some of non-digestive diseases, such as children's nutritional iron deficiency anemia, growth retardation, malnutrition, autoimmune idiopathic thrombocytopenic purpura, chronic urticaria, as well as the development of adult atherosclerosis-related cardiovascular diseases and some nervous system diseases. Hp infection can be a lifetime issues of children. Hp infection of children will bring many socio-economic problems. In this paper, the correlation of Hp infection in stomach and oral cavity, and diagnostic technology, prevention as well as treatment strategies for Hp infection will be discussed. PMID:24661515

  13. Human bocavirus in children with acute respiratory infections in Vietnam.

    PubMed

    Tran, Dinh Nguyen; Nguyen, Tran Quynh Nhu; Nguyen, Tuan Anh; Hayakawa, Satoshi; Mizuguchi, Masashi; Ushijima, Hiroshi

    2014-06-01

    Acute respiratory infections are the major cause of morbidity and mortality globally. Human bocavirus (HBoV), a novel virus, is recognized to increasingly associate with previously unknown etiology respiratory infections in young children. In this study, the epidemiological, clinical, and molecular characteristics of HBoV infections were described in hospitalized Vietnamese pediatric patients. From April 2010 to May 2011, 1,082 nasopharyngeal swab samples were obtained from patients with acute respiratory infections at the Children's Hospital 2, Ho Chi Minh City, Vietnam. Samples were screened for HBoV by PCR and further molecularly characterized by sequencing. HBoV was found in 78 (7.2%) children. Co-infection with other viruses was observed in 66.7% of patients infected with HBoV. Children 12-24 months old were the most affected age group. Infections with HBoV were found year-round, though most cases occurred in the dry season (December-April). HBoV was possible to cause severe diseases as determined by higher rates of hypoxia, pneumonia, and longer hospitalization duration in patients with HBoV infection than in those without (P-value <0.05). Co-infection with HBoV did not affect the disease severity. The phylogenetic analysis of partial VP1 gene showed minor variations and all HBoV sequences belonged to species 1 (HBoV1). In conclusion, HBoV1 was circulating in Vietnam and detected frequently in young children during dry season. Acute respiratory infections caused by HBoV1 were severe enough for hospitalization, which implied that HBoV1 may have an important role in acute respiratory infections among children. PMID:24123072

  14. Progressive Hearing Impairment in Children with Congenital Cytomegalovirus Infection.

    ERIC Educational Resources Information Center

    Dahle, Arthur J.; And Others

    1979-01-01

    Audiological assessment of 86 children (mean age 38 months at last evaluation time) with congenital cytomegalovirus infection revealed progressive hearing loss in four of 12 Ss with sensorineural hearing impairments. Case descriptions documented the progression of the hearing loss. (Author)

  15. Background, Epidemiology, and Impact of HIV Infection in Children.

    ERIC Educational Resources Information Center

    Rubinstein, Arye

    1989-01-01

    The article reviews issues of diagnosis and treatment of children with HIV (Human Immunodeficiency Virus) infection. A spectrum of clinical signs is correlated with serological results. The intense central nervous system involvement typically present in childhood cases is examined. (DB)

  16. Hypothetical performance of syndrome-based management of acute paediatric admissions of children aged more than 60 days in a Kenyan district hospital.

    PubMed Central

    English, Mike; Berkley, James; Mwangi, Isiah; Mohammed, Shebbe; Ahmed, Maimuna; Osier, Faith; Muturi, Neema; Ogutu, Bernhards; Marsh, Kevin; Newton, Charles R. J. C.

    2003-01-01

    OBJECTIVE: To investigate whether the outpatient, syndrome-based approach of the Integrated Management of Childhood Illness (IMCI) protocol could be extended to the inpatient arena to give clear and simple minimum standards of care for poorly resourced facilities. METHODS: A prospective, one-year admission cohort retrospectively compared hypothetical performance of syndrome-based management with paediatrician-defined final diagnosis. Admission syndrome definitions were based on local adaptations to the IMCI protocol that encompassed 20 clinical features, measurement of oxygen saturation, and malaria microscopy. FINDINGS: After 315 children with clinically obvious diagnoses (e.g. sickle cell disease and burns) were excluded, 3705 admission episodes were studied. Of these, 2334 (63%) met criteria for at least one severe syndrome (mortality 8% vs <1% for "non-severe" cases), and half of these had features of two or more severe syndromes. No cases of measles were seen. Syndrome-based treatment would have been appropriate (sensitivity >95%) for severe pneumonia, severe malaria, and diarrhoea with severe dehydration, and probably for severe malnutrition (sensitivity 71%). Syndrome-directed treatment suggested the use of broad-spectrum antibiotics in 75/133 (56% sensitivity) children with bacteraemic and 63/71 (89% sensitivity) children with meningitis. CONCLUSIONS: Twenty clinical features, oxygen saturation measurements, and results of malaria blood slides could be used for inpatient, syndrome-based management of acute paediatric admissions. The addition of microscopy of the cerebrospinal fluid and haemoglobin measurements would improve syndrome-directed treatment considerably. This approach might rationalize admission policy and standardize inpatient paediatric care in resource-poor countries, although the clinical detection of bacteraemia remains a problem. PMID:12764512

  17. Hepatitis C Viral Infection in Children: Updated Review

    PubMed Central

    2016-01-01

    Hepatitis C virus (HCV) infection is a major medical challenge affecting around 200 million people worldwide. The main site of HCV replication is the hepatocytes of the liver. HCV is a positive enveloped RNA virus from the flaviviridae family. Six major HCV genotypes are implicated in the human infection. In developed countries the children are infected mainly through vertical transmission during deliveries, while in developing countries it is still due to horizontal transmission from adults. Minimal nonspecific and brief symptoms are initially found in approximately 15% of children. Acute and chronic HCV infection is diagnosed through the recognition of HCV RNA. The main objective for treatment of chronic HCV is to convert detected HCV viremia to below the detection limit. Children with chronic HCV infection are usually asymptomatic and rarely develop severe liver damage. Therefore, the benefits from current therapies, pegylated-Interferon plus ribavirin, must be weighed against their adverse effects. This combined treatment offers a 50-90% chance of clearing HCV infection according to several studies and on different HCV genotype. Recent direct acting antiviral (DAA) drugs which are well established for adults have not yet been approved for children and young adults below 18 years. The most important field for the prevention of HCV infection in children would be the prevention of perinatal and parenteral transmission. There are areas of focus for new lines of research in pediatric HCV-related disease that can be addressed in the near future. PMID:27437184

  18. Recurrent Respiratory Infections and Psychological Problems in Junior School Children

    ERIC Educational Resources Information Center

    Kelmanson, Igor A.

    2015-01-01

    Background: Recurrent respiratory infections (RRI) are among most common diseases in school-aged children. Little is known about possible associations between RRI and children psychological well-being. Aim: To study possible associations between RRI in junior school pupils and their emotional/behavioural characteristics. Methods: The RRI group…

  19. Susceptibility of Children to Sapovirus Infections, Nicaragua, 2005–2006

    PubMed Central

    Bucardo, Filemón; Carlsson, Beatrice; Nordgren, Johan; Larson, Göran; Blandon, Patricia; Vilchez, Samuel

    2012-01-01

    We describe the genetic diversity of sapovirus (SaV) in children in Nicaragua and investigate the role of host genetic factors and susceptibility to SaV infections. Our results indicate that neither ABO blood group, Lewis phenotype, nor secretor status affects susceptibility to SaV infection in Nicaragua. PMID:23092588

  20. Safety and Reactogenicity of an MSP-1 Malaria Vaccine Candidate: A Randomized Phase Ib Dose-Escalation Trial in Kenyan Children

    PubMed Central

    Withers, Mark R; McKinney, Denise; Ogutu, Bernhards R; Waitumbi, John N; Milman, Jessica B; Apollo, Odika J; Allen, Otieno G; Tucker, Kathryn; Soisson, Lorraine A; Diggs, Carter; Leach, Amanda; Wittes, Janet; Dubovsky, Filip; Stewart, V. Ann; Remich, Shon A; Cohen, Joe; Ballou, W. Ripley; Holland, Carolyn A; Lyon, Jeffrey A; Angov, Evelina; Stoute, José A; Martin, Samuel K; Heppner, D. Gray

    2006-01-01

    Objective: Our aim was to evaluate the safety, reactogenicity, and immunogenicity of an investigational malaria vaccine. Design: This was an age-stratified phase Ib, double-blind, randomized, controlled, dose-escalation trial. Children were recruited into one of three cohorts (dosage groups) and randomized in 2:1 fashion to receive either the test product or a comparator. Setting: The study was conducted in a rural population in Kombewa Division, western Kenya. Participants: Subjects were 135 children, aged 12–47 mo. Interventions: Subjects received 10, 25, or 50 μg of falciparum malaria protein 1 (FMP1) formulated in 100, 250, and 500 μL, respectively, of AS02A, or they received a comparator (Imovax® rabies vaccine). Outcome Measures: We performed safety and reactogenicity parameters and assessment of adverse events during solicited (7 d) and unsolicited (30 d) periods after each vaccination. Serious adverse events were monitored for 6 mo after the last vaccination. Results: Both vaccines were safe and well tolerated. FMP1/AS02A recipients experienced significantly more pain and injection-site swelling with a dose-effect relationship. Systemic reactogenicity was low at all dose levels. Hemoglobin levels remained stable and similar across arms. Baseline geometric mean titers were comparable in all groups. Anti-FMP1 antibody titers increased in a dose-dependent manner in subjects receiving FMP1/AS02A; no increase in anti-FMP1 titers occurred in subjects who received the comparator. By study end, subjects who received either 25 or 50 μg of FMP1 had similar antibody levels, which remained significantly higher than that of those who received the comparator or 10 μg of FMP1. A longitudinal mixed effects model showed a statistically significant effect of dosage level on immune response (F3,1047 = 10.78, or F3, 995 = 11.22, p < 0.001); however, the comparison of 25 μg and 50 μg recipients indicated no significant difference (F1,1047 = 0.05; p = 0.82). Conclusions

  1. Strategies for addressing restorative challenges in HIV-infected children.

    PubMed

    Abdelnur, Juliana Pires; Cerqueira, Daniella Ferraz; Castro, Gloria Fernanda; Maia, Lucianne Cople; de Souza, Ivete Pomarico Ribeiro

    2008-01-01

    The complete caries removal of deep/extensive dentin carious lesions with conventional procedures (high- and low-speed bur) may increase the risk of pulp exposure. In children with systemic diseases, such as HIV-infected children, the dental treatment proposed for the primary dentition with pulp involvement is tooth extraction once endodontic therapies cannot be guaranteed successfully. Therefore, the objective of this study was to describe 3 cases of alternative techniques for caries removal in extensive and/or deep dentin carious lesions in the primary dentition of HIV-infected children: (1) atraumatic restorative treatment (ART); (2) Carisolv; and (3) Papacarie. PMID:18505652

  2. HIV infection in children--impact upon ENT doctors.

    PubMed

    Hoare, Simon

    2003-12-01

    The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria

  3. What's new in hepatitis C virus infections in children?

    PubMed

    Pawlowska, Malgorzata; Domagalski, Krzysztof; Pniewska, Anna; Smok, Beata; Halota, Waldemar; Tretyn, Andrzej

    2015-10-14

    The number of hepatitis C virus (HCV) infection cases is relatively low in children. This low number may be connected with the lack of screening tests and the asymptomatic course of infection. Currently, mother-to-infant transmission is the most common cause of HCV infection amongst children in developed countries. It is important to introduce routine screening tests for HCV in pregnant women. The risk of vertical transmission of HCV is estimated at approximately 5% (3%-10%). Currently, we do not have HCV transmission prevention methods. Some factors could potentially be eliminated by elective caesarean section. Currently, the method of prevention of perinatal HCV infection is the early identification and effective treatment of infections in young women in the preconception period. We describe genetic tests (IL-28B single nucleotide polymorphisms) to identify children with an increased chance of spontaneous clearance or sustained virologic response achievement and vitamin D level as a potential predictor of treatment response in children. It is also important to develop non-invasive tests that can predict liver fibrosis. The existence of differences in the mechanisms leading to liver injury between children and adults creates new perspectives of action to reduce liver disease progression in children in the early years of life. PMID:26478670

  4. Novel Risk Factors for Recurrent Clostridium difficile Infection in Children

    PubMed Central

    Nicholson, Maribeth R.; Thomsen, Isaac P.; Slaughter, James C.; Creech, C. Buddy; Edwards, Kathryn M.

    2014-01-01

    Objectives Clostridium difficile, a common cause of antibiotic-associated diarrhea, has been reported to recur in high rates in adults. The rates and risk factors for recurrent Clostridium difficile infection (rCDI) in children have not been well established. Methods We conducted a retrospective cohort study of 186 pediatric patients seen at a tertiary care referral center over a 5-year period diagnosed with a primary infection with Clostridium difficile. Children with recurrent disease, defined as return of symptoms of Clostridium difficile infection and positive testing ≤60 days after the completion of therapy, were compared to children who did not experience an episode of recurrence. Results Of the 186 pediatric patients included in this study, 41 (22%) experienced recurrent Clostridium difficile infection. On univariable analysis, factors significantly associated with recurrent Clostridium difficile infection included malignancy, recent hospitalization, recent surgery, antibiotic use, number of antibiotic exposures by class, acid blocker use, immunosuppressant use, and hospital acquired disease. On multivariable analysis, malignancy (OR=3.39, 95% CI=1.52–7.85), recent surgery (OR=2.40, 95% CI=1.05–5.52), and the number of antibiotic exposures by class (OR=1.33, 95% CI=1.01–1.75) were significantly associated with recurrent disease in children. Conclusions The rate of recurrent Clostridium difficile infection in children was 22%. Recurrence was significantly associated with the risk factors of malignancy, recent surgery, and the number of antibiotic exposures by class. PMID:25199038

  5. Immune reconstitution and vaccination outcome in HIV-1 infected children

    PubMed Central

    Cagigi, Alberto; Cotugno, Nicola; Giaquinto, Carlo; Nicolosi, Luciana; Bernardi, Stefania; Rossi, Paolo; Douagi, Iyadh; Palma, Paolo

    2012-01-01

    Current evidence on routine immunization of HIV-1 infected children point out the need for a special vaccine schedule in this population. However, optimal strategies for identifying individuals susceptible to infections, and then offering them sustained protection through appropriate immunization schedule, both in terms of timing and number of vaccine doses, still remain to be elucidated. Understanding the degree of immune recovery after HAART initiation is important in guiding administration of routine vaccination in HIV-1 infected children. Although quantitative measures (e.g., CD4+ T-cell counts and immunoglobulin levels) are frequently performed to evaluate immune parameters, these measures do not fully mirror functional immune recovery. Here, we will review the status of single mandatory and recommended vaccines for HIV-1 infected children in relation to immune recovery after HAART initiation with the aim of identifying new means to help design personalized vaccine schedules for this population. PMID:22906931

  6. Intestinal parasitic infections among children in central Albania

    PubMed Central

    Sejdini, A; Mahmud, R; Lim, Y A L; Mahdy, M; Sejdini, F; Gjoni, V; Xhaferraj, K; Kasmi, G

    2011-01-01

    Although intestinal parasitic infections (IPI) among children remain a global issue, the current information on such infections in Albanian children is very limited. A cross-sectional study of the IPI in 321 children living in the Albanian counties of Tirana (152) and Elbasan (169) was therefore conducted in 2008, with a pre-tested standard questionnaire employed to gather the relevant personal and clinical data. Using formalin–ether concentration and permanent stains, stool samples were examined microscopically for the ova, cysts and oocysts of any parasites. The overall prevalence of IPI was 19% (61 of 321), with protozoan infections (11·5%) apparently more common than infections with soil-transmitted helminths (STH; 8·1%). Giardia duodenalis was the parasite most frequently detected (10·9%), followed by hookworm (5·6%), Ascaris lumbricoides (1·9%), Trichuris trichiura (0·6%), Cryptosporidium (0·3%) and Entamoeba histolytica/dispar (0·3%). The results of a univariate analysis indicated that the children from Tirana county were significantly more likely to be found infected with STH compared with the children from Elbasan county (12·5% v. 4·1%; P = 0·006). Children sampled in the community were also more likely to be found STH-positive than the children sampled as they attended hospitals and health clinics (10·5% v. 6·0%) but this difference did not reach statistical significance. The children found STH-positive were five times more likely to be suffering from diarrhoea than the other children checked in clinical settings (P = 0·004) and were also more likely to be suffering from abdominal pain (P = 0·054) and/or diminished appetite (P = 0·016). PMID:21801503

  7. Cardiac Complications in Children With Human Immunodeficiency Virus Infection

    PubMed Central

    Starc, Thomas J.; Lipshultz, Steven E.; Kaplan, Samuel; Easley, Kirk A.; Bricker, J. Timothy; Colan, Steven D.; Lai, Wyman W.; Gersony, Welton M.; Sopko, George; Moodie, Douglas S.; Schluchter, Mark D.

    2015-01-01

    Objective Although numerous cardiac abnormalities have been reported in HIV-infected children, precise estimates of the incidence of cardiac disease in these children are not well-known. The objective of this report is to describe the 2-year cumulative incidence of cardiac abnormalities in HIV-infected children. Methodology: Design Prospective cohort (Group I) and inception cohort (Group II) study design. Setting A volunteer sample from 10 university and public hospitals. Participants Group I consisted of 205 HIV vertically infected children enrolled at a median age of 22 months. This group was comprised of infants and children already known to be HIV-infected at the time of enrollment in the study. Most of the children were African-American or Hispanic and 89% had symptomatic HIV infection at enrollment. The second group included 611 neonates born to HIV-infected mothers, enrolled during fetal life or before 28 days of age (Group II). In contrast to the older Group I children, all the Group II children were enrolled before their HIV status was ascertained. Interventions According to the study protocol, children underwent a series of cardiac evaluations including two-dimensional echocardiogram and Doppler studies of cardiac function every 4 to 6 months. They also had a 12-or 15-lead surface electrocardiogram (ECG), 24-hour ambulatory ECG monitoring, and a chest radiograph every 12 months. Outcome Measures Main outcome measures were the cumulative incidence of an initial episode of left ventricular (LV) dysfunction, cardiac enlargement, and congestive heart failure (CHF). Because cardiac abnormalities tended to cluster in the same patients, we also determined the number of children who had cardiac impairment which we defined as having either left ventricular fractional shortening (LV FS) ≤25% after 6 months of age, CHF, or treatment with cardiac medications. Results: Cardiac Abnormalities In Group I children (older cohort), the prevalence of decreased LV function

  8. Urinary Tract Infection in Children: Diagnosis and Treatment

    PubMed Central

    Robson, Wm. Lane M.

    1990-01-01

    The history and the physical examination are important and rewarding in the assessment of urinary tract infection in children. Urinary tract infection is usually an ascending infection; periurethral colonization is fundamental to its pathogenesis. It is important to treat predisposing factors, such as poor personal hygiene, diarrhea, and diaper rash. Parents should be specifically instructed on the proper procedures for introital and foreskin cleansing. To minimize the risk of urinary tract infection, children should be encouraged to void frequently and instructed not to hold their urine. Antibiotics should be chosen after taking into account the susceptibilities of the common bacterial pathogens and antibiotics received by the child. Consideration of the symptoms and signs of urinary tract infection is important to develop an appropriate treatment plan. PMID:21233931

  9. Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

    PubMed Central

    Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

    2016-01-01

    Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most

  10. Children and Objects: Affection and Infection

    ERIC Educational Resources Information Center

    Jones, Liz; MacLure, Maggie; Holmes, Rachel; MacRae, Christina

    2012-01-01

    This paper considers young children's (aged 3-5 years) relations with objects, and in particular objects that are brought from home to school. We begin by considering the place of objects within early years classrooms and their relationship to children's education before considering why some objects are often separated from their owners on entry…

  11. Burkholderia Sepsis in Children as a Hospital-Acquired Infection

    PubMed Central

    Kim, Kyu Yeun; Yong, Dongeun; Lee, Kyungwon; Kim, Ho-Seong

    2016-01-01

    Purpose Hospital-acquired Burkholderia cepacia (B. cepacia) infection are not commonly recorded in patients without underlying lung disease, such as cystic fibrosis and chronic granulomatous disease. However, in 2014, B. cepacia appeared more frequently in pediatric blood samples than in any other year. In order to access this situation, we analyzed the clinical characteristics of B. cepacia infections in pediatric patients at our hospital. Materials and Methods We conducted a retrospective study of blood isolates of B. cepacia taken at our hospital between January 2004 and December 2014. Patient clinical data were obtained by retrospective review of electronic medical records. We constructed a dendrogram for B. cepacia isolates from two children and five adult patients. Results A total of 14 pediatric patients and 69 adult patients were identified as having B. cepacia bacteremia. In 2014, higher rates of B. cepacia bacteremia were observed in children. Most of them required Intensive Care Unit (ICU) care (12/14). In eleven children, sputum cultures were examined, and five of these children had the same strain of B. cepacia that grew out from their blood samples. Antibiotics were administered based on antibiotic sensitivity results. Four children expired despite treatment. Compared to children, there were no demonstrative differences in adults, except for history of ICU care. Conclusion Although there were not many pediatric cases at our hospital, awareness of colonization through hospital-acquired infection and effective therapy for infection of B. cepacia is needed, as it can cause mortality and morbidity. PMID:26632388

  12. Cerebrovascular disease in children with HIV-1 infection.

    PubMed

    Hammond, Charles K; Eley, Brian; Wieselthaler, Nicky; Ndondo, Alvin; Wilmshurst, Jo M

    2016-05-01

    An estimated 3.2 million children worldwide have human immunodeficiency virus (HIV) infection. Antiretroviral therapy (ART) has resulted in prolonged survival, leading to an increase in complications previously recognized in adults. Children with HIV infection have increased risk of cerebrovascular disease from multiple aetiologies including HIV-associated vasculopathy, opportunistic vasculitis, cardioembolism or coagulopathy, all of which may be secondary to the infection. Prevalence of cerebrovascular disease in HIV-infected children is underestimated because of limited neuroimaging in low and middle income countries, silent events without overt motor manifestations, and mislabeling as HIV encephalopathy for non-motor manifestations such as behavioural and cognitive difficulties. No management guidelines for cerebrovascular disease in HIV-infected children exist but common practices target risk factors for stroke in low and middle income countries. Where capacity permits, screening for opportunistic infections, vasculitis, coagulopathy and cardioembolism is important. Optimising virological suppression, correction of anaemia, control of seizures and aspirin prophylaxis are management priorities. Neurosurgical interventions may have a role. PMID:26890389

  13. Classroom Interaction in Kenyan Primary Schools.

    ERIC Educational Resources Information Center

    Ackers, Jim; Hardman, Frank

    2001-01-01

    Reports on a study of classroom interaction in Kenyan primary schools. Analyzes video recordings of 102 lessons in English, mathematics, and science using systematic observation, discourse analysis, and a time-line analysis. Reveals the preponderance of teacher dominated lessons with little opportunity for student interaction. Considers…

  14. Oseltamivir for influenza infection in children: risks and benefits.

    PubMed

    Esposito, Susanna; Principi, Nicola

    2016-01-01

    Influenza is a common disease affecting many children each year. In a number of cases, particularly in children <2 years old and in those with severe chronic underlying disease, influenza can be complicated by lower respiratory tract infections, acute otitis media, rhinosinusitis, febrile seizures, dehydration or encephalopathy. Oseltamivir is the influenza virus drug that is most commonly studied in children for both the treatment and prevention of influenza. To avoid the risk that children with mild influenza or patients suffering from different viral infections receive oseltamivir, oseltamivir treatment should be recommended only in severe influenza cases, especially if confirmed by reliable laboratory tests. However, therapy must be initiated considering the risk of complications and the presence of severe clinical manifestations at age- and weight-appropriate doses. Because the vaccine remains the best option for preventing influenza and its complications, prophylaxis using oseltamivir should only be considered in select patients. PMID:26616633

  15. Diagnosis of Bloodstream Infections in Children.

    PubMed

    Dien Bard, Jennifer; McElvania TeKippe, Erin

    2016-06-01

    Identification of bloodstream infections is among the most critical tasks performed by the clinical microbiology laboratory. While the criteria for achieving an adequate blood culture specimen in adults have been well described, there is much more ambiguity in pediatric populations. This minireview focuses on the available pediatric literature pertaining to the collection of an optimal blood culture specimen, including timing, volume, and bottle selection, as well as rapid diagnostic approaches and their role in the management of pediatric bloodstream infections. PMID:26818669

  16. Options for Treating Resistant Shigella Species Infections in Children

    PubMed Central

    Erdman, Sharon M.; Buckner, Elizabeth E.; Hindler, Janet F.

    2008-01-01

    Infection due to Shigella species remains an important public health problem, especially in developing countries where it remains the most common cause of bloody diarrhea. In the United States (US), 10,000 to 15,000 cases of shigellosis are reported each year in both children and adults. US surveillance data from 2004 has demonstrated increased resistance in Shigella species to first-line antibiotics such as ampicillin and trimethoprim-sulfamethoxazole, with approximately 37% of isolates demonstrating resistance to both ampicillin and trimethoprim-sulfamethoxazole. Since approximately 69% of Shigella infections occur in children younger than 5 years of age, it is important that alternative antibiotics other than typical first-line agents such as ampicillin and trimethoprim-sulfamethoxazole be available to treat Shigella infections in this population. The American Academy of Pediatrics (AAP) recommends cefixime, ceftriaxone, azithromycin, and fluoroquinolones as alternative antibiotics for the treatment of Shigella species infections in children. This paper will review the microbiology, susceptibility, efficacy and safety data of these alternative antibiotics with regard to the treatment of Shigella species infections in children, and will attempt to define the role of each of these agents in the pediatric population. PMID:23055862

  17. Measles Virus Infection Among Vaccinated and Unvaccinated Children in Nigeria

    PubMed Central

    Adeniji, Johnson A.; Olusola, Babatunde A.; Motayo, Babatunde O.; Akintunde, Grace B.

    2015-01-01

    Abstract This study investigated measles infection in vaccinated and unvaccinated children presenting with fever and maculopapular rash during measles outbreaks in the southern and western states of Nigeria. Measles, an acute viral illness caused by a virus in the family Paramyxoviridae, is a vaccine-preventable disease. Measles outbreak is common in Nigeria, despite the national immunization program. Children presenting with symptoms of measles infection in general hospitals and health centers in the states of southern and western Nigeria were recruited for this study. Vaccination history, clinical details, and 5 mL of blood were obtained from the children. Their sera samples were screened for specific immunoglobulin M antibodies to measles virus. Of 234 children tested (124 [53.2%] female), 133 (56.8%) had previously been vaccinated against measles virus, while 93 (39.7%) had not been vaccinated. Vaccination information for eight children could not be retrieved. One hundred and forty-three (62.4%) had measles IgM antibodies. Of these, 79 (55.3%) had been vaccinated for measles, while 65 (44.7%) had not. Despite the ongoing vaccination program in Nigeria, a high number of children are still being infected with measles, despite their vaccination status. Therefore, there is need to identify the reason for the low level of vaccine protection. PMID:26102341

  18. Infection with and Carriage of Mycoplasma pneumoniae in Children

    PubMed Central

    Meyer Sauteur, Patrick M.; Unger, Wendy W. J.; Nadal, David; Berger, Christoph; Vink, Cornelis; van Rossum, Annemarie M. C.

    2016-01-01

    “Atypical” pneumonia was described as a distinct and mild form of community-acquired pneumonia (CAP) already before Mycoplasma pneumoniae had been discovered and recognized as its cause. M. pneumoniae is detected in CAP patients most frequently among school-aged children from 5 to 15 years of age, with a decline after adolescence and tapering off in adulthood. Detection rates by polymerase chain reaction (PCR) or serology in children with CAP admitted to the hospital amount 4–39%. Although the infection is generally mild and self-limiting, patients of every age can develop severe or extrapulmonary disease. Recent studies indicate that high rates of healthy children carry M. pneumoniae in the upper respiratory tract and that current diagnostic PCR or serology cannot discriminate between M. pneumoniae infection and carriage. Further, symptoms and radiologic features are not specific for M. pneumoniae infection. Thus, patients may be unnecessarily treated with antimicrobials against M. pneumoniae. Macrolides are the first-line antibiotics for this entity in children younger than 8 years of age. Overall macrolides are extensively used worldwide, and this has led to the emergence of macrolide-resistant M. pneumoniae, which may be associated with severe clinical features and more extrapulmonary complications. This review focuses on the characteristics of M. pneumoniae infections in children, and exemplifies that simple clinical decision rules may help identifying children at high risk for CAP due to M. pneumoniae. This may aid physicians in prescribing appropriate first-line antibiotics, since current diagnostic tests for M. pneumoniae infection are not reliably predictive. PMID:27047456

  19. Nuclear imaging for musculoskeletal infections in children

    SciTech Connect

    Herndon, W.A.; Alexieva, B.T.; Schwindt, M.L.; Scott, K.N.; Shaffer, W.O.

    1985-05-01

    The authors retrospectively reviewed all patients who underwent bone scanning for possible osteomyelitis at the Naval Regional Medical Center (Portsmouth, VA, U.S.A.) between 1980 and 1983. Among 63 children, there were 20 sites of osteomyelitis. They were able to conclude that a high proportion of neonates with septic arthritis will have osteomyelitis and that bone scan is not helpful in this age group. Nuclear imaging of the foot was less reliable than imaging of the remainder of the extremities. The bone scan can be a useful adjunct in the diagnosis of osteomyelitis in certain children, but is not a substitute for an accurate clinical examination and appropriate workup.

  20. Tuberculosis and HIV co-infection in children

    PubMed Central

    2014-01-01

    HIV is the top and tuberculosis is the second leading cause of death from infectious disease worldwide, with an estimated 8.7 million incident cases of tuberculosis and 2.5 million new HIV infections annually. The World Health Organization estimates that HIV prevalence among children with tuberculosis, in countries with moderate to high prevalence, ranges from 10 to 60%. The mechanisms promoting susceptibility of people with HIV to tuberculosis disease are incompletely understood, being likely caused by multifactorial processes. Paediatric tuberculosis and HIV have overlapping clinical manifestations, which could lead to missed or late diagnosis. Although every effort should be made to obtain a microbiologically-confirmed diagnosis in children with tuberculosis, in reality this may only be achieved in a minority, reflecting their paucibacillary nature and the difficulties in obtain samples. Rapid polymerase chain reaction tests, such as Xpert MTB/RIF assay, are increasingly used in children. The use of less or non invasive methods of sample collection, such as naso-pharyngeal aspirates and stool samples for a polymerase chain reaction-based diagnostic test tests and mycobacterial cultures is promising technique in HIV negative and HIV positive children. Anti-tuberculosis treatment should be started immediately at diagnosis with a four drug regimen, irrespective of the disease severity. Moreover, tuberculosis disease in an HIV infected child is considered to be a clinical indication for initiation of antiretroviral treatment. The World Health Organization recommends starting antiretroviral treatment in children as soon as anti-tuberculosis treatment is tolerated and within 2- 8 weeks after initiating it. The treatment of choice depends on the child’s age and availability of age-appropriate formulations, and potential drug interactions and resistance. Treatment of multi-drug resistant tuberculosis in HIV-infected children follows same principles as for HIV

  1. Mycoplasma Pneumoniae Infections of Adults and Children

    PubMed Central

    Cherry, James D.; Welliver, Robert C.

    1976-01-01

    Although the hallmark of Mycoplasma pneumoniae infection is pneumonia, the organism is also responsible for a protean array of other symptoms. With an increased awareness of the board clinical spectrum of M. pneumoniae disease and the ready availability of the cold agglutinin and M. pneumoniae complement-fixation tests, interested clinicians will note additional clinical-mycoplasmal associations in their patients. PMID:782043

  2. Keep Children Healthy: Prevent and Curb Infections.

    ERIC Educational Resources Information Center

    Texas Child Care, 2003

    2003-01-01

    Asserts that child care workers must follow basic health and sanitary practices to minimize the chance of illness and promote good health. Highlights the following strategies: (1) monitoring staff health; (2) maintaining a healthy environment; (3) managing infections; and (4) reporting infectious illnesses. Specifically addresses pregnant staff,…

  3. Psychosocial Issues of Children Infected with HIV/AIDS

    PubMed Central

    Vranda, M. N.; Mothi, S. N.

    2013-01-01

    The chronic medical conditions in the paediatric population pose a range of potential psychosocial challenges not only to the child, but also to the family members and health care providers. This paper comprehensively reviews the psychosocial issues of children infected with HIV and AIDS and offer some of the strategies to address the issues comprehensively by multidisciplinary team. PMID:23833337

  4. Confidentiality and Public Policy Regarding Children with HIV Infection.

    ERIC Educational Resources Information Center

    Harvey, David C.

    1994-01-01

    Addresses the relationship between law and policy, examining significant gains in establishing legal precedents for protecting the educational rights of children with Human Immunodeficiency Virus (HIV) infection in confronting HIV-related discrimination. The article looks at legal principles of confidentiality, disclosure, negligence and potential…

  5. "Toxocara canis" Infection of Children: Epidemiology and Neurospychologic Findings.

    ERIC Educational Resources Information Center

    Marmor, Michael; And Others

    1987-01-01

    Presents results of a serologic survey for antibodies to Toxocara canis (the common roundworm of dogs) in a sample of 4,652 New York City children. Discusses findings of a case-control study conducted to identify host and environmental risk factors for T. canis infection and to investigate its consequences. (KH)

  6. Helicobacter pylori infection in children: should it be carefully assessed?

    PubMed

    Ortiz-Princz, D; Daoud, G; Salgado-Sabel, A; Cavazza, M E

    2016-05-01

    The prevalence of H. pylori infection, mainly acquired during childhood and may be persisting throughout life, has been found high in developing countries; this high prevalence is related to low socioeconomic status. The persistence of bacterium exposure is related to gastritis and other severe complications including peptic ulcer, lymphoma MALT and gastric cancer, which are rarely present in the pediatric age due to a lower inflammatory and immunological response. Virulence factors, host gastric mucosal factors, and the natural environment of patients are associated with the clinical outcome of H. pylori infection. The main bacterial virulence factors include adhesins (BabA, SabA), vacuolating cytotoxin VacA, and the products of the cag pathogenicity island (cag PAI). There are geographic differences between cagA, vacA status and H. pylori related diseases. The main criteria to evaluate H. pylori infection in children are gastrointestinal and extra gastrointestinal manifestations related to H. pylori infection, familial history of gastric cancer, peptic ulcer, lymphoma MALT, symptomatic children living in high prevalence regions, and immigrant or adopted children in developed countries. Early detection of H. pylori and its virulence factors, in addition to effective methods of eradication associated with prevention programs, may lead to the decrease of H. pylori incidence and gastritis, especially in endemic high-risk regions. The early assessment in children may prevent further severe complications in adulthood. PMID:27212173

  7. Characterization of Staphylococcus aureus infections in children with Down syndrome.

    PubMed

    Johnston, Jeffrey N; Kaplan, Sheldon L; Mason, Edward O; Hulten, Kristina G

    2015-11-01

    Staphylococcus aureus infections in the Down syndrome (DS) population have not been well characterized. This study determined clinical and molecular characteristics of S. aureus infections in children with DS followed at Texas Children's Hospital (TCH), from 2001 to 2011. Patients were retrospectively identified from an ongoing S. aureus surveillance study. Medical records were reviewed. Isolates were characterized by antimicrobial susceptibility, pulsed-field gel electrophoresis patterns, and detection of PVL genes (pvl), mupA (high-level mupirocin resistance gene), smr (chlorhexidine resistance conferring gene), and Staphylococcal Chromosomal Cassette mec (SCCmec) type. Twenty-six patients with DS had a total of 34 S. aureus infections (8 recurrent); 61% were MRSA. DS patients represented 16.8 per 10,000 community onset S. aureus infections seen at TCH. Among 26 initial infections 17 were skin and soft tissue (SSTI), 7 were outer or middle ear and 2 were invasive infections. Seventeen patients were hospitalized. Thirteen (65%) of 20 available isolates were USA300, 14 were pvl+, 5 were mupA+, and 8 were smr+. Five of 8 (63%) recurrent infections were ear infections. All 4 recurrent ear isolates available for study were smr+, ciprofloxacin non-susceptible and treated with ciprofloxacin otic drops. S. aureus infections among patients with DS were similar in presentation to other patient groups, except for a greater proportion being associated with ear infections. Seventy percent of ear fluid isolates carried antiseptic and fluoroquinolone resistance genes. A study of a greater number of DS patients is warranted to further explore these findings. PMID:26386776

  8. Molecular evidence of simian virus 40 infections in children

    NASA Technical Reports Server (NTRS)

    Butel, J. S.; Arrington, A. S.; Wong, C.; Lednicky, J. A.; Finegold, M. J.

    1999-01-01

    Recent studies have detected simian virus 40 (SV40) DNA in certain human tumors and normal tissues. The significance of human infections by SV40, which was first discovered as a contaminant of poliovirus vaccines used between 1955 and 1963, remains unknown. The occurrence of SV40 infections in unselected hospitalized children was evaluated. Polymerase chain reaction and DNA sequence analyses were done on archival tissue specimens from patients positive for SV40 neutralizing antibody. SV40 DNA was identified in samples from 4 of 20 children (1 Wilms' tumor, 3 transplanted kidney samples). Sequence variation among SV40 regulatory regions ruled out laboratory contamination of specimens. This study shows the presence of SV40 infections in pediatric patients born after 1982.

  9. Treatment of Recurrent Upper Respiratory Infection in Children

    PubMed Central

    Sher, N.

    1977-01-01

    The care of a child with recurrent upper respiratory infections can be a frustrating experience for the physician, parent and patient. In this presentation, the history, age incidence, etiology and therapy of recurrent respiratory infection are discussed. As in other conditions the importance of the history cannot be over-emphasized. This alone may indicate the appropriate form of therapy. The age incidence in 32 pediatric patients is presented. Regular daily administration of sulfonamide can be an effective prophylaxis. The indications for tonsillectomy and adenoidectomy are discussed, and a respiratory vaccine has also been found effective. When these measures were unsuccessful, a trial of sodium cromoglycate was undertaken in 32 children, approximately 60 percent of whom improved within ten days. Repeated respiratory infection in children may sensitize the mucosa of the respiratory tract with consequent liberation of histamine. PMID:21304799

  10. Influenza and parainfluenza viral infections in children.

    PubMed

    Fox, Thomas G; Christenson, John C

    2014-06-01

    • On the basis of strong epidemiologic evidence, influenza and parainfluenza viruses are responsible for significant morbidity and mortality in young infants and children and in persons with chronic medical conditions. (1)(4)(26)(27)(35). • On the basis of research evidence, influenza vaccines are effective in preventing disease in high-risk individuals. (8)(17)(18). • On the basis of strong research evidence, influenza vaccines are safe in young infants and children 6 months or older. (8)(15).• On the basis of research evidence, the use of corticosteroids and epinephrine is beneficial in the treatment of laryngotracheitis caused by parainfluenza viruses. (44)(45)(46)(47). • Strong evidence supports the use of influenza vaccines in pregnant mothers as a strategy to prevent disease in infants younger than 6 months. (17)(18)(19). PMID:24891595

  11. Cytomegalovirus Infection After Intestinal Transplantation in Children

    PubMed Central

    Bueno, Javier; Green, Michael; Kocoshis, Samuel; Furukawa, Hiroyuki; Ahu-Elmagd, Kareem; Yunis, Eduardo; Irish, William; Todo, Satoru; Reyes, Jorge; Starzl, Thomas E.

    2010-01-01

    Sixteen episodes of cytomegalovirus (CMV) disease occurred in 10 of 41 children undergoing intestinal transplantation from 1990 to 1995. Stratification of CMV disease by donor (D)/recipient (R) serological status was as follows: 3 of 8, D+/R−; 3 of 9, D+/R+; 4 of 9, D−/R+; and 0 of 15, D−/R−. Treatment resulted in resolution of CMV disease in 93.3% of episodes. No deaths attributable to CMV disease occurred in this series. CMV in D+/R− children resulted in more extensive and persistent disease. However, patient and graft survival rates were similar in the different D/R subgroups and between children with and without CMV disease. Cumulative dose of steroid boluses (relative risk [RR]. 1.59; 95% confidence interval [CI]. 1.14–2.21) and history of steroid recycles (RR, 2.72; 95% CI, 1.21–6.13) were associated with CMV disease. These results suggest that although CMV-associated morbidity in pediatric intestinal transplant recipients was substantial, it was not associated with an increased rate of mortality or graft loss, even among high-risk D+/R− patients. PMID:9402361

  12. Fertility Decision-Making Among Kenyan HIV-Serodiscordant Couples Who Recently Conceived: Implications for Safer Conception Planning.

    PubMed

    Pintye, Jillian; Ngure, Kenneth; Curran, Kathryn; Vusha, Sophie; Mugo, Nelly; Celum, Connie; Baeten, Jared M; Heffron, Renee

    2015-09-01

    HIV-serodiscordant couples often choose to attempt pregnancy despite their HIV transmission risk. Optimizing delivery of HIV risk reduction strategies during peri-conception periods (i.e., safer conception) requires understanding how HIV-serodiscordant couples approach fertility decisions. We conducted 36 in-depth individual interviews with male and female partners of Kenyan heterosexual HIV-serodiscordant couples who recently conceived. Transcripts were analyzed by gender and HIV serostatus using open coding. Matrices were used to identify patterns and emerging themes. Most participants expressed acceptance of being in an HIV-serodiscordant couple and affirmed their resilience to live with serodiscordance and achieve their fertility goals. Overall, while the goal for childbearing was unchanged, conception became an urgent desire so that both partners could experience childrearing together while the HIV-infected partner was still healthy. Children also add value to the relationship, and multiple children were a commonly expressed desire. Couples' desires dominated those of individual partners in fertility decision-making, but male preferences were more influential when the individual desires differed. Values and preferences of the couple as a unit may mediate fertility decision-making in HIV-discordant couples. Thus, it is important that safer conception programs include both partners when appropriate and consider the relationship context during risk reduction counseling and when recommending risk reduction interventions. PMID:26301703

  13. Albuterol Use in Children Hospitalized with Human Metapneumovirus Respiratory Infection

    PubMed Central

    Rasmussen, Lindsey K.

    2016-01-01

    Introduction. Human metapneumovirus (HMPV) is a paramyxovirus from the same subfamily as respiratory syncytial virus (RSV) and causes similar acute lower respiratory tract infection. Albuterol in the setting of acute RSV infection is controversial and has not yet been studied in HMPV. We sought to determine the frequency of albuterol use in HMPV infection and the association between albuterol administration and patient outcomes. Methods. We conducted a retrospective cohort study identifying all patients hospitalized in a tertiary care children's hospital with laboratory-confirmed HMPV infection between January 2010 and December 2010. Results. There were 207 patients included in the study; 57% had a chronic medical condition. The median hospital length of stay was 3 days. Only 31% of patients in the study had a documented wheezing history, while 69% of patients received at least one albuterol treatment. There was no difference in length of stay between patients who received albuterol and those who did not. Conclusion. There is a high frequency of albuterol use in children hospitalized with HMPV infection. As with RSV, evidence may not support routine use of bronchodilators in patients with acute HMPV respiratory infection. Research involving additional patient outcomes and illness severity indicators would be useful in future studies. PMID:26925109

  14. Contrasting Patterns of Serologic and Functional Antibody Dynamics to Plasmodium falciparum Antigens in a Kenyan Birth Cohort

    PubMed Central

    Malhotra, Indu; Wang, Xuelie; Babineau, Denise; Yeo, Kee Thai; Anderson, Timothy; Kimmel, Rhonda J.; Angov, Evelina; Lanar, David E.; Narum, David; Dutta, Sheetij; Richards, Jack; Beeson, James G.; Crabb, Brendan S.; Cowman, Alan F.; Horii, Toshihiro; Muchiri, Eric; Mungai, Peter L.; King, Christopher L.; Kazura, James W.

    2015-01-01

    IgG antibodies to Plasmodium falciparum are transferred from the maternal to fetal circulation during pregnancy, wane after birth, and are subsequently acquired in response to natural infection. We examined the dynamics of malaria antibody responses of 84 Kenyan infants from birth to 36 months of age by (i) serology, (ii) variant surface antigen (VSA) assay, (iii) growth inhibitory activity (GIA), and (iv) invasion inhibition assays (IIA) specific for merozoite surface protein 1 (MSP1) and sialic acid-dependent invasion pathway. Maternal antibodies in each of these four categories were detected in cord blood and decreased to their lowest level by approximately 6 months of age. Serologic antibodies to 3 preerythrocytic and 10 blood-stage antigens subsequently increased, reaching peak prevalence by 36 months. In contrast, antibodies measured by VSA, GIA, and IIA remained low even up to 36 months. Infants sensitized to P. falciparum in utero, defined by cord blood lymphocyte recall responses to malaria antigens, acquired antimalarial antibodies at the same rate as those who were not sensitized in utero, indicating that fetal exposure to malaria antigens did not affect subsequent infant antimalarial responses. Infants with detectable serologic antibodies at 12 months of age had an increased risk of P. falciparum infection during the subsequent 24 months. We conclude that serologic measures of antimalarial antibodies in children 36 months of age or younger represent biomarkers of malaria exposure rather than protection and that functional antibodies develop after 36 months of age in this population. PMID:26656119

  15. [Invasive fungal infections in children: similarities and differences with adults].

    PubMed

    Ramos, J T; Francisco, L; Daoud, Z

    2016-09-01

    Invasive fungal infections (IFI) are a major cause of morbidity and mortality in immunocompromised adults and children. The purpose of this review was to update the epidemiological, clinical and therapeutic options in children, and to compare them with the adult population. Although there are important differences, the epidemiology, clinical features and risk factors for IFI have many similarities. Patient at risk include neutropenic hematology children, in whom Candida spp. y Aspergillus spp. predominate; primary immunodeficiencies, particularly chronic granulomatous disease with high susceptibility for Aspergillus spp.; and extremely premature infants, in whom C. albicans y C. parapsilosis are more prevalent. Premature babies are prone to dissemination, including the central nervous system. There are peculiarities in radiology and diagnostic biomarkers in children. In pulmonary aspergillosis, clasical signs in CT are usually absent. There is scant information on PCR and beta-D-glucan in children, and more limited on the performance of galactomannan enzyme immunoassay, that does not appear to be much different in neutropenic patients. There is a delay in the development of antifungals, limiting their use in children. Most azoles require therapeutic drug monitoring in children to optimize its safety and effectiveness. Pediatric treatment recommendations are mainly extrapolated from results of clinical trials performed in adults. There is no evidence for the benefit of preemptive therapy in children. It is necessary to foster specific pediatric studies with current and new antifungals to evaluate their pharmacokinetics, safety, and effectiveness at different ages in the pediatric population. PMID:27608317

  16. Risk factors for Mycobacterium tuberculosis infection among children in Greenland

    PubMed Central

    Andersen, Aase Bengaard; Melbye, Mads; Wohlfahrt, Jan; Andersson, Mikael; Biggar, Robert J; Ladefoged, Karin; Thomsen, Vibeke Ostergaard; Koch, Anders

    2011-01-01

    Abstract Objective To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection. Methods Between 2005 and 2007, 1797 Greenlandic schoolchildren in five different areas were tested for MTI with an interferon gamma release assay (IGRA) and a tuberculin skin test (TST). Parents or guardians were surveyed using a standardized self-administered questionnaire to obtain data on crowding in the household, parents’ educational level and the child’s health status. Demographic data for each child – i.e. parents’ place of birth, number of siblings, distance between siblings (next younger and next older), birth order and mother’s age when the child was born – were also extracted from a public registry. Logistic regression was used to check for associations between these variables and MTI, and all results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Children were considered to have MTI if they tested positive on both the IGRA assay and the TST. Findings The overall prevalence of MTI was 8.5% (152/1797). MTI was diagnosed in 26.7% of the children with a known TB contact, as opposed to 6.4% of the children without such contact. Overall, the MTI rate was higher among Inuit children (OR: 4.22; 95% CI: 1.55–11.5) and among children born less than one year after the birth of the next older sibling (OR: 2.48; 95% CI: 1.33–4.63). Self-reported TB contact modified the profile to include household crowding and low mother’s education. Children who had an older MTI-positive sibling were much more likely to test positive for MTI themselves (OR: 14.2; 95% CI: 5.75–35.0) than children without an infected older sibling. Conclusion Ethnicity, sibling relations, number of household residents and maternal level of education are factors associated with the risk of TB infection among children in Greenland. The strong household clustering of

  17. Bone health in children and adolescents with perinatal HIV infection

    PubMed Central

    Puthanakit, Thanyawee; Siberry, George K

    2013-01-01

    The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood. PMID:23782476

  18. Beta-lactamases in Enterobacteriaceae infections in children.

    PubMed

    Moxon, Christopher Alan; Paulus, Stéphane

    2016-07-01

    Multi-drug resistance in Gram negative bacteria, particularly in Enterobacteriaceae, is a major clinical and public health challenge. The main mechanism of resistance in Enterobacteriaceae is linked to the production of beta-lactamase hydrolysing enzymes such as extended spectrum beta-lactamases (ESBL), AmpC beta-lactamases and carbapenemases (Carbapenemase Producing Enterobacteriaceae (CPE)). ESBL and CPE resistance genes are located on plasmids, which can be transmitted between Enterobacteriaceae, facilitating their spread in hospitals and communities. These plasmids usually harbour multiple additional co-resistance genes, including to trimethoprim-sulfamethoxazole, aminoglycosides, and fluoroquinolones, making these infections challenging to treat. Asymptomatic carriage in healthy children as well as community acquired infections are increasingly reported, particularly with ESBL. Therapeutic options are limited and previously little used antimicrobials such as fosfomycin and colistin have been re-introduced in clinical practice. Paediatric experience with these agents is limited hence there is a need to further examine their clinical efficacy, dosage and toxicity in children. Antimicrobial stewardship along with strict infection prevention and control practices need to be adopted widely in order to preserve currently available antimicrobials. The future development of novel agents effective against beta-lactamases producers and their applicability in children is urgently needed to address the challenge of multi-resistant Gram negative infections. PMID:27180312

  19. Postoperative nosocomial infections among children with congenital heart disease

    PubMed Central

    Zhang, Jian; Yuan, Yan; Li, Peiling; Wang, Tuanjie; Gao, Jun; Yao, Jinhua; Li, Shujun

    2014-01-01

    Objective: To study the pathogen distribution, antimicrobial susceptibility and risk factors of postoperative nosocomial infections among children with congenital heart disease. Methods: Three hundreds children with congenital heart disease admitted to our hospital to receive surgeries from February 2010 to February 2013 were selected. Results: A total of 120 children were tested as positive by sputum culture, with the infection rate of 40.0%. The top five most common pathogenic microorganisms included Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus, Pseudomonas aeruginosa, and Candida albicans. S. epidermidis, S. aureus and Enterococcus were highly resistant to penicillin, azithromycin and erythromycin, moderately susceptible to levofloxacin and cefazolin, and completely susceptible to vancomycin. Multivariate Logistic regression analysis showed that hospitalization stay length, combined use of antibiotics, systemic use of hormones, mechanical ventilation and catheter indwelling were the independent risk factors of postoperative nosocomial infections (P<0.05). Conclusion: Nosocomial infection, which was the most frequent postoperative complication of pediatric congenital heart disease, was predominantly induced by Gram-positive bacteria that were highly susceptible to cephalosporins and vancomycin. Particular attention should be paid to decrease relevant risk factors to improve the prognosis. PMID:24948978

  20. Human bocavirus infection in hospitalized children in Italy

    PubMed Central

    Pierangeli, Alessandra; Scagnolari, Carolina; Trombetti, Simona; Grossi, Rosanna; Battaglia, Massimo; Moretti, Corrado; Midulla, Fabio; Antonelli, Guido

    2008-01-01

    Background  Human bocavirus (HBoV) was first discovered in Sweden in 2005 and has now been found worldwide; however its role in clinically relevant diseases has not yet been clearly defined. Objectives  To gain new insight into HBoV infection among children hospitalized with acute respiratory infections in Rome. Methods  Between November 2004 and May 2007, 415 nasal washings were tested for the presence of an extensive range of respiratory viruses using molecular methods. Results  Viral pathogens were detected in 214 children (51·6%), 28·9% being respiratory syncytial virus (RSV) and 9·6% being rhinovirus positive. Of the 34 children (8·2%) who tested positive for HBoV, 21 (61·8%) were co‐infected with another respiratory virus, mainly RSV. Human bocavirus was the only pathogen identified in four pneumonia and six bronchiolitis cases in March 2005 and January 2007, respectively. Human bocavirus was also detected in one child hospitalized with gastroenteritis and in another with erythema. Conclusions  In the examined population, HBoV was the third most common virus detected but with a high rate of co‐infection with other respiratory viruses. Human bocavirus appeared to be the etiological agent in some pneumonia and bronchiolitis cases in which tests for all likely respiratory pathogens were negative. PMID:19453422

  1. Invasive Group A Streptococcus Infection among Children, Rural Kenya

    PubMed Central

    Davies, Mark R.; Anampiu, Kirimi; Morpeth, Susan C.; Nyongesa, Sammy; Mwarumba, Salim; Smeesters, Pierre R.; Efstratiou, Androulla; Karugutu, Rosylene; Mturi, Neema; Williams, Thomas N.; Scott, J. Anthony G.; Kariuki, Samuel; Dougan, Gordon; Berkley, James A.

    2016-01-01

    To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998–2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type–specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence. PMID:26811918

  2. Invasive Group A Streptococcus Infection among Children, Rural Kenya.

    PubMed

    Seale, Anna C; Davies, Mark R; Anampiu, Kirimi; Morpeth, Susan C; Nyongesa, Sammy; Mwarumba, Salim; Smeesters, Pierre R; Efstratiou, Androulla; Karugutu, Rosylene; Mturi, Neema; Williams, Thomas N; Scott, J Anthony G; Kariuki, Samuel; Dougan, Gordon; Berkley, James A

    2016-02-01

    To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998-2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type-specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence. PMID:26811918

  3. Asthma and risk of breakthrough varicella infection in children

    PubMed Central

    Umaretiya, Puja J.; Swanson, Jennifer B.; Kwon, Hyo-Jin; Grose, Charles; Lohse, Christine M.

