scholarly journals Correlation of SARS-CoV-2 serology and clinical phenotype amongst hospitalised children in a tertiary children’s hospital in India

2021 ◽  
Author(s):  
Aishwarya Venkataraman ◽  
S Balasubramanian ◽  
Sulochana Putilibai ◽  
S Lakshan Raj ◽  
Sumanth Amperayani ◽  
...  
Keyword(s):  
Antibody Titre ◽  
South India ◽  
Clinical Phenotype ◽  
Antibody Responses ◽  
Antibody Testing ◽  
Middle Income ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Disease Stratification ◽  
Antibody Levels

AbstractIntroductionChildren usually present with minimal or no symptoms of SARS-CoV-2 infection. Antibody responses to SARS-CoV-2 in children from low- and middle-income countries (LMIC) have not been well described. We describe the prevalence of anti-SARS-CoV-2 antibodies and clinical phenotype of seropositive children admitted to a tertiary children’s hospital in South India.MethodsTo determine the seropositivity and describe the clinical characteristics of SARS-CoV-2 infection amongst hospitalised children, we performed a prospective clinical data collection and blood sampling of children admitted to Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India over 4 months of the COVID-19 pandemic. In seropositive children, we compared antibody titres between children with and without PIMS-TS.ResultsOf 463 children, 91 (19.6%) were seropositive. The median (range) age of seropositive children was 5 years (1 month - 17 years). Clinical presentation was consistent with Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) in 48% (44/91) of seropositive children. The median (range) antibody titre was 54.8 (11.1–170.9) AU/ml among all seropositive children. The median antibody titre among the children with PIMS-TS (60.3 AU/mL) was significantly (p=0.01) higher when compared to the children without PIM-TS (54.8 AU/mL).ConclusionWe describe the antibody responses to SARS-CoV-2 amongst hospitalised children in a LMIC tertiary children’s hospital. Almost half of the seropositive children had PIMS-TS. Antibody levels may be helpful in the diagnosis and disease stratification of PIMS-TS.Lay summaryChildren usually present with minimal or no symptoms of SARS-CoV-2 infection. However, Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) has emerged as a distinctive paediatric illness related to SARS-CoV-2. Recently, antibody testing for SARS-CoV-2 is being used increasingly as a diagnostic test for PIMS-TS. However, data on the antibody responses to SARS-CoV-2 in children is sparse. We therefore, attempted to identify the seropositivity and describe the clinical spectrum of SARS-CoV-2 infection amongst infants and children getting hospitalised in a children’s hospital in south India. Nearly one-fifth of the hospitalised children tested serology positive over 4 months. Antibody levels in children with PIMS-TS were significantly higher in comparison to the other two groups (acute SARS-CoV-2 infection and children without PIMS-TS). Results from our study suggest that all children are at risk of SARS-CoV-2 infection though they may present with mild illness or no symptoms. We also observed that antibody testing may have a possible role in diagnosis of PIMS-TS.

scholarly journals Correlation of SARS-CoV-2 Serology and Clinical Phenotype Amongst Hospitalised Children in a Tertiary Children’s Hospital in India

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Aishwarya Venkataraman ◽  
S Balasubramanian ◽  
Sulochana Putilibai ◽  
S Lakshan Raj ◽  
Sumanth Amperayani ◽  
...  
Keyword(s):  
Antibody Titre ◽  
South India ◽  
Clinical Phenotype ◽  
Antibody Responses ◽  
Antibody Testing ◽  
Middle Income ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Disease Stratification ◽  
Antibody Levels

