Prevalence of Paediatric Surgical Conditions in Eastern Uganda: A Cross-Sectional Study

Background The role of surgery in global health has gained greater attention in recent years. Approximately 1.8 billion children below 15 years live in low- and middle-income countries (LMIC). Many surgical conditions affect children. Therefore, paediatric surgery requires specific emphasis. Left unattended, the consequences can be dire. Despite this, there is a paucity of data regarding prevalence of surgical conditions in children in LMIC. The present objective was to investigate the prevalence of paediatric surgical conditions in children in a defined geographical area in Eastern Uganda. Method A cross-sectional study was carried out in the Iganga-Mayuge Health and Demographic Surveillance Site located in Eastern Uganda. Through a two-stage, cluster-based sampling process, 490 households from 49 villages were randomly selected, generating a study population of 1581 children. The children’s caregivers were interviewed, and the children were physically examined by two medical doctors to identify any surgical conditions. Results The interview was performed with 1581 children, and 1054 were physically examined. Among these, the overall prevalence of any surgical condition was 16.0 per cent (n = 169). Of these, 39 per cent had an unmet surgical need (66 of 169). This is equivalent to a 6.3 per cent prevalence of current unmet surgical need. The most common groups of surgical condition were congenital anomalies and trauma-related conditions. Conclusion Surgical conditions in children are common in eastern Uganda. The unmet need for surgery is high. With a growing population, the need for paediatric surgical capacity will increase even further. The health care system must be reinforced to provide services for children with surgical conditions if United Nations Sustainability Development Goal 3 is to be achieved by 2030.

Non-prescription antibiotic use for cough among Chinese children under 5 years of age: a community-based cross-sectional study

ObjectiveThis study aimed to investigate the non-prescription use of antibiotics for cough among children under 5 years in China.DesignA community-based cross-sectional survey.SettingA face-to-face interview based on a standard questionnaire in the community from October to December 2019.ParticipantsA total of 3102 children under 5 years of age were enrolled with probability proportionate to size sampling method. The children’s caregivers provided the responses as their agents.Outcome measuresCough in the past month, non-prescription use of antibiotics after cough.Results1211 of 3102 children were reported to have a cough in the past month. Of these, 40.2% (487/1211) were medicated with antibiotics, and 18.7% (91/487) of these were not prescribed. Cephalosporins were the most frequently used antibiotic (52.8%), and community pharmacies were the main source (53.7%). Children who coughed for 1–2 weeks (OR 1.73, 95% CI 1.03 to 2.90) or 3–4 weeks (OR 2.39, 95% CI 1.08 to 4.97), with runny nose (OR 1.86, 95% CI 1.13 to 3.19) or those whose family annual income between ¥50 000 and ¥100 000 (OR 4.44, 95% CI 1.52 to 18.95) had a higher risk of non-prescription use of antibiotics than those coughing for <1 week, without runny nose or with family annual income <¥50 000.ConclusionsOur findings indicated that a high proportion of infants and young children had been treated with antibiotics for cough, and nearly one in five of them were used without prescription. More public health campaigns and further education on the appropriate use of antibiotics are needed to ensure the rational treatment of cough in children.

Caregiver Intervention Implementation Fidelity: An Empirical Investigation of a Multidimensional Model

The extant literature on implementation fidelity has found mixed evidence for empirically establishing the dimensionality of implementation fidelity. The current study aims to add to this growing body of literature by examining implementation fidelity in a book-reading intervention for young children’s caregivers. Caregivers ( n = 291) implemented Sit Together and Read 2 (STAR 2) with their preschool-age children. These data indicated that implementation fidelity was determined to be a four-dimensional construct including adherence/dose, quality of delivery, participant responsiveness, and program differentiation. The main findings of this work are twofold: (a) implementation fidelity is a more complex construct than some previous descriptions, and (b) early childhood education research should aim to report on all aspects of implementation fidelity.