    2016-01-01

    Background: We recently reported a more rapid waning of vaccine-induced humoral immunity (measles vaccine) in children with asthma. It is unknown if asthma affects susceptibility to vaccine-preventable diseases. Objective: To determine whether asthma is associated with an increased risk of vaccine-preventable disease, e.g., breakthrough varicella infection. Methods: This was a retrospective population-based case-control study that examined cases of breakthrough varicella among children between 2005 and 2011. Children with a diagnosis of breakthrough varicella infection in Olmsted County, Minnesota (infection of >42 days after vaccination) between 2005 and 2011 and two age- and sex-matched controls were enrolled for each case. Asthma status was determined by using predetermined criteria. Conditional logistic regression models were used to calculate matched odds ratios (OR) and their corresponding 95% confidence intervals (CI). Results: Of the 165 cases and their 330 matched controls, 48% were boys and the mean (standard deviation) age at the index date was 6.6 ± 3.5 years for both cases and controls. Of the 330 controls, 80 (24%) had two doses of the varicella vaccine compared with only 23 (14%) of the 165 cases (OR 0.29 [95% CI, 0.14–0.61]; p = 0.001). Children with a history of asthma ever had a higher risk of developing breakthrough varicella compared with those without a history of asthma (adjusted OR 1.63 [95% CI, 1.04–2.55]; p = 0.032) when adjusting for elapsed time since the first varicella vaccination and the number of varicella vaccine doses. Conclusions: A history of asthma might be an unrecognized risk factor for breakthrough varicella infection. Children with asthma should follow the two-dose varicella vaccine policy. PMID:27178889

  4. Risk factors for Giardia infection among hospitalized children in Cuba

    PubMed Central

    Bello, J; Núñez, F A; González, O M; Fernández, R; Almirall, P; Escobedo, A A

    2011-01-01

    The risk factors associated with Giardia infection, in children hospitalized in Havana, Cuba, were recently explored. Children aged ⩾5 years were more likely to be positive for Giardia infection than the younger children, with an odds ratio (OR) of 3.41 [95% confidence interval (CI) = 1.36–9.69]. The risk factors found to be associated with Giardia infection in univariate analyses were rural residence (OR = 3.01; CI = 1.23–7.35), belonging to a household that did not receive water from an aqueduct (OR = 3.27; CI = 1.21–8.91), drinking unboiled water (OR = 3.64; CI = 2.14–6.26), nail biting (OR = 3.47; CI = 1.97–6.08), eating unwashed vegetables raw (OR = 4.84; CI = 2.33–10.14), and a personal (OR = 3.23; CI = 1.58–6.59) or family history (OR = 3.96; CI = 1.53–10.47) of previous parasitic infection. In multivariate analyses, however, only two (modifiable) risk factors were found to be independently and significantly associated with Giardia infection: nail biting and eating unwashed vegetables raw. It therefore seems that, at least at the individual level, giardiasis-prevention activities in Havana should be focussed on health education to improve personal hygiene and food-related practices. If appropriately managed, the surveillance of drinking water and foodstuffs, for Giardia and other parasites, might also help to reduce the hospitalization of Cuban children. PMID:21294949

  5. Premature aging and immune senescence in HIV-infected children

    PubMed Central

    Gianesin, Ketty; Noguera-Julian, Antoni; Zanchetta, Marisa; Del Bianco, Paola; Petrara, Maria Raffaella; Freguja, Riccardo; Rampon, Osvalda; Fortuny, Clàudia; Camós, Mireia; Mozzo, Elena; Giaquinto, Carlo; De Rossi, Anita

    2016-01-01

    Objective: Several pieces of evidence indicate that HIV-infected adults undergo premature aging. The effect of HIV and antiretroviral therapy (ART) exposure on the aging process of HIV-infected children may be more deleterious since their immune system coevolves from birth with HIV. Design: Seventy-one HIV-infected (HIV+), 65 HIV-exposed-uninfected (HEU), and 56 HIV-unexposed-uninfected (HUU) children, all aged 0–5 years, were studied for biological aging and immune senescence. Methods: Telomere length and T-cell receptor rearrangement excision circle levels were quantified in peripheral blood cells by real-time PCR. CD4+ and CD8+ cells were analysed for differentiation, senescence, and activation/exhaustion markers by flow cytometry. Results: Telomere lengths were significantly shorter in HIV+ than in HEU and HUU children (overall, P < 0.001 adjusted for age); HIV+ ART-naive (42%) children had shorter telomere length compared with children on ART (P = 0.003 adjusted for age). T-cell receptor rearrangement excision circle levels and CD8+ recent thymic emigrant cells (CD45RA+CD31+) were significantly lower in the HIV+ than in control groups (overall, P = 0.025 and P = 0.005, respectively). Percentages of senescent (CD28−CD57+), activated (CD38+HLA-DR+), and exhausted (PD1+) CD8+ cells were significantly higher in HIV+ than in HEU and HUU children (P = 0.004, P < 0.001, and P < 0.001, respectively). Within the CD4+ cell subset, the percentage of senescent cells did not differ between HIV+ and controls, but programmed cell death receptor-1 expression was upregulated in the former. Conclusions: HIV-infected children exhibit premature biological aging with accelerated immune senescence, which particularly affects the CD8+ cell subset. HIV infection per se seems to influence the aging process, rather than exposure to ART for prophylaxis or treatment. PMID:26990630

  6. Urinary tract infections in infants and children: Diagnosis and management.

    PubMed

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2014-06-01

    Recent studies have resulted in major changes in the management of urinary tract infections (UTIs) in children. The present statement focuses on the diagnosis and management of infants and children >2 months of age with an acute UTI and no known underlying urinary tract pathology or risk factors for a neurogenic bladder. UTI should be ruled out in preverbal children with unexplained fever and in older children with symptoms suggestive of UTI (dysuria, urinary frequency, hematuria, abdominal pain, back pain or new daytime incontinence). A midstream urine sample should be collected for urinalysis and culture in toilet-trained children; others should have urine collected by catheter or by suprapubic aspirate. UTI is unlikely if the urinalysis is completely normal. A bagged urine sample may be used for urinalysis but should not be used for urine culture. Antibiotic treatment for seven to 10 days is recommended for febrile UTI. Oral antibiotics may be offered as initial treatment when the child is not seriously ill and is likely to receive and tolerate every dose. Children <2 years of age should be investigated after their first febrile UTI with a renal/bladder ultrasound to identify any significant renal abnormalities. A voiding cystourethrogram is not required for children with a first UTI unless the renal/bladder ultrasound reveals findings suggestive of vesicoureteral reflux, selected renal anomalies or obstructive uropathy. PMID:25332662

  7. Aerobic and anaerobic microbiology of infections after trauma in children.

    PubMed Central

    Brook, I

    1998-01-01

    OBJECTIVE: To review the recovery of aerobic and anaerobic bacteria from infections after trauma in children over a 20 year period. METHODS: Only specimens that were studied for both aerobic and anaerobic bacteria were included in the analysis. They were collected from seven separate centres in which the microbiology laboratories only accepted specimens that were properly collected without contamination and were submitted in appropriate transport media. Anaerobes and aerobic bacteria were cultured and identified using standard techniques. Clinical records were reviewed to identify post-trauma patients. RESULTS: From 1974 to 1994, 175 specimens obtained from 166 children with trauma showed bacterial growth. The trauma included blunt trauma (71), lacerations (48), bites (42), and open fractures (5). Anaerobic bacteria only were isolated in 38 specimens (22%), aerobic bacteria only in 51 (29%), and mixed aerobic-anaerobic flora in 86 (49%); 363 anaerobic (2.1/specimen) and 158 aerobic or facultative isolates (0.9/specimen) were recovered. The predominant anaerobic bacteria included Peptostreptococcus spp (115 isolates), Prevotella spp (68), Fusobacterium spp (52), B fragilis group (42), and Clostridium spp (21). The predominant aerobic bacteria included Staph aureus (51), E coli (13), Ps aeruginosa (12), Str pyogenes (11) and Klebsiella pneumoniae (9). Principal infections were: abscesses (52), bacteraemia (3), pulmonary infections (30, including aspiration pneumonia, tracheostomy associated pneumonia, empyema, and ventilator associated pneumonia), wounds (36, including cellulitis, post-traumatic wounds, decubitus ulcers, myositis, gastrostomy and tracheostomy site wounds, and fasciitis), bites (42, including 23 animal and 19 human), peritonitis (4), osteomyelitis (5), and sinusitis (3). Staph aureus and Str pyogenes were isolated at all sites. However, organisms of the oropharyngeal flora predominated in infections that originated from head and neck wounds and

  8. Campylobacter infections in children exposed to infected backyard poultry in Egypt.

    PubMed

    El-Tras, W F; Holt, H R; Tayel, A A; El-Kady, N N

    2015-01-01

    Campylobacteriosis is a zoonotic disease which has a worldwide public health impact. The disease is endemic in Egypt; however, the epidemiology in animals and humans has not been fully characterized. The objective of this study was to compare the risk of Campylobacter faecal carriage in children exposed to Campylobacter-infected vs. non-infected backyard poultry and to identify risk factors for a backyard being classified as infected. A total of 103 households which owned backyard poultry were sampled from a rural community in Egypt. Within these households 379 poultry and 106 children were tested for C. jejuni and C. coli; 23·5% and 5·5% of poultry were positive for C. jejuni and C. coli, respectively. In the studied households; 12·3% of children were positive for C. jejuni, and 2·8% were positive for C. coli. Using logistic regression, households with poultry positive for C. jejuni had 3·86 (95% confidence interval 1·0-15·0) times the odds of having children positive for C. jejuni compared to those housed with poultry which all tested negative. Backyard poultry may present a transmission route of C. jejuni to children. Backyards with poor cleaning and disinfection, wet litter and manure disposed of within the backyard had increased odds of being positive for C. jejuni. Enhancing biosecurity and management in poultry backyards may reduce the risk of the disease. PMID:24774694

  9. Clinical Indicators for Bacterial Co-Infection in Ghanaian Children with P. falciparum Infection

    PubMed Central

    Nielsen, Maja Verena; Amemasor, Solomon; Agyekum, Alex; Loag, Wibke; Marks, Florian; Sarpong, Nimako; Dekker, Denise; Adu-Sarkodie, Yaw; May, Jürgen

    2015-01-01

    Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40%) of the children malaria parasites were detected. This group was analyzed for indicators of bacterial co-infections using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0%) of the children with malaria infection, bacterial co-infection was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%), followed by Streptococcus spp. (13.0%). Coughing, dehydration, splenomegaly, severe anemia and leukocytosis were positively associated with bacteremia. Domestic hygiene and exclusive breastfeeding is negatively associated with bacteremia. In cases of high parasitemia (>10,000/μl), a significant association with bacteremia was found for splenomegaly (OR 8.8; CI 1.6–48.9), dehydration (OR 18.2; CI 2.0–166.0) and coughing (OR 9.0; CI 0.7–118.6). In children with low parasitemia, associations with bacteremia were found for vomiting (OR 4.7; CI 1.4–15.8), severe anemia (OR 3.3; CI 1.0–11.1) and leukocytosis (OR 6.8 CI 1.9–24.2). Clinical signs of impaired microcirculation were negatively associated with bacteremia. Ceftriaxone achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine bacterial co-infections in P. falciparum infected children. Best clinical indicators are dependent on the

  10. Competing Motivations for NP Order in Kenyan English.

    ERIC Educational Resources Information Center

    Kuha, Mai

    1998-01-01

    Examines competition between conflicting principles in Kenyan English (animacy hierarchy and discourse pressure to place given information before new), manifested in news discourse. Results suggest some differences between spoken and written Kenyan English pointing to a tendency toward a more standard native-speaker variety in news discourse, and…

  11. Fatherhood in Kenyan Ethnic Communities: Implication for Child Development

    ERIC Educational Resources Information Center

    Lasser, Jon; Fite, Kathleen; Wadende, Akinyi P.

    2011-01-01

    This article reviews the traditional and evolving constructions of fatherhood in Kenyan society, with an emphasis on fatherhood's impact on child development outcomes. Western influence and increased access to technology have changed the role of the Kenyan father, and in turn affected his role in the family. Special attention is given to…

  12. Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children

    PubMed Central

    Restrepo-Gualteros, Sonia M.; Jaramillo-Barberi, Lina E.; Gonzalez-Santos, Monica; Rodriguez-Martinez, Carlos E.; Perez, Geovanny F.; Gutierrez, Maria J.; Nino, Gustavo

    2014-01-01

    Cytomegalovirus (CMV) is a prevalent pathogen in the immunocompromised host and invasive pneumonia is a feared complication of the virus in this population. In this pediatric case series we characterized CMV lung infection in 15 non-HIV infected children (median age 3 years; IQR 0.2–4.9 years), using current molecular and imaging diagnostic modalities, in combination with respiratory signs and symptoms. The most prominent clinical and laboratory findings included cough (100%), hypoxemia (100%), diffuse adventitious breath sounds (100%) and increased respiratory effort (93%). All patients had abnormal lung images characterized by ground glass opacity/consolidation in 80% of cases. CMV was detected in the lung either by CMV PCR in bronchoalveolar lavage (82% detection rate) or histology/immunohistochemistry in lung biopsy (100% detection rate). CMV caused respiratory failure in 47% of children infected and the overall mortality rate was 13.3%. Conclusion: CMV pneumonia is a potential lethal disease in non-HIV infected children that requires a high-index of suspicion. Common clinical and radiological patterns such as hypoxemia, diffuse adventitious lung sounds and ground-glass pulmonary opacities may allow early identification of CMV lung infection in the pediatric population, which may lead to prompt initiation of antiviral therapy and better clinical outcomes. PMID:24811320

  13. Natural History of Primary Epstein-Barr Virus Infection in Children of Mothers Infected with Human Immunodeficiency Virus Type 1

    PubMed Central

    Jenson, Hal; McIntosh, Kenneth; Pitt, Jane; Husak, Scott; Tan, Ming; Bryson, Yvonne; Easley, Kirk

    2015-01-01

    The natural history of Epstein-Barr virus (EBV) infection in 556 infants born to 517 human immunodeficiency virus (HIV) type 1–infected mothers was studied in a prospective, multicenter, cohort study. HIV-1–infected children had a cumulative EBV infection rate similar to HIV-1–uninfected children at age 3 years (77.8% vs. 84.9%) but had more frequent oropharyngeal EBV shedding (50.4% vs. 28.2%; P < .001). The probability of shedding decreased with longer time from EBV seroconversion and was similar to that of HIV-1–uninfected children 3 years after seroconversion. HIV-1–infected children identified as rapid progressors shed EBV more frequently than nonrapid progressors (69.4% vs.41.0%; P = .01). HIV-1–infected children with EBV infection had higher mean CD8 cell counts. EBV infection did not have an independent effect on mean CD4 cell counts, percent CD4, IgG levels, HIV-1 RNA levels, lymphadenopathy, hepatomegaly, or splenomegaly. Early EBV infection is common in children born to HIV-1–infected mothers. Children with rapidly progressive HIV-1 disease have more frequent EBV shedding. PMID:10228060

  14. Vitamin D sufficiency and Staphylococcus aureus infection in children.

    PubMed

    Wang, Jeffrey W; Hogan, Patrick G; Hunstad, David A; Fritz, Stephanie A

    2015-05-01

    Vitamin D promotes epithelial immunity by upregulating antimicrobial peptides, including LL-37, which have bactericidal activity against Staphylococcus aureus. We found that children with vitamin D deficiency or insufficiency [25-hydroxyvitamin D <30 ng/mL] were more likely to present with recurrent, rather than primary, S. aureus skin or soft tissue infection. Vitamin D sufficiency may be one of a myriad of host and environmental factors that can be directly impacted to reduce the frequency of S. aureus skin and soft tissue infection. PMID:25860535

  15. Isolation and molecular characterization of Fikirini rhabdovirus, a novel virus from a Kenyan bat.

    PubMed

    Kading, Rebekah C; Gilbert, Amy T; Mossel, Eric C; Crabtree, Mary B; Kuzmin, Ivan V; Niezgoda, Michael; Agwanda, Bernard; Markotter, Wanda; Weil, M Ryan; Montgomery, Joel M; Rupprecht, Charles E; Miller, Barry R

    2013-11-01

    Zoonotic and vector-borne pathogens have comprised a significant component of emerging human infections in recent decades, and bats are increasingly recognized as reservoirs for many of these disease agents. To identify novel pathogens associated with bats, we screened tissues of bats collected in Kenya. Virus isolates were identified by next generation sequencing of viral nucleic acid preparations from the infected cell culture supernatant and characterized. Here we report the identification of Fikirini rhabdovirus, a novel rhabdovirus isolated from a bat, Hipposideros vittatus, captured along the Kenyan coast. PMID:23939976

  16. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program

    PubMed Central

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-01-01

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public health The Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program’s emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program’s student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  17. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program.

    PubMed

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-04-26

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public healthThe Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program's emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program's student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  18. Risk of Nephrotic Syndrome following Enteroviral Infection in Children: A Nationwide Retrospective Cohort Study

    PubMed Central

    Lin, Jiun-Nong; Lin, Cheng-Li; Yang, Chi-Hui; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

    2016-01-01

    Purpose Nephrotic syndrome is a common chronic illness encountered during childhood. Infections have been identified as a cause of nephrotic syndrome. The aim of this study was to evaluate the association between enteroviral infection and nephrotic syndrome. Methods A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged <18 years with enteroviral infection were enrolled. Non-enterovirus-infected children were randomly selected as the comparison cohort. The primary endpoint was the occurrence of nephrotic syndrome. Methods This study included 280,087 enterovirus-infected children and 280,085 non-enterovirus-infected children. The mean age of the enterovirus-infected children was 2.38 years, and 53.7% of these children were boys. The overall incidence densities of nephrotic syndrome for enterovirus- and non-enterovirus-infected children were 2.65 and 2.21 per 10,000 person-years, respectively. The enterovirus-infected cohort had a higher cumulative incidence of nephrotic syndrome than did the non-enterovirus-infected cohort (log-rank test, p = 0.01). Multivariable analyses revealed that children with enteroviral infection were significantly associated with an increased risk of nephrotic syndrome compared with those without enteroviral infection (adjusted hazard ratio, 1.20; 95% confidence interval, 1.04–1.39; p = 0.01), particularly in children infected with coxsackievirus. Subgroup analyses revealed that enterovirus-infected girls, children of blue-collar workers, and children without allergies had a higher risk of nephrotic syndrome than did children in the non-enterovirus-infected cohort. Conclusion This study revealed a significant association between enteroviral infection and nephrotic syndrome. Additional studies elucidating the role and pathogenesis of enterovirus in nephrotic syndrome are warranted. PMID:27508414

  19. Risk factors associated with intestinal parasitic infections among children.

    PubMed

    El-Sherbini, Gehad T; Abosdera, Mostafa Mohamed

    2013-04-01

    Intestinal parasites are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. The effective prevention and control of intestinal parasitic infections requires identification of local risk factors, particularly among high-risk groups. This study retrospectively analyzed demographic factors that may affect the prevalence of intestinal parasites among school children. Interviews, observation, and anthropometric indices assessment were used to identify the risk factors. The findings of the study showed that young age, female gender, and severe malnutrition, Poverty, illiteracy, poor hygiene, lack of access to potable water and hot and humid tropical climate are the factors associated with intestinal parasitic infections all correlated positively with increased rates of infection. Clinical visits were performed on 650 school children aged 5-15 years over a four-year period (2010-2013) in the Nahya Village, Giza Governorate. Stool specimens were examined using the formal ether concentration technique. Data were analysed using the SPSS statistical software. The results suggest that the prevalence of gastrointestinal parasites among young children is highly dependent on the specific species of the parasite. PMID:23697034

  20. Borrelia burgdorferi infection and Lyme disease in children.

    PubMed

    Esposito, Susanna; Bosis, Samantha; Sabatini, Caterina; Tagliaferri, Laura; Principi, Nicola

    2013-03-01

    Lyme disease is a multisystem disease that frequently affects children. It is caused by a group of related spirochetes, Borrelia burgdorferi sensu lato, that are transmitted by ticks belonging to species of the genus Ixodes. The clinical characteristics of Lyme disease in pediatrics resemble those observed in adults, although the symptoms may last for a shorter time and the outcome may be better. However, identifying Lyme disease in children can be significantly more difficult because some of its signs and symptoms can be similar to those of other common pediatric clinical manifestations. Finally, the diagnostic and therapeutic approach to childhood Lyme disease is frequently not codified, and guidelines specifically prepared for adults are used for children without having been validated. This review of the currently available data will evaluate what may be the best approach to the diagnosis and treatment of B. burgdorferi infection and disease in the pediatric population. PMID:23141587

  1. Airway microbiota and acute respiratory infection in children.

    PubMed

    Hasegawa, Kohei; Camargo, Carlos A

    2015-01-01

    Acute respiratory infections (ARIs), such as bronchiolitis and pneumonia, are the leading cause of hospitalization of infants in the US. While the incidence and severity of ARI can vary widely among children, the reasons for these differences are not fully explained by traditional risk factors (e.g., prematurity, viral pathogens). The recent advent of molecular diagnostic techniques has revealed the presence of highly functional communities of microbes inhabiting the human body (i.e., microbiota) that appear to influence development of local and systemic immune response. We propose a 'risk and resilience' model in which airway microbiota are associated with an increased (risk microbiota) or decreased (resilience microbiota) incidence and severity of ARI in children. We also propose that modulating airway microbiota (e.g., from risk to resilience microbiota) during early childhood will optimize airway immunity and, thereby, decrease ARI incidence and severity in children. PMID:25961472

  2. The Diagnosis of HIV Infection in Infants and Children.

    PubMed

    Abdollahi, Alireza; Saffar, Hana

    2016-01-01

    It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions. Timing of virological testing is also important. Infants infected at or around delivery may take short time to have detectable virus. Therefore, sensitivity of virological tests is lower at birth. In utero HIV infection, HIV DNA or RNA can be detected within 48 h of birth and in infants with peripartum acquisition it needs one to two weeks. Finally it is emphasized that all laboratories performing HIV tests should follow available services provided by WHO or CDC for quality assurance programs. Both clinicians and staffs providing laboratory services need regular communications, well-defined SOPs and nationally validated algorithms for optimal use of laboratory tests. Every country should use assays that have been validated by national reference laboratory. PMID:27499768

  3. The Diagnosis of HIV Infection in Infants and Children

    PubMed Central

    Abdollahi, Alireza; Saffar, Hana

    2016-01-01

    It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions. Timing of virological testing is also important. Infants infected at or around delivery may take short time to have detectable virus. Therefore, sensitivity of virological tests is lower at birth. In utero HIV infection, HIV DNA or RNA can be detected within 48 h of birth and in infants with peripartum acquisition it needs one to two weeks. Finally it is emphasized that all laboratories performing HIV tests should follow available services provided by WHO or CDC for quality assurance programs. Both clinicians and staffs providing laboratory services need regular communications, well-defined SOPs and nationally validated algorithms for optimal use of laboratory tests. Every country should use assays that have been validated by national reference laboratory.

  4. Infection-Related Focal Segmental Glomerulosclerosis in Children.

    PubMed

    Dettmar, Anne Katrin; Oh, Jun

    2016-01-01

    Focal segmental glomerulosclerosis (FSGS) is the most common cause of steroid resistant nephrotic syndrome in children. It describes a unique histological picture of glomerular damage resulting from several causes. In the majority of patients the causing agent is still unknown, but in some cases viral association is evident. In adults, the most established FSGS causing virus is the human immune-deficiency virus, which is related to a collapsing variant of FSGS. Nevertheless, other viruses are also suspected for causing a collapsing or noncollapsing variant, for example, hepatitis B virus, parvovirus B19, and Cytomegalovirus. Although the systemic infection mechanism is different for these viruses, there are similarities in the pathomechanism for the induction of FSGS. As the podocyte is the key structure in the pathogenesis of FSGS, a direct infection of these cells or immediate damage through the virus or viral components has to be considered. Although viral infections are a very rare cause for FSGS in children, the treating pediatric nephrologist has to be aware of a possible underlying infection, as this has a relevant impact on therapy and prognosis. PMID:27294131

  5. Evidence of SV40 infections in hospitalized children

    NASA Technical Reports Server (NTRS)

    Butel, J. S.; Jafar, S.; Wong, C.; Arrington, A. S.; Opekun, A. R.; Finegold, M. J.; Adam, E.

    1999-01-01

    Simian virus 40 (SV40) is known to have contaminated poliovirus vaccines used between 1955 and 1963. Accumulating reports have described the presence of SV40 DNA in human tumors and normal tissues, although the significance of human infections by SV40 is unknown. We investigated whether unselected hospitalized children had evidence of SV40 infections and whether any clinical correlations were apparent. Serum samples were examined for SV40 neutralizing antibody using a specific plaque reduction test; of 337 samples tested, 20 (5.9%) had antibody to SV40. Seropositivity increased with age and was significantly associated with kidney transplants (6 of 15 [40%] positive, P < .001). Many of the antibody-positive patients had impaired immune systems. Molecular assays (polymerase chain reaction and DNA sequence analysis) on archival tissue specimens confirmed the presence of SV40 DNA in 4 of the antibody-positive patients. This study, using 2 independent assays, shows the presence of SV40 infections in children born after 1980. We conclude that SV40 causes natural infections in humans.

  6. Infection-Related Focal Segmental Glomerulosclerosis in Children

    PubMed Central

    Dettmar, Anne Katrin; Oh, Jun

    2016-01-01

    Focal segmental glomerulosclerosis (FSGS) is the most common cause of steroid resistant nephrotic syndrome in children. It describes a unique histological picture of glomerular damage resulting from several causes. In the majority of patients the causing agent is still unknown, but in some cases viral association is evident. In adults, the most established FSGS causing virus is the human immune-deficiency virus, which is related to a collapsing variant of FSGS. Nevertheless, other viruses are also suspected for causing a collapsing or noncollapsing variant, for example, hepatitis B virus, parvovirus B19, and Cytomegalovirus. Although the systemic infection mechanism is different for these viruses, there are similarities in the pathomechanism for the induction of FSGS. As the podocyte is the key structure in the pathogenesis of FSGS, a direct infection of these cells or immediate damage through the virus or viral components has to be considered. Although viral infections are a very rare cause for FSGS in children, the treating pediatric nephrologist has to be aware of a possible underlying infection, as this has a relevant impact on therapy and prognosis. PMID:27294131

  7. Bone and Joint Infections in Children: Acute Hematogenous Osteomyelitis.

    PubMed

    Agarwal, Anil; Aggarwal, Aditya N

    2016-08-01

    Acute hematogenous osteomyelitis (AHO) is one of the commonest bone infection in childhood. Staphylococcus aureus is the commonest organism causing AHO. With use of advanced diagnostic methods, fastidious Kingella kingae is increasingly becoming an important organism in etiology of osteoarticular infections in children under the age of 3 y. The diagnosis of AHO is primarily clinical. The main clinical symptom and sign in AHO is pain and tenderness over the affected bone especially in the metaphyseal region. However, in a neonate the clinical presentation may be subtle and misleading. Laboratory and radiological investigations supplement the clinical findings. The acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are frequently elevated. Ultrasonography and MRI are key imaging modalities for early detection of AHO. Determination of infecting organism in AHO is the key to the correct antibiotic choice, treatment duration and overall management and therefore, organism isolation using blood cultures and site aspiration should be attempted. Several effective antibiotics regimes are available for managing AHO in children. The choice of antibiotic and its duration and mode of delivery requires individualization depending upon severity of infection, causative organism, regional sensitivity patterns, time elapsed between onset of symptoms and child's presentation and the clinical and laboratory response to the treatment. If pus has been evidenced in the soft tissues or bone region, surgical decompression of abscess is mandatory. PMID:26096866

  8. Visceral basidiobolomycosis: An overlooked infection in immunocompetent children

    PubMed Central

    Mandhan, Parkash; Hassan, Kamal Osman; Samaan, Sandra Moustafa; Ali, Mansour J

    2015-01-01

    Visceral basidiobolomycosis is an unusual fungal infection of viscera caused by saprophyte Basidiobolus ranarum. It is very rare in healthy children and poses a diagnostic challenge due to the non-specific clinical presentation and the absence of predisposing factors. We report a case of gastrointestinal basidiobolomycosis in a 4-year-old healthy girl who presented with a short history of abdominal pain, bleeding per rectum, fever, and weight loss. The diagnosis was based on high eosinophilic count, classical histopathology findings of fungal hyphae (the Splendore-Hoeppli phenomenon), and positive fungal culture from a tissue biopsy. Fungal infection was successfully eradicated with a combined approach of surgical resection of the infected tissue and a well-monitored course of antifungal therapy. The atypical clinical presentation, diagnostic techniques, and the role of surgery in the management of a rare and lethal fungal disease in an immunocompetent child are discussed. PMID:26612126

  9. [Pulmonary complications in children with human immunodeficiency virus infection].

    PubMed

    Brockmann V, Pablo; Viviani S, Támara; Peña D, Anamaría

    2007-08-01

    Pulmonary complications in children infected by human immunodeficiency virus (HIV) are common and may be the first manifestation of acquired immunodeficiency syndrome (AIDS). The aim of our study was to review pulmonary diseases and complications in pediatric patients with HIV infection in a large tertiary hospital in Santiago, Chile. We performed a retrospective, descriptive analysis of 17 patients with HIV infection controlled at the Hospital Dr. Sótero del Rio. Respiratory complications/diseases were: overall pneumonia (n: 14), recurrent pneumonia (n: 10), citomegalovirus associated pneumonia (n: 4), Pneumocystis jiroveci associated pneumonia (n: 1) pulmonary tuberculosis (n: 1), lymphoid interstitial pneumonia (n: 3) and chronic pulmonary disease (n: 7). Microorganisms isolated were mostly atypical and frequently associated with severe and chronic pulmonary damage. A high degree of suspicion is required to detect atypical microorganisms promptly, in order to rapidly implement pathogen targeted therapy that could potentially decrease the possibility of sequelae. PMID:17728918

  10. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children

    PubMed Central

    Vreeman, Rachel C; Scanlon, Michael L; McHenry, Megan S; Nyandiko, Winstone M

    2015-01-01

    Introduction As highly active antiretroviral therapy (HAART) transforms human immunodeficiency virus (HIV) into a manageable chronic disease, new challenges are emerging in treating children born with HIV, including a number of risks to their physical and psychological health due to HIV infection and its lifelong treatment. Methods We conducted a literature review to evaluate the evidence on the physical and psychological effects of perinatal HIV (PHIV+) infection and its treatment in the era of HAART, including major chronic comorbidities. Results and discussion Perinatally infected children face concerning levels of treatment failure and drug resistance, which may hamper their long-term treatment and result in more significant comorbidities. Physical complications from PHIV+ infection and treatment potentially affect all major organ systems. Although treatment with antiretroviral (ARV) therapy has reduced incidence of severe neurocognitive diseases like HIV encephalopathy, perinatally infected children may experience less severe neurocognitive complications related to HIV disease and ARV neurotoxicity. Major metabolic complications include dyslipidaemia and insulin resistance, complications that are associated with both HIV infection and several ARV agents and may significantly affect cardiovascular disease risk with age. Bone abnormalities, particularly amongst children treated with tenofovir, are a concern for perinatally infected children who may be at higher risk for bone fractures and osteoporosis. In many studies, rates of anaemia are significantly higher for HIV-infected children. Renal failure is a significant complication and cause of death amongst perinatally infected children, while new data on sexual and reproductive health suggest that sexually transmitted infections and birth complications may be additional concerns for perinatally infected children in adolescence. Finally, perinatally infected children may face psychological challenges, including

  11. An Epidemiological Comparison of Parasitic Infection among Preschool Children in Four Areas in Lagos, Nigeria.

    ERIC Educational Resources Information Center

    Abidoye, R. O.

    1995-01-01

    Examined incidence of parasitic infections in school children in four contrasting areas of Lagos, Nigeria. Found that almost 40% of the infections identified were of the low socioeconomic status children. The 20 children from the higher socioeconomic status area, with the highest environmental sanitation, were without parasites. Twelve percent of…

  12. Review of tenofovir use in HIV-infected children.

    PubMed

    Aurpibul, Linda; Puthanakit, Thanyawee

    2015-04-01

    Tenofovir disoproxil fumarate (TDF) is approved by the Food and Drug Administration for use in children ages 2 years and older and is recommended by the World Health Organization for use as a preferred first-line nucleotide reverse transcriptase inhibitor in adults and adolescents ages 10 years and older. The simplicity of once daily dosing, few metabolic side effects and efficacy against hepatitis B virus make TDF suitable for use in a large scale program. Unlike thymidine analoge nucleoside reverse transcriptase inhibitors (NRTIs); tenofovir does not induce multi-NRTI resistance mutations, so more NRTI options are available for future second-line-regimens. Fixed-dose combinations of TDF with other ARVs as a single tablet regimen are now widely available for adults and adolescents, but none are available for young children. Current information on TDF including the pharmacokinetics, safety and tolerability in children and adolescents was reviewed. A dosing regimen according to body-weight-band has been established for pediatric use. Safety concerns of TDF mainly relate to its effects on renal function and bone mineral density. Regular monitoring of renal function in high-risk patients, including those on other nephrotoxic drugs, may be warranted to detect adverse renal effects. Long-term-data on renal and bone outcomes among HIV-infected children is needed. Lessons learned from clinical studies will help clinicians balance the risks and benefits of TDF and design appropriate antiretroviral regimens for children in different circumstances. PMID:25247583

  13. Oxidative status parameters in children with urinary tract infection

    PubMed Central

    Petrovic, Stanislava; Bogavac-Stanojevic, Natasa; Kotur-Stevuljevic, Jelena; Peco-Antic, Amira; Ivanisevic, Ivana; Ivanisevic, Jasmina; Paripovic, Dusan; Jelic-Ivanovic, Zorana

    2014-01-01

    Introduction: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases in children. The aim of this study was to determine the total prooxidant and antioxidant capacity of children with UTI, as well as changes of oxidative status parameters according to acute inflammation persistence and acute kidney injury (AKI) development. Materials and methods: The patients enrolled in the study comprised 50 Caucasian children (median age was 6 months) with UTI. Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), inflammation marker C-reactive protein (CRP) and renal function parameters urea and creatinine were analyzed in patient’s serums. Results: According to duration of inflammation during UTI, TAS values were significantly higher (0.99 vs. 0.58 mmol/L, P = 0.017) and OSI values were significantly lower (0.032 vs. 0.041 AU, P = 0.037) in the subjects with longer duration of inflammation than in the subjects with shorter duration of inflammation. We did not find significant difference in basal values of oxidative status parameters according to AKI development. Conclusions: OSI values could detect the simultaneous change of TAS and TOS due to change in the oxidative-antioxidant balance during the recovery of children with UTI. TAS and OSI as markers of oxidative stress during UTI are sensitive to accompanying inflammatory condition. Further investigations are needed to evaluate whether TAS, TOS and OSI could be used to monitor disease severity in children with UTI. PMID:24969920

  14. Moyamoya Syndrome in South African Children With HIV-1 Infection.

    PubMed

    Hammond, Charles K; Shapson-Coe, Alexander; Govender, Rajeshree; van Toorn, Ronald; Ndondo, Alvin; Wieselthaler, Nicky; Eley, Brian; Mubaiwa, Lawrence; Wilmshurst, Jo M

    2016-07-01

    A national multicenter study identified 17 South African children with vertically acquired HIV-1 infection and HIV-associated vasculopathy. Five of the children (all indigenous African ancestry) had progressive vascular disease, consistent with moyamoya syndrome. Median presentation age 5.8 years (range 2.2-11). The children with moyamoya syndrome presented with abnormal CD4 counts and raised viral loads. Clinical features included motor deficits, neuroregression, and intellectual disability. Neuroimaging supported progressive vascular disease with preceding clinically silent disease course. Neurologic recovery occurred in 1 patient with improved CD4 counts. Four of the 5 children presented during the era when access to antiretroviral therapy was limited, suggesting that with improved management of HIV-1, progressive vasculopathy is less prevalent. However the insidious disease course illustrated indicates that the syndrome can progress "silently," and manifest with misleading phenotypes such as cognitive delay or regression. Sub-Saharan Africa has limited access to neuroimaging and affected children may be underdiagnosed. PMID:26961262

  15. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  16. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  17. Diterpenoid derivatives of Kenyan Croton sylvaticus.

    PubMed

    Ndunda, Beth; Langat, Moses K; Midiwo, Jacob O; Omosa, Leonidah K

    2015-04-01

    Kenyan Croton sylvaticus Hochst. ex Krauss gave four clerodane diterpenoids, the new ent-3,13E-clerodadiene-15-formate (1), the known 15-acetoxy-ent-3,13E-clerodadiene (2), ent-3,13E-clerodadien-15-ol (3) and hardwickiic acid (4), two known halimane diterpenoids, penduliflaworosin (5) and crotohalimaneic acid (6) and one labdane diterpenoid, labda-13E-ene-8a,15-diol (7). The compounds, when tested for their anti-microbial activities against Bacillus subtilis, Xanthomonas campestris and Candida albicans, were found to be inactive. PMID:25973474

  18. Bacteremia in Children Hospitalized with Respiratory Syncytial Virus Infection

    PubMed Central

    Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Martinón-Sánchez, José María; Justicia-Grande, Antonio; Rivero-Calle, Irene; Pinnock, Elli; Salas, Antonio; Fink, Colin

    2016-01-01

    Background The risk of bacteremia is considered low in children with acute bronchiolitis. However the rate of occult bacteremia in infants with RSV infection is not well established. The aim was to determine the actual rate and predictive factors of bacteremia in children admitted to hospital due to confirmed RSV acute respiratory illness (ARI), using both conventional culture and molecular techniques. Methods A prospective multicenter study (GENDRES-network) was conducted between 2011–2013 in children under the age of two admitted to hospital because of an ARI. Among those RSV-positive, bacterial presence in blood was assessed using PCR for Meningococcus, Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus, in addition to conventional cultures. Results 66 children with positive RSV respiratory illness were included. In 10.6% patients, bacterial presence was detected: H. influenzae (n = 4) and S. pneumoniae (n = 2). In those patients with bacteremia, there was a previous suspicion of bacterial superinfection and had received empirical antibiotic treatment 6 out of 7 (85.7%) patients. There were significant differences in terms of severity between children with positive bacterial PCR and those with negative results: PICU admission (100% vs. 50%, P-value = 0.015); respiratory support necessity (100% vs. 18.6%, P-value < 0.001); Wood-Downes score (mean = 8.7 vs. 4.8 points, P-value < 0.001); GENVIP scale (mean = 17 vs. 10.1, P-value < 0.001); and length of hospitalization (mean = 12.1 vs. 7.5 days, P-value = 0.007). Conclusion Bacteremia is not frequent in infants hospitalized with RSV respiratory infection, however, it should be considered in the most severe cases. PMID:26872131

  19. Infective endocarditis in children in the Guinea savannah of Nigeria.

    PubMed

    Ifere, O A; Masokano, K A

    1991-01-01

    Thirty-two children with 33 episodes of infective endocarditis were admitted into the paediatric unit of Ahmadu Bello University Teaching Hospital, Zaria during an 8-year period (January 1982-December 1989). Thirty (94%) had underlying heart disease. Rheumatic heart disease was the pre-existing anomaly in 21 (66%) while congenital cardiac anomalies were detected in nine (28%). Cardiac failure, changing murmur or persisting fever drew attention to the disease. Bacterial isolation was achieved in 19 patients (58%), staphylococci in 11, and salmonella was found in three children. Others included Acinetobacter spp. in two patients, one of whom had a mixed infection involving alpha haemolytic streptococcus whereas three children had Klebsiella, pseudomonas or alpha haemolytic Streptococcus, respectively. Only six patients (18%) recovered. Abscondment rates were high (28%) and overall hospital mortality was 47%. Intractable cardiac failure and neurological complications were the most important events heralding death. There is a need for increased awareness and improved facilities for prompt and effective treatment. PMID:1719922

  20. [Obsessive-compulsive disorder in children induced by streptococcal infection].

    PubMed

    Kochman, F; Hantouche, E G; Karila, L; Bayart, D; Bailly, D

    2001-11-24

    FROM OBSESSIVE-COMPULSIVE DISORDER TO PANDAS: Obsessive-compulsive disorder (OCD) represents a potentially severe and handicapping disorder that affects several hundreds of thousands of children in France. OCD has, for many years, been considered as a neurosis resulting from mental conflicts. It is currently seen as a neurobiological disorder, the etiological substratum of which is more organic than mental. Recently a sub-type of OCD was isolated in children following infection by Group A b-hemolytic streptococci. This sub-type has been described as Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS). A NEW PHYSIOPATHOLOGICAL APPROACH: The putative dysimmune relationship between bacterial infection and neurotic disorder has led to the development of an original etiopathogenic model that may lead to new therapeutic strategies. The clinical case report of an adolescent presenting with trichotillomania associated with recurrent pharyngitis is a good illustration of this. PUBLISHED DATA: Data published in medical literature over the last 10 years indicates a 10% prevalence in the young suffering from OCD, i.e. 0.1 to 0.3% of the young population. PMID:11769071

  1. Viral infections and the development of asthma in children.

    PubMed

    Saglani, Sejal

    2013-08-01

    Viral aetiology, host susceptibility (in particular allergic predisposition and sensitization), and illness severity, timing and frequency all appear to contribute as synergistic factors to the risk of developing asthma. Experimental models have shown both innate and adaptive immune responses contribute to this risk with lung inflammatory cells showing marked differences in phenotype and function in young compared with older animals, and these differences are further enhanced following virus infection. Findings to date strongly suggest that the impact of infant and preschool viral infections on the maturing immune system and developing lung that subsequently result in an asthma phenotype occur during a critical susceptibility period, and in a genetically susceptible host. There are currently no therapeutic strategies that allow primary or secondary prevention of asthma following early life viral respiratory infections in high-risk children, thus a focus on understanding the mechanisms of progression from viral wheezing in infants and preschool children to asthma development are urgently needed. This review summarizes the data reporting the role of the two most common viruses, that is, respiratory syncytial virus and human rhinovirus, that result in asthma development, comparing risk factors for disease progression, and providing insight into strategies that might be adopted to prevent asthma development. PMID:25165549

  2. Viral infections and the development of asthma in children

    PubMed Central

    2013-01-01

    Viral aetiology, host susceptibility (in particular allergic predisposition and sensitization), and illness severity, timing and frequency all appear to contribute as synergistic factors to the risk of developing asthma. Experimental models have shown both innate and adaptive immune responses contribute to this risk with lung inflammatory cells showing marked differences in phenotype and function in young compared with older animals, and these differences are further enhanced following virus infection. Findings to date strongly suggest that the impact of infant and preschool viral infections on the maturing immune system and developing lung that subsequently result in an asthma phenotype occur during a critical susceptibility period, and in a genetically susceptible host. There are currently no therapeutic strategies that allow primary or secondary prevention of asthma following early life viral respiratory infections in high-risk children, thus a focus on understanding the mechanisms of progression from viral wheezing in infants and preschool children to asthma development are urgently needed. This review summarizes the data reporting the role of the two most common viruses, that is, respiratory syncytial virus and human rhinovirus, that result in asthma development, comparing risk factors for disease progression, and providing insight into strategies that might be adopted to prevent asthma development. PMID:25165549

  3. CD45RA and CD45RO isoforms in infected malnourished and infected well-nourished children

    PubMed Central

    Nájera, O; González, C; Toledo, G; López, L; Cortés, E; Betancourt, M; Ortiz, R

    2001-01-01

    The aim of this study was to determine if the distribution in vivo of CD4+CD45RA+/CD45RO− (naive), CD4+CD45RA+/CD45RO+ (Ddull) and CD4+CD45RO+ (memory) lymphocytes differs in malnourished infected and well-nourished infected children. The expression of CD45RA (naive) and CD45RO (memory) antigens on CD4+ lymphocytes was analysed by flow cytometry in a prospectively followed cohort of 15 malnourished infected, 12 well-nourished infected and 10 well-nourished uninfected children. Malnourished infected children showed higher fractions of Ddull cells (11·4 ± 0·7%) and lower fractions of memory cells (20·3 ± 1·7%) than the well-nourished infected group (8·8 ± 0·8 and 28·1 ± 1·8%, respectively). Well-nourished infected children showed increased percentages of memory cells, an expected response to infection. Impairment of the transition switch to the CD45 isoforms in malnourished children may explain these findings, and may be one of the mechanisms involved in immunodeficiency in these children. PMID:11737063

  4. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  5. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  6. Virological and clinical characterizations of respiratory infections in hospitalized children

    PubMed Central

    2013-01-01

    Background The purpose of this study was to determine the incidence and seasonal distribution of viral etiological agents and to compare their clinical manifestations and disease severity, including single and co infections. Methods Multiplex reverse-transcription PCR was performed for the detection of viruses in nasopharyngeal aspirat. Disease severity was grouped using a categorization index as very mild/mild, and moderate/severe. Clinical and laboratory characteristics of hospitalized children with viral respiratory tract infection were analyzed. Results Viral pathogens were detected in 103/155 (66.5%) of patients. In order of frequency, identified pathogens were respiratory syncytial virus (32.0%), adenovirus (26.2%), parainfluenza viruses type 1–4 (19.4%), rhinovirus (18.4%), influenza A and B (12.6%), human metapneumovirus (12.6%), coronavirus (2.9%), and bocavirus (0.9%). Coinfections were present in 21 samples. Most of the children had very mild (38.8%) and mild disease (37.9%). Severity of illness was not worse with coinfections. The most common discharge diagnoses were "URTI" with or without LRTI/asthma (n=58). Most viruses exhibited strong seasonal patterns. Leukocytosis (22.2%) and neutrophilia (36.6%) were most commonly detected in patients with adenovirus and rhinovirus (p<0.05). Monocytosis was the most remarkable finding in the patients (n=48, 53.3%), especially in patients with adenovirus (p<0.05). Conclusions RSV and RhV were associated with higher severity of illness in hospitalized children. RSV found to account for half of LRTI hospitalizations. In AdV and FluA and B infections, fever lasted longer than in other viruses. Coinfections were detected in 21 of the patients. The presence of coinfections was not associated with increased disease severity. PMID:23536956

  7. Laboratory Diagnosis of Mycobacterium tuberculosis Infection and Disease in Children.

    PubMed

    Dunn, James J; Starke, Jeffrey R; Revell, Paula A

    2016-06-01

    Diagnosis of tuberculosis in children is challenging; even with advanced technologies, the diagnosis is often difficult to confirm microbiologically in part due to the paucibacillary nature of the disease. Clinical diagnosis lacks standardization, and traditional and molecular microbiologic methods lack sensitivity, particularly in children. Immunodiagnostic tests may improve sensitivity, but these tests cannot distinguish tuberculosis disease from latent infection and some lack specificity. While molecular tools like Xpert MTB/RIF have advanced our ability to detect Mycobacterium tuberculosis and to determine antimicrobial resistance, decades old technologies remain the standard in most locales. Today, the battle against this ancient disease still poses one of the primary diagnostic challenges in pediatric laboratory medicine. PMID:26984977

  8. [Oral antibiotic treatment of urinary tract infections in children].

    PubMed

    Klingenberg, Claus; Småbrekke, Lars; Døllner, Henrik; Simonsen, Gunnar Skov

    2009-06-25

    Urinary tract infection (UTI) is one of the most common bacterial infections in childhood. Empiric antibiotic therapy is guided by the clinical presentation, the patient's ability to take oral agents and the local resistance pattern of Escherichia coli (E. coli), the most common pathogen. Most children (with both upper and lower UTI) can safely be treated with oral antibiotics. We recommend pivmecillinam or amoxicillin-clavulanic acid as first-line empiric therapy for upper UTI. Amoxicillin and trimethoprim-sulfamethoxazole are no longer first-line oral agents due to increasing E. coli resistance to both drugs. For lower UTI nitrofurantoin is an excellent first choice. In Norway, lack of paediatric antibiotic syrups is a great challenge and we recommend that such formulations are introduced to the Norwegian market. PMID:19561661

  9. Diagnosis of invasive fungal infections in immunocompromised children.

    PubMed

    Dornbusch, H J; Groll, A; Walsh, T J

    2010-09-01

    Early recognition and rapid initiation of effective treatment is a prerequisite for successful management of children with invasive fungal infections. The increasing diversity of fungal pathogens in high-risk patients, the differences in the antifungal spectra of available agents and the increasing rates of resistance call for identification of the infecting isolate at the species level and for information on drug resistance, in order to provide state-of-the-art patient care. Microscopy and culture of appropriate specimens remain the reference standard for mycological diagnosis, despite difficulties in obtaining appropriate and/or sufficient specimens, long durations of culture and false-negative results. Modern imaging studies and detection of circulating fungal cell wall components and DNA in blood and other body fluids or in affected tissues may improve the laboratory diagnosis of invasive mycoses. PMID:20678175

  10. Management of upper respiratory tract infections in children

    PubMed Central

    Cotton, MF; Innes, S; Jaspan, H; Madide, A; Rabie, H

    2011-01-01

    Upper respiratory tract infection (URTI) occurs commonly in both children and adults and is a major cause of mild morbidity. It has a high cost to society, being responsible for absenteeism from school and work and unnecessary medical care, and is occasionally associated with serious sequelae. URTIs are usually caused by several families of virus; these are the rhinovirus, coronavirus, parainfluenza, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus, influenza, enterovirus and the recently discovered bocavirus. This review will mainly focus on the rhinovirus, where significant advances have been made in understanding the epidemiology, natural history and relationship with other pathogens. PMID:21603094

  11. Invasive Streptococcus pneumoniae infections of children in central Taiwan.

    PubMed

    Ma, J S; Chen, P Y; Chi, C S; Lin, J F; Lau, Y J

    2000-09-01

    We carried out a retrospective study on childhood invasive pneumococcal infections (IPI) diagnosed from the January 1990 through the April 2000 at a medical center in central Taiwan. Their clinical features, outcome of the patients and the resistance patterns of the isolates were analyzed. A total of 95 clinical isolates from 72 patients younger than 14 years of age were included in this study. Of these 72 patients, 51 had bacteremia, 28 meningitis, 14 bacteremic pneumonia, 12 pleural empyema, eight otitis media, four arthritis, three sinusitis, two periorbital abscesses, one deep neck infection, one psoas muscle abscess, one peritonitis, one urinary tract infection, and one cutaneous infection. Ancillary diagnostic tests, including Gram stain smears and latex agglutination tests, were applied and the sensitivities were 86.2% and 54.3%, respectively. The prevalence rate of penicillin nonsusceptible Streptococcus pneumoniae has increased dramatically since 1995 in central Taiwan, with rates of 5.6% and 74.1% before and after 1995, and the overall mortality rate was 20.8% and 53.3% respectively. Ten of 19 children (52.6%) with pneumococcal meningitis who survived had long-term sequelae. PMID:11045380

  12. The incidence of antibody to infectious bovine rhinotracheitis virus in Kenyan cattle.

    PubMed

    Jessett, D M; Rampton, C S

    1975-03-01

    A total of 3204 cattle sera, collected between 1966 and 1974, from all seven provinces and 34 of the 42 districts of Kenya were screened in a neutralisation test for antibody to infectious bovine rhinotracheitis virus (IBRV). Antibody to IBRV was found in some sera from all the districts, with cattle over two years old showing the highest incidence. A small number of goat sera also showed some antibody. From the results obtained it is concluded that IBRV infection is widespread in Kenyan cattle. PMID:165572

  13. Education and Nutritional Status of Orphans and Children of HIV-Infected Parents in Kenya

    ERIC Educational Resources Information Center

    Mishra, Vinod; Arnold, Fred; Otieno, Fredrick; Cross, Anne; Hong, Rathavuth

    2007-01-01

    We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate…

  14. Congenital TORCH Infections in Infants and Young Children: Neurodevelopmental Sequelae and Implications for Intervention.

    ERIC Educational Resources Information Center

    Hutchinson, M. Katherine; Sandall, Susan R.

    1995-01-01

    This article describes TORCH infections, a congenital cluster of infections including toxoplasmosis, syphilis, rubella, cytomegalovirus, and herpes which often results in developmental disabilities for infected children. Methods of transmission, incidence, and developmental outcomes for common TORCH infections are described, as are program…

  15. Does Viral Co-Infection Influence the Severity of Acute Respiratory Infection in Children?

    PubMed Central

    Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Justicia, Antonio; Rivero-Calle, Irene; Sumner, Edward; Fink, Colin

    2016-01-01

    Background Multiple viruses are often detected in children with respiratory infection but the significance of co-infection in pathogenesis, severity and outcome is unclear. Objectives To correlate the presence of viral co-infection with clinical phenotype in children admitted with acute respiratory infections (ARI). Methods We collected detailed clinical information on severity for children admitted with ARI as part of a Spanish prospective multicenter study (GENDRES network) between 2011–2013. A nested polymerase chain reaction (PCR) approach was used to detect respiratory viruses in respiratory secretions. Findings were compared to an independent cohort collected in the UK. Results 204 children were recruited in the main cohort and 97 in the replication cohort. The number of detected viruses did not correlate with any markers of severity. However, bacterial superinfection was associated with increased severity (OR: 4.356; P-value = 0.005), PICU admission (OR: 3.342; P-value = 0.006), higher clinical score (1.988; P-value = 0.002) respiratory support requirement (OR: 7.484; P-value < 0.001) and longer hospital length of stay (OR: 1.468; P-value < 0.001). In addition, pneumococcal vaccination was found to be a protective factor in terms of degree of respiratory distress (OR: 2.917; P-value = 0.035), PICU admission (OR: 0.301; P-value = 0.011), lower clinical score (-1.499; P-value = 0.021) respiratory support requirement (OR: 0.324; P-value = 0.016) and oxygen necessity (OR: 0.328; P-value = 0.001). All these findings were replicated in the UK cohort. Conclusion The presence of more than one virus in hospitalized children with ARI is very frequent but it does not seem to have a major clinical impact in terms of severity. However bacterial superinfection increases the severity of the disease course. On the contrary, pneumococcal vaccination plays a protective role. PMID:27096199

  16. A preliminary evaluation of the cognitive and motor effects of pediatric HIV infection in Zairian children.

    PubMed

    Boivin, M J; Green, S D; Davies, A G; Giordani, B; Mokili, J K; Cutting, W A

    1995-01-01

    Fourteen asymptomatic HIV-infected Zairian children under 2 years of age displayed social and motor developmental deficits on the Denver Developmental Screening Test when compared with 20 HIV-negative cohorts born to HIV-infected mothers and 16 control children. In a second study, 11 infected children over 2 years of age had sequential motor and visual-spatial memory deficits on the Kaufman Assessment Battery for Children and motor development deficits on the Early Childhood Screening Profiles. HIV infection affects central nervous system structures mediating motor and spatial memory development, even in seemingly asymptomatic children. Furthermore, maternal HIV infection compromises the labor-intensive provision of care in the African milieu and undermines global cognitive development in even uninfected children. PMID:7737068

  17. Fusobacterium invasive infections in children: a retrospective study in two French tertiary care centres.

    PubMed

    Bailhache, M; Mariani-Kurkdjian, P; Lehours, P; Sarlangue, J; Pillet, P; Bingen, E; Faye, A

    2013-08-01

    The purpose of this investigation was to describe the clinical and biological characteristics and evolution of invasive Fusobacterium infections in children admitted to two French paediatric tertiary care centres. Children who were admitted from 1998 to 2009 to two tertiary care centres for invasive Fusobacterium infection were included in a retrospective study. Thirty-one children with a median age of 5.7 years (interquartile range, IQR [2.3; 9.3]) were included. Nine children had an underlying condition, most commonly sickle cell disease (n = 3) or immunodeficiency (n = 3). Two children had skin effraction prior to the infection. The major sites of infection were the head and neck (n = 14) and abdomen (n = 10). Three children suffered from atypical Lemierre's syndrome. More than half of the children had a bacterial co-infection (58 %). Six children were hospitalised in an intensive care unit, and 67 % of them had a chronic underlying disease. None of the children died. Six children with negative cultures had Fusobacterium identified through 16S RNA-PCR. Fusobacterium is responsible for severe infection in children. Microbiological diagnosis might be improved by the wider use of molecular detection. PMID:23471481

  18. Profiling Acute Respiratory Tract Infections in Children from Assam, India

    PubMed Central

    Islam, Farzana; Sarma, Ratna; Debroy, Arup; Kar, Sumit; Pal, Ranabir

    2013-01-01

    Background: Acute respiratory infections (ARI) are leading global cause of under-five mortality and morbidity. Objective: To elicit the prevalence and risk factors associated with ARI among under-five children. Materials and Methods: A community-based cross-sectional study was undertaken in 21 registered urban slums of Guwahati in Assam to determine the prevalence and risk factors associated with ARI among 370 under-five children from 184 households and 370 families. Results: The prevalence of ARI was found to be 26.22%; infants and female children were more affected. Majority of the ARI cases were from nuclear families (84.54%), living in kutcha houses (90.72%) with inadequate ventilation (84.54%), overcrowded living condition (81.44%), with kitchen attached to the living room (65.98%) and using biomass fuel for cooking (89.69%). ARI was significantly associated with ventilation, location of kitchen in household; presence of overcrowding, nutritional status, and primary immunization status also had impacts on ARI. Conclusion: The present study had identified a high prevalence of the disease among under-fives. It also pointed out various socio-demographic, nutritional, and environmental modifiable risk factors which can be tackled by effective education of the community. PMID:23599611

  19. Chlamydia pneumoniae infection among healthy children and children hospitalised with pneumonia in Greece.

    PubMed

    Triga, M G; Anthracopoulos, M B; Saikku, P; Syrogiannopoulos, G A

    2002-04-01

    Chlamydia pneumoniae has been recognized as a cause of respiratory tract infection in humans, and its prevalence has been shown to vary among different age groups and populations. The prevalence of Chlamydia pneumoniae antibody was determined by serological investigation in 343 healthy children and in 77 children consecutively hospitalised for pneumonia in southwestern Greece. Seventy-eight (22.7%) healthy children had IgG Chlamydia pneumoniae titers > or =1/8. The prevalence of Chlamydia pneumoniae antibody in the age groups 6 months-5 years, 6-9 years and 10-15 years was 7.9%, 11.4% and 36%, respectively. One child hospitalised for pneumonia had serological results consistent with acute Chlamydia pneumoniae infection. The results of the present study suggest a low prevalence of Chlamydia pneumoniae antibody among preschoolers in Greece, followed by a steep rise in children 10-15 years of age. Chlamydia pneumoniae is not a common etiologic agent of childhood pneumonia requiring hospitalisation. PMID:12072942

  20. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

    PubMed

    Goldberg, Brittany E; Mongodin, Emmanuel F; Jones, Cheron E; Chung, Michelle; Fraser, Claire M; Tate, Anupama; Zeichner, Steven L

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  1. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection

    PubMed Central

    Goldberg, Brittany E.; Mongodin, Emmanuel F.; Jones, Cheron E.; Chung, Michelle; Fraser, Claire M.; Tate, Anupama; Zeichner, Steven L.