Abstract Introduction Children usually present with minimal or no symptoms of COVID-19 infection. Antibody responses to SARS-CoV-2 in children from low- and middle-income countries (LMIC) have not been well described. We describe the prevalence of anti-SARS-CoV-2 antibodies and clinical phenotype of seropositive children admitted to a tertiary children’s hospital in South India. Methods To determine the seropositivity and describe the clinical characteristics of COVID-19 infection amongst hospitalised children, we performed a prospective clinical data collection and blood sampling of children admitted to Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India over 4 months of the COVID-19 pandemic. In seropositive children, we compared antibody titres between children with and without PIMS-TS. Results Of 463 children, 91 (19.6%) were seropositive. The median (range) age of seropositive children was 5 years (1 month–17 years). Clinical presentation was consistent with Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) in 48% (44/91) of seropositive children. The median (range) antibody titre was 54.8 (11.1–170.9) AU/ml among all seropositive children. The median antibody titre among the children with PIMS-TS (60.3 AU/mL) was significantly (p = 0.01) higher when compared to the children without PIMS-TS (54.8 AU/mL). Conclusion We describe the antibody responses to SARS-CoV-2 amongst hospitalised children in a LMIC tertiary children’s hospital. Almost half of the seropositive children had PIMS-TS. Antibody levels may be helpful in the diagnosis and disease stratification of PIMS-TS. LAY SUMMARY Children usually present with minimal or no symptoms of COVID-19 infection. However, Multisystem Inflammatory Syndrome in Children (MIS-C) or Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) has emerged as a distinctive paediatric illness related to SARS-CoV-2. Recently, antibody testing for SARS-CoV-2 is being used increasingly as a diagnostic test for PIMS-TS. However, data on the antibody responses to SARS-CoV-2 in children are sparse. We, therefore, attempted to identify the seropositivity and describe the clinical spectrum of COVID-19 infection amongst infants and children getting hospitalised in a children’s hospital in south India. Nearly one-fifth of the hospitalised children tested serology positive over 4 months. Antibody levels in children with PIMS-TS were significantly higher in comparison to the other two groups (acute COVID-19 infection and children without PIMS-TS). Results from our study suggest that all children are at risk of COVID-19 infection though they may present with mild illness or no symptoms. We also observed that antibody testing may have a possible role in diagnosis of PIMS-TS.

scholarly journals Direct Comparison of Antibody Responses to Four SARS-CoV-2 Vaccines in Mongolia

2021 ◽  
Author(s):  
Naranjargal J. Dashdorj ◽  
Oliver F. Wirz ◽  
Katharina Roeltgen ◽  
Emily Haraguchi ◽  
Anthony S. Buzzanco ◽  
...  
Keyword(s):  
Antibody Responses ◽  
Health Interventions ◽  
High Antibody ◽  
Antibody Testing ◽  
Public Health Interventions ◽  
Vaccine Responses ◽  
Blocking Activity ◽  
Antibody Titers ◽  
Alpha Variant ◽  
Antibody Levels

Different vaccines for SARS-CoV-2 are approved in various countries, but few direct comparisons of the antibody responses they stimulate have been reported. We collected plasma specimens in July 2021 from 196 Mongolian participants fully vaccinated with one of four Covid vaccines: Pfizer/BioNTech, AstraZeneca, Sputnik V and Sinopharm. Functional antibody testing with a panel of nine SARS-CoV-2 viral variant RBD proteins reveal marked differences in the vaccine responses, with low antibody levels and RBD-ACE2 blocking activity stimulated by the Sinopharm and Sputnik V vaccines in comparison to the AstraZeneca or Pfizer/BioNTech vaccines. The Alpha variant caused 97% of infections in Mongolia in June and early July 2021. Individuals who recover from SARS-CoV-2 infection after vaccination achieve high antibody titers in most cases. These data suggest that public health interventions such as vaccine boosting, potentially with more potent vaccine types, may be needed to control the COVID-19 pandemic in Mongolia and worldwide.

scholarly journals ORAL/ENTERAL NUTRITIONAL SUPPLEMENTATION IN CHILDREN TREATED FOR CANCER IN LOW-MIDDLE-INCOME COUNTRIES IS FEASIBLE AND EFFECTIVE: THE EXPERIENCE OF THE CHILDREN'S HOSPITAL MANUEL DE JESUS RIVERA "LA MASCOTA" IN NICARAGUA.

2018 ◽  
Vol 10 (1) ◽  
pp. e2018038 ◽  
Author(s):  
Nicolò Peccatori ◽  
Roberta Ortiz ◽  
Emanuela Rossi ◽  
Patricia Calderon ◽  
Valentino Conter ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Nutritional Assessment ◽  
Malignant Tumors ◽  
Nutritional Intervention ◽  
Nutritional Supplementation ◽  
Middle Income ◽  
Children's Hospital ◽  
Low Middle Income Countries ◽  
Pediatric Cancer Patients ◽  
Children’S Hospital

