Evaluation of Parent's Knowledge About Fever

Introduction: Fever in children is the most frequent reason for pediatric consultation. Aims of the Study: To assess parent's knowledge and behavior regarding fever in children before the consultation. Methodology: This survey was carried out among 614 who agreed to answer a pre-established questionnaire, having consulted in the pediatric medical emergency department of the children's hospital in rabat. Results: Fever was defined in 64.2% of parents as a temperature above the threshold of 38 ° C. It was measured in 37.9% of cases by the axillary method, the drugs most used were paracetamol and ibuprofen, with the use of paracetamol first in 73.9%, the administration of the drug was based of the weight in 58.7%. Angina was considered the most likely cause of fever (72.7% of cases). Conclusion: The results of our survey show the need to improve parent's knowledge of fever as well as its management at home.

The Epidemiological and Clinical Profile of Sexually Abused Children: A Hospital-Based Study

Introduction: Child sexual abuse is an extensive health and societal problem as even the lowest prevalence of child sexual abuse includes a huge number of victims who still need to be considered. Africa has the highest prevalence of child sexual abuse yet still with a paucity of literature on the subject matter. Objective: Describe the epidemiological and clinical profile of children victim of sexual abuse reported at the Yaounde Gynaeco-obstetric and Pediatric Hospital (YGOPH). Methods: A hospital based cross sectional descriptive study was conducted from January 1st, 2017 – December 31st, 2019 at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. Consultation files were examined and identified cases of child sexual abuse (CSA) recruited. Epidemiological and clinical data of included participants were treated using a pre-established questionnaire. Collected data were entered and analysed using SPSS (Statistical Package for Social Sciences) software version 26.0 with p-values calculated following a one variable binomial sampling. Results: In total, data was assessed from 51,331 pediatric consultation files of which 127 cases of child sexual abuse met our inclusion criteria. The prevalence of child sexual abuse was 0.25%. Most victims of child sexual abuse were of the female gender (92%) from single parenting homes (36.8%) (p< 0.05) within two age groups < 5years (32.9%) and 10-15 years (32.9%). Perpetrators were in majority males (84%) of age ≥18 years (72.4%) and were persons known to the victims (73.7%) who proceeded by taking advantage of the victims’ trust. Vaginal penetration (57.9%) with vaginal lesions (59.2%) were the most encountered cases which were placed on highly active anti-retroviral prophylaxis however with poor clinical follow-up (35.5%) as the patients did not turn-up for their visits. Conclusion: Child sexual abuse though not addressed as a matter of urgency, yet it is a problem with a gradual upward trend in our community most especially as perpetrators are persons we are familiar with. Thus, a call for greater vigilance with regards to the guidance we leave our children with.

Identification of Pathogens Potentially Associated with Non-Malarial Fever in Children: A Pilot Study in Peri-Urban Dakar, Senegal

ABSTRACTFever is one of the most common reasons for pediatric consultation in Africa. Malaria incidence has now dropped considerably, yet etiologies of non-malarial febrile diseases are poorly documented. This pilot study aimed to 1) identify pathogens potentially associated with non-malarial fever in children younger than 10 years in the suburbs of Dakar and 2) describe the epidemiological characteristics of these patients. During the study period, all eligible children (< 10 years of age, body temperature ≥ 38°C, negative result for the malaria rapid diagnostic test, living in Guediawaye/Pikine for the previous four calendar months, not receiving any anti-infectious treatment since the onset of fever, and with parent’s consent to participate) presenting to the health post in Medina Gounass located in Guediawaye on Mondays and Fridays were included. In total, 106 children participated in the study, and PCR from nasopharyngeal swabs, hemoculture, C-reactive protein, blood cell counts, and quantitative buffy coat from blood samples and coproculture from stool samples were performed. In 70 (66%) children, at least one pathogen was isolated. Viruses were identified in 55 children, most commonly enteroviruses, rhinoviruses, and adenoviruses, and dengue virus was identified in three children. Only five children had bacterial infections, and 10 had bacterial and viral coinfections. Ninety-seven children (92%) received prescription for antibiotics. Many strains of bacteria were found to be resistant to several antibiotics. Despite limitations, this pilot study showed that pathogens potentially associated with non-malarial fever in children younger than 10 years near Dakar were predominantly viruses, most commonly upper respiratory infections, although bacteria accounted for a small proportion.

Wheeze Recognition Algorithm for Remote Medical Care Device in Children: Validation Study (Preprint)

BACKGROUND Since 2020, peoples’ lifestyles have been largely changed due to the COVID-19 pandemic worldwide. In the medical field, although many patients prefer remote medical care, this prevents the physician from examining the patient directly; thus, it is important for patients to accurately convey their condition to the physician. Accordingly, remote medical care should be implemented and adaptable home medical devices are required. However, only a few highly accurate home medical devices are available for automatic wheeze detection as an exacerbation sign. OBJECTIVE We developed a new handy home medical device with an automatic wheeze recognition algorithm, which is available for clinical use in noisy environments such as a pediatric consultation room or at home. Moreover, the examination time is only 30 seconds, since young children cannot endure a long examination time without crying or moving. The aim of this study was to validate the developed automatic wheeze recognition algorithm as a clinical medical device in children at different institutions. METHODS A total of 374 children aged 4-107 months in pediatric consultation rooms of 10 institutions were enrolled in this study. All participants aged ≥6 years were diagnosed with bronchial asthma and patients ≤5 years had reported at least three episodes of wheezes. Wheezes were detected by auscultation with a stethoscope and recorded for 30 seconds using the wheeze recognition algorithm device (HWZ-1000T) developed based on wheeze characteristics following the Computerized Respiratory Sound Analysis guideline, where the dominant frequency and duration of a wheeze were &gt;100 Hz and &gt;100 ms, respectively. Files containing recorded lung sounds were assessed by each specialist physician and divided into two groups: 177 designated as “wheeze” files and 197 as “no-wheeze” files. Wheeze recognitions were compared between specialist physicians who recorded lung sounds and those recorded using the wheeze recognition algorithm. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value for all recorded sound files, and evaluated the influence of age and sex on the wheeze detection sensitivity. RESULTS Detection of wheezes was not influenced by age and sex. In all files, wheezes were differentiated from noise using the wheeze recognition algorithm. The sensitivity, specificity, positive predictive value, and negative predictive value of the wheeze recognition algorithm were 96.6%, 98.5%, 98.3%, and 97.0%, respectively. Wheezes were automatically detected, and heartbeat sounds, voices, and crying were automatically identified as no-wheeze sounds by the wheeze recognition algorithm. CONCLUSIONS The wheeze recognition algorithm was verified to identify wheezing with high accuracy; therefore, it might be useful in the practical implementation of asthma management at home. Only a few home medical devices are available for automatic wheeze detection. The wheeze recognition algorithm was verified to identify wheezing with high accuracy and will be useful for wheezing management at home and in remote medical care.

Psychiatric Disorders in Pediatric Psycho-Oncology

For patients and families affected by pediatric cancer, distress is often part of a larger picture of adjustment and resiliency. Pediatric psychosocial oncology clinicians should be proficient in recognizing clinically significant psychiatric symptoms, syndromes and disorders, in order to differentiate these from normal distress and adjustment. Access to child and adolescent psychiatric expertise is an essential component of care for children with cancer and their families. It is feasible and important to differentiate psychiatric syndromes from normal trajectories of adjustment to a life-threatening diagnosis. The chapter reviews psychiatric presentations in children, and youth with cancer and treatment considerations, with a focus on the role of the pediatric consultation-liaison/psycho-oncology psychiatrist on a multidisciplinary team.