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi’s sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  2. HIV-Infected African Parents Living in Stockholm, Sweden: Disclosure and Planning for Their Children's Future

    ERIC Educational Resources Information Center

    Asander, Ann-Sofie; Bjorkman, Anders; Belfrage, Erik; Faxelid, Elisabeth

    2009-01-01

    In Sweden, most HIV-infected parents are of African origin. The present study explored the frequency of HIV-infected African parents' disclosure of their status to their children and custody planning for their children's future to identify support needs among these families. Semistructured interviews were conducted with 47 parents (41 families).…

  3. The Prevalence of Motor Delay among HIV Infected Children Living in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Ferguson, Gillian; Jelsma, Jennifer

    2009-01-01

    Children living with HIV often display delayed motor performance owing to HIV infection of the central nervous system, the effects of opportunistic infections and, indirectly, owing to their social environments. Although these problems have been well documented, the impact of the virus on the development of South African children is less well…

  4. Fecal Leukocytes in Children Infected with Diarrheagenic Escherichia coli▿

    PubMed Central

    Mercado, Erik H.; Ochoa, Theresa J.; Ecker, Lucie; Cabello, Martin; Durand, David; Barletta, Francesca; Molina, Margarita; Gil, Ana I.; Huicho, Luis; Lanata, Claudio F.; Cleary, Thomas G.

    2011-01-01

    The purpose of this study was to determine the presence and quantity of fecal leukocytes in children infected with diarrheagenic Escherichia coli and to compare these levels between diarrhea and control cases. We analyzed 1,474 stool samples from 935 diarrhea episodes and 539 from healthy controls of a cohort study of children younger than 2 years of age in Lima, Peru. Stools were analyzed for common enteric pathogens, and diarrheagenic E. coli isolates were studied by a multiplex real-time PCR. Stool smears were stained with methylene blue and read by a blinded observer to determine the number of polymorphonuclear leukocytes per high-power field (L/hpf). Fecal leukocytes at >10 L/hpf were present in 11.8% (110/935) of all diarrheal episodes versus 1.1% (6/539) in controls (P < 0.001). Among stool samples with diarrheagenic E. coli as the only pathogen isolated (excluding coinfection), fecal leukocytes at >10 L/hpf were present in 8.5% (18/212) of diarrhea versus 1.3% (2/157) of control samples (P < 0.01). Ninety-five percent of 99 diarrheagenic E. coli diarrhea samples were positive for fecal lactoferrin. Adjusting for the presence of blood in stools, age, sex, undernutrition, and breastfeeding, enterotoxigenic E. coli (ETEC) isolation as a single pathogen, excluding coinfections, was highly associated with the presence of fecal leukocytes (>10 L/hpf) with an odds ratio (OR) of 4.1 (95% confidence interval [CI], 1.08 to 15.51; P < 0.05). Although diarrheagenic E. coli was isolated with similar frequencies in diarrhea and control samples, clearly it was associated with a more inflammatory response during symptomatic infection; however, in general, these pathogens elicited a mild inflammatory response. PMID:21325554

  5. Fecal leukocytes in children infected with diarrheagenic Escherichia coli.

    PubMed

    Mercado, Erik H; Ochoa, Theresa J; Ecker, Lucie; Cabello, Martin; Durand, David; Barletta, Francesca; Molina, Margarita; Gil, Ana I; Huicho, Luis; Lanata, Claudio F; Cleary, Thomas G

    2011-04-01

    The purpose of this study was to determine the presence and quantity of fecal leukocytes in children infected with diarrheagenic Escherichia coli and to compare these levels between diarrhea and control cases. We analyzed 1,474 stool samples from 935 diarrhea episodes and 539 from healthy controls of a cohort study of children younger than 2 years of age in Lima, Peru. Stools were analyzed for common enteric pathogens, and diarrheagenic E. coli isolates were studied by a multiplex real-time PCR. Stool smears were stained with methylene blue and read by a blinded observer to determine the number of polymorphonuclear leukocytes per high-power field (L/hpf). Fecal leukocytes at >10 L/hpf were present in 11.8% (110/935) of all diarrheal episodes versus 1.1% (6/539) in controls (P < 0.001). Among stool samples with diarrheagenic E. coli as the only pathogen isolated (excluding coinfection), fecal leukocytes at >10 L/hpf were present in 8.5% (18/212) of diarrhea versus 1.3% (2/157) of control samples (P < 0.01). Ninety-five percent of 99 diarrheagenic E. coli diarrhea samples were positive for fecal lactoferrin. Adjusting for the presence of blood in stools, age, sex, undernutrition, and breastfeeding, enterotoxigenic E. coli (ETEC) isolation as a single pathogen, excluding coinfections, was highly associated with the presence of fecal leukocytes (>10 L/hpf) with an odds ratio (OR) of 4.1 (95% confidence interval [CI], 1.08 to 15.51; P < 0.05). Although diarrheagenic E. coli was isolated with similar frequencies in diarrhea and control samples, clearly it was associated with a more inflammatory response during symptomatic infection; however, in general, these pathogens elicited a mild inflammatory response. PMID:21325554

  6. Are Maternal Genitourinary Infection and Pre-Eclampsia Associated with ADHD in School-Aged Children?

    ERIC Educational Resources Information Center

    Mann, Joshua R.; McDermott, Suzanne

    2011-01-01

    Objective: To investigate the hypothesis that maternal genitourinary infection (GU) infection is associated with increased risk of ADHD. Method: The authors obtained linked Medicaid billing data for pregnant women and their children in South Carolina, with births from 1996 through 2002 and follow-up data through 2008. Maternal GU infections and…

  7. Bone and Joint Infections in Children: Septic Arthritis.

    PubMed

    Agarwal, Anil; Aggarwal, Aditya N

    2016-08-01

    The pathological invasion of a joint and subsequent inflammation is known as septic arthritis. The knee and hip are the most frequently involved joints. Staphylococcus aureus is the most common cause of septic arthritis in children. An acute onset of illness with an inflamed painful joint and restricted movements and inability to use joint (pseudoparalysis) clinically indicates septic arthritis. The diagnosis is difficult in a neonate or young child where refusal to feed, crying, discomfort during change of diaper (if hip is involved) or attempted joint movement may be the only findings. Fever and other systemic signs may also be absent in neonates. Septic arthritis is diagnosed clinically, supported by appropriate radiological and laboratory investigations. The peripheral blood white cell count is frequently raised with a predominance of polymorphonuclear cells. The acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often markedly raised. Ultrasonography and MRI are preferred investigations in pediatric septic arthritis. Determination of infecting organism in septic arthritis is the key to the correct antibiotic choice, treatment duration and overall management. Joint aspirate and/or blood culture should be obtained before starting antibiotic treatment. Several effective antibiotic regimes are available for managing septic arthritis in children. Presence of large collections, thick pus, joint loculations and pus evacuating into surrounding soft tissues are main indications for surgical drainage. Joint aspiration can be a practical alternative in case the lesion is diagnosed early, with uncomplicated presentations and superficial joints. PMID:26189923

  8. Evaluation of Novel Urinary Tract Infection Biomarkers in Children

    PubMed Central

    Watson, Joshua R.; Hains, David S.; Cohen, Daniel M.; Spencer, John David; Kline, Jennifer M.; Yin, Han; Schwaderer, Andrew L.

    2016-01-01

    Background Pediatricians frequently use urinalysis to diagnose urinary tract infection (UTI) while awaiting urine culture results, but sensitivity and specificity of urinalysis are limited. This study evaluated the diagnostic accuracy of the antimicrobial peptides human α-defensin 5 (HD5) and human neutrophil peptides (HNP) 1-3 as novel UTI biomarkers in children. Methods We prospectively enrolled 199 pediatric Emergency Department or Urgent Care patients evaluated for a UTI. Urine concentrations of HD5 and HNP1-3 were measured by enzyme-linked immunosorbent assay. Urine culture was the reference standard. Sensitivities and specificities of leukocyte esterase (LE), HD5, HNP1-3, and test combinations were compared. Results For predicting positive urine culture, the areas under the receiver operating characteristic curves for HD5 and HNP1-3 were 0.86 (95% CI, 0.81-0.92) and 0.88 (95% CI, 0.82-0.93), respectively. Compared to LE ≥ trace, the combination test “LE and HD5” increased specificity by 6% (95% CI, 3%-10%) without decreasing sensitivity. In the subgroup whose urine was collected by a clean-catch method, combination tests “LE and HD5” and “HD5 and HNP1-3” increased specificity by > 10% compared to LE alone. Conclusion Urine antimicrobial peptide profiles are a promising novel strategy as an adjunct to urinalysis to aid UTI diagnosis in children. PMID:26885759

  9. Updates on the Diagnosis of Helicobacter pylori Infection in Children: What Are the Differences between Adults and Children?

    PubMed Central

    2016-01-01

    Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the 13C-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection. PMID:27437185

  10. Updates on the Diagnosis of Helicobacter pylori Infection in Children: What Are the Differences between Adults and Children?

    PubMed

    Yang, Hye Ran

    2016-06-01

    Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the (13)C-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection. PMID:27437185

  11. Gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy in the years 2000

    PubMed Central

    Castagnola, Elio; Ruberto, Eliana; Guarino, Alfredo

    2016-01-01

    AIM: To review gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy. To look at gut microflora features in oncology children. METHODS: We selected studies published after year 2000, excluding trials on transplanted pediatric patients. We searched English language publications in MEDLINE using the keywords: “gastrointestinal infection AND antineoplastic chemotherapy AND children”, “gastrointestinal infection AND oncology AND children”, “liver infection AND antineoplastic chemotherapy AND children”, “liver abscess AND chemotherapy AND child”, “neutropenic enterocolitis AND chemotherapy AND children”, “thyphlitis AND chemotherapy AND children”, “infectious diarrhea AND children AND oncology”, “abdominal pain AND infection AND children AND oncology”, “perianal sepsis AND children AND oncology”, “colonic pseudo-obstruction AND oncology AND child AND chemotherapy”, “microflora AND children AND malignancy”, “microbiota AND children AND malignancy”, “fungal flora AND children AND malignancy”. We also analysed evidence from several articles and book references. RESULTS: Gastrointestinal and liver infections represent a major cause of morbidity and mortality in children undergoing antineoplastic chemotherapy. Antineoplastic drugs cause immunosuppression in addition to direct toxicity, predisposing to infections, although the specific risk is variable according to disease and host features. Common pathogens potentially induce severe diseases whereas opportunistic microorganisms may attack vulnerable hosts. Clinical manifestations can be subtle and not specific. In addition, several conditions are rare and diagnostic process and treatments are not standardized. Diagnosis may be challenging, however early diagnosis is needed for quick and appropriate interventions. Interestingly, the source of infection in those children can be exogenous or endogenous. Indeed, mucosal damage may allow the

  12. A 6 year Geohelminth infection profile of children at high altitude in Western Nepal

    PubMed Central

    Mukhopadhyay, Chiranjay; Wilson, Godwin; Chawla, Kiran; VS, Binu; Shivananda, PG

    2008-01-01

    Background Geohelminth infections are a major problem of children from the developing countries. Children with these infections suffer from developmental impairments and other serious illnesses. This study aimed to measure the prevalence of geohelminth infection, infection intensity as well as the change in the intensity in children from Western Nepal over years. Methods This 6-year hospital based prospective study at the Manipal Teaching Hospital, Pokhara included children (< 15 years) visiting the hospital from Kaski and 7 surrounding districts. Samples were also collected from children in the community from different medical camps. Three stool samples from every child were processed using direct and concentration methods. The Kato-Katz technique was used for measuring the intensity of infection. Results The overall prevalence in hospital - attending children was 9.2% with 7.6% in preschool (0 – 5 y) and 11.0% in school-age (6 – 15 y) children, and in community 17.7% with 14.8% in pre-school and 20.5% in school-age children. Ascaris lumbricoides, Trichuris trichiura, Ancylostoma deodenale and Strongyloides stercoralis were the common geohelminths with a gradual decrease in worm load over the years. School-age children were found to be significantly more prone to geohelminth infection as compared to preschool children, but no statistical difference was detected by gender, district as well as season. Conclusion This heavy infection of geohelminths in children should be corrected by appropriate medication and maintaining strict personal hygiene. Health education, clean water, good sewage management and a congenial environment should be ensured to minimise infection. PMID:18366807

  13. Vitamin A Modifies the Intestinal Chemokine and Cytokine Responses to Norovirus Infection in Mexican Children12

    PubMed Central

    Long, Kurt Z.; Garcıa, Coralith; Ko, GwangPyo; Santos, Jose I.; Al Mamun, Abdullah; Rosado, Jorge L.; DuPont, Herbert L.; Nathakumar, Nanda

    2011-01-01

    Vitamin A supplementation is associated with divergent clinical norovirus (NoV) outcomes in Mexican children. Fecal cytokine concentrations following NoV genogroup infections among 127 Mexican children 5–15 mo old enrolled in a randomized, double-blind, placebo-controlled, vitamin A supplementation trial were determined to clarify the role the gut immune response plays in these associations. Stools collected from supplemented children [20,000 IU retinol (3.3 IU = 1 μg retinol) for children < 12 mo of age; 45,000 iu for children ≥ 12 mo] or children in the placebo group were screened for NoV genogroups I (GI) and II (GII). Monocyte chemoattractant protein-1 (MCP-1), TNFα, IL-5, IL-6, IL-8, IL-4, IFNγ, and IL-10 fecal concentrations were also determined. Differences in cytokine levels between the 2 groups following GI and GII infections were determined using ordered logistic regression models. MCP-1 and IL-8 levels were greater among GI- and GII-infected children, respectively, compared with uninfected children, whereas IL-5 levels were greater following both genogroup infections. MCP-1, IL-8, and IL-6 fecal levels were reduced among supplemented children with GII-associated diarrhea compared with the placebo group. Vitamin A–supplemented, GII-infected children had reduced MCP-1 and TNFα levels compared with GII-infected children in the placebo group (P-interaction = 0.02 and 0.03, respectively). Supplemented children with GI-associated diarrhea had higher TNFα and IL-4 levels compared with children in the placebo group with diarrhea (P-interaction = 0.02 and 0.02, respectively). The divergent effects of supplementation on NoV outcomes may result from the different effects vitamin A has on the genogroup-specific immune responses. PMID:21411606

  14. Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital

    PubMed Central

    Oyedeji, Olusola Adetunji; Adejuyigbe, Ebun; Oninla, Samuel Olorunyomi; Akindele, Abiodum Akeem; Adedokun, Samuel Adeyinka

    2015-01-01

    Background Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. Objective To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital. Materials and Methods Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. Results A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 – 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 – 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 – 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 – 12.1). Conclusion Cryptosporidial infection is the most

  15. Unintended consequences of Helicobacter pylori infection in children in developing countries

    PubMed Central

    Queiroz, Dulciene MM; Rocha, Andreia MC; Crabtree, Jean E

    2013-01-01

    Helicobacter pylori infection is predominantly acquired early in life. The prevalence of the infection in childhood is low in developed countries, whereas in developing countries most children are infected by 10 y of age. In poor resource settings, where malnutrition, parasitic/enteropathogen and H. pylori infection co-exist in young children, H. pylori might have potentially more diverse clinical outcomes. This paper reviews the impact of childhood H. pylori infection in developing countries that should now be the urgent focus of future research. The extra-gastric manifestations in early H. pylori infection in infants in poor resource settings might be a consequence of the infection associated initial hypochlorhydria. The potential role of H. pylori infection on iron deficiency, growth impairment, diarrheal disease, malabsorption and cognitive function is discussed in this review. PMID:23988829

  16. Immunization of children at risk of infection with human immunodeficiency virus.

    PubMed Central

    Moss, William J.; Clements, C. John; Halsey, Neal A.

    2003-01-01

    This paper reviews the English language literature on the safety, immunogenicity and effectiveness in children infected with the human immunodeficiency virus (HIV) of vaccines currently recommended by WHO for use in national immunization programmes. Immunization is generally safe and beneficial for children infected with HIV, although HIV-induced immune suppression reduces the benefit compared with that obtained in HIV-uninfected children. However, serious complications can occur following immunization of severely immunocompromised children with bacillus Calmette-Gu rin (BCG) vaccine. The risk of serious complications attributable to yellow fever vaccine in HIV-infected persons has not been determined. WHO guidelines for immunizing children with HIV infection and infants born to HIV-infected women differ only slightly from the general guidelines. BCG and yellow fever vaccines should be withheld from symptomatic HIV-infected children. Only one serious complication (fatal pneumonia) has been attributed to measles vaccine administered to a severely immunocompromised adult. Although two HIV-infected infants have developed vaccine-associated paralytic poliomyelitis, several million infected children have been vaccinated and the evidence does not suggest that there is an increased risk. The benefits of measles and poliovirus vaccines far outweigh the potential risks in HIV-infected children. The policy of administering routine vaccines to all children, regardless of possible HIV exposure, has been very effective in obtaining high immunization coverage and control of preventable diseases. Any changes in this policy would have to be carefully examined for a potential negative impact on disease control programmes in many countries. PMID:12640478

  17. `No One Should Destroy the Forest': Using photo-based vignette interviews to understand Kenyan teachers' views of the environment

    NASA Astrophysics Data System (ADS)

    Quigley, Cassie F.; Miller, Zachary D.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

    2014-11-01

    In the midst of the current environmental crisis, scientists, academics, authors, and politicians worldwide are urging citizens to create sustainable communities. However, there is little capability to build a sustainable society without an informed, active, and engaged populous. This requires more than just environmentally knowledgeable citizens. It requires a society that understands the principles of the environment and can also exemplify them in daily life. In order to create a more environmentally literate world, there has been a push for environmental education integrated into schools. This qualitative study sought to examine Kenyan teachers' perspectives on the human-nature interaction by conducting vignette focus-group interviews. It is a subject not widely explored but vital for conservation not only in this area, but also other areas that seek to have an ecological informed populous. The vignettes were created using photographs and explanations of the photographs that the participants collected and emailed to the authors. For the focus-group vignette interviews, there were a total of 55 participants (30 females and 25 males). After InVivo analysis, we had 6 codes (resentment, pride, perils, blame, pragmatism, and self-interested) within 3 major themes. This study has implications for informing science education to combat these traditions of subjecting students to a science curriculum that demotes Kenyan cultural heritage and lifestyle. By incorporating local knowledge such as the ideas discussed in this paper into Kenyan science education, Kenyans can reach one of most challenging objectives of education, which is to produce children who are fundamentally aware of their environment.

  18. The effect of vitamin D on lower respiratory tract infections in children

    PubMed Central

    Şişmanlar, Tuğba; Aslan, Ayşe Tana; Gülbahar, Özlem; Özkan, Seçil

    2016-01-01

    Aim: Lower respiratory tract infections including mainly pneumonia represent an important public health problem leading to high mortality and mobidity rates in children aged below five years in developing countries including our country. Vitamin D deficiency has been associated with increased risk of rickets/osteomalacia, various cancers, autoimmune diseases, hyperproliferative skin diseases, cardiovascular system diseases and infectious diseases. Vitamin D has an important role in cellular and humoral immunity and pulmonary functions. Vitamin D deficiency and lower respiratory tract infection are common health problems in children in our country and no clinical study investigating the relationship between these problems has been conducted so far. In this case-control study, we aimed to assess the association between vitamin D level and lower respiratory tract infection in children. Material and Methods: Sixty-three children aged between six months and five years with lower respiratory infections and 59 age-matched children who had no history of respiratory symptoms in the last month and no accompanying chronic disease were compared in terms of vitamin D levels. The children in the patient group were also evaluated by the clinical picture. Results: No significant correlation was found between vitamin D levels and lower respiratory tract infection in terms of disease and its severity. However, it was found that vitamin D deficiency/ insufficiency was observed with a high rate in all children included in the study. Conclusions: Although no correlation was found between vitamin D level and lower respiratory tract infection, it is recommended that vitamin D level should be measured in children with lower respiratory tract infection and vitamin D supplementation should be given to all children especially in winter months based on the fact that the level of vitamin D was lower than normal in approximately half of the children included in the study and considering the

  19. Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

    PubMed Central

    Ebonyi, Augustine O.; Oguche, Stephen; Ejeliogu, Emeka U.; Agbaji, Oche O.; Shehu, Nathan Y.; Abah, Isaac O.; Sagay, Atiene S.; Ugoagwu, Placid O.; Okonkwo, Prosper I.; Idoko, John A.; Kanki, Phyllis J.

    2016-01-01

    Introduction Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. Methods We performed a retrospective analysis of 876 children, aged 2 months – 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. Results The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). Conclusion In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes. PMID:27019829

  20. Meat supplementation increases arm muscle area in Kenyan schoolchildren.

    PubMed

    Neumann, Charlotte G; Jiang, Luohua; Weiss, Robert E; Grillenberger, Monika; Gewa, Constance A; Siekmann, Jonathan H; Murphy, Suzanne P; Bwibo, Nimrod O

    2013-04-14

    The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1-2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plain githeri and control groups (P< 0.05). The meat group showed the least increase in TSF and MAFA of all groups. These findings have implications for increasing micronutrient intake and lean body mass in primary schoolchildren consuming vegetarian diets. PMID:22856533

  1. A Qualitative Evaluation of Hand Drying Practices among Kenyans

    PubMed Central

    Person, Bobbie; Schilling, Katharine; Owuor, Mercy; Ogange, Lorraine; Quick, Rob

    2013-01-01

    Background Recommended disease prevention behaviors of hand washing, hygienic hand drying, and covering one’s mouth and nose in a hygienic manner when coughing and sneezing appear to be simple behaviors but continue to be a challenge to successfully promote and sustain worldwide. We conducted a qualitative inquiry to better understand current hand drying behaviors associated with activities of daily living, and mouth and nose covering practices, among Kenyans. Methods and Findings We conducted 7 focus group discussions; 30 in-depth interviews; 10 structured household observations; and 75 structured observations in public venues in the urban area of Kisumu; rural communities surrounding Kisumu; and a peri-urban area outside Nairobi, Kenya. Using a grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes. Hand drying, specifically on a clean towel, was not a common practice among our participants. Most women dried their hands on their waist cloth, called a leso, or their clothes whether they were cooking, eating or cleaning the nose of a young child. If men dried their hands, they used their trousers or a handkerchief. Children rarely dried their hands; they usually just wiped them on their clothes, shook them, or left them wet as they continued with their activities. Many people sneezed into their hands and wiped them on their clothes. Men and women used a handkerchief fairly often when they had a runny nose, cold, or the flu. Most people coughed into the air or their hand. Conclusions Drying hands on dirty clothes, rags and lesos can compromise the benefits of handwashing. Coughing and sneezing in to an open hand can contribute to spread of disease as well. Understanding these practices can inform health promotion activities and campaigns for the prevention and control of diarrheal disease and influenza. PMID:24069302

  2. Kenyan and Ethiopian distance runners: what makes them so good?

    PubMed

    Wilber, Randall L; Pitsiladis, Yannis P

    2012-06-01

    Since the 1968 Mexico City Olympics, Kenyan and Ethiopian runners have dominated the middle- and long-distance events in athletics and have exhibited comparable dominance in international cross-country and road-racing competition. Several factors have been proposed to explain the extraordinary success of the Kenyan and Ethiopian distance runners, including (1) genetic predisposition, (2) development of a high maximal oxygen uptake as a result of extensive walking and running at an early age, (3) relatively high hemoglobin and hematocrit, (4) development of good metabolic "economy/efficiency" based on somatotype and lower limb characteristics, (5) favorable skeletal-muscle-fiber composition and oxidative enzyme profile, (6) traditional Kenyan/Ethiopian diet, (7) living and training at altitude, and (8) motivation to achieve economic success. Some of these factors have been examined objectively in the laboratory and field, whereas others have been evaluated from an observational perspective. The purpose of this article is to present the current data relative to factors that potentially contribute to the unprecedented success of Kenyan and Ethiopian distance runners, including recent studies that examined potential links between Kenyan and Ethiopian genotype characteristics and elite running performance. In general, it appears that Kenyan and Ethiopian distance-running success is not based on a unique genetic or physiological characteristic. Rather, it appears to be the result of favorable somatotypical characteristics lending to exceptional biomechanical and metabolic economy/efficiency; chronic exposure to altitude in combination with moderate-volume, high-intensity training (live high + train high), and a strong psychological motivation to succeed athletically for the purpose of economic and social advancement. PMID:22634972

  3. Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.

    PubMed Central

    Boulanger, L. L.; Lee, L. A.; Odhacha, A.

    1999-01-01

    Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034

  4. Children Living with HIV-Infected Adults: Estimates for 23 Countries in sub-Saharan Africa

    PubMed Central

    Short, Susan E.; Goldberg, Rachel E.

    2015-01-01

    Background In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children’s health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children’s health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children. Methods Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households. Results The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent. Conclusion Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct

  5. Effector T lymphocytes in well-nourished and malnourished infected children

    PubMed Central

    Nájera, O; González, C; Cortés, E; Toledo, G; Ortiz, R

    2007-01-01

    The mechanisms involved in impaired immunity in malnourished children are not well understood. CD4+ CD62L– and CD8+ CD28– do not express the naive cell markers CD62L and CD28, suggesting that they function as effector T cells. Using a flow cytometry-based analysis we examined the proportions of CD4+ CD62L– and CD8+ CD28– T cell subsets in well-nourished infected (WNI) and malnourished infected (MNI) children. Here we report that WNI children had a higher percentage of CD4+ CD62L– (11·1 ± 1·0) and CD8+ D28– (40·2 ± 5·0) T cell subsets than healthy (6·5 ± 1·0 and 23·9 ± 4·8) and MNI children (7·4 ± 1·1 and 23·1 ± 6·2, respectively) (P < 0·5). Data suggest that WNI children respond efficiently against pathogenic microbes. In contrast, relatively low numbers of circulating of CD4+ CD62L– and CD8+ CD28– T cells in MNI children may represent an ineffective response to infection. Levels of effector T cells in children with gastrointestinal infections versus those suffering from respiratory infections were also significantly different within the WNI group. While WNI children with gastrointestinal infections had higher absolute and relative values of CD8+, and CD8+ CD28– T subsets, by those with respiratory infections had higher values of CD4+ lymphocytes. However, due to the small number of subjects examined, our results in WNI children should be interpreted with caution and confirmed using a larger sample size. Our data suggest that altered expression of CD62L and CD28 receptors may contribute to impaired T cell function observed in MNI children. PMID:17362263

  6. Disclosure of parental HIV infection to children and psychosocial impact on children in China: a qualitative study

    PubMed Central

    Zhang, Liying; Li, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang; Kaljee, Linda; Stanton, Bonita

    2014-01-01

    This qualitative study aims to investigate parental HIV disclosure and psychological impact from the perspectives of their children. In-depth individual interviews with 47 children who had lost one or both parents to AIDS were conducted in China. All transcripts were coded using the software ATLAS.ti 5. Results showed that few of children knew of parental HIV status before the death of their parents. The main disclosers were the children’s current caregivers. Some children knew about their parent’s HIV infection based on their own observations or through overheard conversation, or their interactions with villagers. Both positive and negative psychological outcomes related to parental HIV disclosure were reported. Psychological counseling is needed for both parents and children to dealing with the parental HIV infection. PMID:24761258

  7. Pulmonary tuberculosis in severely-malnourished or HIV-infected children with pneumonia: a review.

    PubMed

    Chisti, Mohammod Jobayer; Ahmed, Tahmeed; Pietroni, Mark A C; Faruque, Abu S G; Ashraf, Hasan; Bardhan, Pradip K; Hossain, Iqbal; Das, Sumon Kumar; Salam, Mohammed Abdus

    2013-09-01

    Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIV-positive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score <-3 of the WHO median, or presence of nutritional oedema). We conducted a literature search, using PubMed and Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/ very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies

  8. Breastfeeding versus infant formula: the Kenyan case.

    PubMed

    Elliot, T C; Agunda, K O; Kigondu, J G; Kinoti, S N; Latham, M C

    1985-02-01

    An Infant Feeding Practices Study (IFPS) in 1982 in Kenya, which included a cross-sectional survey of a weighted sample of 980 low and middle income Nairobi mothers who had given birth in the previous 18 months, found that most women breastfeed their infants for long periods, but many introduce alternate feeding, especially infant formula, in the 1st 4 months (86 and 50% of the infants were breastfed at 6 and 15 months respectively, but 50% of the 2 month-olds and 63% of the 4 month-olds were receiving substitutes, mostly formula). This is done largely out of the belief that infant formula is an additional health benefit. A workshop to discuss the findings of the IFPS and other available data, and to make policy recommendations urged the adoption of a policy of protection, support and promotion of breastfeeding. Since breastfeeding is already widely prevalent in Kenya, protection of breastfeeding should receive the 1st priority in policy related to infant feeding. Attention should be directed at at least 2 influences which help undermine breastfeeding: widespread availability and promotion of breast milk substitutes. Support for breastfeeding is viewed as the 2nd policy priority. Situations where support can play a helpful role are, women's paid employment outside the home, hospital practices, maternal morbidity, and difficulties in breastfeeding. Since promotion is the least cost effective of the 3 options, and most Kenyan women are already motivated to breastfeed, this should be the last priority. Promotion includes reeduction of mothers to make them better aware of the benefits of breastfeeding. The workshop recommended the dissemination of appropriate information, consisting of standarized messages based on clearcut guidelines, using mass media techniques. PMID:12280100

  9. Intestinal Parasite Infections in Symptomatic Children Attending Hospital in Siem Reap, Cambodia

    PubMed Central

    Moore, Catrin E.; Nget, Phot; Saroeun, Mao; Kuong, Suy; Chanthou, Seng; Kumar, Varun; Bousfield, Rachel; Nader, Johanna; Bailey, J. Wendi; Beeching, Nicholas J.; Day, Nicholas P.; Parry, Christopher M.

    2015-01-01

    Background Infections with helminths and other intestinal parasites are an important but neglected problem in children in developing countries. Accurate surveys of intestinal parasites in children inform empirical treatment regimens and can assess the impact of school based drug treatment programmes. There is limited information on this topic in Cambodia. Methods In a prospective study of intestinal parasites in symptomatic children attending Angkor Hospital for Children, Siem Reap, Cambodia, April-June 2012, samples were examined by microscopy of a direct and concentrated fecal sample. Two culture methods for hookworm and Strongyloides stercoralis were employed when sufficient sample was received. Demographic, clinical and epidemiological data were collected. Principal Findings We studied 970 samples from 865 children. The median (inter-quartile range) age of the children was 5.4 (1.9-9.2) years, 54% were male. The proportion of children with abdominal pain was 66.8%, diarrhea 34.9%, anemia 12.7% and malnutrition 7.4%. 458 parasitic infections were detected in 340 (39.3%) children. The most common parasites using all methods of detection were hookworm (14.3%), Strongyloides stercoralis (11.6%) and Giardia lamblia (11.2%). Giardia lamblia was most common in children aged 1-5 years, hookworm and Strongyloides stercoralis were more common with increasing age. Hookworm, Strongloides stercoralis and Giardia lamblia were more common in children living outside of Siem Reap town. In a multivariate logistic regression increasing age was associated with all three infections, defecating in the forest for hookworm infection, the presence of cattle for S. stercoralis and not using soap for handwashing for G. lamblia. Conclusions/Significance This study confirms the importance of intestinal parasitic infections in symptomatic Cambodian children and the need for adequate facilities for laboratory diagnosis together with education to improve personal hygiene and sanitation. PMID

  10. Towards Economic Empowerment: Segregation versus Inclusion in the Kenyan Context

    ERIC Educational Resources Information Center

    Cobley, David S.

    2012-01-01

    Given the well-documented links between poverty and disability in the majority world, and the mandate given to address this issue by international agreements, such as the recent United Nations Convention on the Rights of Persons with Disabilities, this paper examines the issue of how best to promote economic empowerment in the Kenyan context. The…

  11. The Relationship between Kenyan Sign Language and English Literacy

    ERIC Educational Resources Information Center

    Aura, Lillie Josephine; Venville, Grady; Marais, Ida

    2016-01-01

    This paper presents results of an investigation into the relationship between Kenyan Sign Language (KSL) and English literacy skills. It is derived from research undertaken towards an MEd degree awarded by The University of Western Australia in 2011. The study employed a correlational survey strategy. Sixty upper primary deaf students from four…

  12. HIV-1 Encephalopathy among Perinatally Infected Children: Neuropathogenesis and Response to Highly Active Antiretroviral Therapy

    ERIC Educational Resources Information Center

    Mitchell, Charles D.

    2006-01-01

    HIV-1 encephalopathy among perinatally infected children in the United States was initially defined by a classic triad of findings that included: (1) developmental delay, (2) secondary or acquired microcephaly, and (3) pyramidal tract neuromotor deficits. The most severe form of this disorder typically occurred among young children who developed…

  13. Immune Responses to "Helicobacter pylori" Infection in Children with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Douraghi, Masoumeh; Goudarzi, Hossein; Rostami, Mahmoud Nateghi; Nikmanesh, Bahram

    2012-01-01

    Infection with "Helicobacter pylori" was assessed through serum "H. pylori" IgG antibody in children with intellectual disabilities (ID). The sero-status of cytotoxin-associated gene A (CagA) was determined as a risk determinant for severe "H. pylori"-associated diseases. In total, 210 children with ID were included who were permanent resident of…

  14. A Developmental Neuropsychological Model for the Study of Children with HIV Infection.

    ERIC Educational Resources Information Center

    Gioia, Gerard A.; And Others

    A developmental neuropsychological model is presented to address critical factors critical to the functional outcome in children with human immunodeficiency virus (HIV) infection. In the model, which is derived from work at the Boston Children's Hospital Acquired Immune Deficiency Syndrome (AIDS) program, neuropsychological outcomes are determined…

  15. Neuropsychiatric Disorders Associated with Streptococcal Infection: A Case-Control Study among Privately Insured Children

    ERIC Educational Resources Information Center

    Leslie, Douglas L.; Kozma, Laura; Martin, Andres; Landeros, Angeli; Katsovich, Liliya; King, Robert A.; Leckman, James F.

    2008-01-01

    The link between streptococcal infections and the onset of a variety of neuropsychiatric disorders is studied using a national sample of privately insured children. Findings suggest that patients with new-onset of obsessive-compulsive disorder, Tourette syndrome or tic orders were more likely to have been diagnosed with streptococcal infections in…

  16. Aetiology of Acute Respiratory Tract Infections in Hospitalised Children in Cyprus

    PubMed Central

    Richter, Jan; Panayiotou, Christakis; Tryfonos, Christina; Koptides, Dana; Koliou, Maria; Kalogirou, Nikolas; Georgiou, Eleni; Christodoulou, Christina

    2016-01-01

    In order to improve clinical management and prevention of viral infections in hospitalised children improved etiological insight is needed. The aim of the present study was to assess the spectrum of respiratory viral pathogens in children admitted to hospital with acute respiratory tract infections in Cyprus. For this purpose nasopharyngeal swab samples from 424 children less than 12 years of age with acute respiratory tract infections were collected over three epidemic seasons and were analysed for the presence of the most common 15 respiratory viruses. A viral pathogen was identified in 86% of the samples, with multiple infections being observed in almost 20% of the samples. The most frequently detected viruses were RSV (30.4%) and Rhinovirus (27.4%). RSV exhibited a clear seasonality with marked peaks in January/February, while rhinovirus infections did not exhibit a pronounced seasonality being detected almost throughout the year. While RSV and PIV3 incidence decreased significantly with age, the opposite was observed for influenza A and B as well as adenovirus infections. The data presented expand our understanding of the epidemiology of viral respiratory tract infections in Cypriot children and will be helpful to the clinicians and researchers interested in the treatment and control of viral respiratory tract infections. PMID:26761647

  17. Factors associated with parasitic infection amongst street children in orphanages across Lima, Peru

    PubMed Central

    Bailey, Chris; Lopez, Sonia; Camero, Anahí; Taiquiri, Carmen; Arhuay, Yanina; Moore, David A J

    2013-01-01

    Infection caused by intestinal parasites has significant public health consequences amongst children in the developing world. Street children are an under-studied group of society subjected to increased health risks when compared to their peers. To estimate the prevalence of intestinal parasitic infection and ascertain risk factors for parasitosis amongst this population, stool samples were collected from 258 children across four orphanages in three districts of Lima, Peru. Surveys were used to determine associations between risk factors and infection status. The prevalence of parasitic infection within the study sample was 66.3%, with 30.6% testing positive for pathogenic species. Entamoeba coli was the most commonly detected parasite (41.9%) and Giardia lamblia was the most commonly detected pathogenic parasite (17.1%). Of the group 15.1% had helminth infection. When testing for association, age and BMI were risk factors for infection. A notable difference in prevalence (P < 0.00001) based on orphanage was observed, but the duration of residence in an orphanage was not a predictor for infection. A sub-analysis conducted amongst children who were given anti-parasitic treatment 5 months beforehand found no significant difference in parasitosis between those who had been given treatment and those who had not (P  =  0.218). It is suggested that a single dose of albendazole alone may not be effective in combating long-term infection rates. PMID:23683330

  18. A study of ocular infections amongst primary school children in Delhi.

    PubMed

    Kumar, Rajesh; Mehra, M; Dabas, Pratibha; Kamlesh; Raha, R

    2004-06-01

    The present study of ocular infections was conducted amongst primary school children residing in an urban slum and rural area of Delhi. A total of four schools were selected, two from urban slum in Central Delhi Rouse Avenue and two from a peripheral village on the outskirts of Delhi. All the children studying in the above mentioned schools and residing in the same area were covered. All the study subjects were interviewed, clinically examined and given a proforma to be filled by their parents. Of the total 775 subjects only 91 (11.74%) had ocular infections. Conjunctivitis was the most prevalent infection followed by trachoma, stye, blepharitis and chalazion. The type and prevalence of infection was similar, in both sexes and both areas, rural and urban. There was a significant rising trend of ocular infection with increase in age. A significant association was found between ocular infections and religion but the association with per capita income was not significant. PMID:16295674

  19. High Prevalence of Human Metapneumovirus Infection in Young Children and Genetic Heterogeneity of the Viral Isolates

    PubMed Central

    Viazov, S.; Ratjen, F.; Scheidhauer, R.; Fiedler, M.; Roggendorf, M.

    2003-01-01

    RNA of the newly identified human metapneumovirus (HMPV) was detected in nasopharyngeal aspirates of 11 of 63 (17.5%) young children with respiratory tract disease. Markers of infection caused by another member of the Pneumovirinae subfamily of the family Paramyxoviridae, respiratory syncytial virus (RSV), were identified in 15 of these patients (23.8%). Three patients were simultaneously infected with HMPV and RSV. Studies of the clinical characteristics of HMPV-infected children did not reveal any difference between HMPV-infected patients and a control population of RSV-infected patients with regard to disease severity, but the duration of symptoms was significantly shorter for HMPV-infected patients. Phylogenetic analysis of the amplified viral genome fragments confirmed the existence and simultaneous circulation within one epidemic season of HMPV isolates belonging to two genetic lineages. PMID:12843040

  20. INTESTINAL PARASITIC INFECTIONS AND ATOPIC DISEASES IN CHILDREN: A HOSPITAL BASED STUDY.

    PubMed

    Al Ghwass, Mohamed Me; El Dash, Hanaa H; Amin, Sayed A; Hussin, Shimaa S

    2015-08-01

    Different helminth parasites may have different effects on allergy depending on the timing of the exposure. A meta-analysis of many of studies reported the association between the presence of geohelminth eggs in stool samples and asthma provided some evidence for parasite-specific effects. This study evaluated the occurrence of allergy among different intestinal parasitic infected patients. A cross sectional study was carried out from June, 2013 to October, 2013 in the Pediatric Outpatient Clinic of Al-Fayoum University Hospitals among 55 children aged 2 years to 13 years. The data were collected using ISSAC questionnaire of allergy (International Study of Asthma and Allergies in Childhood) also laboratory analysis of complete blood picture, stool analysis and measurement of total serum IgE were performed for the patients. Among the patients 27 suffered from allergy and 28 had no allergic complain. Stool examinations showed Entrobius vernicularis (15), Trichostrongylus species (9), Hymenolepis nana (8), Entameba histolytica (8), Giardia lamblia (6), and mixed infections (9). The allergic group by parasitological examination 7 children (25.9%) had Entrobius vermicularis; 6 children (22.2%) Entameba histolytica; and 2 children (7.4 %) Giardia lamblia, with eosinophilic count was higher in the enterobiasis infected children than in protozoa infected ones. There were significantly high IgE levels in mixed parasitic infection (P= 0.006) and with Entrobius vermicularis infections (P=0.04). Also statistically significant difference between allergic groups by ISAAC score and the non allergic group regarding Ig E levels (P= 0.03). There was no significant difference between numbers of children with allergy and those without allergy among different parasitic infections. However, a marked significant association between the allergy and parasitic infected children was not declaimed. PMID:26485861

  1. Effects of Perinatal HIV Infection and Early Institutional Rearing on Physical and Cognitive Development of Children in Ukraine

    ERIC Educational Resources Information Center

    Dobrova-Krol, Natasha A.; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Juffer, Femmie

    2010-01-01

    To study the effects of perinatal HIV-1 infection and early institutional rearing on the physical and cognitive development of children, 64 Ukrainian uninfected and HIV-infected institutionalized and family-reared children were examined (mean age = 50.9 months). Both HIV infection and institutional care were related to delays in physical and…

  2. Hepatitis a virus infection-associated hemophagocytic lymphohistiocytosis in two children.

    PubMed

    Navamani, Kirubakaran; Natarajan, Manivachagan Muthappa; Lionel, Arul Premanand; Kumar, Sathish

    2014-09-01

    Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by high fever, maculopapular rash, neurological symptoms, abnormal liver functions and coagulopathy. Primary HLH is due to an underlying genetic abnormality. Secondary HLH are due to an underlying infection, autoimmune disease or malignancy. Secondary HLH due to viral infections are commonly due to the herpes group commonest of which is the Ebstein Barr virus (EBV). We describe two children with virus associated hemophagocytic lymphohistiocytosis (VAHLH) secondary to hepatitis A infection. PMID:25332588

  3. Brief Report: Autistic Disorder in Three Children with Cytomegalovirus Infection

    ERIC Educational Resources Information Center

    Sweeten, Thayne L.; Posey, David J.; McDougle, Christopher J.

    2004-01-01

    Previous research has identified a relationship between autistic disorder (autism) and specific congenital infections. Three cases of congenital or perinatal cytomegalovirus (CMV) infection occurring in association with autism are described. Hypothetical mechanisms relating congenital infection, such as CMV, to the development of autism are…

  4. Nutritional Deficiencies and Food Insecurity Among HIV-infected Children in Tanzania

    PubMed Central

    Modlin, Chelsea E.; Naburi, Helga; Hendricks, Kristy M.; Lyatuu, Goodluck; Kimaro, Josphine; Adams, Lisa V.; Palumbo, Paul E.; von Reyn, C. Fordham

    2014-01-01

    Background: Poor nutrition has been associated with impaired immunity and accelerated disease progression in HIV-infected children. The aim of this study was to quantify the levels of nutrient intake in HIV-infected children and compare these to standard recommendations. Methods: We surveyed HIV-infected Tanzanian children enrolled in a pediatric care program that provided routine nutritional counseling and vitamin supplementation. We obtained anthropometric measurements and determined 24-hour macronutrient and micronutrient intakes and food insecurity. Values were compared to recommended nutrient intakes based on age and gender. Results: We interviewed 48 pairs of children and their caregiver(s). The age of the child ranged from 2-14 years; median age 6 and 60% female. The median weight-for-height z-score for children ≤ 5 years was 0.69 and BMI-for-age z-scores for children >5 was -0.84. Macronutrient evaluation showed that 29 (60%) children were deficient in dietary intake of energy; deficiency was more common in older children (p=0.004). Micronutrient evaluation shows that over half of study subjects were deficient in dietary intake of vitamin A, vitamin D, vitamin E, thiamine, riboflavin, niacin, folate, vitamin B12, and calcium. Food insecurity was reported by 20 (58%) caregivers. Conclusions and Public Health Implications: The diets of many HIV-infected children at a specialized treatment center in Tanzania do not meet recommended levels of macro-and micro-nutrients. Food insecurity was a contributory factor. Enhanced dietary counseling and provision of macro- and micro-nutrient supplements will be necessary to achieve optimal nutrition for most HIV-infected children in resource-poor regions.

  5. Patterns of postnatal growth in HIV-infected and HIV-exposed children

    PubMed Central

    Isanaka, Sheila; Duggan, Christopher; Fawzi, Wafaie W.

    2009-01-01

    HIV infection can contribute to disturbances in both linear growth and weight gain in early childhood, with disturbances often apparent as early as 3 mo of age. There is little evidence for a difference in the early growth of HIV-exposed but uninfected children compared to healthy controls. Owing to the close association of growth with immune function and clinical progression, an understanding of growth patterns may be an important tool to ensure the provision of appropriate care to HIV-infected and exposed children. Timely growth monitoring may be used to improve the clinical course and quality of life of these children. PMID:19519675

  6. Epidemiological characteristics of Toxocara canis zoonotic infection of children in a Caribbean community

    PubMed Central

    Thompson, D. E.; Bundy, D. A. P.; Cooper, E. S.; Schantz, P. M.