Background and objectives. The prevalence of malnutrition in children diagnosed with malignant tumors in Nicaragua has been reported to be 67%. Thus, a nutritional program for children with cancer has been developed at the Children’s Hospital Manuel de Jesus Rivera (Managua, Nicaragua).Methods. A qualified nutritionist evaluated all patients and prescribed oral/enteral supplementation. The nutritional assessment was based on weight, height or length, mid upper arm circumference (MUAC) and triceps skin fold thickness (TSFT). In this descriptive study, pre and post-nutritional intervention data were compared and analyzed in terms of event free survival.Results. 104 patients (median age 7.0 years, 52 with leukemia/lymphoma and 52 with solid tumor) underwent oral/enteral nutritional supplementation; 64 of these patients had pre and post supplementation nutritional assessment. Overall, 55% of patients in the leukemia/lymphoma group and the 35% in the solid tumor group improved their condition or remained in an adequately nourished status.Conclusion. This experience demonstrates that nutritional supplementation in pediatric cancer patients who are inadequately nourished is feasible also in countries with limited resources and is effective in improving the nutritional conditions.

scholarly journals Booster and anergic effects of the Covishield vaccine among healthcare workers in South India

2021 ◽  
Author(s):  
Priya Kannian ◽  
Pasuvaraj Mahanathi ◽  
Ashwini Veeraraghavan ◽  
Nagalingeswaran Kumarasamy
Keyword(s):  
Healthcare Workers ◽  
South India ◽  
Senior Citizens ◽  
Fold Increase ◽  
Antibody Responses ◽  
Responder Rate ◽  
Limited Data ◽  
Serum Samples ◽  
Antibody Levels ◽  
Booster Effect

Covishield (same as ChAdOx1) vaccine was rolled out in January 2021 against SARS-CoV2 in India. Although studies show good efficacy after two doses, there is limited data on the fate of the elicited antibody responses over time in groups with or without prior exposure to SARS-CoV2. Therefore, in this study we proposed to test naive or previously exposed healthcare workers (HCWs) longitudinally after both doses for anti-SARS-CoV2 spike antibody (ASSA) levels. Serum samples were collected from 205 HCWs at days 14 and 28 after first dose, and at days 14, 28 and 3-months after second dose. ASSA levels were quantitated by ECLIA method. Non-responder rate was 17% (35 of 205) on day 14 and 2% (5 of 205) on day 28 after the first dose. After the second dose, the responder rate was 100%. Non-responder rate was significantly higher among males (p<0.00001) and senior citizens (p=0.008). The second dose boosted a 27-fold increase in the COVID-19 naive (CN) group, but caused a 1.5-fold decline in the previously exposed groups. By three months, the antibody levels declined 3-4-folds in all the groups. In spite of high antibody levels (GM-1007 U per ml) after the second dose, 14% developed mild breakthrough infections (BTI). The booster effect was significantly higher when given 10-14 weeks later. The responder rate for Covishield was 98% after first dose and 100% after second dose. The vaccine elicited a prime-boost effect in CN HCWs and a boost-anergy effect in the previously exposed HCWs. ASSA levels began to decline proportionately by three months.

scholarly journals High burden of infections caused by ESBL-producing MDR Escherichia coli in paediatric patients, Yangon, Myanmar

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Thida San ◽  
Ingyin Moe ◽  
Elizabeth A Ashley ◽  
Nilar San
Keyword(s):  
Escherichia Coli ◽  
Microbiology Laboratory ◽  
Middle Income ◽  
Clinical Specimens ◽  
High Burden ◽  
E Coli ◽  
Children's Hospital ◽  
Paediatric Patients ◽  
Children’S Hospital ◽  
Diagnostic Microbiology

Abstract Background There is mounting evidence of a high burden of antimicrobial-resistant infections in children in low- and middle-income countries (LMICs). Objectives To detect the frequency of ESBL-producing Escherichia coli in clinical specimens from paediatric patients attending Yangon Children’s Hospital in Myanmar. Methods All children attending Yangon Children’s Hospital who had clinical specimens submitted to the hospital diagnostic microbiology laboratory from June 2019 to December 2019 were included in the study. Specimens were processed routinely using standard methods with BD Phoenix used for pathogen identification and susceptibility testing. Presence of ESBLs was determined using the cephalosporin/clavulanate combination disc method with confirmation by PCR. Results From 3462 specimens submitted to the Microbiology Laboratory, a total of 123 E. coli were isolated. Among them, 100 isolates were phenotypically ESBL producers, 94 (76.4%) of which were confirmed by PCR [82/94 (87%) CTX-M, 72/94 (77%) TEM, 1/94 (1%) SHV]. Most of the ESBL-producing E. coli were isolated from urine samples (52.1%, 49/94) and the majority were from the surgical unit (61.7%, 58/94). Only 34/94 (36%) isolates were susceptible to meropenem. Conclusions This study confirms a high proportion of infections caused by ESBL-producing and MDR E. coli in children hospitalized in Yangon, where access to effective second-line antimicrobials is limited.