Frequency of Hypoglycemia in Severe Acute Malnutrition

Malnutrition is a major health problem throughout the world and contributes to at least one third of all children deaths worldwide. Hypoglycemia is a basic metabolic complication in pediatric patients which can be easily prevented by proper care and management. Objective of this study was to determine the frequency of hypoglycemia in sever acute Malnurished children (SAM). The study was conducted in nutritional division of Nangarhar University Teaching Hospital pediatric department. For 8 months, all the patients were subjected for measurement of blood glucose level by glucose oxidase method .Hypoglycemia was labeled according to value mentioned in operational definition. The study included a total of 252 patients with SAM. 137 (54.4%) were Males and 115 (45.6%) females with no significant difference in the number of gender and with an average age of (Mean± SD) 16.20±11.74 (6 months to 60 months). Out of 252 patients 54.80% (138) were hypoglycemic, and 85.70% (216) suffering from Marasmus. 38.9% of children’s caregivers were illiterate and 86.5% poor and middle-level of socioeconomic status. 12.7%( 32) of the SAM children with hypoglycemia were dying, most of the patient from Nangarhar province. Sever acute malnutrition (SAM) constitutes a significant health problem and important cause of mortality and morbidity in children, in marasmus patients the hypoglycemia is more common than kwashiorkor children; early diagnosis and treatment can prevent and decrease the morbidity and mortality of Sever acute malnutrition (SAM) in children significantly, education, socioecnomic status of caregivers are important in prevention of sever acute malnutrition (SAM) and their complications.

Vitamin A Levels Among Pre-School Children of Central and Western China

Objective: To investigate vitamin A deficiency of pre-school children in central and western China for developing strategies to prevent and control vitamin A deficiency (VAD) among children.Design: From November 2018 to September 2019, a total of 2,194 healthy children aged 2–6 years were enrolled. Serum retinol levels in the children were detected by liquid-phase tandem mass spectrometry. In addition, social demographic and dietary questionnaires were collected through interviews with children's caregivers.Setting: The participants were enrolled in 12 cities or their subordinate jurisdictions in the central and western regions of China.Participants: Two thousand one hundred and ninety four healthy children aged 2–6 years old.Results: Overall, 35.51% (779/2,194) of the children were found to be vitamin A insufficient (VAI, serum retinol &lt; 1.05 μmol/L). Elder children had a higher risk to suffer from VAI, with proportions of 25.00% (87/348), 28.92% (142/491), 38.38% (256/667), and 42.73% (294/688) among children aged 2, 3, 4, and 5 years, respectively. Vitamin A levels were also positively correlated with per capita income (AOR = 1.18) and regional economic level (0.71), and the frequency of milk intake (0.91).Conclusions: The incidence of VAI was higher among children aged 2–6 years, and the incidence of VAI increases with age. VA levels were positively correlated with levels of economic development in the family and region. So prevention strategies for VAD need to focus on pre-school children, especially dairy intake and developing regions.

Under-five malnutrition among Palestine refugee children living in camps in Jordan: a mixed-methods study

BackgroundJordan hosts the largest Palestine refugee population in the world. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) is the primary healthcare provider for Palestine refugees. To better inform UNRWA’s health programme, we conducted this study to assess the prevalence and determinants of malnutrition among Palestine refugee children in Jordan and to analyse caregiver perceptions of food insecurity and structural barriers to accessing food.MethodsA cross-sectional study was conducted with a randomly selected sample of 405 households, for children under 5 years old in two refugee camps in Jordan, Jerash and Souf. Sociodemographic, food insecurity, diet quality and child anthropometric data were collected. Also, twenty in-depth interviews were conducted with children’s caregivers, along with two focus group discussions with UNRWA staff.ResultsOut of the 367 participants, the prevalence of stunting was 23.8% in Jerash and 20.4% in Souf (p=0.46), and overweight was 18.2% versus 7.1%, respectively (p=0.008). However, high food insecurity in Jerash was 45.7% and 26.5% in Souf (p=0.001), with no significant difference after multivariable adjustment. Qualitative perspectives saw food insecurity and low-quality children’s diets as largely mediated by job and income insecurity, especially marked in Jerash due to the lack of Jordanian citizenship.ConclusionWe found a moderate-to-high prevalence of stunting and overweight levels among Palestine refugee children, which are three times higher than the 2012 Demographic and Health Survey data for Jordanian non-refugee children. High rates of household food insecurity were closely tied to households’ lack of essential civil and economic rights. We call for international collective efforts to expand economic livelihoods for Palestine refugees and to support UNRWA’s ongoing operations.