    1986-01-01

    The study reports the results of a summary of the prevalence and symptomatology of paediatric toxocariasis in Anse-la-Raye, St. Lucia. The seroprevalence of Toxocara canis among the children, as determined by ELISA, was 86%, the highest level recorded to date. In contrast, the prevalence of infection in dogs was not abnormally high, although the canine population was large and unconstrained compared to that in industrial countries. The presence of infective ova in peridomestic areas and the widespread practice of pica among children in the village probably combine to enhance exposure to infection. PMID:3488844

  7. What’s new in hepatitis C virus infections in children?

    PubMed Central

    Pawlowska, Malgorzata; Domagalski, Krzysztof; Pniewska, Anna; Smok, Beata; Halota, Waldemar; Tretyn, Andrzej

    2015-01-01

    The number of hepatitis C virus (HCV) infection cases is relatively low in children. This low number may be connected with the lack of screening tests and the asymptomatic course of infection. Currently, mother-to-infant transmission is the most common cause of HCV infection amongst children in developed countries. It is important to introduce routine screening tests for HCV in pregnant women. The risk of vertical transmission of HCV is estimated at approximately 5% (3%-10%). Currently, we do not have HCV transmission prevention methods. Some factors could potentially be eliminated by elective caesarean section. Currently, the method of prevention of perinatal HCV infection is the early identification and effective treatment of infections in young women in the preconception period. We describe genetic tests (IL-28B single nucleotide polymorphisms) to identify children with an increased chance of spontaneous clearance or sustained virologic response achievement and vitamin D level as a potential predictor of treatment response in children. It is also important to develop non-invasive tests that can predict liver fibrosis. The existence of differences in the mechanisms leading to liver injury between children and adults creates new perspectives of action to reduce liver disease progression in children in the early years of life. PMID:26478670

  8. Challenges of malnutrition care among HIV-infected children on antiretroviral treatment in Africa.

    PubMed

    Jesson, J; Leroy, V

    2015-05-01

    More than 90% of the estimated 3.2 million children with HIV worldwide, at the end of 2013, were living in sub-Saharan Africa. The management of these children was still difficult in 2014 despite the progress in access to antiretroviral drugs. A great number of HIV-infected children are not diagnosed at 6 weeks and start antiretroviral treatment late, at an advanced stage of HIV disease complicated by other comorbidities such as malnutrition. Malnutrition is a major problem in the sub-Saharan Africa global population; it is an additional burden for HIV-infected children because they do not respond as well as non-infected children to the usual nutritional care. HIV infection and malnutrition interact, creating a vicious circle. It is important to understand the relationship between these 2 conditions and the effect of antiretroviral treatment on this circle to taking them into account for an optimal management of pediatric HIV. An improved monitoring of growth during follow-up and the introduction of a nutritional support among HIV-infected children, especially at antiretroviral treatment initiation, are important factors that could improve response to antiretroviral treatment and optimize the management of pediatric HIV in resource-limited countries. PMID:25861689

  9. A mutation in the leptin receptor is associated with Entamoeba histolytica infection in children

    PubMed Central

    Duggal, Priya; Guo, Xiaoti; Haque, Rashidul; Peterson, Kristine M.; Ricklefs, Stacy; Mondal, Dinesh; Alam, Faisal; Noor, Zannatun; Verkerke, Hans P.; Marie, Chelsea; Leduc, Charles A.; Jr., Streamson C. Chua; Jr., Martin G. Myers; Leibel, Rudolph L.; Houpt, Eric; Gilchrist, Carol A.; Sher, Alan; Porcella, Stephen F.; Jr., William A. Petri

    2011-01-01

    Malnutrition substantially increases susceptibility to Entamoeba histolytica in children. Leptin is a hormone produced by adipocytes that inhibits food intake, influences the immune system, and is suppressed in malnourished children. Therefore we hypothesized that diminished leptin function may increase susceptibility to E. histolytica infection. We prospectively observed a cohort of children, beginning at preschool age, for infection by the parasite E. histolytica every other day over 9 years and evaluated them for genetic variants in leptin (LEP) and the leptin receptor (LEPR). We found increased susceptibility to intestinal infection by this parasite associated with an amino acid substitution in the cytokine receptor homology domain 1 of LEPR. Children carrying the allele for arginine (223R) were nearly 4 times more likely to have an infection compared with those homozygous for the ancestral glutamine allele (223Q). An association of this allele with amebic liver abscess was also determined in an independent cohort of adult patients. In addition, mice carrying at least 1 copy of the R allele of Lepr were more susceptible to infection and exhibited greater levels of mucosal destruction and intestinal epithelial apoptosis after amebic infection. These findings suggest that leptin signaling is important in mucosal defense against amebiasis and that polymorphisms in the leptin receptor explain differences in susceptibility of children in the Bangladesh cohort to amebiasis. PMID:21393862

  10. Molecular and Clinical Characterization of Giardia duodenalis Infection in Preschool Children from Lisbon, Portugal

    PubMed Central

    Ferreira, Filipa Santana; Machado Sá da Bandeira, Rita Alexandre dos Santos Soares de Bellegarde; Constantino, Cláudia Alexandra Cecílio de Sampaio Ferreira; da Fonseca, Ana Maria Teixeira Duarte Cancela; Gomes, Joana da Graça Matias; Rodrigues, Rúben Miguel Lopes; Atouguia, Jorge Luís Marques da Silva; Centeno-Lima, Sónia Chavarria Alves Ferreira

    2013-01-01

    Giardia duodenalis is the most prevalent intestinal protozoan infection especially in children. In Portugal scarce data are available relative to this infection in preschoolers. The present study was conducted from April to July 2009 in public preschools in Lisbon enrolling 316 children. Stool examination was performed through microscopy. Molecular analysis was conducted in all positive samples for G. duodenalis in order to determine the assemblage and subassemblage of this parasite. Eight of the preschoolers studied children (2.5%, 8/316) were infected with G. duodenalis. Additionally the brother of one of the infected children was also infected. Genotyping analysis targeting ssu-rRNA and β-giardin loci revealed six infections with assemblage A and 3 with assemblage B. Sub-assemblage determination was possible in four of the samples, with three A2 and one A3. The limited number of cases precluded an association of a determined symptom with an assemblage. The data presented here show the relevance of considering G. duodenalis analysis in children with intestinal complaints even in developed countries. PMID:24089633

  11. Immune responses in children infected with the pinworm Enterobius vermicularis in central Greece.

    PubMed

    Patsantara, G G; Piperaki, E-T; Tzoumaka-Bakoula, C; Kanariou, M G

    2016-05-01

    Previous studies have suggested an immunomodulatory and even protective role for Enterobius vermicularis, the least pathogenic human intestinal helminth. Here, in a study using haematological and serological parameters, we tested a total of 215 children from central Greece, with a mean age of 8.39, of whom 105 (48.84%) were infected with E. vermicularis and 110 (51.16%) were matched healthy controls. In particular, we analysed eosinophil counts (EO), serum eosinophil cationic protein (ECP), total and specific serum immunoglobulin E (IgE) and the ECP/EO ratio. The atopic status and the potential occurrence of clinically expressed allergic diseases were both taken into account. Eosinophils, ECP and IgE were found to be higher in infected than in uninfected children, indicating a type-2 immune response activation during infection. Atopic infected children exhibited higher IgE levels compared to non-atopic ones. EO and ECP were found to be lower in atopic children who had a history of allergic disease than in those with no such history. The type-2 oriented immune response elicited against E. vermicularis could contribute to a balanced activation of the immune system in the examined children. Interestingly, although the atopic children showed a stronger activation, they did not exhibit any symptoms and, moreover, there seemed to be some indication of immunosuppression in those children with a positive history of allergic disease. PMID:25989836

  12. Malnutrition and infection influence the peripheral blood reticulocyte micronuclei frequency in children.

    PubMed

    Cervantes-Ríos, Elsa; Ortiz-Muñiz, Rocío; Martínez-Hernández, Ana Lidia; Cabrera-Rojo, Lilián; Graniel-Guerrero, Jaime; Rodríguez-Cruz, Leonor

    2012-03-01

    Malnutrition is a serious public health problem that affects approximately one third of all children. Developing countries have the highest incidence of malnourished children, and approximately 60% of deaths that occur in children under five are directly related to malnutrition and associated diseases. The relationship between malnutrition and genetic damage has been widely studied in humans and animal models. The micronucleus (MN) assay is useful in detecting chromosome damage induced by several factors. The aim of this study was to evaluate the effects of infection and malnutrition on the frequency of MN in erythrocytes from the peripheral blood of well-nourished, uninfected (WN) and well-nourished, infected (WNI) children, and moderately malnourished (UNM) and severely malnourished (UNS) children, both with infection, using a flow cytometric analysis technique. The percentage of reticulocytes (RETs) was significantly higher (1.5-fold) in WNI children than well-nourished controls. In addition, the UNS group had a 2.2-fold increase in the percentage of RETs compared to the WNI group. The frequency of micronucleated reticulocytes (MN-RETs) was 2.5 times greater, in WNI group compared to the WN group. These frequencies were significantly higher (1.7- and 2.1-fold) in UNM and UNS, respectively, compared to the WNI group. The results suggest that infection and malnutrition induce DNA damage in children. PMID:22119781

  13. Pertussis antibodies in the sera of children exposed to Bordetella pertussis by vaccination or infection.

    PubMed

    Dolby, J M; Stephens, S

    1973-03-01

    Low agglutinin titres to pertussis suspensions were found in 99% of sera from a group comprising healthy adults and non-vaccinated, non-infected infants of 1-6 months of age. These are attributable to agglutinins to heat-stable antigens and/or heat labile agglutinogen 1, and cross-absorption tests must be done on the sera in order to distinguish between the two. Agglutinins to agglutinogens 2 and 3 were found in only about 20% of adult sera. Bactericidal antibody was low in titre or absent in all sera from non-exposed individuals.Raised bactericidal antibody titres and the presence of agglutinins 2 and 3 were attributed to exposure to Bordetella pertussis antigens, either as vaccine or as infection. The variation, amongst both vaccinated and infected children, was very great. A vaccinated child who became ill responded to the infection in much the same way as a non-vaccinated child. We were unable to relate the immunity of the child to the titres either of agglutinins or of the bactericidal antibody.The protective ability of sera from vaccinated or infected children measured in mice against small, lethal brain infections was also unrelated to the state of immunity in the children, but this protective ability was correlated with the complement-mediated bactericidal antibody titres of the sera.The distribution of agglutinins, bactericidal antibody, and anti-haemagglutinin in serum IgG and IgM was different in vaccinated and infected children. PMID:4348456

  14. Pertussis antibodies in the sera of children exposed to Bordetella pertussis by vaccination or infection

    PubMed Central

    Dolby, Jean M.; Stephens, Susan

    1973-01-01

    Low agglutinin titres to pertussis suspensions were found in 99% of sera from a group comprising healthy adults and non-vaccinated, non-infected infants of 1-6 months of age. These are attributable to agglutinins to heat-stable antigens and/or heat labile agglutinogen 1, and cross-absorption tests must be done on the sera in order to distinguish between the two. Agglutinins to agglutinogens 2 and 3 were found in only about 20% of adult sera. Bactericidal antibody was low in titre or absent in all sera from non-exposed individuals. Raised bactericidal antibody titres and the presence of agglutinins 2 and 3 were attributed to exposure to Bordetella pertussis antigens, either as vaccine or as infection. The variation, amongst both vaccinated and infected children, was very great. A vaccinated child who became ill responded to the infection in much the same way as a non-vaccinated child. We were unable to relate the immunity of the child to the titres either of agglutinins or of the bactericidal antibody. The protective ability of sera from vaccinated or infected children measured in mice against small, lethal brain infections was also unrelated to the state of immunity in the children, but this protective ability was correlated with the complement-mediated bactericidal antibody titres of the sera. The distribution of agglutinins, bactericidal antibody, and anti-haemagglutinin in serum IgG and IgM was different in vaccinated and infected children. PMID:4348456

  15. Hantavirus infection among children hospitalized for febrile illness suspected to be dengue in Barbados.

    PubMed

    Kumar, Alok; Krishnamurthy, Kandamaran; Nielsen, Anders L

    2016-01-01

    Emerging picture of hantavirus infection in the South America is characterized by greater proportion of childhood infection and wider spectrum of disease from mild asymptomatic to lethal cardiopulmonary disease. Barbados is endemic for dengue and leptospirosis, both of which share clinical features with hantavirus infection and in many cases neither of these diagnosis could be confirmed. We investigate whether some of the children hospitalized with suspected dengue could indeed have been hantavirus infections. In this prospective study children hospitalized with suspected dengue were tested for hantavirus infection using ELISA for the IgM antibodies. Thirty-eight children tested positive for hantavirus infection. They presented with fever, headache and mild respiratory and gastrointestinal symptoms and signs. None of them had features suggestive of hantavirus cardiopulmonary syndrome. Blood count values ranged from low to normal to high for their age. There were no deaths. Hantavirus infection is prevalent in this Caribbean country. It predominantly presents with milder disease and is responsible for some of the nonspecific febrile illnesses in children. PMID:26153080

  16. Anemia Among Children Exposed to Polyparasitism in Coastal Kenya.

    PubMed

    Chang Cojulun, Alicia; Bustinduy, Amaya L; Sutherland, Laura J; Mungai, Peter L; Mutuku, Francis; Muchiri, Eric; Kitron, Uriel; King, Charles H

    2015-11-01

    Anemia represents a substantial problem for children living in areas with limited resources and significant parasite burden. We performed a cross-sectional study of 254 Kenyan preschool- and early school-age children in a setting endemic for multiple chronic parasitic infections to explore mechanisms of their anemia. Complete venous blood cell counts revealed a high prevalence of local childhood anemia (79%). Evaluating the potential links between low hemoglobin and socioeconomic factors, nutritional status, hemoglobinopathy, and/or parasite infection, we identified age < 9 years (odds ratio [OR]: 12.0, 95% confidence interval [CI]: 4.4, 33) and the presence of asymptomatic malaria infection (OR: 6.8, 95% CI: 2.1, 22) as the strongest independent correlates of having anemia. A total of 130/155 (84%) of anemic children with iron studies had evidence of iron-deficiency anemia (IDA), 16% had non-IDA; 50/52 of additionally tested anemic children met soluble transferrin-receptor (sTfR) criteria for combined anemia of inflammation (AI) with IDA. Children in the youngest age group had the greatest odds of iron deficiency (OR: 10.0, 95% CI: 3.9, 26). Although older children aged 9-11 years had less anemia, they had more detectable malaria, Schistosoma infection, hookworm, and proportionately more non-IDA. Anemia in this setting appears multifactorial such that chronic inflammation and iron deficiency need to be addressed together as part of integrated management of childhood anemia. PMID:26324733

  17. Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines

    PubMed Central

    Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

    2014-01-01

    Objective To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. Methods We followed up children aged 2–59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. Results We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4–5.1) and 12.4% (95% CI 7.9–18.4) for SP and 21.4% (95% CI 15.9–27) and 39.3% (95% CI 32.5–46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P < 0.001). Using propensity score matching to account for imbalance in the distribution of baseline clinical characteristics among children with VSP revealed no difference in TF between those treated with the guideline-recommended regimen vs. more costly broad-spectrum alternatives [risk difference 0.37 (95% CI −0.84 to 0.51)]. Conclusion Before revising current pneumonia case management guidelines, standardised definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required. Objectif Déterminer l'ampleur et les caractéristiques de l’échec du traitement (ET) chez les enfants hospitalisés avec une pneumonie acquise dans la communauté dans

  18. Children Who Acquire HIV Infection Perinatally Are at Higher Risk of Early Death than Those Acquiring Infection through Breastmilk: A Meta-Analysis

    PubMed Central

    Becquet, Renaud; Marston, Milly; Dabis, François; Moulton, Lawrence H.; Gray, Glenda; Coovadia, Hoosen M.; Essex, Max; Ekouevi, Didier K.; Jackson, Debra; Coutsoudis, Anna; Kilewo, Charles; Leroy, Valériane; Wiktor, Stefan Z.; Nduati, Ruth; Msellati, Philippe; Zaba, Basia; Ghys, Peter D.; Newell, Marie-Louise

    2012-01-01

    Background Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed. Methodology/Principal Findings A pooled analysis was conducted of individual data of all available intervention cohorts and randomized trials on prevention of HIV mother-to-child transmission in Africa. Studies were right-censored at the time of infant antiretroviral initiation. Overall mortality rate per 1000 child-years of follow-up was calculated by selected maternal and infant characteristics. The Kaplan-Meier method was used to estimate survival curves by child's HIV infection status and timing of HIV infection. Individual data from 12 studies were pooled, with 12,112 children of HIV-infected women. Mortality rates per 1,000 child-years follow-up were 39.3 and 381.6 for HIV-uninfected and infected children respectively. One year after acquisition of HIV infection, an estimated 26% postnatally and 52% perinatally infected children would have died; and 4% uninfected children by age 1 year. Mortality was independently associated with maternal death (adjusted hazard ratio 2.2, 95%CI 1.6–3.0), maternal CD4<350 cells/ml (1.4, 1.1–1.7), postnatal (3.1, 2.1–4.1) or peri-partum HIV-infection (12.4, 10.1–15.3). Conclusions/Results These results update previous work and inform future UNAIDS modelling by providing survival estimates for HIV-infected untreated African children by timing of infection. We highlight the urgent need for the prevention of peri-partum and postnatal transmission and timely assessment of HIV infection in infants to initiate antiretroviral care and support for HIV-infected children. PMID:22383946

  19. Onchocerciasis infection in children born during 14 years of Simulium control in West Africa.

    PubMed

    De Sole, G; Remme, J

    1991-01-01

    The incidence of onchocerciasis infection in children born since the start of vector control is one of the indicators used in the epidemiological evaluation of the Onchocerciasis Control Programme in West Africa (OCP). Though initially of littel value, after a decade of control it has become a sensitive indicator of residual transmission. The results of 14 years of control are reported. In 179 villages parasitological surveys were undertaken at intervals of 3-4 years. 15,286 children were examined and 110 were found to be infected, compared to an expected number of 2467 infected had there been no control. There was considerable geographical variation in the results. In the large central OCP area the results were excellent. Of 12,172 children examined in 127 villages, only 23 were found to be infected compared to an expected number of 1960 without control. This suggests that larviciding had achieved a 99% reduction in the incidence of infection in children. Additional surveys in 2 foci in the central OCP area where transmission had relapsed showed that these problems were very localized. Most villages with infected children were found in OCP border areas in the east and west, which had been reinvaded by infective vectors from elsewhere, and in the intermediate area between forest and savanna in Côte d'Ivoire where there had been partial control failures because of resistance. The incidence of infection in children was reduced by an estimated 68% in the eastern reinvaded area, by 87% in the western reinvaded area, and by 84% in the intermediate area. PMID:1949145

  20. Molecular Epidemiology and Clinical Manifestations of Adenovirus Respiratory Infections in Taiwanese Children

    PubMed Central

    Wang, Ya-Fang; Shen, Fan-Ching; Wang, Shan-Li; Kuo, Pin-Hwa; Tsai, Huey-Pin; Liu, Ching-Chuan; Wang, Jen-Ren; Chi, Chia-Yu

    2016-01-01

    Abstract Human adenoviruses (HAdVs) are important causes of respiratory infections in children. They usually cause mild upper respiratory symptoms, but they can also produce severe pneumonia and other complications. The aims of this retrospective study were to better define the molecular epidemiology of respiratory adenoviruses circulating in Taiwanese children during 2002 and 2013, detect reinfections and co-infections, and characterize the clinical features and laboratory findings according to the causative genotypes. We collected a representative sample of 182 isolates of adenoviruses from 175 children during the 12-year study period. The most prevalent species was HAdV-B genotype 3 (HAdV-3) (92/182, 50.5%) followed by HAdV-C (HAdV-2) (38/182, 20.9%). A single outbreak of HAdV-E (6/182, 3.3%) was noted in 2007. The mean age of children with adenovirus infections was 3.7 ± 2.0 years, with a slight predominance of males (53.1%). Children with HAdV-B tended to be older, had more lower respiratory tract infections, gastrointestinal symptoms, and a higher rate of hospitalization than those with HAdV-C (P < 0.05). Adenovirus co-infections were noted in 25/175 (14.3%) of the children. The most frequent co-infections were with species B (HAdV-3) and C (HAdV-2) (14/25, 56.0%). Additional infections were noted in 23/175 (13.1%) of the children. Of these repeated infections, the initial isolates were always genotypes of HAdV-C. The second isolates were genotypes of HAdV-B or HAdV-E. The clinical features of the first HAdV-B infection and the reinfection of HAdV-B followed the HAdV-C were similar. In conclusion, HAdV-B, C, and E were the only adenovirus species that were isolated from children who were sufficiently ill with respiratory infections to require a visit to the hospital. Human adenovirus B (HAdV-3) accounted for half of these species. HAdV-B was more likely than other species to produce severe disease. The high incidence of adenovirus co-infection and

  1. Long-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children.

    PubMed Central

    West, T. E.; Goetghebuer, T.; Milligan, P.; Mulholland, E. K.; Weber, M. W.

    1999-01-01

    Acute lower respiratory infections (ALRI) are the main cause of death in young children worldwide. We report here the results of a study to determine the long-term survival of children admitted to hospital with severe pneumonia. The study was conducted on 190 Gambian children admitted to hospital in 1992-94 for ALRI who survived to discharge. Of these, 83 children were hypoxaemic and were treated with oxygen, and 107 were not. On follow-up in 1996-97, 62% were traced. Of the children with hypoxaemia, 8 had died, compared with 4 of those without. The mortality rates were 4.8 and, 2.2 deaths per 100 child-years of follow-up for hypoxaemic and non-hypoxaemic children, respectively (P = 0.2). Mortality was higher for children who had been malnourished (Z-score < -2) when seen in hospital (rate ratio = 3.2; 95% confidence interval (CI) = 1.03-10.29; P = 0.045). Children with younger siblings experienced less frequent subsequent respiratory infections (rate ratio for further hospitalization with respiratory illness = 0.15; 95% CI = 0.04-0.50; P = 0.002). Children in Gambia who survive hospital admission with hypoxaemic pneumonia have a good prognosis. Survival depends more on nutritional status than on having been hypoxaemic. Investment in oxygen therapy appears justified, and efforts should be made to improve nutrition in malnourished children with pneumonia. PMID:10083713

  2. Viruses as Sole Causative Agents of Severe Acute Respiratory Tract Infections in Children

    PubMed Central

    Moesker, Fleur M.; van Kampen, Jeroen J. A.; van Rossum, Annemarie M. C.; de Hoog, Matthijs; Koopmans, Marion P. G.; Osterhaus, Albert D. M. E.; Fraaij, Pieter L. A.

    2016-01-01

    Background Respiratory syncytial virus (RSV) and influenza A viruses are known to cause severe acute respiratory tract infections (SARIs) in children. For other viruses like human rhinoviruses (HRVs) this is less well established. Viral or bacterial co-infections are often considered essential for severe manifestations of these virus infections. Objective The study aims at identifying viruses that may cause SARI in children in the absence of viral and bacterial co-infections, at identifying disease characteristics associated with these single virus infections, and at identifying a possible correlation between viral loads and disease severities. Study Design Between April 2007 and March 2012, we identified children (<18 year) with or without a medical history, admitted to our paediatric intensive care unit (PICU) with SARI or to the medium care (MC) with an acute respiratory tract infection (ARTI) (controls). Data were extracted from the clinical and laboratory databases of our tertiary care paediatric hospital. Patient specimens were tested for fifteen respiratory viruses with real-time reverse transcriptase PCR assays and we selected patients with a single virus infection only. Typical bacterial co-infections were considered unlikely to have contributed to the PICU or MC admission based on C-reactive protein-levels or bacteriological test results if performed. Results We identified 44 patients admitted to PICU with SARI and 40 patients admitted to MC with ARTI. Twelve viruses were associated with SARI, ten of which were also associated with ARTI in the absence of typical bacterial and viral co-infections, with RSV and HRV being the most frequent causes. Viral loads were not different between PICU-SARI patients and MC-ARTI patients. Conclusion Both SARI and ARTI may be caused by single viral pathogens in previously healthy children as well as in children with a medical history. No relationship between viral load and disease severity was identified. PMID:26964038

  3. Challenges in the Management of HIV-Infected Malnourished Children in Sub-Saharan Africa

    PubMed Central

    Trehan, Indi; O'Hare, Bernadette A.; Phiri, Ajib; Heikens, Geert Tom

    2012-01-01

    Infection with HIV, and oftentimes coinfection with TB, complicates the care of severely malnourished children in sub-Saharan Africa. These superimposed infections challenge clinicians faced with a population of malnourished children for whose care evidence-based guidelines have not kept up. Even as the care of HIV-uninfected malnourished children has improved dramatically with the advent of community-based care and even as there are hopeful signs that the HIV epidemic may be stabilizing or ameliorating, significant gaps remain in the care of malnourished children with HIV. Here we summarize what is currently known, what remains unknown, and what remains challenging about how to treat severely malnourished children with HIV and TB. PMID:22606378

  4. Social ecological factors associated with future orientation of children affected by parental HIV infection and AIDS.

    PubMed

    Lin, Xiuyun; Fang, Xiaoyi; Chi, Peilian; Heath, Melissa Allen; Li, Xiaoming; Chen, Wenrui

    2016-07-01

    From a social ecological perspective, this study examined the effects of stigma (societal level), trusting relationships with current caregivers (familial level), and self-esteem (individual level) on future orientation of children affected by HIV infection and AIDS. Comparing self-report data from 1221 children affected by parental HIV infection and AIDS and 404 unaffected children, affected children reported greater stigma and lower future orientation, trusting relationships, and self-esteem. Based on structural equation modeling, stigma experiences, trusting relationships, and self-esteem had direct effects on future orientation, with self-esteem and trusting relationships partially mediating the effect of stigma experiences on children's future orientation. Implications are discussed. PMID:25370572

  5. [Decreased intraepithelial lymphocytes in the intestinal mucosa in children with malnutrition and parasitic infections].

    PubMed

    Gendrel, D; Richard-Lenoble, D; Kombila, M; Nardou, M; Gahouma, D; Barbet, J P; Walter, P

    1992-02-01

    In Gabon, 15 children aged 13 to 36 months admitted for malnutrition with chronic diarrhea underwent a small bowel biopsy for detection of parasites in the duodenal contents and histologic evaluation of the intestinal mucosa. In every case, intraepithelial lymphocyte counts (IELC) were under the lower limit of normal for children and adults, regardless of whether or not parasites were found. Partial villous atrophy was a consistent finding. Proportion of lymphocytes among intraepithelial cells was 7.4% in the 6 children with no parasitic infection, 7.9% in the children with giardiasis, and 8.1% in the children with strongyloidiasis. Appropriate treatment of the parasitic infections was quickly followed by resolution of the diarrhea in the nine patients with demonstrable intestinal parasites. These data should be compared with the well documented lymphocyte function anomalies associated with protein-calory malnutrition. The fall in IELC and lack of response to local anigenic stimulations are features of malnutrition. PMID:1580534

  6. Impact of Antiretroviral Therapy on Opportunistic Infections of HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database

    PubMed Central

    Prasitsuebsai, Wasana; Kariminia, Azar; Puthanakit, Thanyawee; Lumbiganon, Pagakrong; Hansudewechakul, Rawiwan; Moy, Fong Siew; Law, Matthew; Kumarasamy, Nagalingeswaran; Razali, Kamarul; Sirisanthana, Virat; Sohn, Annette H.; Chokephaibulkit, Kulkanya

    2014-01-01

    Background There are limited data on opportunistic infections (OI) and factors associated with their occurrence after highly active antiretroviral therapy (HAART) in Asian children. The use of HAART in Asia started much later than in developed countries and therefore reported findings may not be fully applicable to the pediatric HIV epidemic in Asia. Methods Retrospective and prospectively collected data from the TREAT Asia Pediatric HIV Observational Database cohort study from March 1993 to March 2009 were analyzed. OIs were defined according to WHO clinical staging criteria, and incidence rates calculated. Factors associated with the incidence of severe OIs were analyzed using random effects Poisson regression modeling. Results Of 2280 children in the cohort, 1752 were ever reported to have received ART, of whom 1480 (84%) started on HAART. Before commencing any ART, OIs occurred at a rate of 89.5 per 100 person-years. The incidence rate was 28.8 infections per 100 person-years during mono- or dual-therapy, and 10.5 infections per 100 person-years during HAART. The most common OIs both before and after ART initiation were recurrent upper respiratory tract infections, persistent oral candidiasis, and pulmonary tuberculosis. The incidence rates of WHO clinical stage 3 or 4 OIs after HAART were highest among children <18 months of age and those with low weight-for-age z scores, CD4 cell percentage <15%, and WHO stage 3 at HAART initiation. Conclusions Despite dramatic declines in their incidence, OIs remained important causes of morbidity after HAART initiation in this regional cohort of HIV-infected children in Asia. PMID:24378942

  7. Original Research: Parvovirus B19 infection in children with sickle cell disease in the hydroxyurea era.

    PubMed

    Hankins, Jane S; Penkert, Rhiannon R; Lavoie, Paul; Tang, Li; Sun, Yilun; Hurwitz, Julia L

    2016-04-01

    Parvovirus B19 infection causes transient aplastic crisis in sickle cell disease (SCD) due to a temporary interruption in the red blood cell production. Toxicity from hydroxyurea includes anemia and reticulocytopenia, both of which also occur during a transient aplastic crisis event. Hydroxyurea inhibits proliferation of hematopoietic cells and may be immunosuppressive. We postulated that hydroxyurea could exacerbate parvovirus B19-induced aplastic crisis and inhibit the development of specific immune responses in children with SCD. We conducted a retrospective review of parvovirus B19 infection in 330 children with SCD. Altogether there were 120 known cases of aplastic crisis attributed to parvovirus B19 infection, and 12% of children were on hydroxyurea treatment during the episode. We evaluated hematological and immune responses. Children with HbSS or HbSβ(0)-thalassemia treated with hydroxyurea, when compared with untreated children, required fewer transfusions and had higher Hb concentration nadir during transient aplastic crisis. Duration of hospital stays was no different between hydroxyurea-treated and untreated groups. Children tested within a week following aplastic crisis were positive for parvovirus-specific IgG. Immune responses lasted for the duration of the observation period, up to 13 years after transient aplastic crisis, and there were no repeat aplastic crisis episodes. The frequencies of parvovirus-specific antibodies in all children with SCD increased with age, as expected due to the increased likelihood of a parvovirus exposure, and were comparable to frequencies reported for healthy children. Approximately one-third of children had a positive parvovirus B19-specific IgG test without a documented history of transient aplastic crisis, and 64% of them were treated with hydroxyurea. Hydroxyurea may reduce requirements for blood transfusions and may attenuate symptoms during transient aplastic crisis episodes caused by parvovirus B19 infections

  8. Language Impairment in Children Perinatally Infected with HIV Compared to Children Who Were HIV-Exposed and Uninfected

    PubMed Central

    Rice, Mabel L.; Buchanan, Ashley L.; Siberry, George K; Malee, Kathleen M.; Zeldow, Bret; Frederick, Toni; Purswani, Murli U.; Hoffman, Howard J.; Sirois, Patricia A.; Smith, Renee; Torre, Peter; Allison, Susannah M; Williams, Paige L.

    2011-01-01

    Objective To investigate risk for language impairment in children perinatally infected or exposed to HIV. Methods We evaluated the prevalence of language impairment (LI) in 7–16 year old children with perinatal HIV infection (HIV+) compared to children HIV-exposed and uninfected (HEU), using a comprehensive standardized language test (CELF-4). LI was classified as primary LI (Pri-LI) (monolingual English exposure and no cognitive or hearing impairment), concurrent LI (Con-LI) (cognitive or hearing impairment), or no LI. Associations of demographic, caregiver, HIV disease and antiretroviral treatment (ART) factors with LI category were evaluated using univariate and multivariable logistic regression models. Results Of 468 children with language assessments, 184 (39%) had LI. No difference was observed by HIV infection status for overall LI or for Pri-LI or Con-LI; mean (SD) CELF-4 scores were 88.5 (18.4) for HIV+ vs 87.5 (17.9) for HEU. After adjustment, Black children had higher odds of Pri-LI vs no LI (aOR=2.43, p=0.03). Children who were Black, Hispanic, had a caregiver with low education or low IQ, or a non-biological parent as caregiver had higher odds of Con-LI vs no LI. Among HIV+ children, viral load >400 copies/ml (aOR=3.04, p<0.001), CDC Class C (aOR=2.19, p=0.02) and ART initiation <6 months of age (aOR=2.12, p=0.02) were associated with higher odds of Con-LI vs. no LI. Conclusions Children perinatally exposed to HIV are at high risk for LI, but such risk was not increased for youth with HIV. Risk factors differed for Pri-LI and Con-LI. PMID:22179050

  9. Cardiac Effects of Antiretroviral-Naïve versus Antiretroviral-Exposed HIV Infection in Children

    PubMed Central

    Grobbee, Diederick E.; Burgner, David; Kurniati, Nia

    2016-01-01

    Background Cardiac involvement in HIV infected children has been frequently reported, but whether this is due to HIV infection itself or to antiretroviral treatment (ART) is unknown. Methods This cross sectional study involved 114 vertically-acquired HIV-infected (56 ART-naive, 58 ART-exposed) and 51 healthy children in Jakarta, Indonesia. Echocardiography was performed to measure dimensions of the left ventricle (LV) and systolic functions. We applied general linear modeling to evaluate the associations between HIV infection/treatment status and cardiac parameters with further adjustment for potential confounders or explanatory variables. Findings are presented as (adjusted) mean differences between each of the two HIV groups and healthy children, with 95% confidence intervals and p values. Results Compared to healthy children, ART-naïve HIV-infected children did not show significant differences in age-and-height adjusted cardiac dimensions apart from larger LV internal diameter (difference 2.0 mm, 95%CI 0.2 to 3.7), whereas ART exposed HIV infection showed thicker LV posterior walls (difference = 1.1 mm, 95%CI 0.5 to 1.6), larger LV internal diameter (difference = 1.7 mm, 95%CI 0.2 to 3.2) and higher LV mass (difference = 14.0 g, 7.4 to 20.5). With respect to systolic function, reduced LV ejection fraction was seen in both ART-naïve HIV infected (adjusted difference = -6.7%, -11.4 to -2.0) and, to a lesser extent, in ART-exposed HIV infected children (difference = -4.5%, -8.5 to -0.4). Inflammation level seemed to be involved in most associations in ART-exposed HIV-infected, but few, if any, for decreased function in the ART-naive ones, whereas lower hemoglobin appeared to partially mediate chamber dilation in both groups and reduced function, mainly in ART-exposed children. Conclusions ART-naive HIV infected children have a substantial decrease in cardiac systolic function, whereas the ART-exposed have thicker ventricular walls with larger internal diameter

  10. IL-8 Alterations in HIV-1 Infected Children With Disease Progression

    PubMed Central

    Pananghat, Ambili Nair; Aggarwal, Heena; Prakash, Somi Sankaran; Makhdoomi, Muzamil Ashraf; Singh, Ravinder; Lodha, Rakesh; Ali, Shakir; Srinivas, Maddur; Das, Bimal Kumar; Pandey, Ravindra Mohan; Kabra, Sushil Kumar; Luthra, Kalpana

    2016-01-01

    Abstract Disease progression in HIV-1 infected children is faster than in adults. Less than 5% of the infected children maintain stable CD4 counts beyond 7 years of infection and are termed long-term nonprogressors (LTNPs). Delineating the host immune response in antiretroviral naïve (ART) and treated HIV-1 infected children at different disease stages will help in understanding the immunopathogenesis of the disease. A total of 79 asymptomatic, perinatally HIV-1 infected children (50 ART naïve and 29 ART treated) and 8 seronegative donors were recruited in this study. T- and B-cell activation PCR arrays were performed from the cDNA, using total RNA extracted from the peripheral blood mononuclear cells (PBMCs) of 14 HIV-1 infected children at different stages of the disease. The differentially expressed genes were identified. Quantitative RT-PCR was performed for the (interleukin-8) IL-8 gene and its transcriptional mediators, that is, SHP2, GRB2, and IL-8R (IL-8 receptor/CXCR1). Plasma levels of IL-8 were measured by flow cytometry. Gene array data revealed a higher expression of IL-8 in the ART naïve HIV-1 infected progressors and in ART nonresponders than LTNPs and ART responders, respectively. Quantitative RT-PCR analysis demonstrated a significant higher expression of IL-8 (P < 0.001), its receptor CXCR1 (P = 0.03) and the upstream signaling molecule SHP2 (P = 0.04) in the progressors versus LTNPs. Plasma levels of IL-8 were significantly higher in progressors versus LTNPs (P < 0.001), and ART nonresponders versus ART responders (P < 0.001). A significant negative correlation of plasma levels of IL-8 with CD4 counts (cells/μL) was observed in HIV-1 infected ART naïve subjects (r = −0.488; P < 0.001), while the IL-8 levels positively correlated with viral load in the ART treated children (r = 0.5494; P < 0.001). ART naïve progressors on follow up demonstrated a significant reduction in the mRNA expression (P = 0

  11. Parasite Infection and Tuberculosis Disease among Children: A Case–Control Study

    PubMed Central

    Franke, Molly F.; del Castillo, Hernán; Pereda, Ynés; Lecca, Leonid; Fuertes, Jhoelma; Cárdenas, Luz; Becerra, Mercedes C.; Bayona, Jaime; Murray, Megan

    2014-01-01

    We conducted a case–control study to examine associations between parasite infection, including protozoa infection, and tuberculosis (TB) in children in Lima, Peru. We enrolled 189 matched-pairs. In multivariable conditional logistic regression analyses, Blastocystis hominis infection (rate ratio = 0.30, 95% confidence interval = 0.14–0.64, P = 0.002) was strongly associated with a lower risk of TB. We observed a statistically significant inverse linear dose-response relationship between Blastocystis hominis infection and TB. These findings should be confirmed in future prospective studies. PMID:24379242

  12. Adult Toxocara cati infections in U.S. children: report of four cases.

    PubMed

    Eberhard, M L; Alfano, E

    1998-09-01

    We report four cases of passage of subadult or adult Toxocara cati worms by young children ages 20 months to seven years. Worms were expelled rectally in two cases and in two cases they were vomited. A single worm was passed in two cases, three worms in one case, and 15 worms in the fourth case. All worms that were available for study were identified as T. cati by morphologic criteria, including the arrow-shaped cervical alae and the digitiform shape of the male tail. None of the four children exhibited clinical signs of ocular or visceral larva migrans, and in two cases where serum samples were available, neither child had a titer to Toxocara. These results further the argument that these children acquired the worms through the ingestion of immature worms passed by infected cats, not through the ingestion of infective eggs. Although the children were generally not ill as a result of these unusual infections, it does serve to reinforce the public health issue that potential serious consequences can occur where children have exposure to an environment that has been contaminated with cat feces, or, more specifically, infective eggs, and could become infected with larval forms of Toxocara. PMID:9749634

  13. The importance of nutritional care in HIV-infected children in resource-limited settings.

    PubMed

    McHenry, Megan S; Apondi, Edith; Vreeman, Rachel C

    2014-12-01

    Renewed efforts to provide proper nutritional care are essential for appropriate pediatric HIV management. Current studies support the use of vitamin A and macronutrients that increase caloric and protein intake. With additional research on key issues such as the needed composition and timing for nutritional supplementation, we can determine the best strategies to support the growth and development of HIV-infected children in resource-limited settings. Malnutrition among children is common in the resource-limited settings where HIV infection is most prevalent. While malnutrition is associated with higher morbidity and mortality for HIV-infected children, there is only limited evidence to guide the use of nutritional support for HIV-infected children. The best studied is vitamin A, which is associated with improved mortality and clinical outcomes. Zinc and multivitamin supplementation have not consistently been associated with clinical benefits. Limited research suggests macronutrient supplementation, which typically uses enriched formulas or foods, improves key anthropometrics for HIV-infected children, but the optimal composition of nutrients for supplementation has not been determined. More research is needed to understand the most efficient and sustainable ways to ensure adequate nutrition in this vulnerable population. PMID:25371264

  14. School placement for human immunodeficiency virus-infected children: the Baltimore City experience.

    PubMed

    Santelli, J S; Birn, A E; Linde, J

    1992-05-01

    Over the past 6 years, the city of Baltimore has successfully implemented a school placement policy for human immunodeficiency virus (HIV)-infected children and children with acquired immunodeficiency syndrome (AIDS). Both policy and specific procedures are based on nationally promulgated guidelines. School placement policy is part of an overall AIDS policy that includes education of students and staff and adoption of universal precautions to prevent transmission of communicable diseases in school. Implementation has been marked by excellent collaboration between the departments of health and education. Important policy components include expedited clinical investigation of each case, an interagency review panel, strict protection of confidentiality, a restricted setting for certain children, a school site visit for each placement, and continued monitoring of the school placement by school nurses. Many HIV-infected students need special educational services and/or school health services. The Baltimore City school placement process has avoided the exaggerated publicity endured by some communities, where media reporting has aggravated community fears and invaded the lives of families with HIV-infected children. Baltimore City has succeeded in ensuring access to education, protecting families' confidentiality, and providing special care for HIV-infected students. Local communities should emphasize national guidelines in designing school placement policies for HIV-infected children. School placement policies work best in the context of a comprehensive policy incorporating AIDS education and care. PMID:1579392

  15. Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

    PubMed Central

    Page, Anne-Laure; de Rekeneire, Nathalie; Sayadi, Sani; Aberrane, Said; Janssens, Ann-Carole; Rieux, Claire; Djibo, Ali; Manuguerra, Jean-Claude; Ducou-le-Pointe, Hubert; Grais, Rebecca F.; Schaefer, Myrto; Guerin, Philippe J.; Baron, Emmanuel

    2013-01-01

    Background Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger. Methods Children with complicated SAM hospitalized in the intensive care unit of a therapeutic feeding center, with no antibiotics in the previous 7 days, were included. A clinical examination, blood, urine and stool cultures, and chest radiography were performed systematically on admission. Results Among the 311 children included in the study, gastroenteritis was the most frequent clinical diagnosis on admission, followed by respiratory tract infections and malaria. Blood or urine culture was positive in 17% and 16% of cases, respectively, and 36% had abnormal chest radiography. Enterobacteria were sensitive to most antibiotics, except amoxicillin and cotrimoxazole. Twenty-nine (9%) children died, most frequently from sepsis. Clinical signs were poor indicators of infection and initial diagnoses correlated poorly with biologically or radiography-confirmed diagnoses. Conclusions These data confirm the high level of infections and poor correlation with clinical signs in children with complicated SAM, and provide antibiotic resistance profiles from an area with limited microbiological data. These results contribute unique data to the ongoing debate on the use and choice of broad-spectrum antibiotics as first-line treatment in children with complicated SAM and reinforce the call for an update of international guidelines on management of complicated SAM based on more recent data. PMID:23874731

  16. Systemic Immune Activation Profiles of HIV-1 Subtype C-Infected Children and Their Mothers

    PubMed Central

    Makhubele, Tinyiko G.; Steel, Helen C.; Anderson, Ronald; van Dyk, Gisela; Theron, Annette J.; Rossouw, Theresa M.

    2016-01-01

    Little is known about immune activation profiles of children infected with HIV-1 subtype C. The current study compared levels of selected circulating biomarkers of immune activation in HIV-1 subtype C-infected untreated mothers and their children with those of healthy controls. Multiplex bead array, ELISA, and immunonephelometric procedures were used to measure soluble CD14 (sCD14), beta-2 microglobulin (β2M), CRP, MIG, IP-10, and transforming growth factor beta 1 (TGF-β1). Levels of all 6 biomarkers were significantly elevated in the HIV-infected mothers and, with the exception of MIG, in their children (P < 0.01–P < 0.0001). The effects of antiretroviral therapy (ART) and maternal smoking on these biomarkers were also assessed. With the exception of TGF-β1, which was unchanged in the children 12 months after therapy, initiation of ART was accompanied by decreases in the other biomarkers. Regression analysis revealed that although most biomarkers were apparently unaffected by smoking, exposure of children to maternal smoking was associated with a significant increase in IP-10. These findings demonstrate that biomarkers of immune activation are elevated in HIV-infected children pre-ART and decline, with the exception of TGF-β1, after therapy. Although preliminary, elevation of IP-10 in smoke-exposed infants is consistent with a higher level of immune activation in this group. PMID:27019552

  17. Tuberculosis in HIV-infected infants, children, and adolescents in Latin America

    PubMed Central

    Krauss, Margot R; Harris, D Robert; Abreu, Thalita; Ferreira, Fabiana G; Ruz, Noris Pavia; Worrell, Carol; Hazra, Rohan

    2016-01-01

    Objective To evaluate the occurrence, clinical presentations and diagnostic methods for tuberculosis (TB) in a cohort of HIV-infected infants, children and adolescents from Latin America. Methods A retrospective analysis of children with TB and HIV was performed within a prospective observational cohort study conducted at multiple clinical sites in Latin America. Results Of 1114 HIV-infected infants, children, and adolescents followed from 2002-2011, 69 that could be classified as having confirmed or presumed TB were included in this case series; 52.2% (95% CI: 39.8-64.4%) had laboratory-confirmed TB, 15.9% (95% CI: 8.2-26.7%) had clinically-confirmed disease and 31.9% (95% CI: 21.2-44.2%) had presumed TB. Sixty-six were perinatally HIV-infected. Thirty-two (61.5%) children had a history of contact with an adult TB case; however information on exposure to active TB was missing for 17 participants. At the time of TB diagnosis, 39 were receiving antiretroviral therapy. Sixteen of these cases may have represented immune reconstitution inflammatory syndrome. Conclusions Our study emphasizes the need for adequate contact tracing of adult TB cases and screening for HIV or TB in Latin American children diagnosed with either condition. Preventive strategies in TB-exposed, HIV-infected children should be optimized. PMID:25307683

  18. Clinical and Associated Immunological Manifestations of HFMD Caused by Different Viral Infections in Children

    PubMed Central

    Wang, Jingjing; Pu, Jing; Liu, Longding; Che, Yanchun; Liao, Yun; Wang, Lichun; Guo, Lei; Feng, Min; Liang, Yan; Fan, Shengtao; Cai, Lukui; Zhang, Ying; Li, Qihan

    2016-01-01

    Hand, foot, and mouth disease (HFMD), with vesiculae on the hands, feet and mouth, is an infectious disease caused by many viral pathogens. However, the differences of immune response induced by these pathogens are unclear. We compared the clinical manifestations and the levels of immunologic indicators from 60 HFMD patients caused by different viral pathogens to analyze the differences in the immune response. It was shown that Th2 cytokines (IL-4 and IL-10) increased significantly in EV71-infected children; Th1 cytokines (IL-2 and IFN-γ) rose in CA16-infected children; both Th1 and Th2 cytokines elevated in non-EVG-infected children; only individual cytokines (such as IL-10) went up in EVG-infected children. Meanwhile, the antibodies induced by viral infection could not cross-interfere between the different pathogens. These differences might be due to variations in the immune response induced by the individual pathogens or to the pathogenesis of the infections by the individual pathogens. PMID:27336013

  19. Clinical and Associated Immunological Manifestations of HFMD Caused by Different Viral Infections in Children.

    PubMed

    Wang, Jingjing; Pu, Jing; Liu, Longding; Che, Yanchun; Liao, Yun; Wang, Lichun; Guo, Lei; Feng, Min; Liang, Yan; Fan, Shengtao; Cai, Lukui; Zhang, Ying; Li, Qihan

    2016-01-01

    Hand, foot, and mouth disease (HFMD), with vesiculae on the hands, feet and mouth, is an infectious disease caused by many viral pathogens. However, the differences of immune response induced by these pathogens are unclear. We compared the clinical manifestations and the levels of immunologic indicators from 60 HFMD patients caused by different viral pathogens to analyze the differences in the immune response. It was shown that Th2 cytokines (IL-4 and IL-10) increased significantly in EV71-infected children; Th1 cytokines (IL-2 and IFN-γ) rose in CA16-infected children; both Th1 and Th2 cytokines elevated in non-EVG-infected children; only individual cytokines (such as IL-10) went up in EVG-infected children. Meanwhile, the antibodies induced by viral infection could not cross-interfere between the different pathogens. These differences might be due to variations in the immune response induced by the individual pathogens or to the pathogenesis of the infections by the individual pathogens. PMID:27336013

  20. Social care of children born to HIV-infected mothers in Europe. European Collaborative Study.

    PubMed

    Thorne, C; Newell, M L; Peckham, C

    1998-02-01

    Children of HIV-infected women are likely to be profoundly affected by their mothers' infection, regardless of their own infection status and their number will increase with the spread of infection among women in Europe. This article describes the family circumstances and social care of 1,123 children born to HIV-infected women enrolled in the European Collaborative Study and followed prospectively from birth. Most mothers were white, married or cohabiting, asymptomatic and had a history of drug use, with 45% currently using injecting drugs at the time of enrollment. Seventy percent of children were cared for by their mothers and/or fathers consistently in their first four years of life, but by age eight an estimated 60% will have lived away from their parents (i.e. with foster or adoptive parents, other relatives or in an institution). Whether or not a child was infected did not influence the likelihood of living in alternative care. Maternal injecting drug use, single parenthood and health status were the major reasons necessitating alternative care. The type of alternative care varied according to maternal characteristics, child's age and geographic location. The mothers of 98 children had died and average age at maternal death was four years. PMID:9536198

  1. Saliva and sera IgA and IgG in Egyptian Giardia-infected children.

    PubMed

    El-Gebaly, Naglaa Saad M; Halawa, Eman Fawzy; Moussa, Hanaa M Ezzat; Rabia, Ibrahim; Abu-Zekry, Maha

    2012-08-01

    Giardiasis is a gastrointestinal infection of wide distribution that is more prevalent in childhood. Easy and rapid diagnosis of giardiasis is essential for reduction of this infection. This cross-sectional study included 62 children in which collection of saliva, stool and serum samples was performed. An enzyme-linked immunosorbent assay (ELISA) technique was evaluated to detect IgA and IgG responses in both saliva and serum samples. Twenty-two children were positive for Giardia duodenalis infection by direct examination of faecal specimens, 20 non-infected and 20 infected with other parasites. Salivary and serum IgA and IgG responses against G. duodenalis infection were significantly higher in Giardia parasitized than non-Giardia parasitized children (p < 0.001). This concludes that specific salivary IgA may serve as a diagnostic tool and specific salivary IgG as a screening tool in monitoring the exposure of various populations to Giardia duodenalis. The advantage of salivary assays over serum immunoglobulin assay is being easy and non-invasive in sampling technique which is important especially for young children. PMID:22402609

  2. Predominance of Blastocystis sp. Infection among School Children in Peninsular Malaysia

    PubMed Central

    Nithyamathi, Kalimuthu; Chandramathi, Samudi; Kumar, Suresh

    2016-01-01

    Background One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism. Methods and Principal Findings A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent’s education and presence of symptoms (p<0.05). Conclusion It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children. PMID:26914483

  3. Early Developmental Outcomes of Children With Congenital HHV-6 Infection

    PubMed Central

    Hall, Caroline B.; Canfield, Richard L.; Davidson, Philip; Lofthus, Gerry; Schnabel, Kenneth; Carnahan, Jennifer; Shelley, Lynne; Wang, Hongyue

    2014-01-01

    OBJECTIVE: The goal of this study was to determine if congenital human herpesvirus-6 (HHV-6) infection influences early neurodevelopment. METHODS: We enrolled 57 newborns with HHV-6 congenital infection and 242 control newborns without congenital infection into a prospective, double-blind study with 4 visits between 4 and 30 months of age. Assessments included the Fagan Test of Infant Intelligence, the Visual Expectation Paradigm, and the Mental Development Index (MDI) of the Bayley Scales of Infant Development II. Newborn audiology screening and follow-up audiology examinations were completed at 12 to 24 months. RESULTS: No differences were noted in baseline characteristics between infants with HHV-6 congenital infection and control infants. No clinical syndrome due to congenital infection with HHV-6 was evident at birth. No differences were identified on the Fagan Test of Infant Intelligence or the Visual Expectation Paradigm between the two groups. In 39 infants with HHV-6 congenital infection, the mean ± SD Bayley Scale of Infant Development II MDI score was 103.4 ± 8.9 at 12 months of age. The matched control infants had a mean score of 105.4 ± 12.4. After controlling for covariates, HHV-6 congenital infection was associated with lower scores on the Bayley Scale of Infant Development II MDI at 12 months of age (mean difference: 4.3 [95% confidence interval: 0.4 to 8.1]; P = .03) compared with infants without HHV-6 congenital infection. CONCLUSIONS: Congenital HHV-6 infection may have a detrimental effect on neurodevelopment at 12 months of age and requires further study given that congenital infection with HHV-6 is present in ∼1 in every 101 births. PMID:25367540

  4. Eight Year Prospective Study of Adenoviruses Infections in Hospitalized Children. Comparison with Other Respiratory Viruses

    PubMed Central

    Calvo, Cristina; García-García, María Luz; Sanchez-Dehesa, Rosa; Román, Cristina; Tabares, Ana; Pozo, Francisco; Casas, Inmaculada

    2015-01-01

    Human adenovirus (HAdV) cause upper and lower respiratory tract infections. However, there are few large prospective studies focused on HAdVs acute infections requiring hospitalization. From 2005 to 2013 a prospective study was conducted on children admitted with acute respiratory infections. Specimens of nasopharyngeal aspirate were taken for virological study by PCR and clinical data was recorded. HAdV specimens were genotyped. Frequency and clinical course of HAdV infections were compared with RSV, rhinovirus (RV), human bocavirus (HBoV) and influenza in the same population. HAdV was detected in 403 cases of 2371 confirmed viral infections (17.2%) , of which 154 were single virus infections (38%). We genotyped 154 HAdVs. The most frequent genotypes were HAdV-3 (24%), HAdV-6 (21%), and HAdV-5 (20%). A total of 262 children had fever (64.9%); 194 suffered hypoxia (48%), and 147 presented infiltrate in chest x-rays (36.4%). The most frequent diagnoses were recurrent wheezing or asthma (51.7%), bronchiolitis (18.3 %), and pneumonia (11.9%), and 46 (11.4%) episodes required prolonged hospitalization (>7 days) due to the severity. Adenovirus single infections were compared with single infections of 598 RSV, 494 RV, 83 influenza and 78 HBoV. Significant clinical differences were found between HAdV, RSV and RV infections. PMID:26147465

  5. Risk Factors for Community-Associated Staphylococcus aureus Skin Infection in Children of Maui

    PubMed Central

    Seifried, Steven E

    2012-01-01

    The prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection, and Staphylococcus aureus (S. aureus) infection overall, has dramatically increased in the past 10 years. Children and Native Hawaiians and Pacific Islanders (NHPI) are disproportionately affected by CA-MRSA infection. The purpose of this case-control study was to identify risk factors for CA-S. aureus skin infections in children of Maui, Hawai‘i, as a foundation for reducing the transmission of these infections. Survey data were obtained from patients in pediatric clinician offices over an 8-month period. NHPI participants were well-represented as 58% of cases and 54% of controls. Chi-square analysis and logistic regression were used to identify risk factors. Significant risk factors predictive of infection among all participants were (a) skin abrasions or wounds, (b) household contact, and (c) overweight or obesity. Risk factors predictive of infection among NHPI were (a) skin abrasions or wounds, (b) antibiotic use within 6 months, (c) overweight or obesity, and (d) a history of eczema or other skin disorder. The role of overweight or obesity in S. aureus skin infections among NHPI has not been identified in previous research and indicates a focus for additional education. Further research is needed to better understand the role of eczema, antibiotic use, overweight and obesity, and socio-cultural factors in these infections. PMID:22900237

  6. Dengue Virus (DENV) Neutralizing Antibody Kinetics in Children After Symptomatic Primary and Postprimary DENV Infection.

    PubMed

    Clapham, Hannah E; Rodriguez-Barraquer, Isabel; Azman, Andrew S; Althouse, Benjamin M; Salje, Henrik; Gibbons, Robert V; Rothman, Alan L; Jarman, Richard G; Nisalak, Ananda; Thaisomboonsuk, Butsaya; Kalayanarooj, Siripen; Nimmannitya, Suchitra; Vaughn, David W; Green, Sharone; Yoon, In-Kyu; Cummings, Derek A T

    2016-05-01

    The immune response to dengue virus (DENV) infection is complex and not fully understood. Using longitudinal data from 181 children with dengue in Thailand who were followed for up to 3 years, we describe neutralizing antibody kinetics following symptomatic DENV infection. We observed that antibody titers varied by serotype, homotypic vs heterotypic responses, and primary versus postprimary infections. The rates of change in antibody titers over time varied between primary and postprimary responses. For primary infections, titers increased from convalescence to 6 months. By comparing homotypic and heterotypic antibody titers, we saw an increase in type specificity from convalescence to 6 months for primary DENV3 infections but not primary DENV1 infections. In postprimary cases, there was a decrease in titers from convalescence up until 6 months after infection. Beginning 1 year after both primary and postprimary infections, there was evidence of increasing antibody titers, with greater increases in children with lower titers, suggesting that antibody titers were boosted due to infection and that higher levels of neutralizing antibody may be more likely to confer a sterilizing immune response. These findings may help to model virus transmission dynamics and provide baseline data to support the development of vaccines and therapeutics. PMID:26704615

  7. "I Have Been Given the Power to Teach. The Children Understand Me Very Well." The Social and Academic Impact of Deaf Teacher Training in Kenya

    ERIC Educational Resources Information Center

    Johnstone, Christopher; Corce, Heidi

    2010-01-01

    Kenya has 41 Deaf schools that serve children from Class 1 through secondary school. These schools are all characterised by the fact that they have very few teachers who are fluent in Kenyan sign language. In order to meet the needs of schools and to provide employment opportunities for Deaf Kenyan adults, a small non-governmental organisation…

  8. Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014

    PubMed Central

    Messacar, Kevin; Pastula, Daniel M.; Robinson, Christine C.; Leshem, Eyal; Sejvar, James J.; Nix, W. Allan; Oberste, M. Steven; Feikin, Daniel R.; Dominguez, Samuel R.

    2016-01-01

    During August 8, 2014–October 14, 2014, a total of 11 children with acute flaccid myelitis and distinctive neuroimaging changes were identified near Denver, Colorado, USA. A respiratory prodrome was experienced by 10, and nasopharyngeal specimens were positive for enterovirus D68 (EV-D68) for 4. To determine whether an association exists between EV-D68 infection and acute flaccid myelitis, we conducted a retrospective case–control study comparing these patients with 2 groups of outpatient control children (1 group tested for acute respiratory illness and 1 for Bordetella pertussis infection). Adjusted analyses indicated that, for children with acute flaccid myelitis, the odds of having EV-D68 infection were 10.3 times greater than for those tested for acute respiratory infection and 4.5 times greater than for those tested for B. pertussis infection. No statistical association was seen between acute flaccid myelitis and non–EV-D68 enterovirus or rhinovirus infection. These findings support an association between EV-D68 infection and acute flaccid myelitis. PMID:27434186

  9. Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014.

    PubMed

    Aliabadi, Negar; Messacar, Kevin; Pastula, Daniel M; Robinson, Christine C; Leshem, Eyal; Sejvar, James J; Nix, W Allan; Oberste, M Steven; Feikin, Daniel R; Dominguez, Samuel R

    2016-08-01

    During August 8, 2014-October 14, 2014, a total of 11 children with acute flaccid myelitis and distinctive neuroimaging changes were identified near Denver, Colorado, USA. A respiratory prodrome was experienced by 10, and nasopharyngeal specimens were positive for enterovirus D68 (EV-D68) for 4. To determine whether an association exists between EV-D68 infection and acute flaccid myelitis, we conducted a retrospective case-control study comparing these patients with 2 groups of outpatient control children (1 group tested for acute respiratory illness and 1 for Bordetella pertussis infection). Adjusted analyses indicated that, for children with acute flaccid myelitis, the odds of having EV-D68 infection were 10.3 times greater than for those tested for acute respiratory infection and 4.5 times greater than for those tested for B. pertussis infection. No statistical association was seen between acute flaccid myelitis and non-EV-D68 enterovirus or rhinovirus infection. These findings support an association between EV-D68 infection and acute flaccid myelitis. PMID:27434186

  10. Controversies Surrounding Clostridium difficile Infection in Infants and Young Children

    PubMed Central

    Nicholson, Maribeth R.; Thomsen, Isaac P.; Edwards, Kathryn M.

    2014-01-01

    Clostridium difficile is a frequent cause of antibiotic-associated diarrhea in adults and older children. However, as many as 80% of infants can be asymptomatically colonized. The reasons for this have not been well established but are believed to be due to differences in toxin receptors or toxin internalization. Determining which children who test positive for C. difficile warrant treatment is exceedingly difficult, especially in the setting of increased rates of detection and the rising risk of disease in children lacking classic risk factors for C. difficile.

  11. [Investigation of pinworm infection among kindergarten children in Jurong City, Jiangsu Province].