scholarly journals Establishing a Pediatric Hematology-Oncology Program in Botswana

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Jeremy S. Slone ◽  
Amanda K. Slone ◽  
Oaitse Wally ◽  
Pearl Semetsa ◽  
Mpho Raletshegwana ◽  
...  
Keyword(s):  
Pediatric Cancer ◽  
Patient Characteristics ◽  
Baylor College ◽  
Blood Disorders ◽  
Middle Income ◽  
Children's Hospital ◽  
Pediatric Hematology ◽  
Middle Income Countries ◽  
Histopathologic Diagnosis ◽  
Children’S Hospital

Purpose Annually, 300,000 children are diagnosed with cancer, and the majority of these children live in low- and middle-income countries (LMICs). Currently, there is incomplete information on pediatric cancer incidence, diagnosis distribution, and treatment outcomes in Africa. Since 2007, a pediatric hematology-oncology program has been operating in Botswana through a partnership between the Botswana government, Baylor College of Medicine, and Texas Children’s Hospital. Methods To better understand patient characteristics and outcomes at Botswana’s only pediatric cancer program, a hospital-based data base—the Botswana Pediatric Oncology Database—was established in 2014. Children younger than 18 years of age at the time of diagnosis who presented between 2008 and 2015 were included. Data for this study were extracted in February 2016. Results Of the 240 potential enrollees, 185 (77%) children met eligibility for this study. The median age was 6.4 years, and 50.8% were male. Leukemia was the most common malignancy representing 18.9% of the cohort and 88.1% of the total cohort had a histopathologic diagnosis. HIV seropositivity was confirmed in 13.5%. The 2-year overall survival of all pediatric cancer diagnoses was 52.4%. Abandonment of treatment occurred in 3.8% of patients. Conclusion In the first 9 years of the program, capacity has been developed through a longstanding partnership between Botswana and Baylor College of Medicine/Texas Children’s Hospital that has led to children receiving care for cancer and blood disorders. Although continued improvements are necessary, outcomes to date indicate that children with cancer in Botswana can be successfully diagnosed and treated.

Socio-Economic Challenges in Childhood Cancer Care in a Low-Middle-Income Country

2021 ◽  
Vol 15 (6) ◽  
pp. 1234-1236
Author(s):  
A. Ahmad ◽  
A. Anjum ◽  
M. Hussain ◽  
A. A. Rasul ◽  
A. Mushtaq ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Treatment Center ◽  
P Value ◽  
Psychosocial Needs ◽  
Middle Income ◽  
Female Ratio ◽  
Children's Hospital ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Children’S Hospital

Background: Each year, it is estimated that over 200 000 children and adolescents are diagnosed with cancer, and 80% of these reside in low-middle-income countries, with 90% mortality. There are enormous psychosocial needs of these patients, families, and care-givers, which are primarily affected by the communities' social, economic, cultural, and religious factors. Aim: To elucidate the significant psychosocial and socio-economic issues faced by the caregivers of children suffering from different types of cancer at the Children's Hospital Lahore. Study design: Prospective cohort study Place and duration of study: Department of Paediatric Hematology and Oncology, Children's Hospital Lahore Pakistan from 1st January 2018 to 30th June 2018 Methodology: Two hundred family members/caregivers of the patients were enrolled with ages ranging from <1 to 15 years (43% <5 years and 57% >5years old). Results: Male to female ratio was 1.2:1. 52% belonged to hematological malignancies and 48% from solid tumor groups. Most of these children had malnutrition with anemia (81% with Hb <10g%) and small weight forage in 63% cases at presentation. 80% of families had more than three children, with the youngest child being less than five years in 75%. 95% of families relied on public transport, with 65% of them traveling 100-500Km with 2-10 hours duration to reach the primary treatment center. 80% had a monthly income of less than USD150. 68% of these families had to borrow money for trip to hospital (p-Value=0.003), and 58% took a loan for treatment course. Conclusion: The significant socio-economic challenges faced by these families and caregivers included large family size with low incomes increasing their financial difficulties, logistic burden like traveling long distances to access health care, and parental employment and family dynamics disruptions. Keywords: Socioeconomic Challenges, Childhood Cancer, Low-Middle-Income Countries

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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