Caregivers’ Perspectives of Pharmacist Intervention in Children’s Antibiotic Prescriptions for Upper Respiratory Tract Infections

Background: Community pharmacists can help fight antimicrobial resistance by intervening in children’s antibiotic prescriptions for upper respiratory tract infections (URTIs). However, caregivers’ attitudes and perspectives on this are unknown. Objective: To evaluate children’s caregivers’ acceptability of pharmacists intervening in their antibiotic prescriptions for URTIs with respect to their knowledge of and attitude toward pharmacists and knowledge, beliefs, and behaviors related to antibiotics. Methods: A 69-item survey was created and sent to a panel of caregivers. ANCOVA and path analysis were used to evaluate the relationship between caregiver characteristics and their acceptability of pharmacists intervening in children’s antibiotic prescriptions for URTIs. Results: Responses from 246 caregivers who met the inclusion and exclusion criteria were analyzed. Mean caregivers’ acceptability of pharmacists intervening in children’s antibiotic prescriptions for URTIs was 3.25 out of 5 (±1.01). The ANCOVA model (adjusted R2 = .636) showed positive attitude toward pharmacists and being more accepting of health advice from pharmacists since the start of the COVID-19 pandemic were associated with higher caregiver acceptability of pharmacists intervening in children’s antibiotic prescriptions. Caregivers with better relationships with their pharmacist also tend to have better attitudes toward pharmacists. Not wanting antibiotics for symptom relief was associated with decreased acceptability scores. Conclusion: Overall caregiver acceptability of pharmacists intervening in antibiotic prescriptions was slightly above neutral. Building a relationship with caregivers could help change their attitude and increase the acceptability of pharmacists intervening in children’s antibiotic prescriptions. Caregivers seeking symptomatic relief may be more open to non-antibiotic alternatives.

Participatory Children’s Radio in the Context of a South African Hospital: An Exploratory Study of Stakeholder Perceptions and Experiences

An emerging body of participatory media work aims to access children’s subjective experiences. One such medium, children’s radio, has increasingly become a significant means of motivating and mobilising vulnerable children in many environments, including hospitals, by creating a space in which they can express their lived experiences. The present study describes stakeholders’ perceptions and experiences of a children’s hospital-based radio, drawing on interviews with child patients, family members, health providers, and hospital administrators. Seven healthcare workers or hospital administrators, 10 parents or guardians, 10 child presenters, and 12 child listeners were interviewed, and their interviews analysed using thematic analysis. The children’s caregivers and healthcare professionals felt that the children’s involvement in the radio resulted in significant intrapersonal development. Some benefits of their involvement were pride and increases in confidence. A particularly valuable finding in the present work pertains to the questions of “speaking back” and “voicing”: the radio platform allowed children to voice their feelings and opinions in settings in which they are disadvantaged in terms of the power differential between healthcare providers and those who receive medical care. The children found value in the usual power differentials characterising hospitals, being reversed, as ownership of the radio platform inverted their position as the passive recipients of medical questions and treatment and allowed them the power to voice their questions and concerns.

The Health and Development of Young Children Who Witnessed Their Parent’s Arrest Prior to Parental Jail Incarceration

Most U.S. incarceration occurs in jails, with more than 10 million annual admissions, and most individuals in jail are parents of minor children. In this short-term longitudinal study, we examined the health and development of young children who did or did not witness their parent’s arrest prior to parental jail incarceration. 228 individuals in 76 triads (incarcerated parents, children, at-home caregivers) were enrolled from four jails in two states. Jailed parents and caregivers reported on whether the child witnessed the parent’s arrest or crime. Children’s caregivers completed questionnaires about children’s emotional symptoms during the prior 6 months and demographics, as well as children’s emotional reactions to separation from the parent and child health at the initial assessment and 2 weeks later. Trained researchers conducted a developmental assessment with children while waiting to visit parents. Results of regression-based moderated mediation analyses indicated that when their emotional symptoms were high, children who witnessed parental arrest were more likely to have poorer health initially and more intense negative reactions to the parent leaving for jail. In addition, when children’s general emotional symptoms were low, children who witnessed their parent’s arrest were more likely to exhibit developmental delays, especially in their early academic skills, compared to children who did not witness the arrest. Witnessing the parent’s crime related to missed milestones in social and adaptive development. Findings have implications for policies regarding safeguarding children during parental arrest and referrals for health- and development-promotion services following parental criminal justice system involvement.