    PubMed

    Jiang, Cheng-Gong; Li, Shui-Ming

    2013-10-01

    In order to understand pinworm infection of kindergarten children in Jurong City, Jiangsu Province, a total of 1 088 children were sampled for the survey from September 2011 to October 2012. The cellophane tape swab technique was used to examine pinworm eggs. The infection rate of pinworm was 1.1% (12/1 088). The rate in boys and girls was 1.3% (7/551) and 0.9% (5/537), respectively. Higher infection rate was in the senior class (1.4%, 5/370), and no significant difference was found with gender, as well as among different classes (P > 0.05). Evidently, pinworm prevalence is at a low level in the kindergarten children of Jurong. PMID:24818389

  12. Soil-transmitted helminth infection and urbanization in 880 primary school children in Nicaragua, 2005.

    PubMed

    Rosewell, Alexander; Robleto, Guillermo; Rodríguez, Guillermo; Barragne-Bigot, Philippe; Amador, Juan José; Aldighieri, Sylvain

    2010-07-01

    The prevalence of soil-transmitted helminthiasis is close to half the population in Central America, with the marginalized peri-urban poor disproportionately affected. Previous single province helminth surveys conducted in Nicaragua have shown Ascaris lumbricoides to be the predominant species. In 2005, we conducted a cross-sectional study of 880 children in 10 Nicaraguan primary schools located in four provinces. We aimed to establish the prevalence and intensity of soil-transmitted helminth infections and to investigate the factors associated with helminthiasis. Almost half (46%) of the children were infected with soil-transmitted helminths. Tichuris trichiura was the most common infective species (34.7%). The prevalence and intensity of helminthiasis was heterogeneous in the provinces, with children educated in peri-urban schools most affected. Healthy policies are required that favour the peri-urban poor who have inadequate and declining access to water and sanitation. PMID:20555043

  13. Risk Factors for Sporadic Shiga Toxin–producing Escherichia coli Infections in Children, Argentina1

    PubMed Central

    Rivas, Marta; Sosa-Estani, Sergio; Rangel, Josefa; Caletti, Maria G.; Vallés, Patricia; Roldán, Carlos D.; Balbi, Laura; Marsano de Mollar, Maria C.; Amoedo, Diego; Miliwebsky, Elizabeth; Chinen, Isabel; Hoekstra, Robert M.; Mead, Paul

    2008-01-01

    We evaluated risk factors for sporadic Shiga toxin–producing Escherichia coli (STEC) infection among children in Argentina. We conducted a prospective case–control study in 2 sites and enrolled 150 case-patients and 299 controls. The median age of case-patients was 1.8 years; 58% were girls. Serotype O157:H7 was the most commonly isolated STEC. Exposures associated with infection included eating undercooked beef, living in or visiting a place with farm animals, and contact with a child <5 years of age with diarrhea. Protective factors included the respondent reporting that he or she always washed hands after handling raw beef and the child eating more than the median number of fruits and vegetables. Many STEC infections in children could be prevented by avoiding consumption of undercooked beef, limiting exposure to farm animals and their environment, not being exposed to children with diarrhea, and washing hands after handling raw beef. PMID:18439359

  14. Diagnosis and treatment of Helicobacter pylori infection in children: a survey of WV primary care physicians.

    PubMed

    Stevens, I W; Lawrence, Z; Elitsur, Y

    2001-01-01

    Helicobacter pylori infection has been implicated in the development of peptic ulcer disease in children. Although clinical protocols for the diagnosis and treatment of this infection in children are available, the implementation of those guidelines by primary physicians are insufficient. In this study, we surveyed the clinical practices of 409 primary physicians who practice in West Virginia and treat children with H. pylori infection. Results showed in contradiction with the recommendation, primary physicians are still using serology as the preferred diagnostic method for this disease. Most of the physicians treat this disease with a combination of two antibiotics and anti-acid medication (H2 blockers or PPI) for at least one week. We conclude that an increase in knowledge of those guidelines among primary physicians may improve physicians' compliance with H. pylori guidelines. PMID:11761653

  15. Zinc status in well nourished Bangladeshi children suffering from acute lower respiratory infection.

    PubMed

    Shakur, Md Salim; Malek, M A; Bano, Nasreen; Islam, Khaleda

    2004-05-01

    This study was done to investigate the association of zinc status of well nourished Bangladeshi children with Acute Lower Respiratory Infection (ALRI). In this case control study, simultaneous estimation of serum and hair zinc was performed in 35 well nourished children, aged 6-60 months suffering from ALRI and 38 normal matched controls. Serum zinc was low in children suffering from ALRI as compared to control (90 +/- 51 pg/dL vs 176 +/- 98 pg/dL, OR: 6, 95% CI: 1.83, 19.66;P <0.05) children. Hair zinc was also found significantly low in children suffering from ALRI as compared to control (158 + 48 1g/g vs 247 154 pg/g, OR: 3, 95% CI: 1.46, 10.04, P < 0.05). We conclude that Bangladeshi children suffering from pneumonia, have decreased levels of serum and hair zinc. PMID:15181298

  16. Gastric metaplasia and duodenal ulcer disease in children infected by Helicobacter pylori.

    PubMed Central

    Gormally, S M; Kierce, B M; Daly, L E; Bourke, B; Carroll, R; Durnin, M T; Drumm, B

    1996-01-01

    BACKGROUND--Helicobacter pylori infection of the gastric mucosa is vital in the pathogenesis of duodenal ulcer disease. H pylori will only colonise gastric epithelium and its association with duodenal disease is therefore not easily explained. AIMS--To determine if gastric metaplasia in the duodenum increases the risk of duodenal ulcer disease in children infected with H pylori. PATIENTS--All children undergoing upper endoscopy over a 20 month period in a children's hospital in Ireland. METHODS--Two biopsy specimens were obtained from the antral mucosa and two from the first part of the duodenum. One antral biopsy specimen was used in a rapid urease test (Clo Test). Biopsy sections were stained with haematoxylin and eosin and also with cresyl violet for identification of H pylori. Periodic acid Schiff (PAS) stain was performed to identify areas of gastric metaplasia. RESULTS--Gastric and duodenal biopsy specimens were obtained from 148 patients (M:F 1:2:1). Twenty five children (17%) had H pylori positive gastritis. Thirty four children (23%) had gastric metaplasia in the duodenum. Nine per cent of children under the age of 8 years had gastric metaplasia compared with 38% in those 12 years of age or over (p < 0.005). Seven children had duodenal ulcer disease. Gastric metaplasia was present in six of seven (86%) children with duodenal ulcer disease compared with 28 of 141 (20%) without ulceration (p < 0.001). While both H pylori and gastric metaplasia were each significant risk factors for duodenal ulcer disease, the combined presence of both factors was associated with a pronounced increase in duodenal ulcer disease. Duodenal ulcer disease occurred in over 50% of children with both H pylori infection and gastric metaplasia. In contrast duodenal disease did not occur in children (0 of 100) when both were absent. CONCLUSION--The presence of gastric metaplasia in the duodenum is the major risk factor for duodenal ulcer disease in patients colonised by H pylori. PMID

  17. Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children

    PubMed Central

    Karunanayake, Chandima P.; Albritton, William; Rennie, Donna C.; Lawson, Joshua A.; McCallum, Laura; Gardipy, P. Jenny; Seeseequasis, Jeremy; Naytowhow, Arnold; Hagel, Louise; McMullin, Kathleen; Ramsden, Vivian; Abonyi, Sylvia; Episkenew, Jo-Ann; Dosman, James A.; Pahwa, Punam; Project Research Team, The First Nations Lung Health; Study Team, The Saskatchewan Rural Health

    2016-01-01

    Background. Ear infections in children are a major health problem and may be associated with hearing impairment and delayed language development. Objective. To determine the prevalence and the associated risk factors of ear infections in children 6–17 years old residing on two reserves and rural areas in the province of Saskatchewan. Methodology. Data were provided from two rural cross-sectional children studies. Outcome variable of interest was presence/absence of an ear infection. Logistic regression analysis was conducted to examine the relationship between ear infection and the other covariates. Results. The prevalence of ear infection was 57.8% for rural Caucasian children and 43.6% for First Nations children living on-reserve. First Nations children had a lower risk of ear infection. Ear infection prevalence was positively associated with younger age; first born in the family; self-reported physician-diagnosed tonsillitis; self-reported physician-diagnosed asthma; and any respiratory related allergy. Protective effect of breastfeeding longer than three months was observed on the prevalence of ear infection. Conclusions. While ear infection is a prevalent condition of childhood, First Nations children were less likely to have a history of ear infections when compared to their rural Caucasian counterparts. PMID:26977160

  18. Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.

    PubMed

    Karunanayake, Chandima P; Albritton, William; Rennie, Donna C; Lawson, Joshua A; McCallum, Laura; Gardipy, P Jenny; Seeseequasis, Jeremy; Naytowhow, Arnold; Hagel, Louise; McMullin, Kathleen; Ramsden, Vivian; Abonyi, Sylvia; Episkenew, Jo-Ann; Dosman, James A; Pahwa, Punam; Project Research Team, The First Nations Lung Health; Study Team, The Saskatchewan Rural Health

    2016-01-01

    Background. Ear infections in children are a major health problem and may be associated with hearing impairment and delayed language development. Objective. To determine the prevalence and the associated risk factors of ear infections in children 6-17 years old residing on two reserves and rural areas in the province of Saskatchewan. Methodology. Data were provided from two rural cross-sectional children studies. Outcome variable of interest was presence/absence of an ear infection. Logistic regression analysis was conducted to examine the relationship between ear infection and the other covariates. Results. The prevalence of ear infection was 57.8% for rural Caucasian children and 43.6% for First Nations children living on-reserve. First Nations children had a lower risk of ear infection. Ear infection prevalence was positively associated with younger age; first born in the family; self-reported physician-diagnosed tonsillitis; self-reported physician-diagnosed asthma; and any respiratory related allergy. Protective effect of breastfeeding longer than three months was observed on the prevalence of ear infection. Conclusions. While ear infection is a prevalent condition of childhood, First Nations children were less likely to have a history of ear infections when compared to their rural Caucasian counterparts. PMID:26977160

  19. Case-control study of disease determinants for non-typhoidal Salmonella infections among Michigan children

    PubMed Central

    2010-01-01

    Background Infections with Salmonella serotypes continue to be a significant global public health problem. In addition to contaminated foods, several other sources contribute to infections with Salmonella serotypes. We have assessed the role of socioeconomic factors, exposure to food, and environmental sources in the etiology of non-typhoidal Salmonella infections in Michigan children. Findings A case-control study among Michigan children aged ≤ 10 years was conducted. A total of 123 cases of children with laboratory-confirmed Salmonella infections and 139 control children, who had not experienced symptoms of gastrointestinal illness during the month prior to the interviews, were enrolled. The cases and controls were matched on age-category (<1 year, 2-<6 years and 6-10 years). Data on socioeconomic status, food intake, and environmental exposures, were collected on the queried case and control subjects. After adjusting for race and household-income the final regression multivariable model revealed that Salmonella infections were significantly associated with attendance of a daycare center (adjusted matched odds ratio = 5.00, 95% CI: 1.51 - 16.58), contact with cats (MOR = 2.53, 95% CI: 1.14 - 5.88), and contact with reptiles (MOR = 7.90, 95% CI: 1.52 - 41.01), during the 3 days prior to the onset of child's illness. Conclusions Study results suggest that exposure to environmental sources may play an important role in sporadic infections with Salmonella serotypes in children. Additional efforts are needed to educate parents and caretakers about the risk of Salmonella transmission to children from these sources. PMID:20398398

  20. Impaired Phenotype and Function of T Follicular Helper Cells in HIV-1-Infected Children Receiving ART.

    PubMed

    Bekele, Yonas; Amu, Sylvie; Bobosha, Kidist; Lantto, Rebecka; Nilsson, Anna; Endale, Birtukan; Gebre, Meseret; Aseffa, Abraham; Rethi, Bence; Howe, Rawleigh; Chiodi, Francesca

    2015-07-01

    T follicular helper (Tfh) cells are important components in development of specific humoral immune responses; whether the number and biology of Tfh cells is impaired in HIV-1-infected children is not yet studied.The frequency, phenotype, and function of Tfh cells and B cells were determined in blood of HIV-1-infected children receiving antiretroviral therapy (ART) and age-matched controls. Flow cytometry was used to characterize the frequency of Tfh cells and B cell subsets. Cytokine expression was measured after in vitro activation of Tfh cells.A reduced frequency of memory Tfh cells (P < 0.001) was identified in HIV-1-infected children and, on these cells, a reduced expression of programmed death-1 (PD-1) and inducible T cell costimulator (ICOS) (P < 0.001 and P < 0.01). Upon activation, the capacity of Tfh cells to express IL-4, an important cytokine for B cell function, was impaired in HIV-1-infected children.B cell subpopulations in HIV-1-infected children displayed significant differences from the control group: the frequency of resting memory (RM) B cells was reduced (P < 0.01) whereas the frequency of exhausted memory B cells increased (P < 0.001). Interestingly, the decline of RM cells correlated with the reduction of memory Tfh cells (P = 0.02).Our study shows that function and phenotype of Tfh cells, pivotal cells for establishment of adaptive B cell responses, are impaired during HIV-1 infection in children. A consistent reduction of memory Tfh cells is associated with declined frequencies of RM B cells, creating a novel link between dysfunctional features of these cell types, major players in establishment of humoral immunity. PMID:26166114

  1. Impaired Phenotype and Function of T Follicular Helper Cells in HIV-1-Infected Children Receiving ART

    PubMed Central

    Bekele, Yonas; Amu, Sylvie; Bobosha, Kidist; Lantto, Rebecka; Nilsson, Anna; Endale, Birtukan; Gebre, Meseret; Aseffa, Abraham; Rethi, Bence; Howe, Rawleigh; Chiodi, Francesca

    2015-01-01

    Abstract T follicular helper (Tfh) cells are important components in development of specific humoral immune responses; whether the number and biology of Tfh cells is impaired in HIV-1-infected children is not yet studied. The frequency, phenotype, and function of Tfh cells and B cells were determined in blood of HIV-1-infected children receiving antiretroviral therapy (ART) and age-matched controls. Flow cytometry was used to characterize the frequency of Tfh cells and B cell subsets. Cytokine expression was measured after in vitro activation of Tfh cells. A reduced frequency of memory Tfh cells (P < 0.001) was identified in HIV-1-infected children and, on these cells, a reduced expression of programmed death-1 (PD-1) and inducible T cell costimulator (ICOS) (P < 0.001 and P < 0.01). Upon activation, the capacity of Tfh cells to express IL-4, an important cytokine for B cell function, was impaired in HIV-1-infected children. B cell subpopulations in HIV-1-infected children displayed significant differences from the control group: the frequency of resting memory (RM) B cells was reduced (P < 0.01) whereas the frequency of exhausted memory B cells increased (P < 0.001). Interestingly, the decline of RM cells correlated with the reduction of memory Tfh cells (P = 0.02). Our study shows that function and phenotype of Tfh cells, pivotal cells for establishment of adaptive B cell responses, are impaired during HIV-1 infection in children. A consistent reduction of memory Tfh cells is associated with declined frequencies of RM B cells, creating a novel link between dysfunctional features of these cell types, major players in establishment of humoral immunity. PMID:26166114

  2. Use of Integrase Inhibitors in HIV-Infected Children and Adolescents.

    PubMed

    Dehority, Walter; Abadi, Jacobo; Wiznia, Andrew; Viani, Rolando M

    2015-09-01

    Resistance to antiretroviral drugs is an increasingly prevalent challenge affecting both the adult and pediatric HIV-infected populations. Though data on the safety, pharmacokinetics, and efficacy of newer antiretroviral agents in children typically lags behind adult data, newer agents are becoming available for use in HIV-infected children who are failing to respond to or are experiencing toxicities with traditional antiretroviral regimens. Integrase strand transfer inhibitors are one such new class of antiretrovirals. Raltegravir has been US Food and Drug Administration (FDA) approved for use in patients over the age of 4 weeks. Elvitegravir is a second member of this class, and has the potential for use in children but does not yet have a Pediatric FDA indication. Dolutegravir, a second-generation integrase inhibitor, is approved for those older than 12 years. This review summarizes the use of integrase inhibitors in children and adolescents, and highlights the results of recent clinical trials. PMID:26242765

  3. HIV-infected parents and their children in the United States.

    PubMed Central

    Schuster, M A; Kanouse, D E; Morton, S C; Bozzette, S A; Miu, A; Scott, G B; Shapiro, M F

    2000-01-01

    OBJECTIVES: This study sought to determine the number, characteristics, and living situations of children of HIV-infected adults. METHODS: Interviews were conducted in 1996 and early 1997 with a nationally representative probability sample of 2864 adults receiving health care for HIV within the contiguous United States. RESULTS: Twenty-eight percent of infected adults in care had children. Women were more likely than men to have children (60% vs 18%) and to live with them (76% vs 34%). Twenty-one percent of parents had been hospitalized during the previous 6 months, and 10% had probably been drug dependent in the previous year. Parents continued to have children after being diagnosed with HIV: 12% of all women conceived and bore their youngest child after diagnosis, and another 10% conceived before but gave birth after diagnosis. CONCLUSIONS: Clinical and support services for people affected by the HIV epidemic should have a family focus. PMID:10897185

  4. Viral Etiology of Respiratory Tract Infections in Children at the Pediatric Hospital in Ouagadougou (Burkina Faso)

    PubMed Central

    Ouédraogo, Solange; Traoré, Blaise; Nene Bi, Zah Ange Brice; Yonli, Firmin Tiandama; Kima, Donatien; Bonané, Pierre; Congo, Lassané; Traoré, Rasmata Ouédraogo; Yé, Diarra; Marguet, Christophe; Plantier, Jean-Christophe; Vabret, Astrid; Gueudin, Marie

    2014-01-01

    Background Acute respiratory infections (ARIs) are a major cause of morbidity and mortality in children in Africa. The circulation of viruses classically implicated in ARIs is poorly known in Burkina Faso. The aim of this study was to identify the respiratory viruses present in children admitted to or consulting at the pediatric hospital in Ouagadougou. Methods From July 2010 to July 2011, we tested nasal aspirates of 209 children with upper or lower respiratory infection for main respiratory viruses (respiratory syncytial virus (RSV), metapneumovirus, adenovirus, parainfluenza viruses 1, 2 and 3, influenza A, B and C, rhinovirus/enterovirus), by immunofluorescence locally in Ouagadougou, and by PCR in France. Bacteria have also been investigated in 97 samples. Results 153 children (73.2%) carried at least one virus and 175 viruses were detected. Rhinoviruses/enteroviruses were most frequently detected (rhinovirus n = 88; enterovirus n = 38) and were found to circulate throughout the year. An epidemic of RSV infections (n = 25) was identified in September/October, followed by an epidemic of influenza virus (n = 13), mostly H1N1pdm09. This epidemic occurred during the period of the year in which nighttime temperatures and humidity were at their lowest. Other viruses tested were detected only sporadically. Twenty-two viral co-infections were observed. Bacteria were detected in 29/97 samples with 22 viral/bacterial co-infections. Conclusions This study, the first of its type in Burkina Faso, warrants further investigation to confirm the seasonality of RSV infection and to improve local diagnosis of influenza. The long-term objective is to optimize therapeutic management of infected children. PMID:25360527

  5. Malnutrition and gastrointestinal and respiratory infections in children: a public health problem.

    PubMed

    Rodríguez, Leonor; Cervantes, Elsa; Ortiz, Rocío

    2011-04-01

    Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways. PMID:21695035

  6. Anti-infective use in children and pregnancy: current deficiencies and future challenges

    PubMed Central

    Gwee, Amanda; Cranswick, Noel

    2015-01-01

    There are a number of challenges to using anti-infective agents in children and pregnant women. There is limited understanding of the altered pharmacokinetics of anti-infectives in these populations and as a result, optimized dosing regimens are yet to be established. The potential adverse effects of the drug on pregnancy outcome and the developing foetus is a major consideration, and the long term implications of drug side effects must be taken into account when drug exposure occurs early in life. These factors hinder research and licensing of new anti-infective drugs in these populations. We describe the current deficiencies and future challenges of anti-infective use in children and pregnant women, providing specific examples. PMID:24588467

  7. Malnutrition and Gastrointestinal and Respiratory Infections in Children: A Public Health Problem

    PubMed Central

    Rodríguez, Leonor; Cervantes, Elsa; Ortiz, Rocío

    2011-01-01

    Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways. PMID:21695035

  8. Socio-Cultural Determinants of Health-Seeking Behaviour on the Kenyan Coast: A Qualitative Study

    PubMed Central

    Abubakar, Amina; Van Baar, Anneloes; Fischer, Ronald; Bomu, Grace; Gona, Joseph K.; Newton, Charles R.

    2013-01-01

    Background Severe childhood illnesses present a major public health challenge for Africa, which is aggravated by a suboptimal response to the child's health problems with reference to the health-seeking behaviour of the parents or guardians. We examined the health-seeking behaviour of parents at the Kenyan coast because understanding impediments to optimal health-seeking behaviour could greatly contribute to reducing the impact of severe illness on children's growth and development. Methods and Results Health-seeking behaviour, and the factors influencing this behaviour, were examined in two traditional communities. We held in-depth interviews with 53 mothers, fathers and caregivers from two rural clinics at the Kenyan Coast. Biomedical medicine (from health facilities and purchased over the counter) was found to be the most popular first point of treatment. However, traditional healing still plays a salient role in the health care within these two communities. Traditional healers were consulted for various reasons: a) attribution of causation of ill-health to supernatural sources, b) chronic illness (inability of modern medicine to cure the problem) and c) as prevention against possible ill-health. In developing an explanatory model of decision-making, we observed that this was a complex process involving consultation at various levels, with elders, but also between both parents, depending on the perceived nature and chronicity of the illness. However, it was reported that fathers were the ultimate decision makers in relation to decisions concerning where the child would be taken for treatment. Conclusions Health systems need to see traditional healing as a complementary system in order to ensure adequate access to health care. Importantly, fathers also need to be addressed in intervention and education programs. PMID:24260094

  9. Infections Caused by Rapidly Growing Mycobacteria spp in Children and Adolescents With Cancer

    PubMed Central

    Apiwattankul, Nopporn; Flynn, Patricia M.; Hayden, Randall T.; Adderson, Elisabeth E.

    2015-01-01

    Background Rapidly growing mycobacteria (RGM) infections in pediatric oncology patients have not been completely characterized. Methods We reviewed medical records of oncology patients at St. Jude Children's Research Hospital (St. Jude) from 1990 to 2010 with RGM infections and summarized the results of previously published cases. Results Twenty-five St. Jude patients had 27 episodes of infection. Approximately half of the cases occurred in patients with hematological malignancies and in males; infections were more common in white patients. Most patients were not neutropenic or lymphopenic. The most common causative species were Mycobacterium chelonae, Mycobacterium abscessus, and Mycobacterium fortuitum. Most isolates were susceptible to amikacin and clarithromycin; all were susceptible to at least 1 of these. Treatment regimens varied considerably, particularly with respect to the duration of antimicrobial chemotherapy. Two St. Jude patients died; both had pulmonary infections. The literature search identified an additional 58 cases of infection. Localized catheter-associated infections were more common than bloodstream infections in the current series than in previous reports, and outbreaks were not recognized. Otherwise, the demographic and clinical characteristics of patients were similar. Conclusions Localized catheter-associated infections were most common in this largest reported single center experience reported to date. Pulmonary infection is uncommon in children but, as in adults, has a high mortality rate. Relatively short-term antimicrobial treatment and surgical debridement of infected tissue, if present, may be as effective for catheter-associated infections as prolonged antimicrobial use and may reduce adverse drug effects in these patients, who are vulnerable to drug-drug interactions and toxicity. PMID:26407409

  10. [Infections related to central venous catheters in children affected from malignant diseases].

    PubMed

    Handrup, Mette Møller; Møller, Jens Kjølseth; Schrøder, Henrik

    2011-06-27

    Central venous catheters (CVC) are an essential part of the treatment of children with haematological and oncological diseases. Unfortunately, CVC also represent a major risk factor of bloodstream infections. Catheter-related bloodstream infections (CRBSI) in children are often diagnosed based on blood cultures from the CVC only. Most CRBSI can be treated without catheter removal. On suspicion of CRBSI empirical antibiotic treatment with piperacillin-tazobactam, meropenem or ampicillin in combination with gentamicin is recommended. The systemic treatment can be combined with catheter-lock therapy. PMID:21712011

  11. [Prevalence of caries and its correlation with clinical and immunological classification in HIV-infected children].

    PubMed

    Castro, G F; de Souza, I P; e Oliveira, R H; Portela, M B; Esteves, C

    2001-01-01

    This research aims to determine the relationship between the prevalence of caries and clinical and immunological classification in HIV-infected children. Ninety-two outpatients (42 male and 50 female subjects) with definitive diagnosis of HIV infection took part in this research. The patients were examined in order to determine the prevalence of caries (dmf and DMFT indexes), and medical data were collected from their medical records. The mean age of the subjects was 5.77 years. Although no statistical differences were found, young patients (up to 5 years old) had more caries when they were more clinically and immunologically compromised. The same fact was observed regarding older children. PMID:11705204

  12. Low Prevalence of Parvovirus 4 in HIV-infected Children in Denmark.

    PubMed

    Rosenfeldt, Vibeke; Norja, Päivi; Lindberg, Ellinor; Jensen, Lise; Hedman, Lea; Väisänen, Elina; Li, Xuemeng; Hedman, Klaus; von Linstow, Marie-Louise

    2015-07-01

    Parvovirus 4 (PARV4) has been associated with HIV infection in adults. We examined plasma samples from 46 HIV-infected 0-year-old to 16-year-old children for the presence of PARV4. Four children (8.7%) had detectable PARV4 IgG and 1 had IgM. The result of PARV4 polymerase chain reaction was found to be negative in all patients. PARV4 seropositivity was associated with low CD4 count but not with HIV viral load. PMID:25545184

  13. Helminthic Infection and Nutritional Studies among Orang Asli Children in Sekolah Kebangsaan Pos Legap, Perak.

    PubMed

    Wong, Weng Kin; Foo, Phiaw Chong; Roze, Mohamad Noor Mohamad; Pim, Chau Dam; Subramaniam, Puvaneswari; Lim, Boon Huat

    2016-01-01

    Background. Orang Asli (aborigine) children are susceptible to soil-transmitted helminth (STH) infections due to their lifestyle and substandard sanitation system. Objectives. This study aimed to examine the helminthic and nutritional status of Orang Asli school children in Sekolah Kebangsaan Pos Legap, a remote primary school at Kuala Kangsar District in the state of Perak, Malaysia. In addition, the sensitivities of four STH stool examination techniques were also compared. Methods. Demography and anthropometry data were collected by one-to-one interview session. Collected stools were examined with four microscopy techniques, namely, direct wet mount, formalin ether concentration (FEC), Kato-Katz (KK), and Parasep™. Results. Anthropometry analysis showed that 78% (26/33) of children in SK Pos Legap were malnourished and 33% (11/33) of them were stunted. Stool examinations revealed almost all children (97%) were infected by either one of the three commonest STHs. FEC was the most sensitive method in detection of the three helminth species. Conclusion. This study revealed that STH infections and nutritional status still remain a health concern among the Orang Asli children. These communal problems could be effectively controlled by regular monitoring of STH infection loads, administration of effective antihelminthic drug regimen, and also implementation of effective school nutritional programs. PMID:27366156

  14. Epidemiological and clinical characteristics of respiratory viral infections in children in Shanghai, China.

    PubMed

    Dong, Wei; Chen, Qianqian; Hu, Yihong; He, Dongping; Liu, Jia; Yan, Huajie; Lan, Ke; Zhang, Chiyu

    2016-07-01

    Acute respiratory tract infections (ARTIs) due to various viruses are not only the most common causes of upper and lower respiratory infection but are also major causes of morbidity and mortality in children. In this study, we investigated the prevalence and clinical characteristics of children with virus-related ARTIs and determined the spectrum of respiratory viruses and their correlation with meteorological variables in Jiading District, Shanghai, China. Nasopharyngeal swabs from 2819 children with ARTIs were collected from August 2011 to December 2014, and used for detection of respiratory viruses by multiplex RT-PCR. Seventeen respiratory viruses were detected among 691 (24.5 %) of 2819 patients. The highest prevalence of respiratory viruses was detected in the age group of less than 1 year (29.0 %), and the prevalence decreased with age. This suggests that children less than one year old are the most susceptible to infection. Influenza virus (IFV) was the most frequently detected virus (5.8 %), followed by parainfluenza virus (PIV) (5.7 %), enterovirus (EV) (4.3 %), and respiratory syncytial virus (RSV) (3.6 %). Statistical analysis showed that epidemics of IFV, PIV and EV had distinct seasonal variations. Mean monthly temperature appeared to be the only meteorological factor associated with IFV and PIV infection. These findings will provide valuable information for decision-making, prevention and treatment of ARTIs in children. PMID:27138548

  15. Effectiveness of the First Dose of BCG against Tuberculosis among HIV-Infected, Predominantly Immunodeficient Children

    PubMed Central

    Van-Dunem, Joaquim C. V. D.; Rodrigues, Laura C.; Alencar, Luiz Claudio Arraes; Militão-Albuquerque, Maria de Fátima Pessoa; Ximenes, Ricardo Arraes de Alencar

    2015-01-01

    The objective of this study was to estimate the protective effect of Bacille Calmette-Guérin (BCG) vaccine against tuberculosis among (predominantly immunodeficient) HIV-infected children in Angola. A hospital-based case-control study was conducted with 230 cases, children coinfected with tuberculosis, and 672 controls, HIV-infected children from the same hospital, aged 18 months to 13 years. The presence of a vaccination scar was taken as a proxy marker for BCG vaccination. The crude effectiveness was 8% (95% CI: −26 to 32) and the adjusted effectiveness was 30% (95% CI: −75 to 72). The present study suggests that BCG does not have a protective effect against tuberculosis among immunodeficient HIV-infected children. Since BCG is no longer given to HIV-infected children, the study may not be replicated. Accepting that these findings should be considered with caution, they are nonetheless likely to be the last estimate of BCG efficacy in a sufficiently powered study. PMID:26221585

  16. Helminthic Infection and Nutritional Studies among Orang Asli Children in Sekolah Kebangsaan Pos Legap, Perak

    PubMed Central

    Wong, Weng Kin; Foo, Phiaw Chong; Roze, Mohamad Noor Mohamad; Pim, Chau Dam; Subramaniam, Puvaneswari; Lim, Boon Huat

    2016-01-01

    Background. Orang Asli (aborigine) children are susceptible to soil-transmitted helminth (STH) infections due to their lifestyle and substandard sanitation system. Objectives. This study aimed to examine the helminthic and nutritional status of Orang Asli school children in Sekolah Kebangsaan Pos Legap, a remote primary school at Kuala Kangsar District in the state of Perak, Malaysia. In addition, the sensitivities of four STH stool examination techniques were also compared. Methods. Demography and anthropometry data were collected by one-to-one interview session. Collected stools were examined with four microscopy techniques, namely, direct wet mount, formalin ether concentration (FEC), Kato-Katz (KK), and Parasep™. Results. Anthropometry analysis showed that 78% (26/33) of children in SK Pos Legap were malnourished and 33% (11/33) of them were stunted. Stool examinations revealed almost all children (97%) were infected by either one of the three commonest STHs. FEC was the most sensitive method in detection of the three helminth species. Conclusion. This study revealed that STH infections and nutritional status still remain a health concern among the Orang Asli children. These communal problems could be effectively controlled by regular monitoring of STH infection loads, administration of effective antihelminthic drug regimen, and also implementation of effective school nutritional programs. PMID:27366156

  17. [Recommendations for initial antiretroviral treatment in HIV-infected children. Update 2003].

    PubMed

    2004-03-01

    Highly active antiretroviral therapy in HIV-infected children has been associated with a dramatic decrease in progression to AIDS and HIV-related deaths, and infected children currently have an excellent quality of life. Antiretroviral drugs cannot eradicate the virus, although they can achieve a situation of latent infection. However, chronic use of these drugs has multiple adverse effects, the most important of which are metabolic complications. The large number of drugs required and patient characteristics such as age, tolerance to drugs, adherence, and social problems make unifying the criteria for initial therapy in HIV-infected children difficult. A balance should be sought between not delaying the start of treatment, to avoid immunologic deterioration, and minimizing the long-term adverse effects of the therapy. The present treatment recommendations are adapted from international guidelines and are based on a literature review and on our own experience. Our group previously published recommendations on the treatment of HIV-infected children and the aim of the present article is to provide an update. PMID:14987518

  18. Ear Infection and Its Associated Risk Factors, Comorbidity, and Health Service Use in Australian Children

    PubMed Central

    Yiengprugsawan, Vasoontara; Hogan, Anthony

    2013-01-01

    This study investigates and identifies risk factors, comorbidity, and health service use related to ear infection in Australian children. Two cross-sectional analyses of the Longitudinal Study of Australian Children (LSAC) involved 4,983 children aged 4 to 5 years in 2004 and aged 10 to 11 years in 2010. Odds ratios (ORs) were analysed using bivariate logistic regression. The prevalence of parent-reported ear infection was 7.9% (394) among children aged 4 to 5 years and 3.3% (139) at 10 to 11 years. Our study found that risk factors associated with ear infection were indigenous status, not being breastfed, mother or father smoking at least once a day, and father's school completion at year 9 or lower. By age 10 to 11 years significantly reported comorbidities were tonsillitis (OR 4.67; P < 0.001), headache (OR 2.13; P = 0.006), and asthma (OR 1.67; P = 0.003) and ear infection was found to be associated with the use of pediatrician (OR 1.83; P = 0.031), other specialist (OR 2.12; P < 0.001), and early intervention services (OR 3.08; P = 0.010). This empirical evidence can be used to inform the development of intervention and management programs for ear infection. PMID:23840224

  19. Electronic surveillance for catheter-associated urinary tract infections at a university-affiliated children's hospital.

    PubMed

    Sen, Anita I; Balzer, Krystal; Mangino, Diane; Messina, Maria; Ross, Barbara; Zachariah, Philip; Saiman, Lisa

    2016-05-01

    We sought to describe the characteristics of catheter-associated urinary tract infections (CAUTIs) in a children's hospital while demonstrating efficacy of electronic identification of CAUTIs. There were 25 CAUTIs identified over 24 months, with most (88%) occurring in the intensive care units (ICUs). The incidence of ICU CAUTIs decreased during the study period (P = .04). Concordance between electronic identification and validation by infection control staff was 83% and increased to 100% with correction of nursing documentation. PMID:26856468

  20. Gastrointestinal Infections and Diarrheal Disease in Ghanaian Infants and Children: An Outpatient Case-Control Study

    PubMed Central

    Krumkamp, Ralf; Sarpong, Nimako; Schwarz, Norbert Georg; Adelkofer, Julia; Loag, Wibke; Eibach, Daniel; Hagen, Ralf Matthias; Adu-Sarkodie, Yaw; Tannich, Egbert; May, Jürgen

    2015-01-01

    Introduction Diarrheal diseases are among the most frequent causes of morbidity and mortality in children worldwide, especially in resource-poor areas. This case-control study assessed the associations between gastrointestinal infections and diarrhea in children from rural Ghana. Methods Stool samples were collected from 548 children with diarrhea and from 686 without gastrointestinal symptoms visiting a hospital from 2007–2008. Samples were analyzed by microscopy and molecular methods. Results The organisms most frequently detected in symptomatic cases were Giardia lamblia, Shigella spp./ enteroinvasive Escherichia coli (EIEC), and Campylobacter jejuni. Infections with rotavirus (adjusted odds ratio [aOR] = 8.4; 95% confidence interval [CI]: 4.3–16.6), C. parvum/hominis (aOR = 2.7; 95% CI: 1.4–5.2) and norovirus (aOR = 2.0; 95%CI: 1.3–3.0) showed the strongest association with diarrhea. The highest attributable fractions (AF) for diarrhea were estimated for rotavirus (AF = 14.3%; 95% CI: 10.9–17.5%), Shigella spp./EIEC (AF = 10.5%; 95% CI: 3.5–17.1%), and norovirus (AF = 8.2%; 95% CI 3.2–12.9%). Co-infections occurred frequently and most infections presented themselves independently of other infections. However, infections with E. dispar, C. jejuni, and norovirus were observed more often in the presence of G. lamblia. Conclusions Diarrheal diseases in children from a rural area in sub-Saharan Africa are mainly due to infections with rotavirus, Shigella spp./EIEC, and norovirus. These associations are strongly age-dependent, which should be considered when diagnosing causes of diarrhea. The presented results are informative for both clinicians treating gastrointestinal infections as well as public health experts designing control programs against diarrheal diseases. PMID:25738935

  1. Serum immunoglobulin E levels in human immunodeficiency virus-infected children with pneumonia.

    PubMed

    Zar, Heather J; Latief, Zeino; Hughes, Jane; Hussey, Gregory

    2002-10-01

    Elevated serum immunoglobulin E (IgE) levels have been reported in association with human immunodeficiency virus (HIV) infection in adults, but there is little information in children. The aim of the present study was to compare serum IgE levels in HIV-positive and -negative children hospitalized with pneumonia in South Africa and to investigate whether IgE may be useful as a marker of specific infections or prognosis in HIV-infected children. History, examination, blood tests, and induced sputum or bronchoalveolar lavage were carried out. Of 122 children [45% female, median age 8 months (3-20 months)], 81 were infected with HIV. A history of allergy or asthma was present in three children (two of whom were HIV positive). Serum IgE was higher in HIV-infected children [83 (33-147) vs. 29 (6-113) IU/l; p = 0.011] as was immunoglobulin G (IgG) [49 (37-63) vs. 27.5 (23-34) g/l; p < 0.001]. CD4 lymphocytes [600 (330-1,210) vs. 1,900 (1,500-3,030) cells/ micro l], percentage CD4 cells [13.6 (9.4-20.3) vs. 40.1 (31.1-44.9)] and CD4 : CD8 ratio [0.3 (0.2-0.4) vs. 2 (1.4-2.8)] were lower in HIV-positive children (p < 0.001 for all). Bacteremia occurred in 12 (10%) children; other specific pathogens identified included Mycobacterium tuberculosis in eight (7%) and Pneumocystis carinii in nine (7%). There was no correlation with CD4 count, CD4 : CD8 ratio, or the presence of specific pathogens, and IgE level. In-hospital mortality (11%) did not correlate with IgE levels. HIV-infected children with pneumonia have higher serum IgE compared with seronegative patients. In HIV-positive children, IgE levels did not correlate with the degree of immunosuppression or with outcome. PMID:12431191

  2. Respiratory Infections by Enterovirus D68 in Outpatients and Inpatients Spanish Children

    PubMed Central

    Cuevas, María Teresa; Pozo, Francisco; García-García, María Luz; Molinero, Mar; Calderón, Ana; Gonzalez-Esguevillas, Mónica; Pérez-Sautu, Unai; Casas, Inmaculada

    2016-01-01

    Background: The incidence of enterovirus D68 (EV-D68) and the spectrum of clinical disease in children are not well known in European countries. We have designed a study with the objective of describing the clinical impact of EV-D68 detected in children with respiratory tract infections. Methods: As a part of a prospective study to identify the etiology and clinical characteristics of viral respiratory infections in children in Spain, we performed the analysis of the cases of EV infections in all children hospitalized in a secondary hospital in Madrid, during the epidemic respiratory season 2012–2013. A second group of samples was corresponded to infants of the same area, with ambulatory respiratory infection or asymptomatic. Phylogenetic EV-D68 analysis was made using the viral protein 1 gene (VP1). Clinical data of EV-D68 patients were compared with those infected by rhinovirus in the same period and population. Results: The study population consisted of 720 patients corresponding to 399 episodes of hospitalization for respiratory causes, 44 episodes of ambulatory respiratory infections and 277 children determined as a healthy control group. A total of 22 patients were positive for EVs (3.05%), and 12 of them were specifically typed as EV-D68 (11/443 respiratory infections, 2.5%). The most frequent diagnosis in the 10 hospitalized children with EV-D68 detection was recurrent wheezing. Hypoxia was present in 70% of cases, but admission in the intensive care unit was not required. No neurological signs or symptoms were observed. One patient had an ambulatory mild bronchiolitis and another was asymptomatic. No differences were found with rhinovirus infections except less duration of hypoxia and fever in EV-D68 group. Conclusions: EV-D68 infections were detected in 3.05% of respiratory studied samples (2.5% of admissions). The infection was associated with wheezing episodes with hypoxia. No admissions to intensive care unit or neurological symptoms were found. PMID

  3. Modulation of the immune response by infection with Cryptosporidium spp. in children with allergic diseases.

    PubMed

    Guangorena-Gómez, J O; Maravilla-Domínguez, A; García-Arenas, G; Cervantes-Flores, M; Meza-Velázquez, R; Rivera-Guillén, M; Acosta-Saavedra, L C; Goytia-Acevedo, R C

    2016-08-01

    It has been demonstrated that the allergic response can be ameliorated by the administration of pathogen derivatives that activate Toll-like receptors and induce a Th1-type immune response (IR). Cryptosporidium is a parasite that promotes an IR via Toll-like receptors and elicits the production of Th1-type cytokines, which limit cryptosporidiosis. The aim of this study was to investigate allergy-related immune markers in children naturally infected with Cryptosporidium. In a cross-sectional study, 49 children with or without clinical diagnosis of allergies, oocysts of Cryptosporidium spp. in the faeces were screened microscopically. We microscopically screened for leucocytes, examined T and B cells for allergy-related activation markers using flow cytometry and evaluated serum for total IgE using chemiluminescence. Children with allergies and Cryptosporidium in the faeces had significantly lower levels of total IgE, B cells, CD19(+) CD23(+) and CD19(+) CD124(+) cells as well as a greater percentage of interferon-gamma (IFN-γ(+) ) and IL-4(+) CD4(+) cells than children with allergies without Cryptosporidium. This is the first description of the modulation of the IR in children with allergic diseases in the setting of natural Cryptosporidium infection. Our findings suggest the involvement of CD4(+) cells producing IL-4 and IFN-γ in the IR to Cryptosporidium in naturally infected children. PMID:27150641

  4. Seroprevalence and risk factors of Toxocara infection among children in Shandong and Jilin provinces, China.

    PubMed

    Cong, Wei; Meng, Qing-Feng; You, Hai-Long; Zhou, Na; Dong, Xiao-Yan; Dong, Wei; Wang, Xiang-Yang; Qian, Ai-Dong; Zhu, Xing-Quan

    2015-12-01

    This cross-sectional study was aimed to investigate the Toxocara serology in children in Shandong and Jilin provinces, China using an enzyme-linked immunosorbent assay (ELISA). The overall Toxocara seroprevalence among the study population (n=1458) was 19.3%, sick children (26.4%) had significantly higher seroprevalence than clinically healthy children (14.4%) (P<0.05), and the highest Toxocara seroprevalence was found in children suffering from chronic cough (40.6%), followed by recurrent abdominal pain (40.0%), recurrent headache (38.1%), slight fever (36.2%), and recurrent vomiting (31.6%). Place of residence, education level, type of school, keeping dogs at home, contact with dogs and cats and exposure with soil were found to be associated with Toxocara infection. Our findings show that children infection with Toxocara is common in Shandong and Jilin provinces, eastern and northeastern China, indicating an immediate need for implementing strategies and measures to prevent and control Toxocara infection in children in China. PMID:26384456

  5. Are rectogenital chlamydial infections a marker of sexual abuse in children?

    PubMed

    Hammerschlag, M R; Doraiswamy, B; Alexander, E R; Cox, P; Price, W; Gleyzer, A

    1984-01-01

    In order to examine the occurrence of chlamydial infection in sexually abused children, we cultured 51 abused children and 43 controls, 2 to 14.5 years of age. Only seven of the children were male. Chlamydia trachomatis was isolated from the vagina or rectum of two abused girls, 10 and 12 years of age, at their follow-up examination several weeks after the suspected abuse. C. trachomatis was also isolated from the vaginal culture of two controls and from the throat and rectum of another girl enrolled as a control. The two control children with vaginal infection were sisters, 7 and 10 years of age, who had been abused by their step-father 3 years previously. An antichlamydial immunoglobulin greater than or equal to 1:32 or a fourfold rise in the titer of immunoglobulin G was found in 13 of 49 (27%) abused children and 2 of 40 (5%) controls. This difference was statistically significant. The isolation of C. trachomatis from a rectogenital site was not limited to children with recent sexual abuse in this population. Serology may also be of limited use since serologic evidence of recent chlamydial infection was present in 5% of controls. PMID:6427759

  6. Evaluation of Coxsackievirus Infection in Children with Human Immunodeficiency Virus Type 1–Associated Cardiomyopathy

    PubMed Central

    Jenson, Hal B.; Gauntt, Charles J.; Easley, Kirk A.; Pitt, Jane; Lipshultz, Steven E.; McIntosh, Kenneth; Shearer, William T.

    2015-01-01

    In a matched case-control study of the association between coxsackieviruses and cardiac impairment, 24 human immunodeficiency virus (HIV) type 1–infected children with cardiac impairment were compared with 24 HIV-1–infected control subjects. Serologic evidence of coxsackievirus infection was present in all children, with no significant difference in geometric mean antibody titers between case patients and control subjects. Conditional logistic regression to test for an association between coxsackievirus antibody titer and the presence or absence of cardiac impairment, by any indicator, showed an odds ratio of 1.11 (95% confidence interval, 0.58–2.10; P = .75), indicating no association between coxsackievirus infection and cardiac impairment. Coxsackievirus antibody titers correlated positively with total IgG levels in nonrapid progressors but not in rapid progressors. Paired serum samples taken before and after diagnosis of cardiac impairment in 5 patients showed no evidence of intervening coxsackievirus infection. These results do not identify a causal role for coxsackieviruses for cardiomyopathy in HIV-1–infected children. PMID:12085328

  7. A Review of the Participation of Disabled Persons in the Labour Force: The Kenyan Context

    ERIC Educational Resources Information Center

    Opini, Bathseba M.

    2010-01-01

    This paper presents a review of the challenges that disabled people experience in participating in the Kenyan labour market. It draws on existing literature and on a narrative of the experiences of one disabled academic in a Kenyan university to highlight some of the forms of discrimination that disabled people have to cope with in their…

  8. Challenges of Implementing E-Learning in Kenya: A Case of Kenyan Public Universities

    ERIC Educational Resources Information Center

    Tarus, John K.; Gichoya, David; Muumbo, Alex

    2015-01-01

    In this paper, we discuss the challenges experienced by Kenyan public universities in implementation of e-learning and recommend possible solutions towards its successful implementation. In the last few years, most Kenyan public universities have adopted e-learning as a new approach to teaching and learning. However, the implementation challenges…

  9. Examining the Adjustment Problems of Kenyan International Students Attending Colleges and Universities in the United States

    ERIC Educational Resources Information Center

    Mokua, Rodgers Nyandieka

    2012-01-01

    The literature on international students from Africa, and particularly Kenya, is very limited despite the significant number of Kenyan international students attending colleges and universities in the United States. Therefore, the intent of this study was to examine the adjustment problems of Kenyan international students in the United States. The…

  10. School Counselor Preparation in Kenya: Do Kenyan School Counselors Feel Adequately Prepared to Perform Their Roles?

    ERIC Educational Resources Information Center

    Wambu, Grace W.; Wickman, Scott A.

    2016-01-01

    School counselor training in Kenya is a relatively new phenomenon. This study examined Kenyan school counselors' perceptions of the adequacy of their preparedness to perform their roles within the school setting. The survey was administered to 105 school counselors in four counties. The findings revealed that Kenyan school counselors perceived…

  11. The Association between Helicobacter pylori Infection and Body Weight among Children

    PubMed Central

    Choi, Jun Sik; Ko, Kyung Og; Lim, Jae Woo; Cheon, Eun Jeong; Lee, Gyung Min

    2016-01-01

    Purpose We performed to reveal the association between the Helicobacter pylori infection and body weight among children. Methods Out retrospective study included patients who underwent the H. pylori immunoglobulin G testing at Konyang University Hospital between March 2011 and June 2014. These patients were classified as seropositive (28 boys, 27 girls; mean age: 9.89±3.28 years) or seronegative (55 boys, 54 girls; mean age: 9.84±3.02 years). Next, we compared various characteristics between the seropositive and negative groups, as well as between obese children (body weight ≥90th percentile) and non-obese children (body weight <90th percentile). Furthermore, we compared the change in body weight after 2 months of treatment with amoxicillin, clarithromycin and omeprazole among the 55 seropositive children (14 treated children and 41 non-treated children). Results There were no differences in the weights and laboratory data for the 55 seropositive children and 109 seronegative children (weight; 40.96±18.11 kg vs. 36.85±13.72 kg, respectively; p=0.14). And, there was no difference in the prevalence of H. pylori infection among the 29 obese and 135 non-obese children (p=0.581). However, after 2 months of eradication, the 14 treated patients exhibited a significant weight gain (+0.91±0.52 kg), compared to the 41 non-treated patients (-0.29±1.16 kg, p=0.025). Conclusion Our findings present that obesity was not associated with the H. pylori infection, although H. pylori eradication led to significant increase in body weight. PMID:27437187

  12. Endoscopic and histopathologic findings associated with H. pylori infection in very young children.

    PubMed

    Tutar, Engin; Ertem, Deniz; Kotiloglu Karaa, Esin; Pehlivanoglu, Ender

    2009-01-01

    Most of the individuals infected with H. pylori acquire the infection early in life. However, there is limited data regarding endoscopic and histopathologic findings of H. pylori infection when it is acquired during infancy. The aim of this study was to investigate the H. pylori-related endoscopic and histopathological findings in children younger than 2 years of age. One hundred and fifty-two infants who underwent upper gastrointestinal endoscopy were included in the study. The diagnosis of H. pylori infection was based on histopathology and a positive rapid urease test. Forty of 152 (26.3%) infants were infected with H. pylori, and 65% of the infected infants had histopathologic gastritis. There were no clinical or endoscopic findings suggestive of H. pylori infection. No correlation could be found between the density of H. pylori and the severity of gastritis. H. pylori infection is associated with various degrees of gastritis in more than half of the infected infants. Since the likelihood of normal histopathology is rare in H. pylori-infected infants, its long-term complications should be cautiously followed up in endemic areas. PMID:18594977

  13. The Effect of a Basic Home Stimulation Programme on the Development of Young Children Infected with HIV

    ERIC Educational Resources Information Center

    Potterton, Joanne; Stewart, Aimee; Cooper, Peter; Becker, Pieter

    2010-01-01

    Aims: The human immunodeficiency virus (HIV) potentially causes a significant encephalopathy and resultant developmental delay in infected children. The aim of this study was to determine whether a home-based intervention programme could have an impact on the neurodevelopmental status of children infected with HIV. Method: A longitudinal,…

  14. Growth in early childhood in a cohort of children born to HIV-1-infected women from Durban, South Africa.

    PubMed

    Bobat, R; Coovadia, H; Moodley, D; Coutsoudis, A; Gouws, E

    2001-09-01

    This study describes growth in a cohort of black South African children born to HIV-1-infected women in Durban. Children born to HIV-1-seropositive women were followed up from birth to early childhood. At birth and at each visit, growth parameters were measured. Mean Z-scores were calculated for weight-for-length, weight-for-age and length-for-age and, if they were low, the children were regarded as wasted, malnourished or stunted, respectively. At the end of the study, there were 48 infected and 93 uninfected children. There were no significant differences between the two groups at birth. Thereafter, the infected group was found to have early and sustained low mean Z-scores for length-for-age and weight-for-age but not for weight-for-length. The means reached significance at ages 3, 6 and 12 months for length and at 3, 6 and 9 months for weight. Infected children who died early had more severe stunting, wasting and malnutrition than infected children who survived. Infected children born to HIV-positive women have early and sustained stunting and are malnourished but not wasted. Children with rapidly progressive disease have both stunting and wasting and are more severely affected. Early nutritional intervention might help prevent early progression or death in HIV-infected children, particularly in developing countries without access to anti-retroviral therapy in state hospitals. PMID:11579858

  15. High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico

    PubMed Central

    Escobedo-Melendez, Griselda; Panduro, Arturo; Fierro, Nora A; Roman, Sonia

    2014-01-01

    Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05) than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8%) and genotype A (4%). In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children. PMID:25099333

  16. Pulmonary Tuberculosis in Severely-malnourished or HIV-infected Children with Pneumonia: A Review

    PubMed Central

    Ahmed, Tahmeed; Pietroni, Mark A.C.; Faruque, Abu S.G.; Ashraf, Hasan; Bardhan, Pradip K.; Hossain, Md. Iqbal; Das, Sumon Kumar; Salam, Mohammed Abdus

    2013-01-01

    Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIV-positive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score <-3 of the WHO median, or presence of nutritional oedema). We conducted a literature search, using PubMed and Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies

  17. Reasons for hospitalization in HIV-infected children in West Africa

    PubMed Central

    Dicko, Fatoumata; Desmonde, Sophie; Koumakpai, Sikiratou; Dior-Mbodj, Hélène; Kouéta, Fla; Baeta, Novisi; Koné, Niaboula; Akakpo, Jocelyn; Sy, Haby Signate; Ye, Diarra; Renner, Lorna; Lewden, Charlotte; Leroy, Valériane

    2014-01-01

    Introduction Current knowledge on morbidity and mortality in HIV-infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV-infected children in West Africa (IeDEA West Africa collaboration). Methods We performed a six-month prospective multicentre survey from April to October 2010 in five HIV-specialized paediatric hospital wards in Ouagadougou, Accra, Cotonou, Dakar and Bamako. Baseline and follow-up data during hospitalization were recorded using a standardized clinical form, and extracted from hospitalization files and local databases. Event validation committees reviewed diagnoses within each centre. HIV-related events were defined according to the WHO definitions. Results From April to October 2010, 155 HIV-infected children were hospitalized; median age was 3 years [1–8]. Among them, 90 (58%) were confirmed for HIV infection during their stay; 138 (89%) were already receiving cotrimoxazole prophylaxis and 64 children (40%) had initiated antiretroviral therapy (ART). The median length of stay was 13 days (IQR: 7–23); 25 children (16%) died during hospitalization and four (3%) were transferred out. The leading causes of hospitalization were WHO stage 3 opportunistic infections (37%), non-AIDS-defining events (28%), cachexia and other WHO stage 4 events (25%). Conclusions Overall, most causes of hospitalizations were HIV related but one hospitalization in three was caused by a non-AIDS-defining event, mostly in children on ART. HIV-related fatality is also high despite the scaling-up of access to ART in resource-limited settings. PMID:24763078

  18. The "moral career" of perinatally HIV-infected children: revisiting Goffman's concept.

    PubMed

    Cruz, Maria Letícia Santos; Bastos, Francisco Inácio; Darmont, Mariana; Dickstein, Paulo; Monteiro, Simone

    2015-01-01

    HIV-infected children usually live in vulnerable situations, experiencing discrimination and stigma commonly felt by other people living with HIV/AIDS. The present study aims to analyse primary socialisation of HIV-infected children and adolescents recruited from a public health service in Rio de Janeiro (Brazil) as a social process that shapes a new generation of stigmatised and vulnerable persons. Research was informed by an interactionist perspective, focusing on key aspects of HIV-infected children and adolescents life histories under the conceptual frame of Erving Goffman's theories regarding "moral careers". Goffman defines the making of a moral career as the process through which a person learns that she/he possesses a particular attribute, which may lead her/him to be discredited by members of the surrounding society. We have identified aspects of life histories of HIV-vertically infected children and adolescents for each aspect of "moral career" as described by Goffman, relating them to as family structure, the experience of living HIV within the family, and the position and family role of a given subject. The patterns of "moral career" proposed by Goffman in 1963 were useful in identifying components of HIV-related stigma among children and adolescents. These include gender and social disadvantages, difficulty in coping with a child with a potentially severe disease, orphanhood, abandonment, adoption and disclosure of one's HIV serostatus. Primary socialisation of HIV-infected children and adolescents is a key piece of the complex HIV/AIDS-labelling process that could be targeted by interventions aiming to decrease stigma and marginalisation. Health care workers and stakeholders should be committed to ensuring education and guaranteeing the legal rights of this specific population, including the continuous provision of quality health care, full access to school and support to full disclosure of HIV diagnosis. PMID:25054808

  19. High Prevalence of Hearing Impairment in HIV-Infected Peruvian Children

    PubMed Central

    Chao, Christina K.; Czechowicz, Josephine A.; Messner, Anna H.; Alarcón, Jorge; Roca, Lenka Kolevic; Rodriguez, Marsi M. Larragán; Villafuerte, César Gutiérrez; Montano, Silvia M.; Zunt, Joseph R.

    2012-01-01

    Objectives To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus-infected children living in Peru. Study design Cross-sectional observational study. Setting Two public hospitals and 1 nonprofit center in Lima, Peru, between August 2009 and April 2010. Subjects A total of 139 HIV-infected children, ages 4 to 19 years. Methods Hearing impairment and otologic health were assessed with pure tone audiometry, tympanometry, and otoscopy. The primary outcome was hearing loss, defined as average threshold >25dB for 0.5, 1, 2, and 4 kHz, in one or both ears. Historical and socioeconomic information was obtained through parental survey and medical chart review. Statistical analysis included univariate analysis and multivariate logistic regression. Results Fifty-four (38.8%) of 139 children had hearing impairment. On multivariate analysis, risk factors included: tympanic membrane perforation (odds ratio [OR] 7.08; 95% confidence interval [CI], 1.65-30.5; P = .01), abnormal tympanometry (OR 2.71; 95% CI, 1.09-6.75; P = .03), cerebral infection (OR 11.6; 95% CI, 1.06-126; P = .05), seizures (OR 5.20; 95% CI, 1.21-22.4; P = .03), and CD4 cell count <500 cells/mm3 (OR 3.53; 95% CI, 1.18-10.5; P = .02). Conclusions The prevalence of hearing impairment in HIV-infected children in Lima, Peru was 38.8%. Middle ear disease, prior cerebral infection, and low CD4 cell count were significantly associated with hearing impairment. The high prevalence of hearing impairment emphasizes the need for periodic hearing assessment in the routine clinical care of HIV-infected children. PMID:22128111

  20. Children hospitalized with skin and soft tissue infections: a guide to antibacterial selection and treatment.

    PubMed

    Vayalumkal, Joseph V; Jadavji, Tajdin

    2006-01-01

    Skin and soft tissue infections in children are an important cause for hospitalization. A thorough history and physical examination can provide clues to the pathogens involved. Collection of purulent discharge from lesions should be completed prior to initiating antimicrobial therapy, and results of bacteriologic studies (Gram stain and culture) should guide therapeutic decisions. The main pathogens involved in these infections are Staphylococcus aureus and group A beta-hemolytic streptococci, but enteric organisms also play a role especially in nosocomial infections. Increasing antibacterial resistance is becoming a major problem in the treatment of these infections worldwide. Specifically, the rise of methicillin-resistant S. aureus and glycopeptide-resistant S. aureus pose challenges for the future. Infections of the skin and soft tissues can be broadly classified based on the extent of tissue involvement. Superficial infections such as erysipelas, cellulitis, bullous impetigo, bite infections, and periorbital cellulitis may require hospitalization and parenteral antibacterials. Deeper infections such as orbital cellulitis, necrotizing fasciitis, and pyomyositis require surgical intervention as well as parenteral antibacterial therapy. Surgery plays a key role in the treatment of abscesses and for the debridement of necrotic tissue in deep infections. Intravenous immunoglobulin, as an adjunctive therapy, can be helpful in treating necrotizing fasciitis. For most infections an antistaphylococcal beta-lactam antibacterial is first-line therapy. Third-generation cephalosporins and beta-lactam/beta-lactamase inhibitor antibacterials as well as clindamycin or metronidazole are often required to provide broad-spectrum coverage for polymicrobial infections.Special populations, such as immunocompromised children, those with an allergy to penicillins, and those that acquire infections in hospitals, require specific antibacterial strategies. These usually involve broader

  1. [Therapy of lower urinary tract infections in children].

    PubMed

    Principi, N; Viganò, A; Dalla Villa, A; Tommasi, P

    1988-01-01

    Infection of the urinary tract has been described for nearly two centuries, yet the diagnosis, localization of infection, outcome, and management of UTI continue to generate significant problems. The two basic aims of treatment of UTI are the relief of symptoms and the prevention, or at least limitation, of damage to the renal parenchyma. The initial choice of an antimicrobial in the patient with a suspected UTI is based on knowledge of the expected organisms and their antimicrobial susceptibilities. The spectrum of urinary pathogens and their antibiotic susceptibility patterns in our geographical area are presented. Moreover therapeutic regimens in the treatment of upper and lower UTI are discussed. PMID:3241749

  2. Rhinovirus-C detection in children presenting with acute respiratory infection to hospital in Brazil.

    PubMed

    Fawkner-Corbett, David W; Khoo, Siew Kim; Duarte, Carminha M; Bezerra, Patricia G M; Bochkov, Yury A; Gern, James E; Le Souef, Peter N; McNamara, Paul S

    2016-01-01

    Human rhinovirus (RV) is a common cause of acute respiratory infection (ARI) in children. We aimed to characterize the clinical and demographic features associated with different RV species detected in children attending hospital with ARI, from low-income families in North-east Brazil. Nasopharyngeal aspirates were collected from 630 children <5 years with ARI. Clinical diagnosis and disease severity were also recorded. Samples were analyzed by multiplex PCR for 18 viral and atypical bacterial pathogens; RV positive samples underwent partial sequencing to determine species and type. RV was the fourth commonest pathogen accounting for 18.7% of pathogens detected. RV was commonly detected in children with bronchiolitis, pneumonia, and asthma/episodic viral wheeze (EVW). Species and type were assigned in 112 cases (73% RV-A; 27% RV-C; 0% RV-B). Generally, there were no differences in clinical or demographic characteristics between those infected with RV-A and RV-C. However, in children with asthma/EVW, RV-C was detected relatively more frequently than RV-A (23% vs. 5%; P = 0.04). Our findings highlight RV as a potentially important pathogen in this setting. Generally, clinical and demographic features were similar in children in whom RV-A and C species were detected. However, RV-C was more frequently found in children with asthma/EVW than RV-A. PMID:26100591

  3. Relationship between malaria and filariasis transmission indices in an endemic area along the Kenyan Coast

    PubMed Central

    Muturi, Ephantus J.; Mbogo, Charles M.; Ng'ang'a, Zipporah W.; Kabiru, Ephantus W.; Mwandawiro, Charles; Novak, Robert J.; Beier, John C.

    2009-01-01

    Background & objectives: An entomological survey was conducted to determine the relationship between malaria and lymphatic filariasis transmission by Anopheles gambiae s.l. and An. funestus in two inland villages along the Kenyan coast. Methods: Mosquitoes were sampled inside houses by pyrethrum spray sheet collection (PSC). In the laboratory, the mosquitoes were sorted to species, dissected for examination of filarial infection and the anophelines later tested for Plasmodium falciparum circumsporozoite proteins by an enzyme-linked immunosorbent assay (ELISA). Results: From a total of 2,032 female mosquitoes collected indoors, An. gambiae s.l constituted 94.4% while the remaining 5.6% comprised of An. funestus and Culex quinquefasciatus. None of the Cx. quinquefasciatus was positive for filarial worms. P. falciparum sporozoite rate for An. gambiae s.l. from both villages was significantly higher than Wuchereria bancrofti infectivity rate. Similarly, the entomological inoculation rate for An. gambiae s.l. was significantly higher than the corresponding W. bancrofti infective biting rate and transmission potential for both the villages. Mass treatment of people with filaricidal drugs in Shakahola in the ongoing global elimination of lymphatic filariasis campaign seemed to have reduced the indices of filariasis transmission but had no effect on malaria transmission. Interpretation & conclusion: These results indicate the intensity of malaria transmission by anophelines to be much higher than that of lymphatic filariasis in areas where both diseases co-exist and re-emphasise the need to integrate the control of the two diseases in such areas. PMID:16967820

  4. Seroepidemiology of Human Enterovirus 71 Infection among Children, Cambodia.

    PubMed

    Horwood, Paul F; Andronico, Alessio; Tarantola, Arnaud; Salje, Henrik; Duong, Veasna; Mey, Channa; Ly, Sovann; Dussart, Philippe; Cauchemez, Simon; Buchy, Philippe

    2016-01-01

    Enterovirus 71 is reported to have emerged in Cambodia in 2012; at least 54 children with severe encephalitis died during that outbreak. We used serum samples collected during 2000-2011 to show that the virus had been widespread in the country for at least a decade before the 2012 outbreak. PMID:26690000

  5. Seroepidemiology of Human Enterovirus 71 Infection among Children, Cambodia

    PubMed Central

    Horwood, Paul F.; Andronico, Alessio; Tarantola, Arnaud; Salje, Henrik; Duong, Veasna; Mey, Channa; Ly, Sovann; Dussart, Philippe; Cauchemez, Simon

    2016-01-01

    Enterovirus 71 is reported to have emerged in Cambodia in 2012; at least 54 children with severe encephalitis died during that outbreak. We used serum samples collected during 2000–2011 to show that the virus had been widespread in the country for at least a decade before the 2012 outbreak. PMID:26690000

  6. [Current issues of epidemiology and vaccine prophylaxis of "children" airborne infections in the armies (Navy)].

    PubMed

    Belov, A B; Ogarkov, P I

    2011-04-01

    It highlights the problems associated with the epidemiological situation of the morbidity of the population and the military personnel with infections, which recently were "infant"--measles, mumps, rubella, diphtheria and other infections, controlled now by means of immunization. There is no alternative to the mass immunization of children and adolescents to achieve highly efficient vaccine-resistant sporadic incidence of these infections. However, amid the successes achieved, regular "grow-up" disease causes these infections spread vaccination for adults who are at risk. In military units there are similar conditions, they increase the risk of both infection and disease, especially among conscripts. The ways to improve vaccination calendars troops are discussed, including held for epidemical indications, the need for immunization of groups at risk of chicken pox, and in the future--and against other "childhood" diseases. PMID:21770322

  7. Juvenile rheumatoid arthritis in children with Ebstein Barr virus infection.

    PubMed

    Aghighi, Y; Gilani Sh, Modarres; Razavi, M; Zamani, A; Daneshjoo, K

    2007-10-15

    Juvenile Rheumatoid Arthritis (JRA) is a disease of unknown etiology. A total of 50 patients with JRA who were hospitalized in the Pediatrics Rheumatology Ward of Imam Khomeini Hospital in Tehran during the years 2001-2002, were assessed serologically (IgM and IgG specific viral capsid antigens) for EBV infection and their response to therapy was studied. Minimum age of the patients was at least 6 months and mean age was 60.96 plus/minus 43.46 months. EBV infection was seen in 44 (88%) patients 24 of whom were girls and 20 boys. Ninety two percent of girls and 83% boys were infected with the virus. Ebstein barr virus (EBV) infection was seen in 33 cases, 6 cases, 4 cases and 1 case in the polyarticular, pauciarticular, systemic and spondylitis group, respectively. Fifty four percent of EBV-positive patients with JRA did not respond to the classic therapy. EBV virus is involved in the pathogenesis of JRA and patients with EBV are in greater risk of developing JRA. PMID:19093474

  8. Parasitism in Children Aged Three Years and Under: Relationship between Infection and Growth in Rural Coastal Kenya

    PubMed Central

    McKibben, Maxim; Mungai, Peter; Muchiri, Eric M.; McKibben, Elisabeth; Gildengorin, Ginny; Sutherland, Laura J.; King, Charles H.; King, Christopher L.; Malhotra, Indu

    2015-01-01

    Background Parasitic infections, which are among the most common infections worldwide, disproportionately affect children; however, little is known about the impact of parasitic disease on growth in very early childhood. Our objective was to document the prevalence of parasitic infections and examine their association with growth during the first three years of life among children in coastal Kenya. Methodology/Principal Findings Children enrolled in a maternal-child cohort were tested for soil transmitted helminths (STHs: Ascaris, Trichuris, hookworm, Strongyloides), protozoa (malaria, Entamoeba histolytica and Giardia lamblia), filaria, and Schistosoma infection every six months from birth until age three years. Anthropometrics were measured at each visit. We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference). Of 545 children, STHs were the most common infection with 106 infections (19%) by age three years. Malaria followed in period prevalence with 68 infections (12%) by three years of age. Filaria and Schistosoma infection occurred in 26 (4.8%) and 16 (2.9%) children, respectively. Seven percent were infected with multiple parasites by three years of age. Each infection type (when all STHs were combined) was documented by six months of age. Decreases in growth of weight, length and head circumference during the first 36 months of life were associated with hookworm, Ascaris, E. histolytica, malaria and Schistosoma infection. In a subset analysis of 180 children who followed up at every visit through 24 months, infection with any parasite was associated with decelerations in weight, length and head circumference growth velocity. Multiple infections were associated with greater impairment of linear growth. Conclusions/Significance Our results demonstrate an under-recognized burden of parasitism in the first

  9. [Phytoterapy: a glimmer of hope in the prevention of recurrent respiratory tract infections in children].

    PubMed

    Miniello, V L; Brunetti, L; Cafagna, R; Lieggi, M S; Lippolis, P; Natile, M; Francavilla, R; Armenio, L

    2007-08-01

    Evidence on the efficacy of standardised phytoterapic extracts for the prevention of recurrent respiratory tract infections (RRTIs) in children is reviewed. Echinacea extracts are widely used in European countries and in the United States as immune-stimulating agents. However, further prospective, appropriately powered clinical studies are required to confirm their benefits in reducing duration and severity of RRTIs. PMID:17947844

  10. We Are All Affected: Considering the Recovery of HIV/AIDS Infected and Affected Children

    ERIC Educational Resources Information Center

    Nelson, Carla

    2008-01-01

    This essay acknowledges that the HIV/AIDS pandemic has created entire communities for whom loss has become a common and a shared experience. As a result of this impact of HIV/AIDS, several questions surface. However, the one question upon which this essay focuses is, "What type of environment is required for children infected and affected by…

  11. Molecular Characterization of the Human Immunodeficiency Virus Type 1 in Women and Their Vertically Infected Children.

    PubMed

    Vaz, Sara Nunes; Giovanetti, Marta; Rego, Filipe Ferreira de Almeida; Oliveira, Tulio de; Danaviah, Siva; Gonçalves, Maria Luiza Freire; Alcantara, Luiz Carlos Junior; Brites, Carlos

    2015-10-01

    Approximately 35 million people worldwide are infected with human immunodeficiency virus (HIV) around 3.2 million of whom are children under 15 years. Mother-to-child-transmission (MTCT) of HIV-1 accounts for 90% of all infections in children. Despite great advances in the prevention of MTCT in Brazil, children are still becoming infected. Samples from 19 HIV-1-infected families were collected. DNA was extracted and fragments from gag, pol, and env were amplified and sequenced directly. Phylogenetic reconstruction was performed. Drug resistance analyses were performed in pol and env sequences. We found 82.1% of subtype B and 17.9% of BF recombinants. A prevalence of 43.9% drug resistance-associated mutations in pol sequences was identified. Of the drug-naive children 33.3% presented at least one mutation related to protease inhibitor/nucleoside reverse transcriptase inhibitor/nonnucleoside reverse transcriptase inhibitor (PI/NRTI/NNRTI) resistance. The prevalence of transmitted drug resistance mutations was 4.9%. On env we found a low prevalence of HR1 (4.9%) and HR2 (14.6%) mutations. PMID:26200738

  12. Factors Associated with the Academic Achievement of Perinatally HIV-Infected Elementary and Middle School Children

    ERIC Educational Resources Information Center

    Ellis, Walter L.

    2004-01-01

    It is well documented that perinatally HIV-infected children experience difficulty in learning as well as behavioral and social problems in the school setting. While the research is mixed on the effect of the HIV virus on behavioral and social problems, it is much clearer on the effect of this virus on learning. This exploratory study identifies…

  13. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda1

    PubMed Central

    Roh, Michelle E.; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N.; Mwanga-Amumpaire, Juliet; Boum, Yap

    2016-01-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections. PMID:27434741

  14. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda(1).

    PubMed

    Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N; Mwanga-Amumpaire, Juliet; Parikh, Sunil; Boum, Yap

    2016-08-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non-P. falciparum malarial infections. PMID:27434741

  15. Infection by Intestinal Parasites, Stunting and Anemia in School-Aged Children from Southern Angola

    PubMed Central

    Oliveira, Dinamene; Atouguia, Jorge; Fortes, Filomeno; Guerra, António

    2015-01-01

    Introduction Intestinal parasites are responsible for morbidity in children worldwide, especially in low income countries. In the present study we determine the prevalence of intestinal parasites and explore its association with anemia and stunting in school-aged children. Methods A cross-sectional study was conducted from September to October 2010 enrolling 328 children attending the primary school in Lubango, the second largest city after the capital Luanda. Stool samples were collected for parasite detection through microscopy and molecular identification of Entamoeba histolytica and Entamoeba dispar. Stunting was assessed using the z-scores of height for age and hemoglobin concentration was determined using a portable hemoglobin analyzing system. Results The global prevalence of pathogenic intestinal parasites was 44.2%, the most common being Ascaris lumbricoides (22.0%), Giardia lamblia (20.1%) and Hymenolepis nana (8.8%). Molecular detection revealed that 13.1% of the children carried E. dispar and 0.3% were infected with E. histolytica. The prevalence of stunting (mild to severe) was 41.5%. Stunting was more frequent in older children (p = 0.006, OR = 1.886), while anemia was more frequent in younger children (p = 0.005, OR = 2.210). The prevalence of anemia was 21.6%, and we found a significant association with infection by H. nana (p = 0.031, OR = 2.449). Conclusions This is one of the few published studies reporting intestinal parasites infection, nutritional status and anemia in children from Angola. Furthermore, the present work highlights the importance of regular intestinal parasites screening in children. PMID:26371758

  16. [Exposure to tobacco smoke and type of acute respiratory infections in children].

    PubMed

    Bielska, Dorota; Trofimiuk, Emil; Ołdak, Elzbieta; Cylwik, Bogdan; Chlabicz, Sławomir

    2010-01-01

    Respiratory diseases are the most common cause of the child and family practice physicians are one of the main reasons for referral to a specialist clinic and hospital pediatric wards. The severity of respiratory disease in adolescence influenced by various factors, endo- and exogenous. Some of them, especially environmental factors can be eliminated or reduced and thus reduce the risk of developing this disease. The most common source of pollutants in dwellings is tobacco smoke. The aim of this study was to assess exposure to tobacco smoke in three years old children of attending local kindergartens in Białystok and its influence on the type of recovery from acute respiratory infections by the respondents. The study included 313 children from among the 1,200 who attend the local 51-kindergartens in Bialystok. Information on the structure of tobacco use in three-years-old-children's families and respiratory illnesses among random children were obtained, based on anonymous questionnaires completed by their carers. Exposure to tobacco smoke was based on questionnaires and serum cotinine in relation to creatinine in the urine of patients (K/K). In the 150 families surveyed children found 210 smoking people. Every day smoked 37.3% of fathers and 23.6% of mothers. Of the children surveyed--34% of the houses which where there was a prohibition on tobacco use, 35% of the houses which were smoked in enclosed areas, in 31% of homes have not been established no-smoking rules. Children who during the six-month period to attend kindergarten gone lower respiratory tract infection had mean K/K (59.57 ng/mg) higher than the ones that were healthy and underwent upper respiratory tract infection. Used by the parents of the children tested in part to reduce the exposure to tobacco smoke in the home environment was ineffective and did not influence the decrease in the incidence of lower respiratory tract. PMID:21360910

  17. The effect of single and multiple infections on atopy and wheezing in children

    PubMed Central

    Alcantara-Neves, Neuza Maria; Veiga, Rafael Valente; Dattoli, Vitor Camilo Cavalcante; Fiaccone, Rosimeire Leovigildo; Esquivel, Renata; Cruz, Álvaro Augusto; Cooper, Philip John; Rodrigues, Laura Cunha; Barreto, Maurício Lima

    2016-01-01

    Background The current epidemic of asthma and atopy has been explained by alterations in immune responses related to reduction in childhood infections. However, the findings of epidemiologic studies investigating the association between infection with atopy and asthma have been inconsistent. Objective We sought to investigate the effect of single or multiple infections (pathogen burden) on atopy and wheeze in urban children from Latin America. Methods Specific IgE against aeroallergens (sIgE) and skin prick test (SPT) reactivity for the most common local allergens were measured in 1128 children aged 4 to 11 years. Data on wheezing and potential confounders were collected by questionnaire. Infections by 8 pathogens were assessed by using serology and stool examination. Associations of wheeze and atopic outcomes with single and multiple infections were analyzed by means of logistic regression. Results Negative results for Toxoplasma gondii were associated with a higher prevalence of sIgE (≥0.70 kU/L), whereas negative results for Ascaris lumbricoides, T gondii, herpes simplex virus, and EBV were associated with a higher prevalence of SPT reactivity. Children with 3 or fewer infection markers had a higher prevalence of sIgE and SPT reactivity compared with those with 4 or more infection markers. However, isolated infections or pathogen burden were not associated with the prevalence of atopic or nonatopic wheeze. Conclusion The findings provide support for the idea that the hygiene hypothesis is operating in an urban Latin American context, but its expression is thus far restricted to the atopic status of patients and not the perceived asthma symptoms. PMID:22035877

  18. Psychological functioning among vertically infected HIV-positive children and their primary caregivers.

    PubMed

    Lentoor, Antonio G; Asante, Kwaku Oppong; Govender, Kaymarlin; Petersen, Inge

    2016-01-01

    The current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger children's psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes. PMID:26829395

  19. Association between Nutritional Status and Severity of Dengue Infection in Children in El Salvador

    PubMed Central

    Marón, Gabriela M.; Clará, A. Wilfrido; Diddle, John Wesley; Pleités, Ernesto B.; Miller, Laura; MacDonald, Gene; Adderson, Elisabeth E.

    2010-01-01

    Clinical observations and some studies suggest that dengue virus infection is more severe among children with better nutritional status. We examined the nutritional status of children in El Salvador and its relationship between this and the severity of dengue infection. Z-scores for weight-for-age, height-for-age, and body mass index (BMI)-for-age of children with dengue fever (66), dengue hemorrhagic fever (62), and healthy controls (74) were compared. There were no differences in weight-for-age or BMI-for-age Z-scores between the three groups. Children with dengue fever had a greater height-for-age than healthy controls but no significant differences in rates of stunting. There was no difference in height between children with dengue fever and dengue hemorrhagic fever. Excess nutrition does not appear to be a risk factor for severe forms of dengue infection in El Salvador, nor does malnutrition appear to be predictive of good outcomes. PMID:20134012

  20. Disclosure of Their HIV Status to Infected Children: A Review of the Literature

    PubMed Central

    Pinzón-Iregui, María C.; Malow, Robert M.

    2013-01-01

    Since the introduction of highly active antiretroviral therapy (ART) in 1996, HIV-infected children often survive beyond adolescence. To assess worldwide trends in disclosure since ART was introduced, we reviewed articles that refer to disclosure of their status to HIV-infected children, and which described patient, health care provider and/or caregiver opinions about disclosure and/or reported the proportion of children who knew their diagnosis. Most studies (17 [55%]) were performed in low- or middle-income (LMI) countries. In the 21 articles that included information on whether the children knew their status, the proportion who knew ranged from 1.2 to 75.0% and was lower in LMI (median = 20.4%) than industrialized countries (43%; p = 0.04). LMI country study participants who knew their status tended to have learned it at older ages (median = 9.6 years) than industrialized country participants (median = 8.3 years; p = 0.09). The most commonly reported anticipated risks (i.e. emotional trauma to child and child divulging status to others) and benefits (i.e. improved ART adherence) of disclosure did not vary by the country’s economic development. Only one article described and evaluated a disclosure process. Despite recommendations, most HIV-infected children worldwide do not know their status. Disclosure strategies addressing caregiver concerns are urgently needed. PMID:23070738

  1. Malignancies in UK children with HIV infection acquired from mother to child transmission.

    PubMed

    Evans, J A; Gibb, D M; Holland, F J; Tookey, P A; Pritchard, J; Ades, A E

    1997-04-01

    By April 1995, 302 cases of vertically acquired HIV infection had been reported through the British Paediatric Association Surveillance Unit. Over 50% of these children had developed an AIDS indicator disease, including nine malignancies (seven cases of non-Hodgkin's lymphoma (NHL) and two of Kaposi's sarcoma). There were two other malignancies that were not AIDS indicator diseases. In children less than 5 years of age the incidence of NHL was approximately 2500 times greater than expected in the UK child population. Three children presented with NHL as their AIDS indicator disease and four developed NHL at a median of 14 (range 10-19) months after the initial diagnosis of AIDS. Six of the seven children died at a median of 6.5 (range 2-14) months after the diagnosis of NHL. The seventh child responded to treatment and is alive nearly four years later. Histology was available in five cases, of which four were of B cell and one of T cell origin. Epstein-Barr virus was detected in all three patients with NHL where it was sought; all had B cell lymphomas. Although comparatively rare, malignancies occur in children infected with HIV and may be the presenting illness. Paediatricians now need to consider HIV infection as a predisposing cause of childhood cancer, especially NHL. PMID:9166025

  2. Performance of diagnostic biomarkers in predicting liver fibrosis among hepatitis C virus-infected Egyptian children

    PubMed Central

    Nassef, Yasser E; Shady, Mones M Abu; Galal, Essam M; Hamed, Manal A

    2013-01-01

    The aim of the present study was to identify specific markers that mirror liver fibrosis progression as an alternative to biopsy when biopsy is contraindicated, especially in children. After liver biopsies were performed, serum samples from 30 hepatitis C virus (HCV) paediatric patients (8-14 years) were analysed and compared with samples from 30 healthy subjects. All subjects were tested for the presence of serum anti-HCV antibodies. Direct biomarkers for liver fibrosis, including transforming growth factor-β1, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), hyaluronic acid (HA), procollagen type III amino-terminal peptide (PIIINP) and osteopontin (OPN), were measured. The indirect biomarkers aspartate and alanine aminotransferases, albumin and bilirubin were also tested. The results revealed a significant increase in the serum marker levels in HCV-infected children compared with the healthy group, whereas albumin levels exhibited a significant decrease. Significantly higher levels of PIIINP, TIMP-1, OPN and HA were detected in HCV-infected children with moderate to severe fibrosis compared with children with mild fibrosis (p < 0.05). The diagnostic accuracy of these direct biomarkers, represented by sensitivity, specificity and positive predictive value, emphasises the utility of PIIINP, TIMP-1, OPN and HA as indicators of liver fibrosis among HCV-infected children. PMID:24141960

  3. Neurodevelopment in perinatally HIV-infected children: a concern for adolescence.

    PubMed

    Laughton, Barbara; Cornell, Morna; Boivin, Michael; Van Rie, Annelies

    2013-01-01

    Globally, an estimated 3.4 million children are living with HIV, yet little is known about the effects of HIV and antiretroviral treatment (ART) on the developing brain, and the neurodevelopmental and behavioural outcomes of perinatally HIV-infected (PHIV+) adolescents. We reviewed the literature on neurodevelopmental outcomes in PHIV+ children and adolescents, and summarized the current evidence on behaviour, general cognition, specific domains, hearing and language, school performance and physical disabilities due to neurological problems. Evidence suggests that PHIV+ children do not perform as well as controls on general cognitive tests, processing speed and visual-spatial tasks, and are at much higher risk for psychiatric and mental health problems. Children with AIDS-defining diagnoses are particularly at risk for poorer outcomes. A striking finding is the lack of published data specific to the adolescent age group (10-25 years), particularly from resource-constrained countries, which have the highest HIV prevalence. In addition, extreme heterogeneity in terms of timing and source of infection, and antiretroviral experience limits our ability to summarize findings of studies and generalize results to other settings. Due to the complex nature of the developing adolescent brain, environmental influences and variation in access to ART, there is an urgent need for research on the longitudinal trajectory of neurodevelopment among children and adolescents perinatally infected with HIV, especially in high burden resource-constrained settings. PMID:23782482

  4. Neurometabolite Alterations Associated With Cognitive Performance in Perinatally HIV-Infected Children.

    PubMed

    Van Dalen, Yvonne W; Blokhuis, Charlotte; Cohen, Sophie; Ter Stege, Jacqueline A; Teunissen, Charlotte E; Kuhle, Jens; Kootstra, Neeltje A; Scherpbier, Henriette J; Kuijpers, Taco W; Reiss, Peter; Majoie, Charles B L M; Caan, Matthan W A; Pajkrt, Dasja

    2016-03-01

    Despite treatment with combination antiretroviral therapy (cART), cognitive impairment is still observed in perinatally HIV-infected children. We aimed to evaluate potential underlying cerebral injury by comparing neurometabolite levels between perinatally HIV-infected children and healthy controls. This cross-sectional study evaluated neurometabolites, as measured by Magnetic Resonance Spectroscopy (MRS), in perinatally HIV-infected children stable on cART (n = 26) and healthy controls (n = 36).Participants were included from a cohort of perinatally HIV-infected children and healthy controls, matched group-wise for age, gender, ethnicity, and socio-economic status. N-acetylaspartate (NAA), glutamate (Glu), myo-inositol (mI), and choline (Cho) levels were studied as ratios over creatine (Cre). Group differences and associations with HIV-related parameters, cognitive functioning, and neuronal damage markers (neurofilament and total Tau proteins) were determined using age-adjusted linear regression analyses.HIV-infected children had increased Cho:Cre in white matter (HIV-infected = 0.29 ± 0.03; controls = 0.27 ± 0.03; P value = 0.045). Lower nadir CD4+ T-cell Z-scores were associated with reduced neuronal integrity markers NAA:Cre and Glu:Cre. A Centers for Disease Control and Prevention (CDC) stage C diagnosis was associated with higher glial markers Cho:Cre and mI:Cre. Poorer cognitive performance was mainly associated with higher Cho:Cre in HIV-infected children, and with lower NAA:Cre and Glu:Cre in healthy controls. There were no associations between neurometabolites and neuronal damage markers in blood or CSF.Compared to controls, perinatally HIV-infected children had increased Cho:Cre in white matter, suggestive of ongoing glial proliferation. Levels of several neurometabolites were associated with cognitive performance, suggesting that MRS may be a useful method to assess cerebral changes potentially linked to cognitive outcomes

  5. Respiratory viral infections in children with asthma: do they matter and can we prevent them?

    PubMed Central

    2012-01-01

    Background Asthma is a major public health problem with a huge social and economic burden affecting 300 million people worldwide. Viral respiratory infections are the major cause of acute asthma exacerbations and may contribute to asthma inception in high risk young children with susceptible genetic background. Acute exacerbations are associated with decreased lung growth or accelerated loss of lung function and, as such, add substantially to both the cost and morbidity associated with asthma. Discussion While the importance of preventing viral infection is well established, preventive strategies have not been well explored. Good personal hygiene, hand-washing and avoidance of cigarette smoke are likely to reduce respiratory viral infections. Eating a healthy balanced diet, active probiotic supplements and bacterial-derived products, such as OM-85, may reduce recurrent infections in susceptible children. There are no practical anti-viral therapies currently available that are suitable for widespread use. Summary Hand hygiene is the best measure to prevent the common cold. A healthy balanced diet, active probiotic supplements and immunostimulant OM-85 may reduce recurrent infections in asthmatic children. PMID:22974166

  6. Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The Prospective P2C2 HIV Study

    PubMed Central

    Starc, Thomas J.; Lipshultz, Steven E.; Easley, Kirk A.; Kaplan, Samuel; Bricker, J. Timothy; Colan, Steven D.; Lai, Wyman W.; Gersony, Welton M.; Sopko, George; Moodie, Douglas S.; Schluchter, Mark D.

    2015-01-01

    Objective To describe the 5-year cumulative incidence of cardiac dysfunction in human immunodeficiency virus (HIV)-infected children. Study design We used a prospective cohort design, enrolling children at 10 hospitals. Group I included 205 vertically HIV-infected children enrolled at a median age of 1.9 years. Group II consisted of 600 HIV-exposed children enrolled prenatally or as neonates, of whom 93 were ultimately HIV-infected. The main outcome measures were echocardiographic indexes of left ventricular dysfunction. Results In group I, the 5-year cumulative incidence of left ventricular fractional shortening ≤25% was 28.0%. The 5-year incidence of left ventricular end-diastolic dilatation was 21.7%, and heart failure and/or the use of cardiac medications 28.8%. The mortality rate 1 year after the diagnosis of heart failure was 52.5% [95% CI, 30.5-74.5]. Within group II, the 5-year cumulative incidence of decreased fractional shortening was 10.7% in the HIV-infected compared with 3.1% in the HIV-uninfected children (P = .01). Left ventricular dilation, heart failure, and/or the use of cardiac medications were more common in infected compared with uninfected children. Conclusions During 5 years of follow-up, cardiac dysfunction occurred in 18% to 39% of HIV-infected children and was associated with an increased risk of death. We recommend that HIV-infected children undergo routine echocardiographic surveillance for cardiac abnormalities. PMID:12219051

  7. Brief Report: Prevalence of Latent Rheumatic Heart Disease Among HIV-Infected Children in Kampala, Uganda.

    PubMed

    Gleason, Brigette; Mirembe, Grace; Namuyonga, Judith; Okello, Emmy; Lwabi, Peter; Lubega, Irene; Lubega, Sulaiman; Musiime, Victor; Kityo, Cissy; Salata, Robert A; Longenecker, Chris T

    2016-02-01

    Rheumatic heart disease (RHD) remains highly prevalent in resource-constrained settings around the world, including countries with high rates of HIV/AIDS. Although both are immune-mediated diseases, it is unknown whether HIV modifies the risk or progression of RHD. We performed screening echocardiography to determine the prevalence of latent RHD in 488 HIV-infected children aged 5-18 in Kampala, Uganda. The overall prevalence of borderline/definite RHD was 0.82% (95% confidence interval: 0.26% to 2.23%), which is lower than the published prevalence rates of 1.5%-4% among Ugandan children. There may be protective factors that decrease the risk of RHD in HIV-infected children. PMID:26413847

  8. Barriers to immunization among children of HIV-infected mothers in Kolkata, India: a qualitative study.

    PubMed

    Sensarma, Pinaki; Bhandari, Subhasis; Kutty, V Raman

    2015-03-01

    More than one fourth of children of HIV-infected mothers living in Kolkata city are not completely immunized by 12 months of age. This qualitative study aims to explore the barriers to immunization of these children as perceived by their caregivers and the local health care service providers. In-depth interviews were conducted after obtaining written informed consent. Audio recording and hand-recorded notes were used with permission. The transcripts were coded and analyzed using grounded theory. Deteriorating socioeconomic status, tightening of time schedule of caregivers due to illness in the family, stigma, discrimination, and lack of awareness about immunization prove to be major barriers for immunization of the HIV-exposed children. Interplay of these factors coupled with harassment and negative attitudes of service providers toward HIV-affected/HIV-infected people also impede immunization. The intervention efforts need to address these social barriers and adverse life events to improve immunization coverage. PMID:23666833

  9. Molecular Characterization of Noroviruses and HBGA from Infected Quilombola Children in Espirito Santo State, Brazil

    PubMed Central

    Vicentini, Fernando; Denadai, Wilson; Gomes, Yohanna Mayelle; Rose, Tatiana L.; Ferreira, Mônica S. R.; Le Moullac-Vaidye, Beatrice; Le Pendu, Jacques; Leite, José Paulo Gagliardi; Miagostovich, Marize Pereira; Spano, Liliana Cruz

    2013-01-01

    Noroviruses (NoV) are the main etiological agents of gastroenteritis outbreaks worldwide and susceptibility to NoV infection has been related to the histo-blood group antigen (HBGA). This study aimed to determine the prevalence of NoV strains and to evaluate the HBGA phenotype and genotype of children from semi-isolated Quilombola communities, descendents of black slaves in Brazil. A total of 397 children up to eleven years old, with and without diarrhea, from Quilombola Communities in the Espirito Santo State, Brazil, were investigated for the presence of NoV from August 2007 to September 2009. Feces were collected from all the children, and blood from the NoV positive children. NoV was screened by reverse transcription-PCR with primers for the RNA-dependent RNA polymerase region; genogroup was determined by PCR with primers for the C and D regions and genotyped by sequencing. HBGA phenotype was performed by gel-spinning and FUT2 and FUT3 were analyzed by PCR or sequencing analysis. NoV were detected in 9.2% (12/131) of diarrheic and 1.5% (4/266) of non-diarrheic children (p<0.05, Fisher’s exact test). GI and GII genogroups were present in 12.5% and 87.5% of the samples, respectively. The following genotypes were characterized: GII.4 (25%), GII.12 (25%), GII.6 (12.5%) and GI.1 (6.3%), GI.3 (12.5%) and GI.4 (6.3%). Children infected with NoV showed the A (n = 6), O (n = 6), and B (n = 2) HBGA phenotypes, and 13 of them were classified as secretors (Se) and one as a non secretor (se). Mutations of Se40, 171,216,357,428,739,960 were found for the FUT2 gene and mutations of Le59, 202, 314 for the FUT3 gene. The only se child was infected by NoV GI, whereas the Se children were indiscriminately infected by GI or GII. This study showed rates of NoV infection in symptomatic and asymptomatic Quilombola children consistent with other studies. However, children under 12 months were seven times more affected than those between 1 and 5 years old. GII.12 was as

  10. A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households

    PubMed Central

    2012-01-01

    Background Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. Methods The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. Results At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2–5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Conclusions Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages

  11. Reduced central line infection rates in children with leukemia following caregiver training

    PubMed Central

    Lo Vecchio, Andrea; Schaffzin, Joshua K.; Ruberto, Eliana; Caiazzo, Maria Angela; Saggiomo, Loredana; Mambretti, Daniela; Russo, Danila; Crispo, Sara; Continisio, Grazia Isabella; Dello Iacovo, Rossano; Poggi, Vincenzo; Guarino, Alfredo

    2016-01-01

    Abstract Infections are a leading cause of morbidity and mortality in children with acute leukemia. Central-line (CL) devices increase this population's risk of serious infections. Within the context of a quality improvement (QI) project, we tested the effect of caregiver education on CL management on the CL-associated bloodstream infection (CLABSI) rate among children with acute leukemia seen at a large referral center in Italy. The intervention consisted of 9 in-person sessions for education and practice using mannequins and children. One hundred and twenty caregivers agreed to participate in the initiative. One hundred and five (87.5%) completed the training, 5 (4.1%) withdrew after the first session, and 10 (8.3%) withdrew during practical sessions. After educational intervention, the overall CLABSI rate was reduced by 46% (from 6.86 to 3.70/1000 CL-days). CLABSI rate was lower in children whose caregivers completed the training (1.74/1000 CL-days, 95% CI 0.43–6.94) compared with those who did not receive any training (12.2/1000 CL-days, 95% CI 7.08–21.0, P < 0.05) or were in-training (3.96/1000 CL-days, 95% CI 1.98–7.91) at the time of infection. Caregiver training in CL management, applied within a multifaceted QI approach, reduced the rate of CLABSI in children with acute leukemia. Specific training and active involvement of caregivers in CL management may be effective to reduce CLABSI in high-risk children. PMID:27336888

  12. Antibody response to respiratory syncytial virus infection in children <18 months old.

    PubMed

    Esposito, Susanna; Scarselli, Elisa; Lelii, Mara; Scala, Alessia; Vitelli, Alessandra; Capone, Stefania; Fornili, Marco; Biganzoli, Elia; Orenti, Annalisa; Nicosia, Alfredo; Cortese, Riccardo; Principi, Nicola

    2016-07-01

    The development of a safe and effective respiratory syncytial virus (RSV) vaccine might be facilitated by knowledge of the natural immune response to this virus. The aims of this study were to evaluate the neutralizing antibody response of a cohort of healthy children <18 months old to RSV infection. During the RSV season, 89 healthy children <18 months old were enrolled and followed up weekly for 12 weeks. At each visit, a nasopharyngeal swab was obtained for RSV detection by real-time polymerase chain reaction (PCR). During the study period, 2 blood samples were drawn and they were used to determine RSV geometric mean neutralizing antibody titres (GMT) against RSV. A total of 35 (39.3%) children had RSV detected during the study period. Among RSV-positive patients, children ≥7 months showed a significantly higher increase in antibody response (p<0.001). A significantly higher number of patients with a ≥4 -fold increase in GMT were ≥7 months old (p = 0.02) and presented lower respiratory tract infections (LRTIs) during the study period (p = 0.01). Viral shedding was longer among children aged ≥7 months (p = 0.06), those with viral load ≥10(6) copies/mL (p = 0.03), and those with LRTIs during the study period (p = 0.03), but it was not associated with the immune response (p = 0.41). In conclusion, natural RSV infection seems to evoke a low immune response in younger children. To be effective in this infant population, which is at highest risk of developing severe LRTIs, vaccines must be able to induce in the first months of life a stronger immune response than that produced by the natural infection. PMID:26901128

  13. The changing seroepidemiology of enterovirus 71 infection among children and adolescents in Singapore

    PubMed Central

    2011-01-01

    Background Enterovirus 71 (EV71) has caused recurrent epidemics of hand, foot and mouth disease among children in Singapore. Between August 2008 and July 2010, we conducted a survey to estimate the seroprevalence of EV71 infection among children and adolescents aged 1-17 years. We compared our EV71 seroepidemiologic findings with a previous study conducted in 1996-1997. Methods The survey involved the prospective collection of 1,200 residual sera from Singapore residents aged 1-17 years in two hospitals. Neutralizing antibodies to EV71 were detected by the microneutralization test. The geometric mean titer (GMT) of EV71 antibodies and 95% confidence intervals (CI) were calculated and compared by age groups. Statistical significance was taken as P < 0.05. Results The overall EV71 antibody prevalence was 26.9% (95% CI: 24.5-29.5%). It increased significantly from 14.3% in children aged 1-6 years to 27.8% in those aged 7-12 years, and reached 38.8% in adolescents aged 13-17 years. The seroconversion rate differed by about 12% between the consecutive age groups. The GMT of EV71 antibodies was higher among primary school children aged 7-12 years in our study than that among the 6-12 year age group in the 1996-1997 study. Conclusions Higher antibody titers were observed in children aged 1-6 years than those in the other two age groups, indicating that most of the infections had been acquired during early childhood. EV71 infection is common among children and adolescents in Singapore, with 39% infected by the time they are in secondary school (13-17 years of age). PMID:21988931

  14. Signs and symptoms in children with a serious infection: a qualitative study

    PubMed Central

    Van den Bruel, Ann; Bruyninckx, Rudi; Vermeire, Etienne; Aerssens, Peter; Aertgeerts, Bert; Buntinx, Frank

    2005-01-01

    Background Early diagnosis of serious infections in children is difficult in general practice, as incidence is low, patients present themselves at an early stage of the disease and diagnostic tools are limited to signs and symptoms from observation, clinical history and physical examination. Little is known which signs and symptoms are important in general practice. With this qualitative study, we aimed to identify possible new important diagnostic variables. Methods Semi-structured interviews with parents and physicians of children with a serious infection. We investigated all signs and symptoms that were related to or preceded the diagnosis. The analysis was done according to the grounded theory approach. Participants were recruited in general practice and at the hospital. Results 18 children who were hospitalised because of a serious infection were included. On average, parents and paediatricians were interviewed 3 days after admittance of the child to hospital, general practitioners between 5 and 8 days after the initial contact. The most prominent diagnostic signs in seriously ill children were changed behaviour, crying characteristics and the parents' opinion. Children either behaved drowsy or irritable and cried differently, either moaning or an inconsolable, loud crying. The parents found this illness different from previous illnesses, because of the seriousness or duration of the symptoms, or the occurrence of a critical incident. Classical signs, like high fever, petechiae or abnormalities at auscultation were helpful for the diagnosis when they were present, but not helpful when they were absent. Conclusion behavioural signs and symptoms were very prominent in children with a serious infection. They will be further assessed for diagnostic accuracy in a subsequent, quantitative diagnostic study. PMID:16124874

  15. Microbiology and management of endodontic infections in children.

    PubMed

    Brook, Itzhak

    2003-01-01

    The first step in the origination of caries is the formation of a dental plaque. Dental caries can lead to destruction of enamel and dentin resulting in bacterial invasion of the pulp. Invasion of the pulp and the periapical areas can promote the development of dento-alveolar abscess and spread of the infection to other anatomical areas. Several oral acid producing aerobic and anaerobic bacteria, including Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces viscosus, are capable of initiating the carious lesion. The organisms that predominate in pulpitis and dento-alveolar abscess are Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus spp. Treatment of caries involves removal of all affected tooth structure and proper replacement with a restorative material. Once pulpitis has developed the infected tissue should be removed and root canal therapy instituted, or the tooth should be extracted. Extraction, root canal therapy and/or drainage of pus usually are indicated for an abscess. Antimicrobial therapy supplementing the dental care should be considered, especially when local or systemic spread of the infection is suspected. Penicillin or amoxicillin are generally effective against most of the aerobic and anaerobic bacteria recovered. The patient whose oral cavity may harbor penicillin-resistant organisms should be considered for treatment with drugs effective against these organisms. These agents include amoxicillin-clavulanate, clindamycin or the combination of metronidazole plus amoxicillin or a macrolide. PMID:14604136

  16. Clinical and epidemiological characteristics of acute respiratory virus infections in Vietnamese children.

    PubMed

    Tran, D N; Trinh, Q D; Pham, N T K; Vu, M P; Ha, M T; Nguyen, T Q N; Okitsu, S; Hayakawa, S; Mizuguchi, M; Ushijima, H

    2016-02-01

    Information about viral acute respiratory infections (ARIs) is essential for prevention, diagnosis and treatment, but it is limited in tropical developing countries. This study described the clinical and epidemiological characteristics of ARIs in children hospitalized in Vietnam. Nasopharyngeal samples were collected from children with ARIs at Ho Chi Minh City Children's Hospital 2 between April 2010 and May 2011 in order to detect respiratory viruses by polymerase chain reaction. Viruses were found in 64% of 1082 patients, with 12% being co-infections. The leading detected viruses were human rhinovirus (HRV; 30%), respiratory syncytial virus (RSV; 23·8%), and human bocavirus (HBoV; 7·2%). HRV was detected all year round, while RSV epidemics occurred mainly in the rainy season. Influenza A (FluA) was found in both seasons. The other viruses were predominant in the dry season. HRV was identified in children of all age groups. RSV, parainfluenza virus (PIV) 1, PIV3 and HBoV, and FluA were detected predominantly in children aged 24 months, respectively. Significant associations were found between PIV1 with croup (P < 0·005) and RSV with bronchiolitis (P < 0·005). HBoV and HRV were associated with hypoxia (P < 0·05) and RSV with retraction (P < 0·05). HRV, RSV, and HBoV were detected most frequently and they may increase the severity of ARIs in children. PMID:26145204

  17. Association between secondary thrombocytosis and viral respiratory tract infections in children.

    PubMed

    Zheng, Shou-Yan; Xiao, Qiu-Yan; Xie, Xiao-Hong; Deng, Yu; Ren, Luo; Tian, Dai-Yin; Luo, Zheng-Xiu; Luo, Jian; Fu, Zhou; Huang, Ai-Long; Liu, En-Mei

    2016-01-01

    Secondary thrombocytosis (ST) is frequently observed in children with a variety of clinical conditions. The leading cause of ST is respiratory tract infection (RTI) in children. Nasopharyngeal aspirate samples were collected and assessed for common respiratory viruses. The relationships between virus infections and secondary thrombocytosis were analyzed retrospectively. The blood platelet count and the presence of respiratory viruses were determined for 3156 RTI patients, and 817 (25.9%) cases with platelet ≥500 × 10(9)/L were considered as the thrombocytosis group. Compared with the normal group, the detection rates of respiratory syncytial virus (RSV) and human rhinovirus (HRV) were significantly higher in the thrombocytosis group (P = 0.017 and 0.042, respectively). HRV single infection was a risk factor associated with thrombocytosis [odds ratio (OR) = 1.560, 95% confidence interval (CI) = 1.108-2.197]. Furthermore, ST was more likely to occur in younger patients who had clinical manifestations of wheezing and dyspnea and who had been diagnosed with bronchiolitis. Furthermore, the course of disease lasted longer in these patients. ST is associated with viral respiratory tract infections, especially RSV and HRV infections. HRV single infection is a risk factor associated with thrombocytosis. PMID:26965460

  18. Association between secondary thrombocytosis and viral respiratory tract infections in children

    PubMed Central

    Zheng, Shou-Yan; Xiao, Qiu-Yan; Xie, Xiao-Hong; Deng, Yu; Ren, Luo; Tian, Dai-Yin; Luo, Zheng-Xiu; Luo, Jian; Fu, Zhou; Huang, Ai-Long; Liu, En-Mei

    2016-01-01

    Secondary thrombocytosis (ST) is frequently observed in children with a variety of clinical conditions. The leading cause of ST is respiratory tract infection (RTI) in children. Nasopharyngeal aspirate samples were collected and assessed for common respiratory viruses. The relationships between virus infections and secondary thrombocytosis were analyzed retrospectively. The blood platelet count and the presence of respiratory viruses were determined for 3156 RTI patients, and 817 (25.9%) cases with platelet ≥500 × 109/L were considered as the thrombocytosis group. Compared with the normal group, the detection rates of respiratory syncytial virus (RSV) and human rhinovirus (HRV) were significantly higher in the thrombocytosis group (P = 0.017 and 0.042, respectively). HRV single infection was a risk factor associated with thrombocytosis [odds ratio (OR) = 1.560, 95% confidence interval (CI) = 1.108–2.197]. Furthermore, ST was more likely to occur in younger patients who had clinical manifestations of wheezing and dyspnea and who had been diagnosed with bronchiolitis. Furthermore, the course of disease lasted longer in these patients. ST is associated with viral respiratory tract infections, especially RSV and HRV infections. HRV single infection is a risk factor associated with thrombocytosis. PMID:26965460

  19. Infection and Co-infection with Helminths and Plasmodium among School Children in Côte d’Ivoire: Results from a National Cross-Sectional Survey

    PubMed Central

    Yapi, Richard B.; Hürlimann, Eveline; Houngbedji, Clarisse A.; Ndri, Prisca B.; Silué, Kigbafori D.; Soro, Gotianwa; Kouamé, Ferdinand N.; Vounatsou, Penelope; Fürst, Thomas; N’Goran, Eliézer K.; Utzinger, Jürg; Raso, Giovanna

    2014-01-01

    Background Helminth infection and malaria remain major causes of ill-health in the tropics and subtropics. There are several shared risk factors (e.g., poverty), and hence, helminth infection and malaria overlap geographically and temporally. However, the extent and consequences of helminth-Plasmodium co-infection at different spatial scales are poorly understood. Methodology This study was conducted in 92 schools across Côte d’Ivoire during the dry season, from November 2011 to February 2012. School children provided blood samples for detection of Plasmodium infection, stool samples for diagnosis of soil-transmitted helminth (STH) and Schistosoma mansoni infections, and urine samples for appraisal of Schistosoma haematobium infection. A questionnaire was administered to obtain demographic, socioeconomic, and behavioral data. Multinomial regression models were utilized to determine risk factors for STH-Plasmodium and Schistosoma-Plasmodium co-infection. Principal Findings Complete parasitological and questionnaire data were available for 5,104 children aged 5-16 years. 26.2% of the children were infected with any helminth species, whilst the prevalence of Plasmodium infection was 63.3%. STH-Plasmodium co-infection was detected in 13.5% and Schistosoma-Plasmodium in 5.6% of the children. Multinomial regression analysis revealed that boys, children aged 10 years and above, and activities involving close contact to water were significantly and positively associated with STH-Plasmodium co-infection. Boys, wells as source of drinking water, and water contact were significantly and positively associated with Schistosoma-Plasmodium co-infection. Access to latrines, deworming, higher socioeconomic status, and living in urban settings were negatively associated with STH-Plasmodium co-infection; whilst use of deworming drugs and access to modern latrines were negatively associated with Schistosoma-Plasmodium co-infection. Conclusions/Significance More than 60% of the

  20. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

    PubMed Central

    2012-01-01

    Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection. PMID:22490115

  1. Cytokine Profiles in Human Metapneumovirus Infected Children: Identification of Genes Involved in the Antiviral Response and Pathogenesis

    PubMed Central

    Malmo, Jostein; Moe, Nina; Krokstad, Sidsel; Ryan, Liv; Loevenich, Simon; Johnsen, Ingvild B.; Espevik, Terje; Nordbø, Svein Arne; Døllner, Henrik; Anthonsen, Marit W.

    2016-01-01

    Human metapneumovirus (hMPV) causes severe airway infection in children that may be caused by an unfavorable immune response. The nature of the innate immune response to hMPV in naturally occurring infections in children is largely undescribed, and it is unknown if inflammasome activation is implicated in disease pathogenesis. We examined nasopharynx aspirates and blood samples from hMPV-infected children without detectable co-infections. The expression of inflammatory and antiviral genes were measured in nasal airway secretions by relative mRNA quantification while blood plasma proteins were determined by a multiplex immunoassay. Several genes were significantly up-regulated at mRNA and protein level in the hMPV infected children. Most apparent was the expression of the chemokine IP-10, the pro-inflammatory cytokine IL-18 in addition to the interferon inducible gene ISG54. Interestingly, children experiencing more severe disease, as indicated by a severity index, had significantly more often up-regulation of the inflammasome-associated genes IL-1β and NLRP3. Overall, our data point to cytokines, particularly inflammasome-associated, that might be important in hMPV mediated lung disease and the antiviral response in children with severe infection. Our study is the first to demonstrate that inflammasome components are associated with increased illness severity in hMPV-infected children. PMID:27171557

  2. Down-regulated Th17 Responses Are Associated with Reduced Gastritis in Helicobacter pylori-infected Children

    PubMed Central

    Bimczok, Diane; Shaffer, Carrie L.; Cover, Timothy L.; Venegas, Alejandro; Salazar, Maria G.; Smythies, Lesley E.; Harris, Paul R.; Smith, Phillip D.

    2013-01-01

    Helicobacter pylori induces less gastric inflammation in children than adults. Here we investigated whether this reduced inflammation involves dysregulated Th17 responses. H. pylori-infected children and adults in Santiago, Chile had similar levels of H. pylori colonization, proportions of bacteria containing cagA and s1/s2 vacA markers of virulence and strain genotypes (predominantly hpEurope), but the children had significantly reduced levels of gastric inflammation and neutrophil infiltration. The reduced neutrophil accumulation in infected children was accompanied by significantly fewer gastric Th17 cells and significantly lower levels of IL-17-specific mRNA and protein compared to infected adults. The gastric mucosa of H. pylori-infected children also contained higher numbers of IL-10+ cells and increased levels of both IL-10 and Foxp3 mRNA compared to that of infected adults. Thus, reduced gastric inflammation, including diminished neutrophil accumulation, in H. pylori-infected children compared with infected adults is likely due to down-regulated gastric Th17/IL-17 responses as a consequence of enhanced mucosal regulatory T cell activity in the children. PMID:23299619

  3. [Role of parainfluenza varuses in etiology of acute respiratory infections in children (serological diagnosis)].

    PubMed

    Vancea, D; Oargă, M; Matinca, D

    1979-01-01

    Serologic investigations carried out in 254 children admitted to a Clinic for Children for respiratory diseases, established a diagnosis of infection with parainfluenza virus in 19.2% of cases. The predominant age-group affected was 7--12 months and 0--6 months; the causative agent in most cases was parainfluenza type 3, followed by type 2 and then type 1. The role of parainfluenza viruses in the aetiology of laryngotracheobronchiectasis was confirmed, as well as their participation in the aetiology of pneumonia in infants. The results also showed the wide circulation of parainfluenza viruses in children and their outstanding contribution to respiratory diseases among hospitalized children within a period of four years. PMID:223218

  4. Explaining antiretroviral therapy adherence success among HIV-infected children in rural Uganda: a qualitative study.

    PubMed

    Olds, Peter K; Kiwanuka, Julius P; Ware, Norma C; Tsai, Alexander C; Haberer, Jessica E

    2015-04-01

    High adherence is critical for achieving clinical benefits of HIV antiretroviral therapy (ART) and particularly challenging for children. We conducted 35 qualitative interviews with caregivers of HIV-infected Ugandan children who were followed in a longitudinal study of real-time ART adherence monitoring; 18 participants had undetectable HIV RNA, while 17 had detectable virus. Interviews blinded to viral suppression status elicited information on adherence experiences, barriers and facilitators to adherence, and social support. Using an inductive content analytic approach, we identified 'lack of resources,' 'Lazarus effect,' 'caregiver's sense of obligation and commitment,' and 'child's personal responsibility' as categories of influence on adherence, and defined types of caregiver social support. Among children with viral suppression, high hopes for the child's future and ready access to private instrumental support appeared particularly important. These findings suggest clinical counseling should explore caregivers' views of their children's futures and ability to access support in overcoming adherence barriers. PMID:25323679

  5. Routine Paediatric Sickle Cell Disease (SCD) Outpatient Care in a Rural Kenyan Hospital: Utilization and Costs

    PubMed Central

    Amendah, Djesika D.; Mukamah, George; Komba, Albert; Ndila, Carolyne; Williams, Thomas N.

    2013-01-01

    Background More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth of this disease reaches 2% or higher in some selected areas. There is a dearth of knowledge on comprehensive care received by children with SCD in sub-Saharan Africa and its associated cost. Such knowledge is important for setting prevention and treatment priorities at national and international levels. This study focuses on routine care for children with SCD in an outpatient clinic of the Kilifi District Hospital, located in a rural area on the coast of Kenya. Objective To estimate the per-patient costs for routine SCD outpatient care at a rural Kenyan hospital. Methods We collected routine administrative and primary cost data from the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya. Costs were estimated by evaluating inputs - equipment, medication, supplies, building use, utility, and personnel - to reflect the cost of offering this service within an existing healthcare facility. Annual economic costs were similarly calculated based on input costs, prorated lifetime of equipment and appropriate discount rate. Sensitivity analyses evaluated these costs under different pay scales and different discount rate. Results We estimated that the annual economic cost per patient attending the SCD clinic was USD 138 in 2010 with a range of USD 94 to USD 229. Conclusion This study supplies the first published estimate of the cost of routine outpatient care for children born with SCD in sub-Saharan Africa. Our study provides policy makers with an indication of the potential future costs of maintaining specialist outpatient clinics for children living with SCD in similar contexts. PMID:23593408

  6. IL-8 Alterations in HIV-1 Infected Children With Disease Progression.

    PubMed

    Pananghat, Ambili Nair; Aggarwal, Heena; Prakash, Somi Sankaran; Makhdoomi, Muzamil Ashraf; Singh, Ravinder; Lodha, Rakesh; Ali, Shakir; Srinivas, Maddur; Das, Bimal Kumar; Pandey, Ravindra Mohan; Kabra, Sushil Kumar; Luthra, Kalpana

    2016-05-01

    Disease progression in HIV-1 infected children is faster than in adults. Less than 5% of the infected children maintain stable CD4 counts beyond 7 years of infection and are termed long-term nonprogressors (LTNPs). Delineating the host immune response in antiretroviral naïve (ART) and treated HIV-1 infected children at different disease stages will help in understanding the immunopathogenesis of the disease.A total of 79 asymptomatic, perinatally HIV-1 infected children (50 ART naïve and 29 ART treated) and 8 seronegative donors were recruited in this study. T- and B-cell activation PCR arrays were performed from the cDNA, using total RNA extracted from the peripheral blood mononuclear cells (PBMCs) of 14 HIV-1 infected children at different stages of the disease. The differentially expressed genes were identified. Quantitative RT-PCR was performed for the (interleukin-8) IL-8 gene and its transcriptional mediators, that is, SHP2, GRB2, and IL-8R (IL-8 receptor/CXCR1). Plasma levels of IL-8 were measured by flow cytometry.Gene array data revealed a higher expression of IL-8 in the ART naïve HIV-1 infected progressors and in ART nonresponders than LTNPs and ART responders, respectively. Quantitative RT-PCR analysis demonstrated a significant higher expression of IL-8 (P < 0.001), its receptor CXCR1 (P = 0.03) and the upstream signaling molecule SHP2 (P = 0.04) in the progressors versus LTNPs. Plasma levels of IL-8 were significantly higher in progressors versus LTNPs (P < 0.001), and ART nonresponders versus ART responders (P < 0.001). A significant negative correlation of plasma levels of IL-8 with CD4 counts (cells/μL) was observed in HIV-1 infected ART naïve subjects (r = -0.488; P < 0.001), while the IL-8 levels positively correlated with viral load in the ART treated children (r = 0.5494; P < 0.001). ART naïve progressors on follow up demonstrated a significant reduction in the mRNA expression (P = 0.05) and plasma

  7. Treatment of hepatitis C virus infection for adults and children: Updated Swedish consensus recommendations

    PubMed Central

    Lagging, Martin; Wejstål, Rune; Norkrans, Gunnar; Karlström, Olle; Aleman, Soo; Weiland, Ola; Castedal, Maria; Josephson, Filip

    2016-01-01

    Abstract In a recent expert meeting, Swedish recommendations for the treatment of HCV infection were updated. An interferon-free combination of direct-acting antiviral agents was recommended as the first line standard-of-care treatment for chronic HCV infection. Interferon-based therapy should be considered as a second line option after an individual benefit-risk assessment. Treatment is strongly recommended for HCV infected patients with bridging fibrosis or cirrhosis (Metavir stages F3–4), before and after liver transplantation, and in the presence of extra-hepatic manifestations. Additionally, patients with moderate liver fibrosis (stage F2) as well as women in need of in vitro fertilisation should be prioritised for therapeutic intervention. Treatment indications for people who inject drugs, children, chronic kidney disease and HIV co-infection are also discussed. PMID:26624849

  8. [Urinary tract infection caused by Haemophilus influenzae in 3 children with uropathies].

    PubMed

    Allard, L; Joly-Guillou, M-L; Champion, G

    2012-08-01

    Urinary tract infection (UTI) is one of the most common infections in children but Haemophilus is rarely involved. In our institution, only 3 children below the age of 15 years presented with UTI due to Haemophilus influenzae between January 2010 and October 2011. These children had typical symptoms of UTI: fever, abdominal pain and dysuria. In all 3 patients, standard urinalysis remained negative, but H. influenzae was found after bacterial growth in special media, i.e., blood agar (or chocolate agar). These patients had abnormalities of the urinary tract. The first patient, a 5-year-old girl, had a right ureteropelvic junction syndrome found after her UTI. The second, a 4-year-old girl, had a bilateral ureteral duplication found after many UTIs. The third, a 2-month-old boy, had a right ureteropelvic junction syndrome that had been diagnosed by prenatal ultrasound. In our hospital, during the study period, the prevalence of UTI caused by Haemophilus was 0.02% of all pediatric UTIs. There are few reports in the literature on UTI caused by Haemophilus in children (<1%): they are frequently associated with urinary tract abnormalities. The bacterium is not able to grow in usual media, so that when there is a clinical UTI with Gram negative bacilli on the direct exam but not found in the culture, an infection with Haemophilus should be discussed, and blood agar used, which is all the more important when there are underlying abnormalities of the urinary tract. PMID:22795780

  9. [Mucosal immunity in children with HIV infection and the possibility of correcting this immunity].

    PubMed

    Kostinov, M P; Suloeva, S V; Tarasova, A A; Lukushkina, E F

    2006-01-01

    The influence of bacterial lysate [see text]PC-19 on the mucosal immunity of children with HIV infection was evaluated. The action of this topical immunomodulator was found to increase the synthesis of sIgA, which was indirectly reflected in a rise of the local immunity of the upper respiratory ways, preventing the aggravation of the chronic focal infection and the main disease. It should be pointed out that in a group of HIV-infected children and adolescents with an initially high level of salivary IgG the prescription of preparation [see text]PC-19 led to its considerable decrease. A decrease in the level of IgG and a rise in the content of sIgA in saliva under the action of the preparation correlated with a decrease in inflammatory changes in the nasopharyngeal mucosa. On the basis of results obtained in this study additions to the algorithm of the prophylactic medical observation of children and adolescents with HIV infection have been developed. PMID:16758905

  10. Epidemiology of intestinal parasitic infections in school children in Ghazni Province, eastern Afghanistan

    PubMed Central

    Korzeniewski, Krzysztof; Augustynowicz, Alina; Smoleń, Agata; Lass, Anna

    2015-01-01

    Objective: To estimate the prevalence of intestinal parasites and their species in Afghan school children and to establish appropriate treatment methods for detected pathogens. Methods: Parasitological examination of stool samples collected from 1369 children aged 8-18, students of the Jahan Malika High School in Ghazni Province in eastern Afghanistan, was conducted in the period November 2013-April 2014. Three stool samples were collected from each patient every second day; the samples were fixed in 10% formalin and tested by light microscopy using the methods of direct smear in Lugol’s solution, decantation in distilled water, and Fülleborn’s flotation. Results: Of 535 examined children (39.1% of the study group) were infected with nematodes (n=324), cestodes (n=118), trematodes (n=12), and protozoa (n=228), 132 were diagnosed with co-infections (mainly ascariasis+giardiasis, ascariasis+hymenolepiasis) and received single or combined therapy. Conclusions: The Afghan community is an example of population characterized by a high rate of parasitic infections. Owing to high prevalence of multiple infections among inhabitants of Afghanistan, it seems that a mass deworming campaign with a single-dose chemotherapy may prove ineffective in eradicating intestinal parasites in the local population. PMID:26870108

  11. Human rhinovirus infections in hospitalized children: clinical, epidemiological and virological features.

    PubMed

    Tran, D N; Trinh, Q D; Pham, N T K; Pham, T M H; Ha, M T; Nguyen, T Q N; Okitsu, S; Shimizu, H; Hayakawa, S; Mizuguchi, M; Ushijima, H

    2016-01-01

    Molecular epidemiology and clinical impact of human rhinovirus (HRV) are not well documented in tropical regions. This study compared the clinical characteristics of HRV to other common viral infections and investigated the molecular epidemiology of HRV in hospitalized children with acute respiratory infections (ARIs) in Vietnam. From April 2010 to May 2011, 1082 nasopharyngeal swabs were screened for respiratory viruses by PCR. VP4/VP2 sequences of HRV were further characterized. HRV was the most commonly detected virus (30%), in which 70% were diagnosed as either pneumonia or bronchiolitis. Children with single HRV infections presented with significantly higher rate of hypoxia than those infected with respiratory syncytial virus or parainfluenza virus (PIV)-3 (12·4% vs. 3·8% and 0%, respectively, P < 0·05), higher rate of chest retraction than PIV-1 (57·3% vs. 34·5%, P = 0·028), higher rate of wheezing than influenza A (63·2% vs. 42·3%, P = 0·038). HRV-C did not differ to HRV-A clinically. The genetic diversity and changes of types over time were observed and may explain the year-round circulation of HRV. One novel HRV-A type was discovered which circulated locally for several years. In conclusion, HRV showed high genetic diversity and was associated with significant morbidity and severe ARIs in hospitalized children. PMID:26112743

  12. Incidence of respiratory viruses in Peruvian children with acute respiratory infections.

    PubMed

    del Valle Mendoza, Juana; Cornejo-Tapia, Angela; Weilg, Pablo; Verne, Eduardo; Nazario-Fuertes, Ronald; Ugarte, Claudia; del Valle, Luis J; Pumarola, Tomás

    2015-06-01

    Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses. PMID:25784285

  13. Seroprevalence of CMV, HSV-2 and HBV among HIV-Infected Malawian Children: A Cross-sectional Survey

    PubMed Central

    Chris Buck, W.; Kazembe, Peter N.; Phiri, Sam; Andrianarimanana, Diavolana; Weigel, Ralf

    2016-01-01

    Background: Little is known about viral co-infections in African human immunodeficiency virus (HIV)-infected children. We examined the prevalence of seromarkers for cytomegalovirus (CMV), herpes simplex virus type 2 (HSV-2) and hepatitis B virus (HBV) infections among HIV-infected, antiretroviral treatment (ART)-naïve children in Lilongwe, Malawi. Methods: Ninety-one serum samples were tested for IgG and IgM antibodies to CMV, and IgG antibodies to HSV-2 and hepatitis B surface antigen (HBsAg). Baseline demographic, clinical and laboratory data were abstracted from electronic records. Results: CMV IgG was the most common positive result in all age groups (in 73% of children <1 year, and 100% in all other groups). Three patients were CMV IgM positive (3.3%), suggesting acute infection. HSV-2 IgG was positive in four patients (4.4%), and HBsAg in two (2.2%). Conclusions: CMV infection occurred early in life, and few children had specific signs of CMV infection at the time of ART initiation. Unrecognized HBV infection represents opportunities for testing and treatment of HIV/HBV co-infected children. PMID:26884443

  14. Infection and immunoglobulin levels in Sudanese children with severe protein-energy malnutrition*

    PubMed Central

    Suliman, Omer S. M.; Salih, Mustafa A. M.; Karrar, Zein A.; Mohammed, Abdelrahim O.; Helsing, Chrestover

    2011-01-01

    A hospital-based case control study was carried out to determine the pattern of infections and immunoblobulin levels in Sudanese children with severe protein energy malnutrition (PEM). The pre-dietary rehabilitation levels of the three major immunoglobulins (IgG, IgA and IgM) were compared with those of normal controls, and with the levels after dietary rehabilitation. Eighty one children were included in the study: 49 with severe PEM (23 with marasmus, 17 with marasmic – kwashiorkor and 9 with kwashiorkor), 13 with tuberculosis and 19 healthy children as controls. The study showed high incidence of infections, especially pneumonia and gastrointestinal infections in the malnourished children. Of special concern was the high incidence of urinary tract infection: 13 (26.5%) had significant pyuria and 9 of them had positive urine cultures, mainly Escherichia coli. Eight of the malnourished children also had pulmonary TB, and the ESR and Mantoux tests were not helpful in the diagnosis. The Mantoux test was negative in 88.8% of the malnourished group compared to 62.5% in those malnourished with TB. The malnourished groups had significantly higher plasma levels of the 3 immunoglobulins. While the maramic group attained significantly higher levels of IgG and IgA compared to the marasmic –kwashiorkor and kwashiorkor groups, the 3 groups of PEM showed a uniformly higher level of the IgM. After 2 weeks of rehabilitation, the levels of the 3 immunoglobulins showed no significant changes, except for the IgA which significantly decreased in all malnourished and the oedematous groups, and the IgM which increased significantly in the oedematous group.

  15. FOXP3+Helios+ Regulatory T Cells, Immune Activation, and Advancing Disease in HIV-Infected Children.

    PubMed

    Khaitan, Alka; Kravietz, Adam; Mwamzuka, Mussa; Marshed, Fatma; Ilmet, Tiina; Said, Swalehe; Ahmed, Aabid; Borkowsky, William; Unutmaz, Derya

    2016-08-15

    Regulatory T cells (Tregs) are functionally suppressive CD4 T cells, critical for establishing peripheral tolerance and controlling inflammatory responses. Previous reports of Tregs during chronic HIV disease have conflicting results with higher or lower levels compared with controls. Identifying true Tregs with suppressive activity proves challenging during HIV infection, as traditional Treg markers, CD25 and FOXP3, may transiently upregulate expression as a result of immune activation (IA). Helios is an Ikaros family transcription factor that marks natural Tregs with suppressive activity and does not upregulate expression after activation. Coexpression of FOXP3 and Helios has been suggested as a highly specific marker of "bona fide" Tregs. We evaluated Treg subsets by FOXP3 coexpressed with either CD25 or Helios and their association with HIV disease progression in perinatally infected HIV-positive children. Identifying Tregs by FOXP3 coexpression with Helios rather than CD25 revealed markedly higher Treg frequencies, particularly in HIV+ children. Regardless of antiretroviral therapy, HIV-infected children had a selective expansion of memory FOXP3+Helios+ Tregs. The rise in memory Tregs correlated with declining HIV clinical status, indicated by falling CD4 percentages and CD4:CD8 ratios and increasing HIV plasma viremia and IA. In addition, untreated HIV+ children exhibited an imbalance between the levels of Tregs and activated T cells. Finally, memory Tregs expressed IA markers CD38 and Ki67 and exhaustion marker, PD-1, that tightly correlated with a similar phenotype in memory CD4 T cells. Overall, HIV-infected children had significant disruptions of memory Tregs that associated with advancing HIV disease. PMID:27003495

  16. Validating a decision tree for serious infection: diagnostic accuracy in acutely ill children in ambulatory care

    PubMed Central

    Verbakel, Jan Y; Lemiengre, Marieke B; De Burghgraeve, Tine; De Sutter, An; Aertgeerts, Bert; Bullens, Dominique M A; Shinkins, Bethany; Van den Bruel, Ann; Buntinx, Frank

    2015-01-01

    Objective Acute infection is the most common presentation of children in primary care with only few having a serious infection (eg, sepsis, meningitis, pneumonia). To avoid complications or death, early recognition and adequate referral are essential. Clinical prediction rules have the potential to improve diagnostic decision-making for rare but serious conditions. In this study, we aimed to validate a recently developed decision tree in a new but similar population. Design Diagnostic accuracy study validating a clinical prediction rule. Setting and participants Acutely ill children presenting to ambulatory care in Flanders, Belgium, consisting of general practice and paediatric assessment in outpatient clinics or the emergency department. Intervention Physicians were asked to score the decision tree in every child. Primary outcome measures The outcome of interest was hospital admission for at least 24 h with a serious infection within 5 days after initial presentation. We report the diagnostic accuracy of the decision tree in sensitivity, specificity, likelihood ratios and predictive values. Results In total, 8962 acute illness episodes were included, of which 283 lead to admission to hospital with a serious infection. Sensitivity of the decision tree was 100% (95% CI 71.5% to 100%) at a specificity of 83.6% (95% CI 82.3% to 84.9%) in the general practitioner setting with 17% of children testing positive. In the paediatric outpatient and emergency department setting, sensitivities were below 92%, with specificities below 44.8%. Conclusions In an independent validation cohort, this clinical prediction rule has shown to be extremely sensitive to identify children at risk of hospital admission for a serious infection in general practice, making it suitable for ruling out. Trial registration number NCT02024282. PMID:26254472

  17. [Some immunological changes in children with bacterial infections treated with bacteriophages].

    PubMed

    Pagava, K I; Metskhvarishvili, G D; Gachechiladze, K K; Korinteli, I A; Khoĭle, N; Dzuliashvili, M G

    2012-11-01

    The aim of the study was to reveal the possible immunological changes in children with bacterial infections treated with commercial bacteriophage preparations administered per os. In case of medical indications (for treatment or diagnostic) blood sampling was carried out. In serum the antibodies against bacteriophage preparations - phage cocktail components (phages against Staphylococcus, Streptococcus, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa) were investigated. The neutralisation reaction was used. There were processed samples from 65 children with following diagnoses: sepsis, bacterial pneumonia, urinary tract infection, bacterial infections of upper respiratory ways, bacterial diarrhea. In samples taken in the first days of treatment antibodies were revealed in infants up to one month (I group) in 0/29 cases - 0%, in infants aged from one month till one year (II group)- 1/25 - 4.0%, in children aged from 1 till 15 years (III group) - 3/9 - 33.3%; data after 14-20 days from the beginning of treatment - I group - 0/9 - 0%, II group - 4/15 - 26.7%, III group - 5/5 - 100%; data after 30-60 days from the beginning of the treatment - I group - 1/5 - 20.0%, II group - 6/10 - 60.0%, III group - 3/3 - 100%. Bacteriophages neitralisation degree varied between 50,7% and 97.3%. Any regularity regarding different components of used phage preparations was not established. In case of inclusion of commercial phage preparations administered per os in the treatment of bacterial infections in children, the anti-phage neutralizing antibodies are produced by the macroorganism. This fact limits the duration of phage therapy and its usage in the treatment of future bacterial infections in treated patients. Production of anti-phage antibodies in young infants is substantially less expressed and this indicates to purposefulness and presumably higher efficacy of bacteriophage therapy in this age period. PMID:23221141

  18. Prevalence of Schistosoma haematobium Infection among School-Age Children in Afar Area, Northeastern Ethiopia.

    PubMed

    Degarege, Abraham; Mekonnen, Zeleke; Levecke, Bruno; Legesse, Mengistu; Negash, Yohannes; Vercruysse, Jozef; Erko, Berhanu

    2015-01-01

    In this study, the prevalence and intensity of Schistosoma haematobium infection was determined among school-age children living in the Middle and Lower Awash Valley, Afar Regional State of Ethiopia. Between February and May 2014, urine samples were collected from 885 school-age children (5-16 years of age) from the Middle (n = 632; 4 villages) and Lower (n = 253; 3 villages) Awash Valley. All samples were processed using urine filtration to detect and quantify S. haematobium eggs. In addition, a subset of the urine samples was tested for hematuria using a urine dipstick (n = 556). The overall prevalence was 20.8% (95% Confidence Interval (CI) = 18.1%, 23.5%), based on urine filtration but the prevalence considerably varied across villages both in the Middle (from 12.5% to 37.0%) and Lower Awash Valley (from 0 to 5.3%). The overall mean urine egg count (UEC) among the infected children was 4.0 eggs/10 ml of urine (95% CI = 2.43, 5.52). The infection intensity varied from 0.4 eggs/10 ml of urine to 7.7 eggs/10 ml of urine in the Middle Awash Valley, and from 0 to 1.1 eggs/10 ml of urine in Lower Awash Valley. Age and sex were not associated with S. haematobium infection based on the multivariable logistic regression model. The prevalence of hematuria was 56.3% (95% CI = 52.2%, 60.4%) among a subset of the study participants (556) examined using the urine dipstick. The prevalence of hematuria also varies with villages from 8.3% to 93.2%. In conclusion, the prevalence of S. haematobium infection in the Middle Awash Valley was high and it varies across villages. Hence, children living in the present study villages of the Middle Awash Valley need to be treated with praziquantel to reduce morbidity and disrupt transmission. PMID:26252615

  19. Psychosocial adjustment in perinatally human immunodeficiency virus infected or exposed children – a Retrospective Cohort Study

    PubMed Central

    Zalwango, Sarah K; Kizza, Florence N; Nkwata, Allan K; Sekandi, Juliet N; Kakaire, Robert; Kiwanuka, Noah; Whalen, Christopher C; Ezeamama, Amara E

    2016-01-01

    Objective To determine whether perinatal HIV infection and exposure adversely affected psychosocial adjustment (PA) between 6 and 18 years of life (i.e. during school-age and adolescence). Methods We enrolled 58 perinatally HIV-infected, 56 HIV-exposed uninfected and 54 unexposed controls from Kampala, Uganda. Perinatal HIV status was determined by 18 months of age using a DNA-polymerase chain-reaction test and was confirmed via HIV rapid diagnostic test at psychosocial testing when the children were 6 to 18 years old. Five indicators of PA (depressive symptoms, distress, hopelessness, positive future orientation and esteem) were measured using validated, culturally adapted and translated instruments. Multivariable linear regression analyses estimated HIV-status-related percent differences (β) in PA indicators and corresponding 95% confidence intervals (CIs). Results During school-age and adolescence, positive outlook (β=−3.8, 95% CI: −7.2, −0.1) and self-esteem (β=−4.3, 95% CI: −6.7, −1.8) scores were significantly lower, whereas depressive (β=11.4, 95% CI: 3.3, 19.5) and distress (β=12.3, 95% CI: 5.9, 18.7) symptoms were elevated for perinatally HIV-infected, compared to unexposed controls and exposed uninfected children. Similarly, positive outlook (β=−4.3, 95% CI: −7.3, −1.2) and self-esteem were lower for exposed controls versus HIV-unexposed children. Hopelessness was similar by perinatal HIV status. Likewise, the distress and depressive symptom levels were comparable for HIV-exposed uninfected and HIV-unexposed children. Conclusions Perinatal HIV infection predicted higher distress and depressive symptoms, while HIV-affected status (infection/exposure) predicted low self-esteem and diminished positive outlook in the long term. However, HIV-affected status had no impact on hopelessness, suggesting that psychosocial interventions as an integral component of HIV care for infected children or primary care exposed uninfected children may

  20. Probiotics for prevention and treatment of respiratory tract infections in children

    PubMed Central

    Wang, Yizhong; Li, Xiaolu; Ge, Ting; Xiao, Yongmei; Liao, Yang; Cui, Yun; Zhang, Yucai; Ho, Wenzhe; Yu, Guangjun; Zhang, Ting

    2016-01-01

    Abstract Background: Respiratory tract infections (RTIs) represent one of the main health problems in children. Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance. Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs. The authors systematically reviewed data from randomized controlled trials (RCTs) to investigate the effect of probiotic consumption on RTIs in children. Methods: MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for RCTs regarding the effect of probiotics on RTIs in children. The outcomes included number of children experienced with at least 1 RTI episode, duration of illness episodes, days of illness per subject, and school/day care absenteeism due to infection. A random-effects model was used to calculate pooled relative risks, or mean difference (MD) with the corresponding 95% confidence interval (CI). Results: A total of 23 trials involving 6269 children were eligible for inclusion in the systematic review. None of the trials showed a high risk of bias. The quality of the evidence of outcomes was moderate. The age range of subjects was from newborn to 18 years. The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82–0.96, P = 0.004). Children supplemented with probiotics had fewer numbers of days of RTIs per person compared with children who had taken a placebo (6 RCTs, 2067 children, MD −0.16, 95% CI −0.29 to 0.02, P = 0.03), and had fewer numbers of days absent from day care/school (8 RCTs, 1499 children, MD −0.94, 95% CI −1.72 to −0.15, P = 0.02). However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD −0.60, 95% CI −1

  1. A Retrospective Case-Series of Children With Bone and Joint Infection From Northern Australia

    PubMed Central

    Brischetto, Anna; Leung, Grace; Marshall, Catherine S.; Bowen, Asha C.

    2016-01-01

    Abstract Our clinical workload as infectious diseases pediatricians in northern Australia is dominated by complicated bone and joint infections in indigenous children. We reviewed the clinical presentation, microbiology, management, and outcomes of children presenting to Royal Darwin Hospital with bone and joint infections between 2010 and 2013, and aimed to compare severity and incidence with other populations worldwide. A retrospective audit was performed on children aged 0 to 18 years who were admitted to Royal Darwin Hospital between 1 January 2010 and 31 December 2013 with a bone and joint infection. Seventy-nine patients were identified, of whom 57 (72%) had osteomyelitis ± associated septic arthritis and 22 (28%) had septic arthritis alone. Sixty (76%) were indigenous Australians. The incidence rate of osteomyelitis for indigenous children was 82 per 100,000 children. Staphylococcus aureus was the confirmed pathogen in 43/79 (54%), of which 17/43 (40%) were methicillin resistant. Median length of stay was 17 days (interquartile range: 10–31 days) and median length of IV antibiotics was 15 days (interquartile range: 6–24 days). Fifty-six (71%) required at least 1 surgical procedure. Relapse within 12 months was documented in 12 (15%) patients. We report 3 key findings: osteomyelitis incidence in indigenous children of northern Australia is amongst the highest reported in the world; methicillin-resistant S aureus accounts for 36% of osteomyelitis with a positive microbiological diagnosis; and the severity of disease requires extended antibiotic therapy. Despite this, 15% of the cohort relapsed within 12 months and required readmission. PMID:26937926

  2. A Retrospective Case-Series of Children With Bone and Joint Infection From Northern Australia.

    PubMed

    Brischetto, Anna; Leung, Grace; Marshall, Catherine S; Bowen, Asha C

    2016-02-01

    Our clinical workload as infectious diseases pediatricians in northern Australia is dominated by complicated bone and joint infections in indigenous children. We reviewed the clinical presentation, microbiology, management, and outcomes of children presenting to Royal Darwin Hospital with bone and joint infections between 2010 and 2013, and aimed to compare severity and incidence with other populations worldwide.A retrospective audit was performed on children aged 0 to 18 years who were admitted to Royal Darwin Hospital between 1 January 2010 and 31 December 2013 with a bone and joint infection.Seventy-nine patients were identified, of whom 57 (72%) had osteomyelitis ± associated septic arthritis and 22 (28%) had septic arthritis alone. Sixty (76%) were indigenous Australians. The incidence rate of osteomyelitis for indigenous children was 82 per 100,000 children. Staphylococcus aureus was the confirmed pathogen in 43/79 (54%), of which 17/43 (40%) were methicillin resistant. Median length of stay was 17 days (interquartile range: 10-31 days) and median length of IV antibiotics was 15 days (interquartile range: 6-24 days). Fifty-six (71%) required at least 1 surgical procedure. Relapse within 12 months was documented in 12 (15%) patients.We report 3 key findings: osteomyelitis incidence in indigenous children of northern Australia is amongst the highest reported in the world; methicillin-resistant S aureus accounts for 36% of osteomyelitis with a positive microbiological diagnosis; and the severity of disease requires extended antibiotic therapy. Despite this, 15% of the cohort relapsed within 12 months and required readmission. PMID:26937926

  3. Anaesthesia for children with bronchial asthma and respiratory infections

    PubMed Central

    Rajesh, M C

    2015-01-01

    Asthma represents one of the most common chronic diseases in children with an increasing incidence reported worldwide. The key to successful anaesthetic outcome involves thorough pre-operative assessment and optimisation of the child's pulmonary status. Judicious application of proper anti-inflammatory and bronchodilatory regimes should be instituted as part of pre-operative preparation. Bronchospasm triggering agents should be carefully probed and meticulously avoided. A calm and properly sedated child at the time of induction is ideal, so also is extubation in a deep plane with an unobstructed airway. Wherever possible, regional anaesthesia should be employed. This will avoid airway manipulations, with additional benefit of excellent peri-operative analgesia. Agents with a potential for histamine release and techniques that can increase airway resistance should be diligently avoided. Emphasis must be given to proper post-operative care including respiratory monitoring, analgesia and breathing exercises. PMID:26556917

  4. Pitfalls in the investigation of children with urinary tract infection.

    PubMed Central

    Smellie, J M; Rigden, S P

    1995-01-01

    The histories and imaging results are presented in 10 children in whom errors had been made in the interpretation of early investigations. Ultrasonography may not detect either vesicoureteric reflux (VUR) or renal scars or inflammation. The reduced nephrogram or renal swelling following a first attack of acute pyelonephritis may not be recognised without renal measurement on an intravenous urogram. Renal scarring may be diagnosed incorrectly on the basis of functional defects of isotope uptake on a technetium 99m-dimercaptosuccinic acid study. In the absence of VUR, the micturating cystogram will not visualise the kidneys. Images Figure 1 Figure 2 Figure 3 Figure 4 p254-b p254-c Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:7741579

  5. Latent Tuberculosis Infection Among Immigrant and Refugee Children Arriving in the United States: 2010.

    PubMed

    Taylor, Eboni M; Painter, John; Posey, Drew L; Zhou, Weigong; Shetty, Sharmila

    2016-10-01

    Immigrants and refugees age 2-14 years entering the United States from countries with estimated tuberculosis (TB) incidence rate ≥20 per 100,000 population are screened for TB. Children with TB disease are treated before US arrival. Children with positive tuberculin skin tests (TST), but negative TB evaluation during their pre-immigration examination, are classified with latent TB infection (LTBI) and are recommended for re-evaluation post-arrival. We examined post-immigration TB evaluation and therapy for children arriving with LTBI. We reviewed medical exam data from immigrant children with medical conditions and all refugee children arriving during 2010. Medical examination data were available for 67,334 children. Of these, 8231 (12 %) had LTBI pre-immigration; 5749 (70 %) were re-evaluated for TB post-immigration, and 64 % were retested by TST or IGRA. The pre-immigration LTBI diagnosis was changed for 38 % when retested by TST and for 71 % retested by IGRA. Estimated LTBI therapy initiation and completion rates were 68 and 12 %. In this population, testing with IGRA may limit the number of children targeted for therapy. Increased pre-immigration TB screening with post-immigration follow-up evaluation leading to completion of LTBI therapy should be encouraged to prevent TB reactivation. PMID:26364054

  6. The impact of passive smoking on the development of lower respiratory tract infections in children.

    PubMed

    Keskinoglu, Pembe; Cimrin, Dilek; Aksakoglu, Gazanfer

    2007-10-01

    Environmental tobacco smoke is an important public health problem. The objective of this study was to evaluate the effect of passive smoking on lower respiratory tract infections (LRTIs) in children aged 2-12 years. A case-control study was conducted on matched-pair design. One-hundred and fifty children with LRTIs and 150 healthy children were included in the study. Data were collected through questionnaire and urine samples for the determination of cotinine levels, and were analysed by McNemar chi-square, paired t-test and Pearson correlation tests. The prevalence of parental self-reported, indoor smoking was 71.3% in children with LRTI and 72.0% in healthy children. Employing 30 ng mg(-1), the cut-off level of urinary cotinine/creatinine as commonly accepted, 87.3% of the children with LRTIs and 84.7% of healthy children were found to be passive smokers (p = 0.61, odds ratio (OR) = 0.93; confidence interval (CI) = 0.34-2.53). If 60 ng mg(-1) of urinary cotinine/creatinine was accepted as a cut-off level, it was observed that the rates of passive smoking were 76.7% and 50.7%, respectively (p = 0.000, OR = 4.72; 95% CI = 2.62-8.52). Dose-dependent exposure to environmental tobacco smoke was found to be associated with the incidence of LRTI. PMID:17517813

  7. [Educational level of mothers and their knowledge, attitude and practices concerning respiratory infections of their children].

    PubMed

    Valdés Roque, A I; Martínez Canalejo, H

    1999-12-01

    An evaluation was performed on the influence of different variables on the knowledge, attitudes, and practices that mothers of children under the age of 5 have concerning acute respiratory infections (ARIs). Two groups of mothers were interviewed: 1) mothers of children seen in a polyclinic in the province of Havana (n = 221) and 2) mothers whose children were hospitalized in the respiratory unit of a pediatric hospital in the city of Havana (n = 200). The five variables analyzed were the educational level of the mother, her age, place of residence, number of children, and whether or not she was employed in the health service sector, as well as the interactions between the first variable and the other four variables. A questionnaire was used to measure the ARI knowledge, attitudes, and practices (KAP) of the mothers. Two levels of KAP sufficiency were taken into account, "Adequate I" for obtaining 70% or more of the maximum possible score and "Adequate II" for achieving at least a 50% score. For both levels of adequacy, the KAP of the mothers working in the health sector was significantly higher than that of the mothers interviewed in the secondary health care center. This suggests that the poorer knowledge, attitudes, and practices of mothers with hospitalized children may have contributed to the children's hospitalization. The most important variable associated with sufficient knowledge was educational level, which highlights the fundamental and positive influence education exerts on the preventive and curative care that mothers provide their children with ARI. PMID:10659671

  8. [Change of peripheral blood appetite regulation factor of anorexia children and infect of child anorexia granule].

    PubMed

    Hu, Ai-Hua; Xu, Hui-Min; Hu, Guo-Hua; Jin, Fang; Li, Zhong; Fang, Guo-Xing

    2014-12-01

    Study the infect of child anorexia granule on serum ghrelin and leptin of anorexia children and its clinical efficacy. Selected 81 cases of anorexia children aged 1-6 years old into treatment group (42 cases) and control group (39 cases), in addition, 30 case healthy children as healthy control group. The control group children were treated with domperidone suspension 0.3 mg x kg(-1) x d(-1), tid, orally 30 minutes before meals. Treatment group were treated with child anorexia granule, 1-3 years 1 package, bid; 4-6 years 1 package, tid; po, 4 weeks as a course of treatment. Study the change of serum ghrelin and leptin before and after therapy. The study demonstrates that before treatment, the serum ghrelin level of disease group was lower than healthy group (P < 0.01), and the serum leptin level was higher than healthy group (P < 0.01). After treatment, the serum ghrelin level both increase, and the serum leptin decline. And the change of treatment group was significantly different with control group (P < 0.01). And the clinical effective rate are 95.23% and 74.35% (P < 0.01). After 6 months of follow-up visit, the children weight significantly increase in treatment group (P < 0.01). Results indicate that child anorexia granule can facilitate secretion of ghrelin, and inhibit secretion of leptin, so as to work up an appetite. And the molecular mechanism is its infect on serum ghrelin, leptin. PMID:25911824

  9. Antibody response in children infected with Giardia intestinalis before and after treatment with Secnidazole.

    PubMed

    Jiménez, Juan C; Pinon, Anthony; Dive, Daniel; Capron, Monique; Dei-Cas, Eduardo; Convit, Jacinto

    2009-01-01

    We examined 364 school children for intestinal parasites in a sub-urban zone of Caracas, Venezuela. Giardia intestinalis was the most prevalent parasite in stool samples from 34 children. Levels of IgA and IgG antibodies to G. intestinalis were assessed by enzyme-linked immunosorbent assay and Western blot before and after treatment with secnidazole. All patients were cured with a reduction of IgA antibody levels in 26 of 34 children and a reduction in IgG-specific antibody levels in 18 of 34 children. Serum of infected patients reacted with proteins of 14 kD to 137 kD. Some patients did not show a change in IgA serum reactivity for parasite proteins by Western blot after treatment. Seventeen children showed reduction of the reactivity or disappearance of protein reactivity (mainly the 14-kD, 122-kD, and 137-kD proteins). Antibody response was not related to clinical status, but quantitative and qualitative serum antibody response against G. intestinalis infection could be used to assess levels of new protein markers that decrease or disappear with successful chemotherapy. PMID:19141831

  10. Nutritional status changes in HIV-infected children receiving combined antiretroviral therapy including protease inhibitors.

    PubMed

    Fiore, P; Donelli, E; Boni, S; Pontali, E; Tramalloni, R; Bassetti, D

    2000-11-01

    Maintaining linear growth and weight gain in HIV-infected children is often difficult. Nutritional evaluation and support are recognised as important factors to improve their quality of life. Combination antiretroviral therapy including protease inhibitors (HAART) reduces HIV-viral load and improves survival, quality of life and nutritional status. Our study aimed to determine changes in nutrional status based on body weight, height and nutritional habits, of HIV-infected children receiving HAART. Possible side effects of lipid metabolism were also studied. Twenty five children, 13 treated with HAART (group B) were followed up for 12 months. We did not observe statistically significant differences in nutritional status over that time or between groups A and B. Inadequate energy intake was more common in patients with advanced HIV-disease. Hyperlipidemia was found in 70% of children receiving ritonavir and in approximately 50% of children receiving nelfinavir. We observed an important although not statistically significative modification in the height of those in group B. PMID:11091066

  11. Epidemiology and Outcome of Gram-Negative Bloodstream Infection in Children: A Population-Based Study

    PubMed Central

    Al-Hasan, M. N.; Huskins, W. C.; Lahr, B. D.; Eckel-Passow, J. E.; Baddour, L. M.

    2010-01-01

    SUMMARY Population-based studies of gram-negative bloodstream infection (BSI) in children are lacking. Therefore, we performed this population-based investigation in Olmsted County, Minnesota, to determine the incidence rate, site of acquisition, and outcome of gram-negative BSI in children under 18 years old. We used Kaplan-Meier method and Cox proportional hazard regression for mortality analysis. We identified 56 unique children with gram-negative BSI during the past decade. The gender-adjusted incidence rate of gram-negative BSI per 100,000 person-years was 129.7 (95% confidence interval [CI]: 77.8-181.6]) in infants, with a sharp decline to 14.6 (95% CI: 6.0-23.2) and 7.6 (95% CI: 4.3-10.9) in children 1-4 and 5-18 years old, respectively. The urinary tract was the most common identified source of infection (34%) and Escherichia coli was the most common pathogen isolated (38%). Over two-thirds (68%) of children had underlying medical conditions that predisposed to gram-negative BSI. The overall 28-day and 1-year all-cause mortality rates were 11% (95% CI: 3-18%) and 18% (95% CI: 8-28%), respectively. Younger age and number of underlying medical conditions were associated with 28-day and 1-year mortality, respectively. Nosocomial or healthcare-associated acquisition was associated with both 28-day and 1-year mortality. PMID:20598212

  12. Differences in Liver Impairment Between Adults and Children with Dengue Infection.

    PubMed

    Martínez Vega, Rosario; Phumratanaprapin, Weerapong; Phonrat, Benjaluck; Dhitavat, Jittima; Sutherat, Maleerat; Choovichian, Vorada

    2016-05-01

    Dengue infection (DI) is a major vector-borne disease in southeast Asia and an important cause of morbidity. The complications such as hepatic impairment are common, and because the physiology of the liver differs between children and adults, the DI-associated liver impairments might be expected to differ as well. This study aims to compare the differences in liver impairment between adults and children with DI. We retrospectively studied 158 adults and 79 children with serologically confirmed DI admitted to the Bangkok Hospital for Tropical Diseases from 2008 to 2012. In total, 93% of adults and 87% of children exhibited abnormal liver enzyme levels during hospitalization. Overall, 76 (42.4%) adults and 16 (20.3%) children had dengue hemorrhagic fever (DHF). Compared with children, adults with dengue fever (DF) presented a significantly higher incidence of liver function impairment (alanine transaminase [ALT] > 2 × upper limit of normal [ULN]) (47.1% versus 25.5%), hepatitis (ALT > 4 × ULN) (29.4% versus 12.8%), and severe hepatitis (aspartate transaminase [AST]/ALT > 10 × ULN) (16.5% versus 4.3%). Children with DHF showed a significantly higher incidence of liver function impairment due to AST derangement than did adults (100% versus 73%). There were no differences in the total bilirubin, albumin, or total protein levels between adults and children. Liver enzymes normalized significantly more slowly in adults, and AST recovery was faster than ALT. In conclusion, liver function impairment was more common among adults than children with DF. As the severity progressed to DHF, liver injury became more common in children. PMID:26976884

  13. Respiratory infections in children up to two years of age on prophylaxis with palivizumab

    PubMed Central

    Monteiro, Ana Isabel M. P.; Bellei, Nancy Cristina J.; Sousa, Alessandra Ramos; dos Santos, Amélia Miyashiro N.; Weckx, Lily Yin

    2014-01-01

    OBJECTIVE: To identify the viruses involved in acute respiratory tract infections and to analyze the rates of hospitalization and death in children on palivizumab prophylaxis. METHODS: Prospective cohort of 198 infants up to one year old who were born before 29 weeks of gestational age and infants under two years old with hemodynamically unstable cardiopathy or chronic pulmonary disease who received prophylactic palivizumab against severe respiratory syncytial virus infections in 2008. During the study period, in each episode of acute respiratory tract infection, nasopharyngeal aspirate was collected to identify respiratory syncytial virus, adenovirus, parainfluenza 1, 2 and 3, influenza A and B by direct immunofluorescence, rhinovirus and metapneumovirus by polymerase chain reaction preceded by reverse transcription. Data regarding hospitalization and deaths were monitored. RESULTS: Among the 198 studied infants, 117 (59.1%) presented acute respiratory tract infections, with a total of 175 episodes. Of the 76 nasopharyngeal aspirates collected during respiratory tract infections, 37 were positive, as follow: rhinovirus (75.7%), respiratory syncytial virus (18.9%), parainfluenza (8.1%), adenovirus 2 (2.7%), metapneumovirus (2.7%) and three samples presented multiple agents. Of the 198 children, 48 (24.4%) were hospitalized: 30 (15.2%) for non-infectious etiology and 18 (9.1%) for respiratory causes. Among these 18 children, one case of respiratory syncytial virus was identified. Two deaths were reported, but respiratory syncytial virus was not identified. CONCLUSIONS: During the prophylaxis period, low frequency of respiratory syncytial virus infections and low rates of hospitalization were observed, suggesting the benefit of palivizumab prophylaxis. PMID:25119744

  14. Cardiovascular biomarkers in vertically HIV-infected children without metabolic abnormalities.

    PubMed

    Sainz, Talía; Diaz, Laura; Navarro, María Luisa; Rojo, Pablo; Blázquez, Daniel; Ramos, José Tomás; de José, María Isabel; Álvarez-Fuente, María; Serrano-Villar, Sergio; Mellado, María José; Muñoz-Fernández, María Angeles

    2014-04-01

    Early cardiovascular disease is a major concern for ART-suppressed vertically HIV-infected children; however, evidence is lacking regarding specific preventive measures. In this study, a complete panel of biomarkers was determined together with carotid intima-media thickness (IMT), in a cohort of 64 HIV-infected children and 30 controls. Mean age of participants was 14.1±5 years. HIV-infected patients showed normal lipid profile, with only slightly higher triglycerides, and no differences between groups were found regarding IMT. HIV-infected patients displayed higher levels of soluble CD14 (sCD14) and soluble vascular cell adhesion molecule-1 (sVCAM) (all p<0.05). However, levels of C-reactive protein, interleukin-6, myeloperoxidase, monocyte chemoattractant protein-1, P-selectin and tissue plasminogen activator were similar between groups. Vertically HIV-infected subjects on ART with no significant metabolic disturbances displayed increased sCD14 and sVCAM but not up-regulation of proinflammatory pathways. Larger studies are warranted to assess the impact of a strict metabolic control on cardiovascular risk and to define specific cardiovascular disease preventive strategies in this population. PMID:24530771

  15. Prevalence of Toxoplasma Infection in Mexican Newborns and Children: A Systematic Review from 1954 to 2009

    PubMed Central

    Galvan-Ramírez, Ma. de la Luz; Troyo-Sanroman, Rogelio; Roman, Sonia; Bernal-Redondo, Rosamaría; Vázquez Castellanos, José Luís

    2012-01-01

    Introduction. Recent studies in Mexico have shown that from 20/10,000 to 58/10,000 newborns with Toxoplasma infection could be undetected. The aim of this study was to determine the weighed prevalence of T. gondii infection and describe the epidemiological transition of infection in newborns. Methods. Research literature reporting Toxoplasma infection prevalence in Mexican newborns and children were searched in five international databases. Weighted prevalence was calculated by inverse variance-weighted method in asymptomatic and symptomatic study groups, and the epidemiological transition was estimated by a lineal regression analysis. Results. The weighed prevalence in 4833 asymptomatic newborns was 0.616%, CI95% (0.396%–0.835%) (P < 0.001), whereas, among 895 symptomatic newborns, the weighed prevalence was 3.02%, CI 95% (1.91%–4.1%) (P < 0.001). A downward trend of 0.25%/year represented an accumulated decrease of −13,75% in the prevalence in the symptomatic newborns throughout 55 years, whereas, in the asymptomatic children, the prevalence was similar over the course of the years. Conclusion. The high-weighted prevalence of congenital Toxoplasma infection in newborns justifies that Toxoplasma gondii testing be included in the screening programs for women during pregnancy and newborns in Mexico. A rapid diagnosis and treatment strategy could aid in limiting a potential damage to the newborns. PMID:23050161

  16. Subdural collections due to non-typhi Salmonella infections in two Malaysian children.

    PubMed

    Intan, H I; Zubaidah, C D; Norazah, A; Norlijah, O

    2008-07-01

    Subdural collections caused by Salmonella infection are rarely encountered in children. We present two cases caused by non-typhi Salmonella, one a four-and-a-half-month-old boy presenting with subdural effusion, and the other, a 16-month-old boy with empyema. The diagnosis was confirmed on blood and subdural pus cultures. One patient had status epilepticus following focal fit, and the other had prolonged fever without any localising signs of infection on admission. They responded well to prompt surgical drainage and prolonged systemic antibiotic therapy. Contrary to previous reports, both patients showed favourable outcome in terms of neurological sequelae. PMID:18695854

  17. Cytomegalovirus Infection May Contribute to the Reduced Immune Function, Growth, Development, and Health of HIV-Exposed, Uninfected African Children

    PubMed Central

    Filteau, Suzanne; Rowland-Jones, Sarah

    2016-01-01

    With increasing access to antiretroviral therapy (ART) in Africa, most children born to HIV-infected mothers are not themselves HIV-infected. These HIV-exposed, uninfected (HEU) children are at increased risk of mortality and have immune, growth, development, and health deficits compared to HIV-unexposed children. HEU children are known to be at higher risk than HIV-unexposed children of acquiring cytomegalovirus (CMV) infection in early life. This risk is largely unaffected by ART and is increased by breastfeeding, which itself is critically important for child health and survival. Early CMV infection, namely in utero or during early infancy, may contribute to reduced growth, altered or impaired immune functions, and sensory and cognitive deficits. We review the evidence that CMV may be responsible for the health impairments of HEU children. There are currently no ideal safe and effective interventions to reduce postnatal CMV infection. If a clinical trial showed proof of the principle that decreasing early CMV infection improved health and development of HEU children, this could provide the impetus needed for the development of better interventions to improve the health of this vulnerable population. PMID:27446087

  18. Serum Micronutrient Status of Haart-Naïve, HIV Infected Children in South Western Nigeria: A Case Controlled Study

    PubMed Central

    Anyabolu, H. C.; Adejuyigbe, E. A.; Adeodu, O. O.

    2014-01-01

    Background. Though micronutrients are vital in the pathogenesis of human immunodeficiency virus infection, most studies have been conducted in adults. Knowledge of the status of key micronutrients in HIV infected African children will indicate if supplementation may be beneficial to these children living in this resource-poor region. Objectives. We sought to determine the micronutrient status and associated factors of HAART-naïve HIV infected children and compare them with those of the HIV negative controls. Methods. We enrolled 70 apparently stable HAART naïve HIV infected children. Seventy age and sex matched HIV negative children were equally enrolled as the controls. Their social class, anthropometry, clinical stage, CD4 counts, serum zinc, selenium, and vitamin C were determined. Results. The prevalence of zinc, selenium, and vitamin C deficiency in HIV infected subjects was 77.1%, 71.4%, and 70.0%, respectively, as compared to 44.3%, 18.6%, and 15.7% in HIV negative controls. Among the HIV infected subjects, 58.6% were deficient in the three micronutrients. Micronutrient status was related to the weight, clinical, and immunological stages but not BMI or social class. Conclusion. Deficiency of these key micronutrients is widely prevalent in HAART naïve HIV infected children irrespective of social class. This suggests that supplementation trial studies may be indicated in this population. PMID:25180086

  19. Clinical profile and treatment outcome of febrile infection-related epilepsy syndrome in South Indian children

    PubMed Central

    Patil, Sandeep B.; Roy, Arun Grace; Vinayan, Kollencheri Puthenveettil

    2016-01-01

    Purpose: To describe the clinical features and outcome of febrile infection-related epilepsy syndrome (FIRES), a catastrophic epileptic encephalopathy, in a cohort of South Indian children. Materials and Methods: We performed a retrospective chart review of a cohort of children with previously normal development who presented with status epilepticus or encephalopathy with recurrent seizures following a nonspecific febrile illness during the period between January 2007 and January 2012. They were divided into two groups super refractory status epilepticus (SRSE) and refractory status epilepticus (RSE) depending on the duration and severity of the seizures. Key Findings: Fifteen children who met the inclusion criteria were included for the final analysis. The age of the children at presentation ranged 3-15 years (median 6.3 years). All the children presented with prolonged or recurrent seizures occurring 1-12 days (median 4 days) after the onset of fever. Eight children had SRSE while seven children had refractory seizures with encephalopathy. Cerebrospinal fluid (CSF) analysis was done in all the children in the acute phase, and the cell count ranged 0-12 cells/μL (median 2 cells/μL) with normal sugar and protein levels. Initial neuroimaging done in all children (MRI in 10 and CT in 5), and it was normal in 13 children. Treatment modalities included multiple antiepileptic drugs (AEDs) (4-9 drugs) (median 5 drugs). Midazolam (MDZ) infusion was administered in seven patients. Eight patients required barbiturate coma to suppress the seizure activity. The duration of the barbiturate coma ranged 2-90 days (median 3 days). Steroids were used in 14 children and intravenous immunoglobulin (2 g/kg) in 7 children. Three children died in the acute phase. All children were maintained on multiple AEDs till the last follow-up, the number of AEDs ranged 1-6 (median 5 AEDs). The patients with super refractory status in the acute phase were found to be more severely disabled at

  20. Intestinal parasitic infection among children and neonatus admitted to Ibn-Sina Hospital, Sirt, Libya.

    PubMed

    Kasssem, Hamed H; Zaed, Hana Abdalsalam; Sadaga, Gazala A

    2007-08-01

    A total of 350 stool samples from 196 males and 154 female children and neonatus admitted in Ibn-Sina hospital, Sirt, were examined from June 2001 to May 2002, to determine the prevalence of intestinal parasites. Intestinal parasitic infections were identified in 196 (56%) of children and neonates. No intestinal helminthic parasites were detected but 13 intestinal protozoan parasites were detected. The most prevalent protozoan was Entamoeba histolytica /E. dispar (36.57%); Blastocystis hominis (12.57%), Giardia lamblia (10.29%), Isospora belli (3.14%) and Balantidium coli (0.86%), the latter was detected in non-Libyan children. The non-pathogenic ones were Entamoeba coli (15.14%), Endolimax nana (13.71%), Entamoeba hartmanni (4.29%), Chilomastix mesnilli (4.29%), Retortamonas intestinalis (3.43%), Dientamoeba fragilis (2%), Iodamoeba butschlii (0.86%) and Trichomonas hominis (0.86%). The result showed a significant difference exists between the prevalence of pathogenic and non-pathogenic protozoan parasites (P < 0.05). High prevalence of E. histolytica/ E. dispar followed by E. coli, E. nana, B. hominis and G. lamblia in both sexes of children, while the prevalence of other intestinal parasites were low in both sexes, significantly different existed in the prevalence of intestinal parasites between males and females children (t = 24.68; P < 0.05). Age groups had no effect on the prevalence of intestinal parasites (F = 0.66; P < 0.05). Significant differences existed in the prevalence between single and multiple infections with pathogenic protozoa. The socio-economic status of children parents revealed that high prevalence in children from medium socio-economic status. The family size had no significant effect on the prevalence of the intestinal parasites. PMID:17985574

  1. A Look at Kenya's Children.

    ERIC Educational Resources Information Center

    Roberson, Glenda F.; Muoki, Isaac Mulatya

    Focusing on the education of young children in Kenya, this brief paper contains excerpts from a question and answer interview between two early childhood educators from the United States and Kenya. Both similarities and differences of the Kenyan and the U.S. system of education are revealed. Interview topics covered include the following: socially…

  2. Human papillomavirus infections in children: the potential role of maternal transmission.

    PubMed

    Syrjänen, S; Puranen, M

    2000-01-01

    To date, more than 100 types of human papillomavirus (HPV) have been identified. In the past 20 years, there has been an increasing interest in HPVs because of their potential role in the pathogenesis of malignant tumors. HPV infections are known to affect predominantly adult, sexually active age groups, whereas skin warts, at various anatomic sites, are usually associated with younger individuals. The modes of viral transmission in children remain controversial, including perinatal transmission, auto- and hetero-inoculation, sexual abuse, and, possibly, indirect transmission via fomites. Recent studies on perinatal infection with HPV have been inconclusive. It is still unclear how frequently perinatal infection progresses to clinical lesions, whether genital, laryngeal, or oral. Conflicting reports have been published on the prevalence of HPV infections in children. The current consensus is, however, that newborn babies can be exposed to cervical HPV infection of the mother. The detection rate of HPV DNA in oral swabs of newborn babies varies from 4% to 87%. The concordance of HPV types detected in newborn babies and their mothers is in the range of 57% to 69%, indicating that the infants might acquire the HPV infection post-natally from a variety of sources. HPV antibodies have been detected in 10% to 57% of the children, and there is usually no correlation between seropositivity and the detection of HPV DNA in either the oral or the genital mucosa. There is also evidence that transmission in utero or post-natal acquisition is possible. The mode of in utero transmission remains unknown, but theoretically the virus could be acquired hematogenously, by semen at fertilization, or as an ascending infection in the mother. The understanding of viral transmission routes is important, particularly because several vaccination programs are being planned worldwide. The serologic response to HPV detected in different populations of young women or women at risk of cervical

  3. Complement abnormalities during an epidemic of group B meningococcal infection in children.

    PubMed Central

    Beatty, D W; Ryder, C R; Heese, H D

    1986-01-01

    During an epidemic of group B meningococcal infection mean values obtained in 96 consecutively affected children showed a reduction in classical pathway function (CH50), normal alternate pathway function (AP50), C4 and factor B levels, and raised C3 levels. CH50, C3 and Factor B were however significantly lower in those children who had a rapid onset of illness, were in shock, had signs of septicaemia, had extensive skin purpura, or who died. The presence of detectable meningococcal antigen by Counter Immuno Electrophoresis (CIE) and laboratory evidence of Disseminated Intravascular Coagulation (DIC) also correlated with lower complement levels. The significant reduction in CH50 and Factor B in the more severely affected patients suggests that activation of both classical and alternate pathways occurs in group B meningococcal infection. PMID:3491693

  4. Prevalence and risk factors for Giardia duodenalis infection among children: A case study in Portugal

    PubMed Central

    2012-01-01

    Background Giardia duodenalis is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate G. duodenalis infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon. Methods Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. Giardia infection was diagnosed by direct examination of stools and antigen detection by ELISA. Results The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years. The prevalence of Giardia infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for G. duodenalis infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of Helicobacter pylori infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93). Conclusion The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with Giardia prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between G

  5. Reduction in emergency department visits for children's asthma, ear infections, and respiratory infections after the introduction of state smoke-free legislation.

    PubMed

    Hawkins, Summer Sherburne; Hristakeva, Sylvia; Gottlieb, Mark; Baum, Christopher F

    2016-08-01

    Despite the benefits of smoke-free legislation on adult health, little is known about its impact on children's health. We examined the effects of tobacco control policies on the rate of emergency department (ED) visits for childhood asthma (N=128,807), ear infections (N=288,697), and respiratory infections (N=410,686) using outpatient ED visit data in Massachusetts (2001-2010), New Hampshire (2001-2009), and Vermont (2002-2010). We used negative binomial regression models to analyze the effect of state and local smoke-free legislation on ED visits for each health condition, controlling for cigarette taxes and health care reform legislation. We found no changes in the overall rate of ED visits for asthma, ear infections, and upper respiratory infections after the implementation of state or local smoke-free legislation or cigarette tax increases. However, an interaction with children's age revealed that among 10-17-year-olds state smoke-free legislation was associated with a 12% reduction in ED visits for asthma (adjusted incidence rate ratios (aIRR) 0.88; 95% CI 0.83, 0.95), an 8% reduction for ear infections (0.92; 0.88, 0.97), and a 9% reduction for upper respiratory infections (0.91; 0.87, 0.95). We found an overall 8% reduction in ED visits for lower respiratory infections after the implementation of state smoke-free legislation (0.92; 0.87, 0.96). The implementation of health care reform in Massachusetts was also associated with a 6-9% reduction in all children's ED visits for ear and upper respiratory infections. Our results suggest that state smoke-free legislation and health care reform may be effective interventions to improve children's health by reducing ED visits for asthma, ear infections, and respiratory infections. PMID:27283094

  6. Low to medium WU-virus titers in young children with lower respiratory tract infections.

    PubMed

    Kleines, Michael; Scheithauer, Simone; Hengst, Meike; Honnef, Dagmar; Ritter, Klaus; Mühler, Eberhard; Häusler, Martin; Rostamzadeh, Ayda

    2008-01-01

    The WU-virus (WUV), a novel polyomavirus, has recently been recovered from respiratory tract samples. Within a study collective of children with severe lower respiratory tract disease, 3% of the patients tested WUV positive. Viral loads ranged from 5 x 10(2) copies/ml to 1 x 10(4) copies/ml. The WUV genome-positive patients did not display specific clinical or radiological characteristics to be distinguished from other respiratory tract infections. PMID:19321930

  7. The Impact of HAART on Cardiomyopathy among Children and Adolescents Perinatally Infected with HIV-1

    PubMed Central

    Patel, Kunjal; van Dyke, Russell B.; Mittleman, Murray A.; Colan, Steven D.; Oleske, James M.; Seage, George R.

    2012-01-01

    Objective Previous studies of cardiomyopathy among children perinatally infected with HIV were conducted before the routine use of highly active antiretroviral therapy (HAART). Nucleoside analogues (NRTIs), the backbone of HAART, have been associated with mitochondrial toxicity, which can lead to cardiomyopathy. We evaluated the association of HAART and specific NRTIs associated with mitochondrial toxicity, on development of cardiomyopathy among perinatally HIV-infected children. Design 3,035 perinatally HIV-infected children enrolled in a US-based multicenter prospective cohort study, were followed for cardiomyopathy, defined as a clinical diagnosis or initiation of digoxin, from 1993–2007. Methods Cox models were used to estimate the effects of HAART and NRTIs on cardiomyopathy, identify predictors of cardiomyopathy among HAART users, and estimate the association between development of cardiomyopathy and mortality. Results 99 cases of cardiomyopathy were identified over follow-up (incidence rate: 5.6 cases per 1,000 person-years) at a median age of 9.4 years. HAART was associated with a 50% lower incidence of cardiomyopathy compared to no HAART use (95% confidence interval: 20%, 70%). Zalcitabine (ddC) use, however, was associated with an 80% higher incidence of cardiomyopathy. Among HAART users, older age at HAART initiation, ddC use before HAART initiation, initiating a HAART regimen containing zidovudine (ZDV), and a nadir CD4<15% were independently associated with a higher rate of cardiomyopathy. Cardiomyopathy was associated with a 6-fold higher mortality rate. Conclusions HAART has dramatically decreased the incidence of cardiomyopathy among perinatally HIV-infected children. However, they remain at increased risk for cardiomyopathy and ongoing ZDV exposure may increase this risk. PMID:22781228

  8. [Respiratory tract infections in children treated on an outpatient basis for a year].

    PubMed

    Karkowski, M K

    1993-09-01

    On the basis of doctor's work record an analysis was done of respiratory tract diseases in children treated in the Paediatric Division of the Regional outpatient Clinic of the Railway Health Service in Elblag in 1991. Respiratory tract infections accounted for 24.17% attendance (255.42% in July and 53.62% in March). Despite periodicity, high morbidity persisted over the whole year. PMID:7975596

  9. Immunoglobulin G subclass responses of children during infection with Onchocerca volvulus.

    PubMed Central

    Gbakima, A A; Nutman, T B; Bradley, J E; McReynolds, L A; Winget, M D; Hong, Y; Scott, A L

    1996-01-01

    To characterize the patterns of immunoglobulin G (IgG) subclass and IgE reactivity during the early stages of onchocerciasis, sera were collected from 224 children (age groups, 2 to 5, 6 to 10, and 11 to 15 years) residing in a region of Sierra Leone where Onchocerca volvulus is endemic, and these samples were tested by enzyme-linked immunosorbent assay for their reactivity to adult antigens (OvAg) and against four recombinant proteins (OV11, OV27, OV29, and OV16). Over 88% of the samples contained detectable levels of anti-OvAg IgG. In samples from microfilaria (MF)-positive children, IgG4 responses were significantly elevated and constituted on average 39, 35 and 28% of the total IgG responses for the age groups of 2 to 5, 6 to 10, and 11 to 15 years, respectively. For MF-negative individuals, the mean contributions of IgG4 to the total IgG response were 11% (2 to 5 years), 27% (6 to 10 years), and 56% (11 to 15 years). OvAg-specific IgE was detectable in the sera from both MF-negative and MF-positive individuals. To increase the specificity of the response, recombinant antigens OV11, OV27, and OV29 were tested individually or as a cocktail. Nearly 50% of the MF-negative children and 85% of the MF-positive children had detectable levels of IgG against at least one of the recombinant antigens. Only a small portion of the IgG against the recombinant peptides was IgG4. The prevalence of IgG against OV16 in samples from MF-negative children was 51%, and that for MF-positive children was 75%. The general profile of the humoral immune responses mounted by both MF-positive and a large percentage of the MF-negative children during the initial phases of infection with O. volvulus is similar to the profile reported for adults harboring chronic O. volvulus infections. These results suggest that very quickly after infection, the interactions between parasite and host result in an immunological environment that may contribute to the maintenance of a long-term, chronic

  10. Risk factors for baclofen pump infection in children: a multivariate analysis.

    PubMed

    Spader, Heather S; Bollo, Robert J; Bowers, Christian A; Riva-Cambrin, Jay

    2016-06-01

    OBJECTIVE Intrathecal baclofen infusion systems to manage severe spasticity and dystonia are associated with higher infection rates in children than in adults. Factors unique to this population, such as poor nutrition and physical limitations for pump placement, have been hypothesized as the reasons for this disparity. The authors assessed potential risk factors for infection in a multivariate analysis. METHODS Patients who underwent implantation of a programmable pump and intrathecal catheter for baclofen infusion at a single center between January 1, 2000, and March 1, 2012, were identified in this retrospective cohort study. The primary end point was infection. Potential risk factors investigated included preoperative (i.e., demographics, body mass index [BMI], gastrostomy tube, tracheostomy, previous spinal fusion), intraoperative (i.e., surgeon, antibiotics, pump size, catheter location), and postoperative (i.e., wound dehiscence, CSF leak, and number of revisions) factors. Univariate analysis was performed, and a multivariate logistic regression model was created to identify independent risk factors for infection. RESULTS A total of 254 patients were evaluated. The overall infection rate was 9.8%. Univariate analysis identified young age, shorter height, lower weight, dehiscence, CSF leak, and number of revisions within 6 months of pump placement as significantly associated with infection. Multivariate analysis identified young age, dehiscence, and number of revisions as independent risk factors for infection. CONCLUSIONS Young age, wound dehiscence, and number of revisions were independent risk factors for infection in this pediatric cohort. A low BMI and the presence of either a gastrostomy or tracheostomy were not associated with infection and may not be contraindications for this procedure. PMID:26919315

  11. Benefits of Disclosure of HIV Status to Infected Children and Adolescents: Perceptions of Caregivers and Health Care Providers.

    PubMed

    Gyamfi, Eric; Okyere, Paul; Appiah-Brempong, Emmanuel; Adjei, Rose Odotei; Mensah, Kofi Akohene

    2015-01-01

    The rate of disclosure of HIV status to infected children and adolescents remains low in developing countries. We used a mixed-method approach to determine the perceptions of caregivers and health care providers about the benefits of HIV status disclosure to infected children and adolescents and to assess the support needed by caregivers during disclosure. We recruited a convenience sample of 118 caregivers of HIV-infected children and adolescents for the quantitative component of the study and completed in-depth qualitative interviews with 10 purposefully sampled key informants, including health care providers and volunteer workers. The main benefits of disclosure included improved medication adherence and healthier, more responsible adolescent sexual behavior. The main supports required by caregivers during disclosure included biomedical information, emotional and psychological support, and practical guidelines regarding disclosure. We confirmed the importance of disclosure to HIV-infected children and adolescents and the need to develop culturally specific disclosure guidelines. PMID:26324523

  12. Evidence of Recombination and Genetic Diversity in Human Rhinoviruses in Children with Acute Respiratory Infection

    PubMed Central

    Ren, Peijun; Sheng, Jun; Yan, Huajie; Zhang, Jing; Lin, Xin; Wang, Yongjin; Delpeyroux, Francis; Deubel, Vincent

    2009-01-01

    Background Human rhinoviruses (HRVs) are a highly prevalent cause of acute respiratory infection in children. They are classified into at least three species, HRV-A, HRV-B and HRV-C, which are characterized by sequencing the 5′ untranslated region (UTR) or the VP4/VP2 region of the genome. Given the increased interest for novel HRV strain identification and their worldwide distribution, we have carried out clinical and molecular diagnosis of HRV strains in a 2-year study of children with acute respiratory infection visiting one district hospital in Shanghai. Methodology/Findings We cloned and sequenced a 924-nt fragment that covered part of the 5′UTR and the VP4/VP2 capsid genes. Sixty-four HRV-infected outpatients were diagnosed amongst 827 children with acute low respiratory tract infection. Two samples were co-infected with HRV-A and HRV-B or HRV-C. By comparative analysis of the VP4/VP2 sequences of the 66 HRVs, we showed a high diversity of strains in HRV-A and HRV-B species, and a prevalence of 51.5% of strains that belonged to the recently identified HRV-C species. When analyzing a fragment of the 5′ UTR, we characterized at least two subspecies of HRV-C: HRV-Cc, which clustered differently from HRV-A and HRV-B, and HRV-Ca, which resulted from previous recombination in this region with sequences related to HRV-A. The full-length sequence of one strain of each HRV-Ca and HRV-Cc subspecies was obtained for comparative analysis. We confirmed the close relationship of their structural proteins but showed apparent additional recombination events in the 2A gene and 3′UTR of the HRV-Ca strain. Double or triple infections with HRV-C and respiratory syncytial virus and/or bocavirus were diagnosed in 33.3% of the HRV-infected patients, but no correlation with severity of clinical outcome was observed. Conclusion Our study showed a high diversity of HRV strains that cause bronchitis and pneumonia in children. A predominance of HRV-C over HRV-A and HRV-B was

  13. Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure

    PubMed Central

    Malee, Kathleen M.; Tassiopoulos, Katherine; Huo, Yanling; Siberry, George; Williams, Paige L.; Hazra, Rohan; Smith, Renee A.; Allison, Susannah M.; Garvie, Patricia A.; Kammerer, Betsy; Kapetanovic, Suad; Nichols, Sharon; Van Dyke, Russell; Seage, George R.; Mellins, Claude A.

    2012-01-01

    Mental health problems (MHPs) among children with perinatal HIV infection have been described prior to and during the highly active antiretroviral therapy (HAART) era. Yet child, caregiver and socio-demographic factors associated with MHPs are not fully understood. We examined the prevalence of MHPs among older children and adolescents with perinatal HIV exposure, including both perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHEU) youth. Our aims were to identify the impact of HIV infection by comparing PHIV+ and PHEU youth and to delineate risk factors associated with MHPs, in order to inform development of appropriate prevention and intervention strategies. Youth and their caregivers were interviewed with the Behavior Assessment System for Children, 2nd edition (BASC-2) to estimate rates of at-risk and clinically significant MHPs, including caregiver-reported behavioral problems and youth-reported emotional problems. The prevalence of MHPs at the time of study entry was calculated for the group overall, as well as by HIV status and by demographic, child health, and caregiver characteristics. Logistic regression models were used to identify factors associated with youth MHPs. Among 416 youth enrolled between March 2007 and July 2009 (295 PHIV+, 121 PHEU), the overall prevalence of MHPs at entry was 29% and greater than expected based on recent national surveys of the general population. MHPs were more likely among PHEU than among PHIV+ children (38% versus 25%, p < 0.01). Factors associated with higher odds of MHPs at p < 0.10 included caregiver characteristics (psychiatric disorder, limit-setting problems, health-related functional limitations) and child characteristics (younger age and lower IQ). These findings suggest that PHEU children are at high risk for MHPs, yet current models of care for these youth may not support early diagnosis and treatment. Family-based prevention and intervention programs for HIV affected youth and

  14. Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure.

    PubMed

    Malee, Kathleen M; Tassiopoulos, Katherine; Huo, Yanling; Siberry, George; Williams, Paige L; Hazra, Rohan; Smith, Renee A; Allison, Susannah M; Garvie, Patricia A; Kammerer, Betsy; Kapetanovic, Suad; Nichols, Sharon; Van Dyke, Russell; Seage, George R; Mellins, Claude A

    2011-12-01

    Mental health problems (MHPs) among children with perinatal HIV infection have been described prior to and during the highly active antiretroviral therapy (HAART) era. Yet child, caregiver and socio-demographic factors associated with MHPs are not fully understood. We examined the prevalence of MHPs among older children and adolescents with perinatal HIV exposure, including both perinatally HIV-infected (PHIV +) and perinatally HIV-exposed but uninfected (PHEU) youth. Our aims were to identify the impact of HIV infection by comparing PHIV + and PHEU youth and to delineate risk factors associated with MHPs, in order to inform development of appropriate prevention and intervention strategies. Youth and their caregivers were interviewed with the Behavior Assessment System for Children, 2nd edition (BASC-2) to estimate rates of at-risk and clinically significant MHPs, including caregiver-reported behavioral problems and youth-reported emotional problems. The prevalence of MHPs at the time of study entry was calculated for the group overall, as well as by HIV status and by demographic, child health, and caregiver characteristics. Logistic regression models were used to identify factors associated with youth MHPs. Among 416 youth enrolled between March 2007 and July 2009 (295 PHIV +, 121 PHEU), the overall prevalence of MHPs at entry was 29% and greater than expected based on recent national surveys of the general population. MHPs were more likely among PHEU than among PHIV + children (38% versus 25%, p < 0.01). Factors associated with higher odds of MHPs at p < 0.10 included caregiver characteristics (psychiatric disorder, limit-setting problems, health-related functional limitations) and child characteristics (younger age and lower IQ). These findings suggest that PHEU children are at high risk for MHPs, yet current models of care for these youth may not support early diagnosis and treatment. Family-based prevention and intervention programs for HIV affected youth and

  15. Seroprevalence and Correlates of Hepatitis C Virus Infection in Secondary School Children in Enugu, Nigeria

    PubMed Central

    Eke, CB; Ogbodo, SO; Ukoha, OM; Muoneke, VU; Ibekwe, RC; Ikefuna, AN

    2016-01-01

    Background: Although children comprise a small fraction of the burden of hepatitis C virus (HCV) infections, which is a major global health challenge, a significant number of them develop chronic HCV infection and are at risk of its complications. Aim: The aim of the current study was to determine the prevalence and associated factors of HCV infection in school children in Enugu urban. Subjects and Methods: This was a cross-sectional seroepidemiological study involving children aged 10–18 years selected using multistage systematic sampling in Enugu metropolis, Southeast Nigeria. The anti-HCV was tested using a 3rd generation enzyme-linked immunosorbent assay. Data were analyzed using SPSS Version 16.0 with the level of significance set at P < 0.05. Results: Four hundred and twenty children were selected and screened comprising 210 (50.0%) males and females. The seroprevalence of anti-HCV was 4 (1.0%). Three (75%) out of the four positive cases for the anti-HCV were females while one was a male giving a male to female ratio of 0.3–1. Traditional scarifications/tattoos were the putative risk factors observed to be significantly associated with anti-HCV seropositivity. Conclusion: This study has demonstrated an anti-HCV seroprevalence of 1.0% among children aged 10–18 years in Enugu with traditional scarification as the predominant associated risk factor. Proper health education including school health education and promotion of behavioral change among the public on the practice of safe scarifications/tattoos should be encouraged in our setting. PMID:27398246

  16. Effect of Ascaris lumbricoides infection on T helper cell type 2 in rural Egyptian children.

    PubMed

    Shalaby, Naglaa M; Shalaby, Nehad M

    2016-01-01

    Ascaris lumbricoides is a neglected parasite that induces changes in host immune response. This study is conducted to define the serum levels of tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), and interleukin-5 (IL-5) in some Egyptian children and their relations to intensity of infection, age, and ascariasis symptoms. Stool samples were examined using formol-ether concentration and Kato-Katz thick smear techniques. Sera of 60 A. lumbricoides-infected children and 20 controls were tested by enzyme-linked immunosorbent assay. The mean sera concentrations of TNF-α, IL-4, and IL-5 were 7.41±2.5 pg/mL, 107.60±18.3 pg/mL, and 389.52±28.0 pg/mL, respectively. The controls had mean serum TNF-α 7.10±2.4 pg/mL, IL-4 25.49±2.6 pg/mL, and IL-5 88.76±22.7 pg/mL. The difference in the concentration of sera cytokines was statistically significant for IL-4 and IL-5 (P<0.01) between A. lumbricoides-infected children and controls. The intensity of infection correlated positively with IL-4 and IL-5 at r=0.959 and r=0.919, respectively. The concentrations of IL-4 and IL-5 correlated positively with the age at r=0.845 and r=0.934, respectively. Asthma and gastrointestinal tract upsets were correlated positively with IL-4 and IL-5. These data indicate that A. lumbricoides infection in our locality is associated with significantly high levels of IL-4 and IL-5. PMID:27022269

  17. Infective endocarditis in Ethiopian children: a hospital based review of cases in Addis Ababa

    PubMed Central

    Moges, Tamirat; Gedlu, Etsegenet; Isaakidis, Petros; Kumar, Ajay; Van Den Berge, Rafael; Khogali, Mohammed; Mekasha, Amha; Hinderaker, Sven Gudmund

    2015-01-01

    Introduction Infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. Methods This was a retrospective review of routinely collected data from patient records. Results A total of 40 children (71% female) with 41 episodes of infective endocarditis admitted to a general paediatric ward in Addis Ababa, Ethiopia between 2008 and 2013. Age ranged from 7 months to 14 years, with a median of 9 years (Inter quartile Range: 7-12 years). Rheumatic and congenital heart diseases were underlying risk factors in 49% and 51% of cases respectively. Congestive heart failure, systemic embolization and death occurred in 66%, 12% and 7.3% respectively. Death was associated with the occurrence of systemic embolization (P-value = 0.03). Conclusion Rheumatic heart disease was an important predisposing factor for infective endocarditis in Ethiopian children. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure. A low rate of clinically evident systemic embolization in this study may be a reflection of the diagnostic challenges. High proportion of prior antibiotic intake might explain the cause of significant BCNE. Preventive measures like primary and secondary prophylaxis of rheumatic fever may decrease the associated morbidity and mortality. Early detection and referral of cases, awareness creation about indiscriminate use of antimicrobials, and proper history taking and documentation of information recommended. PMID:26090033

  18. Clinical Experience with Daptomycin for the Treatment of Gram-positive Infections in Children and Adolescents

    PubMed Central

    Syriopoulou, Vassiliki; Dailiana, Zoe; Dmitriy, Nisichenko; Utili, Riccardo; Pathan, Rashidkhan

    2016-01-01

    Background: This subgroup analysis of the European Cubicin Outcomes Registry Experience evaluated the safety and effectiveness of daptomycin in children and adolescent patients (<18 years). Methods: Clinical outcomes at the end of therapy were assessed as success (cured or improved), failure or nonevaluable. Safety was assessed for up to 30 days post treatment. Results: Eighty-one children and adolescent patients were included in this study. The most common primary infections were bacteremia (19.8%), complicated skin and soft-tissue infection (18.5%), osteomyelitis (13.6%), endocarditis (12.3%), foreign body/prosthetic infection (12.3%), uncomplicated skin and soft-tissue infection (9.9%) and other (13.6%). Daptomycin doses ranged from 4 to >10 mg/kg/day. Median duration of therapy was 12.5 (interquartile range, 7–25; mean, 16.7; standard deviation, 12.8) days. Staphylococcus aureus (46.7%) was the most commonly isolated pathogen (23.8% methicillin-resistant S. aureus). Forty-nine (60.5%) patients completed daptomycin therapy without further antibiotics, 27 (33.3%) switched to another antibiotic, 4 (4.9%) discontinued because of adverse events (AEs) and 1 (1.2%) discontinued because of other reason. Overall, 75 (92.6%; 95% confidence interval: 95.2–100.0%) patients achieved clinical success; 39 of 41 (95.1%) patients receiving daptomycin monotherapy and 36 of 40 (90.0%) patients receiving concomitant antibiotics. Six (7.4%) patients reported AEs, including 1 patient with increased blood creatine phosphokinase. Three (3.7%) patients had serious AEs; 1 (1.2%) had a serious AE possibly related to daptomycin. Conclusion: Daptomycin, alone or combined with other antibiotics and/or surgery, demonstrated high clinical success rates against a wide variety of infections and was well tolerated in children and adolescents. PMID:26849158

  19. Effect of Ascaris lumbricoides infection on T helper cell type 2 in rural Egyptian children

    PubMed Central

    Shalaby, Naglaa M; Shalaby, Nehad M

    2016-01-01

    Ascaris lumbricoides is a neglected parasite that induces changes in host immune response. This study is conducted to define the serum levels of tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), and interleukin-5 (IL-5) in some Egyptian children and their relations to intensity of infection, age, and ascariasis symptoms. Stool samples were examined using formol-ether concentration and Kato-Katz thick smear techniques. Sera of 60 A. lumbricoides-infected children and 20 controls were tested by enzyme-linked immunosorbent assay. The mean sera concentrations of TNF-α, IL-4, and IL-5 were 7.41±2.5 pg/mL, 107.60±18.3 pg/mL, and 389.52±28.0 pg/mL, respectively. The controls had mean serum TNF-α 7.10±2.4 pg/mL, IL-4 25.49±2.6 pg/mL, and IL-5 88.76±22.7 pg/mL. The difference in the concentration of sera cytokines was statistically significant for IL-4 and IL-5 (P<0.01) between A. lumbricoides-infected children and controls. The intensity of infection correlated positively with IL-4 and IL-5 at r=0.959 and r=0.919, respectively. The concentrations of IL-4 and IL-5 correlated positively with the age at r=0.845 and r=0.934, respectively. Asthma and gastrointestinal tract upsets were correlated positively with IL-4 and IL-5. These data indicate that A. lumbricoides infection in our locality is associated with significantly high levels of IL-4 and IL-5. PMID:27022269

  20. Altered representation of naive and memory CD8 T cell subsets in HIV-infected children.

    PubMed Central

    Rabin, R L; Roederer, M; Maldonado, Y; Petru, A; Herzenberg, L A; Herzenberg, L A

    1995-01-01

    CD8 T cells are divided into naive and memory subsets according to both function and phenotype. In HIV-negative children, the naive subset is present at high frequencies, whereas memory cells are virtually absent. Previous studies have shown that the overall number of CD8 T cells does not decrease in HIV-infected children. In studies here, we use multiparameter flow cytometry to distinguish naive from memory CD8 T cells based on expression of CD11a, CD45RA, and CD62L. With this methodology, we show that within the CD8 T cell population, the naive subset decreases markedly (HIV+ vs. HIV-, 190 vs. 370 cells/microliter; P < or = 0.003), and that there is a reciprocal increase in memory cells, such that the total CD8 T cell counts remained unchanged (800 vs. 860 cells/microliter; P < or = 0.76). In addition, we show that for HIV-infected children, the naive CD8 T cell and total CD4 T cell counts correlate (chi 2 P < or = 0.001). This correlated loss suggests that the loss of naive CD8 T cells in HIV infection may contribute to the defects in cell-mediated immunity which become progressively worse as the HIV disease progresses and CD4 counts decrease. Images PMID:7738172

  1. Status of Intestinal Parasitic Infections among Primary School Children in Rivers State, Nigeria.

    PubMed

    Abah, A E; Arene, F O I

    2015-01-01

    Status of intestinal parasitic infections among primary school children in Rivers State, Nigeria, was investigated between January and December 2011. A total of 3,826 stool samples were collected from school children (1,828 males and 1998 females) in 36 primary schools from 13 local government areas of Rivers State. The samples were analyzed using wet saline/iodine and formol ether concentration methods. Of the 3,826 stool samples examined, 1059 (27.66%) were positive for different intestinal parasites, namely, Ascaris lumbricoides (51.78%), hookworm sp. (25.0%), Trichuris trichiura (15.18%), Strongyloides stercoralis (7.14%), Taenia sp. (0.89%), and Enterobius vermicularis (0.01%). The prevalence of the infection was generally higher in males (57.60%) than females (42.40%). The differences were not statistically significant (P > 0.05). Among these intestinal parasites, Ascaris lumbricoides, hookworm sp., and Trichuris trichiura were found in all the 13 local government areas studied while Strongyloides stercoralis was found in 12, Taenia sp. in five, and Enterobius vermicularis in only one community in Ahoada Local Government Area. The overall infection rate remains high and would require coordinated deworming of the school children within the state. PMID:26600945

  2. Severe Anemia and Helicobacter Pylori Infection in school age Children; A case reports

    PubMed Central

    Gheibi, Sh; Noroozi, M; Hejazi, S; Karamyyar, M; Farrokh-Eslamlou, H

    2016-01-01

    Background Iron-deficiency anemia is a widespread public health problem with major consequences for human health especially, children. However, in a fraction of patients an underlying cause is never found during routine investigation. Recent studies have suggested an association between Helicobacter pylori (H. Pylori) infection and iron-deficiency anemia. Case presentation Here is reported four school aged children (two male, two female) with refractory severe iron-deficiency anemia associated H. Pylori gastritis. Mean age of the patients was 13.62 years old and they were admitted with chief complaints of abdominal, chest pain weakness, headache and respiratory distress. Mean hemoglobin level in patients was 6.2 g/dl with persistence to iron therapy. After the diagnosis and therapy of H. pylori infection, clinical complaints, hemoglobin level and iron profiles were being normal and they gained weight. Conclusion This study suggests screening of H. pylori infection and appropriate treatment in any case of refractory moderate to severe iron-deficiency anemia, especially with clinical manifestations of gastrointestinal tract in children. PMID:27222704

  3. Status of Intestinal Parasitic Infections among Primary School Children in Rivers State, Nigeria

    PubMed Central

    Abah, A. E.; Arene, F. O. I.

    2015-01-01

    Status of intestinal parasitic infections among primary school children in Rivers State, Nigeria, was investigated between January and December 2011. A total of 3,826 stool samples were collected from school children (1,828 males and 1998 females) in 36 primary schools from 13 local government areas of Rivers State. The samples were analyzed using wet saline/iodine and formol ether concentration methods. Of the 3,826 stool samples examined, 1059 (27.66%) were positive for different intestinal parasites, namely, Ascaris lumbricoides (51.78%), hookworm sp. (25.0%), Trichuris trichiura (15.18%), Strongyloides stercoralis (7.14%), Taenia sp. (0.89%), and Enterobius vermicularis (0.01%). The prevalence of the infection was generally higher in males (57.60%) than females (42.40%). The differences were not statistically significant (P > 0.05). Among these intestinal parasites, Ascaris lumbricoides, hookworm sp., and Trichuris trichiura were found in all the 13 local government areas studied while Strongyloides stercoralis was found in 12, Taenia sp. in five, and Enterobius vermicularis in only one community in Ahoada Local Government Area. The overall infection rate remains high and would require coordinated deworming of the school children within the state. PMID:26600945

  4. Patterns of Disclosure of HIV- Status to Infected Children in a Sub-Saharan African Setting

    PubMed Central

    Vaz, Lara M. E.; Maman, Suzanne; Eng, Eugenia; Barbarin, Oscar A.; Tshikandu, Tomi; Behets, Frieda

    2011-01-01

    Objective Adult caregivers provide children living with HIV with varying amounts and types of information about their health status that may affect their coping and health care behaviors. We aimed to describe patterns of information-sharing with children and thoughts around disclosure among caregivers in the Democratic Republic of the Congo. Methods 259 primary caregivers of children 5–17 years old in an HIV pediatric care and treatment program were screened; 8 adult caregivers (3%) had informed their child of the child’s HIV status. We conducted structured interviews with 201 caregivers whose children had not yet been told their HIV status. Results Nearly 50% of caregivers provided no information to their child about their health; 15% had given partial information without mentioning HIV, and 33% provided information that deflected attention from HIV, whether deliberately so or otherwise. Almost all caregivers said that the child should be told their status some day, and three-fourths reported having ever thought about what might lead them to tell. However, nearly one-third of caregivers saw no benefits to informing the child of her/his HIV status. A majority of caregivers felt that they themselves were the best to eventually disclose to the child, but some wanted support from health care providers. Conclusion HIV-infected children are given limited information about their health. Health care providers may serve as important sources of support to caregivers as they decide when and how to talk candidly with their children about their health. PMID:21317803

  5. Experience With Nosocomial Infection in Children Under 5 Treated in an Urban Diarrheal Treatment Center in Bangladesh

    PubMed Central

    Shahunja, K. M.; Ahmed, Tahmeed; Faruque, Abu Syeed Golam; Shahid, Abu Sadat Mohammad Sayeem Bin; Das, Sumon Kumar; Shahrin, Lubaba; Hossain, Md Iqbal; Islam, Md Munirul; Chisti, Mohammod Jobayer

    2016-01-01

    We aimed to evaluate the factors associated with nosocomial infections (NIs) in under-5 children and in bacterial isolates from their blood, urine, and stool. We reviewed all under-5 hospitalized children with clinically diagnosed NIs in the inpatient ward at Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, between January and December 2012. Comparison was made among the children with (cases = 71) and without NI (controls = 142). NI was defined as the development of new infection 48 hours after admission. Bacterial isolates in urine, blood, and stool were found in 11/52 (21%), 9/69 (13%), and 2/16 (12%) respectively. In logistic regression analysis, the children with NI were independently associated with severe acute malnutrition, congenital anomaly, invasive diarrhea, urinary tract infection on admission, and use of intravenous cannula during hospitalization. Thus, identification of these simple clinical parameters may help in preventive measures being taken to reduce the rate of NIs in such children. PMID:27336005

  6. Experience With Nosocomial Infection in Children Under 5 Treated in an Urban Diarrheal Treatment Center in Bangladesh.

    PubMed

    Shahunja, K M; Ahmed, Tahmeed; Faruque, Abu Syeed Golam; Shahid, Abu Sadat Mohammad Sayeem Bin; Das, Sumon Kumar; Shahrin, Lubaba; Hossain, Md Iqbal; Islam, Md Munirul; Chisti, Mohammod Jobayer

    2016-01-01

    We aimed to evaluate the factors associated with nosocomial infections (NIs) in under-5 children and in bacterial isolates from their blood, urine, and stool. We reviewed all under-5 hospitalized children with clinically diagnosed NIs in the inpatient ward at Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, between January and December 2012. Comparison was made among the children with (cases = 71) and without NI (controls = 142). NI was defined as the development of new infection 48 hours after admission. Bacterial isolates in urine, blood, and stool were found in 11/52 (21%), 9/69 (13%), and 2/16 (12%) respectively. In logistic regression analysis, the children with NI were independently associated with severe acute malnutrition, congenital anomaly, invasive diarrhea, urinary tract infection on admission, and use of intravenous cannula during hospitalization. Thus, identification of these simple clinical parameters may help in preventive measures being taken to reduce the rate of NIs in such children. PMID:27336005

  7. Cytomegalovirus infection in children with Down syndrome in a day-care center in Brazil.

    PubMed

    do Canto, C L; Granato, C F; Garcez, E; Villas Boas, L S; Fink, M C; Estevam, M P; Pannuti, C S

    2000-01-01

    This study evaluates the transmission of CMV infection in 120 children aged 1 to 15 years with Down syndrome who attended a day-care center for handicapped children in São Paulo, Brazil. A blood sample was obtained from each children at the beginning of the study for detection of IgG and IgM cytomegalovirus (CMV) antibodies by an immunofluorescence assay. Samples of saliva and urine were obtained every 3 months from the children with CMV antibodies to detect shedding of the virus by culture in human foreskin fibroblasts, by detection of pp65 CMV-antigen and by a nested PCR assay. The prevalence of anti CMV-IgG antibodies was 76.6% (92/120), and IgM anti-CMV antibodies were detected in 13% (12/92) of the seropositive children. During the first viral evaluation, CMV was detected in the urine and/or saliva in 39/90 (43.3%) of the seropositive children. In the second and third evaluations, CMV was detected in 41/89 (46%) and in 35/89 (39.3%) children, respectively. Detection of CMV was shown both in urine and saliva in 28/39 (71.8%), 19/41(46.3%) and 20/35 (57.1%) of the children excreting the virus, respectively. Additionally, in 3(3/4)9 (67.4%) of the excreters CMV could be demonstrated in urine or saliva in at least two out of the three virological evaluations carried out sequentially in a six month period. Of the 28 initially seronegative children, 26 were re-examined for anti-CMV IgG antibodies about 18 months after the negative sample; seroconversion was found in 10/26 (38.5%). Taking all 536 samples of urine or saliva examined by virus culture and pp65 antigen detection during the study into account, 159 (29.6%) were positive by virus culture and 59 (11%) gave a positive result with the pp65 assay. These data demonstrate the high prevalence of CMV shedding and the high risk of CMV infection in children with Down syndrome attending a day-care center for mentally handicapped patients. The virus culture was more sensitive than the pp65 CMV antigen assay for CMV

  8. Progress in Treatment of Viral Infections in Children with Acute Lymphoblastic Leukemia

    PubMed Central

    Moschovi, Maria; Adamaki, Maria; Vlahopoulos, Spiros A.

    2016-01-01

    In children, the most commonly encountered type of leukemia is acute lymphoblastic leukemia (ALL). An important source of morbidity and mortality in ALL are viral infections. Even though allogeneic transplantations, which are often applied also in ALL, carry a recognized risk for viral infections, there are multiple factors that make ALL patients susceptible to viral infections. The presence of those factors has an influence in the type and severity of infections. Currently available treatment options do not guarantee a positive outcome for every case of viral infection in ALL, without significant side effects. Side effects can have very serious consequences for the ALL patients, which include nephrotoxicity. For this reason a number of strategies for personalized intervention have been already clinically tested, and experimental approaches are being developed. Adoptive immunotherapy, which entails administration of ex vivo grown immune cells to a patient, is a promising approach in general, and for transplant recipients in particular. The ex vivo grown cells are aimed to strengthen the immune response to the virus that has been identified in the patients’ blood and tissue samples. Even though many patients with weakened immune system can benefit from progress in novel approaches, a viral infection still poses a very significant risk for many patients. Therefore, preventive measures and supportive care are very important for ALL patients. PMID:27471584

  9. Meta-analysis of the Prevalence of Helicobacter Pylori Infection among Children and Adults of Iran

    PubMed Central

    Moosazadeh, Mahmood; Lankarani, Kamran B.; Afshari, Mahdi

    2016-01-01

    Helicobacter pylori infection is a common health problem related to many gastrointestinal disorders. This study aims to estimate the total and age specific prevalence of Helicobacter Pylori infection in Iran. We systematically reviewed all national and international databases and finally identified 21 studies were eligible for meta-analysis. Each of them were assigned a quality score using STROBE checklist. Due to significant heterogeneity of the results, random effects model was used to estimate the pooled prevalence and 95% confidence interval of Helicobacter Pylori infection. All statistical analyses were performed using STATA. V11 software. The pooled prevalence (95% confidence interval) of Helicobacter Pylori infection among all population, children and adults were estimated as 54% (53%- 55%), 42% (41%- 44%) and 62% (61%- 64%) respectively. Helicobacter Pylori, has infected more than half of Iranian people during the last decade. Preventive strategies as well as taking into account this infection during clinical visits should be emphasized to reduce its transmission and prevalence within the community. PMID:27076886

  10. Increase of malaria attacks among children presenting concomitant infection by Schistosoma mansoni in Senegal

    PubMed Central

    Sokhna, Cheikh; Le Hesran, Jean-Yves; Mbaye, Pape A; Akiana, Jean; Camara, Pape; Diop, Mamadou; Ly, Abdoulaye; Druilhe, Pierre

    2004-01-01

    Helminthic infections concomitant with malaria are common in inter-tropical areas. A recent study showed that mice co-infected with Schistosoma mansoni and Plasmodium chabaudi develop higher P. chabaudi parasitaemia and had a higher mortality rate. This important observation deserved to be further investigated among human populations. Malaria attacks were recorded in 512 children aged 6–15 years living in Richard Toll (Northern Senegal) among whom 336 were infected by S. mansoni, and 175 were not. The incidence rate of malaria attacks was significantly higher among S. mansoni-infected individuals, particularly those carrying the highest worm loads, as compared to uninfected subjects (26.6% versus 16,4 %). In contrast, the rate of malaria attacks was lower, without reaching significance, in medium grade S. mansoni infections. Thus, infection by S. mansoni affects susceptibility to malaria, but this can vary according to the intensity of parasite load. The immunological mechanisms underlying this dual effect need to be further explored. PMID:15544703

  11. Rapid Diagnostic Tests for Dengue Virus Infection in Febrile Cambodian Children: Diagnostic Accuracy and Incorporation into Diagnostic Algorithms

    PubMed Central

    Carter, Michael J.; Emary, Kate R.; Moore, Catherine E.; Parry, Christopher M.; Sona, Soeng; Putchhat, Hor; Reaksmey, Sin; Chanpheaktra, Ngoun; Stoesser, Nicole; Dobson, Andrew D. M.; Day, Nicholas P. J.; Kumar, Varun; Blacksell, Stuart D.

    2015-01-01

    Background Dengue virus (DENV) infection is prevalent across tropical regions and may cause severe disease. Early diagnosis may improve supportive care. We prospectively assessed the Standard Diagnostics (Korea) BIOLINE Dengue Duo DENV rapid diagnostic test (RDT) to NS1 antigen and anti-DENV IgM (NS1 and IgM) in children in Cambodia, with the aim of improving the diagnosis of DENV infection. Methodology and principal findings We enrolled children admitted to hospital with non-localised febrile illnesses during the 5-month DENV transmission season. Clinical and laboratory variables, and DENV RDT results were recorded at admission. Children had blood culture and serological and molecular tests for common local pathogens, including reference laboratory DENV NS1 antigen and IgM assays. 337 children were admitted with non-localised febrile illness over 5 months. 71 (21%) had DENV infection (reference assay positive). Sensitivity was 58%, and specificity 85% for RDT NS1 and IgM combined. Conditional inference framework analysis showed the additional value of platelet and white cell counts for diagnosis of DENV infection. Variables associated with diagnosis of DENV infection were not associated with critical care admission (70 children, 21%) or mortality (19 children, 6%). Known causes of mortality were melioidosis (4), other sepsis (5), and malignancy (1). 22 (27%) children with a positive DENV RDT had a treatable other infection. Conclusions The DENV RDT had low sensitivity for the diagnosis of DENV infection. The high co-prevalence of infections in our cohort indicates the need for a broad microbiological assessment of non-localised febrile illness in these children. PMID:25710684

  12. Update on recent guidelines for the management of urinary tract infections in children: the shifting paradigm

    PubMed Central

    Paintsil, Elijah

    2016-01-01

    Purpose of review Recent guidelines on the management of urinary tract infections (UTIs) in children have seen a shift from aggressive imaging studies and the use of prophylactic antibiotics to a more restrictive and targeted approach. This review focuses on new additions to the literature on management of UTI from January 2011 to September 2012. Recent findings The causal relationship between UTI–vesicoureteral reflux (VUR) and renal scarring has been challenged by several studies. Concerns about unnecessary exposure to ionizing radiation, invasiveness of some of the procedures, and risk of infection have also been raised. With improved prenatal ultrasound, a ‘top-down’ approach to investigating febrile UTI in children using renal bladder ultrasound alone as an initial study has become popular. Several studies have reported that prophylactic antibiotics and imaging studies after first UTI can be reduced substantially without affecting the risk of recurrent UTI or renal scarring. Summary The use of targeted imaging approach in evaluating febrile UTI in children may lead to improved resource use and reduction of potential harmful procedures and interventions, without affecting outcomes of UTI in children. Providers using current guidelines should endeavor to collect practice-based evidence to validate and inform future guidelines. PMID:23241875

  13. Clinical indicators of ineffective airway clearance in children with acute respiratory infection.

    PubMed

    Pascoal, Livia Maia; Lopes, Marcos Venícios de Oliveira; da Silva, Viviane Martins; Beltrão, Beatriz Amorim; Chaves, Daniel Bruno Resende; Herdman, T Heather; Lira, Ana Luisa Brandão de Carvalho; Teixeira, Iane Ximenes; Costa, Alice Gabrielle de Sousa

    2016-09-01

    The identification of clinical indicators with good predictive ability allows the nurse to minimize the existing variability in clinical situations presented by the patient and to accurately identify the nursing diagnosis, which represents the true clinical condition. The purpose of this study was to analyze the accuracy of NANDA-I clinical indicators of the nursing diagnosis ineffective airway clearance (IAC) in children with acute respiratory infection. This was a prospective cohort study conducted with a group of 136 children and followed for a period of time ranging from 6 to 10 consecutive days. For data analysis, the measures of accuracy were calculated for clinical indicators, which presented statistical significance in a generalized estimated equation model. IAC was present in 91.9% of children in the first assessment. Adventitious breath sounds presented the best measure of accuracy. Ineffective cough presented a high value of sensitivity. Changes in respiratory rate, wide-eyed, diminished breath sounds, and difficulty vocalizing presented high positive predictive values. In conclusion, adventitious breath sounds showed the best predictive ability to diagnose IAC in children with respiratory acute infection. PMID:26311487

  14. Study on Rotavirus Infection and Its Genotyping in Children Below 5 Years in South West Iran

    PubMed Central

    Azaran, Azarakhsh; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Neisi, Niloofar; Hoseinzadeh, Mohsen; Rasti, Mojtaba; Teymurirad, Majid; Teimoori, Ali; Varnaseri, Mehran; Makvandi, Kamyar

    2016-01-01

    Background Human rotaviruses are the most important agents for severe dehydrating diarrhea in children below 5 years old. Rotaviruses (RV) is a serious public health problem in developing and developed countries. Objectives The aim of this study was to determine the prevalence of rotavirus infection and their genotypes in children younger than 5 years of age with acute diarrhea in Ahvaz, Iran. Materials and Methods For this study, 200 stool samples from children below 5 years of age with acute diarrhea were collected between October 2011 and March 2012. Initially all stool samples were tested for rotavirus antigen by ELISA, and positive samples were confirmed by RT-PCR targeting the VP6 rotavirus gene. Determination of rotavirus genotypes was carried out by performing RT-PCR for G and P types. Altogether, 15 samples were sequenced. Results Out of 200 stool samples, 100 (50%) had rotavirus antigen detected by ELISA and 73 (36.5%) were found positive by RT-PCR. Of the rotavirus strains identified, only 63 (86.3%) were positive for both VP7 and VP4 while 10 (13.7%) strains were found nontypeable. Rotavirus infection accounts for 36.5% of gastroenteritis cases in samples from symptomatic children. The most prevalent rotavirus genotypes were G1P [8] (80%) followed by G2P [4] (20%). Conclusions Our results suggest that group A rotavirus is a major pathogene of acute diarrhea in Ahvaz city. The genotypes circulating are similar with those of other countries. PMID:27307959

  15. Haemoglobin concentrations and infection by Giardia intestinalis in children: effect of treatment with secnidazole.

    PubMed

    Jiménez, J C; Rodríguez, N; Di Prisco, M C; Lynch, N R; Costa, V

    1999-12-01

    The blood concentrations of haemoglobin were investigated in 82 children aged 2-9 years. Fifty-seven (31 boys and 26 girls) were stool-positive for Giardia intestinalis but the other 25, used as controls, were negative. The mean (S.D.) haemoglobin concentration among the infected children was significantly lower pre-treatment than that for the control group [11.6 (1.2) v. 12.6 (1.5) g/dl; P < 0.05]. Treatment of the infected children with a single oral dose of secnidazole (30 mg/kg) led to a significant increase in their mean haemoglobin level 15 days later, from 11.6 (1.2) g/dl pre-treatment to 12.4 (1.2) g/dl post-treatment (P < 0.05). The results indicate that the therapeutic control of giardiasis could be important in programmes to combat anaemia in children living in endemic areas. PMID:10715676

  16. Reliable Detection of Respiratory Syncytial Virus Infection in Children for Adequate Hospital Infection Control Management

    PubMed Central

    Abels, Susanne; Nadal, David; Stroehle, Angelika; Bossart, Walter

    2001-01-01

    By using a rapid test for respiratory syncytial virus (RSV) detection (Abbott TestPack RSV), a number of patients were observed, showing repeatedly positive results over a period of up to 10 weeks. A prospective study was initiated to compare the rapid test with an antigen capture enzyme immunoassay (EIA) and a nested reverse transcriptase PCR (RT-PCR) protocol for detection of RSV serotypes A and B. Only respiratory samples from children exhibiting the prolonged presence of RSV (≥5 days) as determined by the rapid test were considered. A total of 134 specimens from 24 children was investigated by antigen capture EIA and nested RT-PCR. Using RT-PCR as the reference method, we determined the RSV rapid test to have a specificity of 63% and a sensitivity of 66% and the antigen capture EIA to have a specificity of 96% and a sensitivity of 69% for acute-phase samples and the homologous virus serotype A. In 7 (29%) of 24 patients, the positive results of the RSV rapid test could not be confirmed by either nested RT-PCR or antigen capture EIA. In these seven patients a variety of other respiratory viruses were detected. For general screening the RSV rapid test was found to be a reasonable tool to get quick results. However, its lack of specificity in some patients requires confirmation by additional tests to rule out false-positive results and/or detection of other respiratory viruses. PMID:11526141

  17. Prevalence of intestinal parasitic infection among children from a shanty town in Tucuman, Argentina.

    PubMed

    Dib, J R; Fernández-Zenoff, M V; Oquilla, J; Lazarte, S; González, S N

    2015-06-01

    A parasitological survey was conducted in children living in a poor area next to a drainage channel, in Tucumán province, Argentina. Stool specimens from 115 children were collected and samples were analyzed by direct microscopy examination and concentration techniques. The prevalence rate of intestinal parasites infection was high (78.3%) and Blastocystis hominis was the most frequent protozoan parasite found (68.9%) followed by Giardia intestinalis (33.3%), Entamoeba coli (24.4%), Endolimax nana (12.2%), Chilomastix mesnili (5.6%) and Iodamoeba bütschlii (2.2%). Ascaris lumbricoides was the most prevalent intestinal helminth, with an infection frequency of 38.9%, followed by Trichuris trichiura (13.3%), Strongyloides stercoralis (13.3%), Hymenolepis nana (7.8%) and Enterobius vermicularis (3.3%). Multiple parasitic infections were also high, affecting 71.1% of infected population. These results indicate that sanitary policies, including health care and sanitary education have been inadequate for the control of intestinal parasitism in this high-risk population. Implementation of sanitation programs is a basic need and a joint collaboration between public servant and health professionals should be a priority. PMID:26691248

  18. The one-film urogram in urinary tract infection in children

    SciTech Connect

    Leonidas, J.C.; Schwartz, R.; Schwartz, A.M.; McCauley, R.G.; Darling, D.B.

    1983-07-01

    The sensitivity and specificity of the 5 min postinjection radiograph during urography were studied in 131 children. The 5 min film was overall accurate in 83.2%, with a 56% sensitivity and 91.3% specificity in patients with urinary tract infection (n = 62). In cases in which the 5 min film was not diagostic, it nevertheless raised enough suspicions to dictate additional films. It is suggested that in urinary tract infection, errors will not be made if the single 5 min postinjection film is reviewed and additional films are obtained only if parts of the urinary tract are incompletely visualized or appear questionable. Further study is necessary to explore the merits of a similar approach for pediatric urography unrelated to urinary tract infection.

  19. The pattern of mucocutaneous disorders in HIV – infected children attending care and treatment centres in Dar es Salaam, Tanzania

    PubMed Central

    Panya, Millembe F; Mgonda, Yassin M; Massawe, Augustine W

    2009-01-01

    Background HIV/AIDS is associated with a wide range of mucocutaneous disorders some of which are useful in the clinical staging and prognosis of the syndrome. There is paucity of information regarding the prevalence and pattern of mucocutaneous disorders among HIV infected children attending paediatric Care and Treatment Centres (CTC) in Dar es Salaam. Objective To determine the prevalence and pattern of mucocutaneous disorders among HIV infected children attending public paediatric 'Care and Treatment Centres' in Dar es Salaam. Methods This was a cross sectional descriptive study involving public paediatric 'Care and Treatment Centres' in Dar es Salaam. Clinical information was obtained using a questionnaire. Dermatological examination was carried out in daylight. Investigations were taken as appropriate. Data was analysed using the Statistical Package for Social Sciences (SPSS) program version 10.0. Chi-squared and Fisher's exact tests were utilized. A p-value of less than 0.05 was considered statistically significant. Results Three hundred and forty seven HIV infected children (52% males) attending CTCs were recruited into the study. Mucocutaneous disorders were encountered in 85% of them. There was no gender difference in the prevalence of the infective mucocutaneous disorders but males had a higher prevalence of non-infective/inflammatory dermatoses (58%) than females (42%) (p = 0.02). Overall, mucocutaneous disorders (infective + non infective) were more prevalent in advanced stages of HIV disease. Children with advanced HIV disease had a significantly increased frequency of fungal and viral infections (43% and 25% respectively than those with less advanced disease; 24% and 13% respectively (p = 0.01). Seventy four percent of the HIV-infected children with mucocutaneous disorders were already on ART. Conclusion Mucocutaneous disorders among HIV infected children attending Care and Treatment Centres are common and highly variable. Comprehensive management

  20. Pneumonia associated with infection with pneumocystis, respiratory syncytial virus, chlamydia, mycoplasma, and cytomegalovirus in children in Papua New Guinea.

    PubMed Central

    Shann, F; Walters, S; Pifer, L L; Graham, D M; Jack, I; Uren, E; Birch, D; Stallman, N D

    1986-01-01

    Paired serum samples were collected from 94 children with pneumonia admitted to Goroka Hospital, Papua New Guinea. All but three of the children were aged 1-24 months. Only nine children were malnourished, with weight for age less than 70% of the Harvard median (three had weight for age less than 60% of the Harvard median). Pneumocystis carinii antigen was detected in the serum of 23 children. Twenty two children had serological evidence of recent infection with respiratory syncytial virus. Five children were probably infected with Chlamydia trachomatis at the time of the study, and there was less convincing serological evidence of current infection in a further 11 children. Five children showed a fourfold rise in antibody to Mycoplasma pneumoniae. Although only one child showed a fourfold rise in antibody to cytomegalovirus, 86 children had this antibody. No child showed a fourfold rise in antibody to Ureaplasma urealyticum or Legionella pneumophila. P carinii, respiratory syncytial virus, C trachomatis, M pneumoniae, and cytomegalovirus may be important causes of pneumonia in children in developing countries. PMID:3002538

  1. Effect of HIV diagnosis disclosure on psychosocial outcomes in Thai children with perinatal HIV-Infection

    PubMed Central

    Boon-yasidhi, V; Naiwatanakul, T; Chokephaibulkit, K; Lolekha, R; Leowsrisook, P; Chotpitayasunond, T; Wolfe, M

    2015-01-01

    Summary A provider-assisted, counseling-based, pediatric HIV disclosure model was developed and implemented at two tertiary-care hospitals in Bangkok, Thailand. All undisclosed perinatally acquired HIV-infected children, ages 7–18 years, and their caretakers were offered the four-step disclosure service, including: screening, readiness assessments and preparation, disclosure sessions, and follow-up evaluations. To assess psychosocial outcomes of disclosure, we compared the scores of the Children Depression Inventory and the PedsQL 4.0™ at baseline and at 2-month and 6-month follow-up visits, and compared the scores of the Child Behavioral Checklist at baseline and at 6-month follow-up. Disclosure was made to 186 children, 160 of whom completed post-disclosure assessments. The median Children’s Depression Inventory score in 135 children decreased significantly from 11 at baseline to 8 at 2-month and 6-month follow-up (p < 0.01). The median PedsQL 4.0™ scores in 126 children increased significantly from 78 at baseline to 80 at 2-month and 84 at 6-month follow-up (p = 0.04). The median Child Behavioral Checklist scores were not significantly changed. In conclusion, pediatric HIV diagnosis disclosure using this model was found to have positive effect on the children’s mood and quality of life, and no negative effect on children’s behaviours. This disclosure program should be expanded to improve psychosocial health of HIV-infected children. PMID:25829519

  2. The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

    PubMed Central

    Ezeamama, Amara E.; McGarvey, Stephen T.; Acosta, Luz P.; Zierler, Sally; Manalo, Daria L.; Wu, Hai-Wei; Kurtis, Jonathan D.; Mor, Vincent; Olveda, Remigio M.; Friedman, Jennifer F.

    2008-01-01

    Objective To estimate the degree of synergism between helminth species in their combined effects on anemia. Methods Quantitative egg counts using the Kato–Katz method were determined for Ascaris lumbricoides, hookworm, Trichuris trichiura, and Schistosoma japonicum in 507 school-age children from helminth-endemic villages in The Philippines. Infection intensity was defined in three categories: uninfected, low, or moderate/high (M+). Anemia was defined as hemoglobin <11 g/dL. Logistic regression models were used to estimate odds ratios (OR), 95% c