Mental health and burden in mothers of children with congenital Zika syndrome during COVID-19 pandemic

Objectives: to evaluate burden, frequency of anxiety and signs and symptoms of depression in mothers of children with congenital Zika syndrome (CZS) during the COVID-19 pandemic and the social isolation period. Methods: this is a cross-sectional study conducted with mothers who care for their children with CZS. The data were collected by an online form with questions regarding mother's socioeconomic conditions and questions related with Zarit burden scale and Beck's inventories on depression and anxiety. Spearman’s correlation tests and multiple regression analyzes were performed to assess factors related to mothers' burden and mental health. Results: 41 mothers were evaluated, 51.2% had mild burden, 39% had minimal anxiety and 73.2% did not have signs and symptoms of depression. Negative correlations were observed between levels of burden and maternal schooling (p=0.01), presence of signs and symptoms of anxiety and receiving financial aid (p<0.04) as well as the presence of signs and symptoms of anxiety and having children with seizures history (p=0.03). Conclusion: despite the risk of their children again being victims of an epidemic virus, mothers who care for their children with CZS did not present serious mental health impairments.

Association Between Oral Diseases And Sociodemographic Variables In Children And Adolescents With Cancer

Objective To evaluate the association between sociodemographic variables and oral diseases in children and adolescents with cancer receiving treatment at the “Nossa Senhora da Glória” State Children Hospital (HEINSG) - Vitória - ES.Method This is a cross-sectional study, in which 51 subjects were evaluated before or three days after the start of chemotherapy from April 2013 to April 2014.Results When the study participants were examined the prevalence of dental caries was 25.4%, xerostomia presented with a frequency of 31%. Other diseases were also observed at lower frequency, such as mucositis, candidiasis and thrush. Caries was significantly associated with poor oral hygiene (OR: 0,114; p - 0.016) and low maternal schooling (OR: 0,188; p - 0.021).Conclusion Some subjects had oral disease before starting chemotherapy; therefore, they were more likely of developing oral manifestations during treatment. The participation of the dental surgeon in the multidisciplinary team of cancer treatment is important to evaluate the oral health status of individuals before and during treatment, thus developing an appropriate treatment plan to prevent or reduce the occurrence of oral manifestations during therapy.Clinical Relevance This study showed and reaffirmed the importance of an evaluation of the oral condition prior to chemotherapy treatment and also the need for a dental surgeon in the team of professionals who accompany cancer patients to treat caries lesions and remove foci of infection, preventing thus the appearance of oral manifestations that may delay chemotherapy, generating unnecessary suffering for these patients.

Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda

IntroductionAn estimated 216 million cases of malaria occurred worldwide every year. Cross-sectional studies have reported negative association between maternal education and child malaria risks; however, no randomised trial or quasi-experimental study using a natural experiment has confirmed a causal relationship between these two factors. I used the free primary education reform in Uganda to assess the causal effects of maternal schooling on children’s risk of malaria infection.MethodsMalaria biomarkers of children aged <5 years were collected from the 2009 and 2014 Uganda Malaria Indicator Surveys (n=5316). In 1997, the government eliminated tuition requirements in primary schools, which increased the educational attainment of the affected cohorts. Using exposure to the reform as an instrumental variable, I used a two-stage least squares approach to estimate the causal effects of maternal year of education on the probability that a child would contract malaria at the time of the survey. I also evaluated the cost-effectiveness of primary schooling as a malaria control intervention.ResultsOne extra year of maternal education reduced children’s risk of malaria infection by 7.5 percentage points (p=0.057) from baseline (34.9%). The length of maternal education was also positively associated with insecticide-treated bednet usage by their children. The results were robust to a variety of sensitivity tests. Primary schooling for women was a cost-effective intervention to reduce children’s malaria infection.ConclusionImproving access to primary education could be a cost-effective measure to reduce malaria prevalence among children of educated mothers aged <5 years in malaria-endemic countries.

BATHING, MAKE-UP, AND SUNSCREEN: WHICH PRODUCTS DO CHILDREN USE?

ABSTRACT Objective: To evaluate the hygiene practices and frequency of use of personal hygiene products, cosmetics, and sunscreen among children and adolescents. Methods: Cross-sectional study with interviews about skincare conducted with caregivers through closed-ended questions. We included patients up to 14 years of age waiting for consultation in pediatric outpatient clinics of a tertiary hospital. We performed a descriptive statistical analysis and applied the Kruskal-Wallis test and Fisher’s exact test to compare the practices according to maternal schooling. Results: We conducted 276 interviews. The median age of the participants was age four, and 150 (54.3%) were males. A total of 143 (51.8%) participants bathed once a day and 128 (46.3%) bathed two or more times a day, lasting up to ten minutes in 132 (47.8%) cases. Adult soap was used by 103 (37.3%) children and bar soap by 220 (79.7%). Fifty-three (19.2%) participants used sunscreen daily. Perfume was used by 182 (65.9%) children, hair gel by 98 (35.5%), nail polish by 62 (22.4%), and some type of make-up by 71 (25.7%) - eyeshadow by 30 (10.8%), lipstick by 52 (18.8%), face powder and mascara by 13 (4.7%). Make-up use started at a median age of 4 years. Henna tattoo was done in eight children. Conclusions: The children studied used unsuitable products for their skin, such as those intended for adults, used sunscreen inadequately, and started wearing make-up early, evidencing the need for medical orientation.

ASSOCIATED FACTORS WITH THE ISOLATED AND SIMULTANEOUS PRESENCE OF OVERWEIGHT AND ABDOMINAL OBESITY IN ADOLESCENTS

ABSTRACT Objective: To analyze the sociodemographic and lifestyle factors associated with excessive weight (EW), abdominal obesity (AO) and the simultaneous presence of EW and AO in adolescents from Southern Brazil. Methods: Cross-sectional study with 583 adolescents (11 to 17 years old) of Criciúma, Santa Catarina, Brazil. EW was assessed by body mass index (BMI) and AO by waist circumference (WC). The independent variables analyzed were gender, age, maternal schooling, balanced diet, physical activity, cigarette use, excessive alcohol use and screen time. Binary logistic regression was used to estimate Odds Ratios (OR) and 95% confidence intervals (95%CI). Results: Boys had 58% higher likelihood of having EW (OR 1.58; 95%CI 1.08-2.29; p<0.05). Younger age group (11 to 14 years) was directly associated with higher likelihood of EW (OR 6.07; 95%CI 4.05-9.11; p<0.05). Adolescents whose mothers had higher education had 75% more likelihood of having AO (OR 1.75; 95%CI 1.01-3.00; p<0.05). Higher likelihood for EW and AO (OR 1.84; 95%CI 1.01-3.34; p<0.05) was identified in younger adolescents (11 to 14 years). Conclusions: Boys and younger age (11 to 14 years) were associated with a higher likelihood of EW. Adolescents whose mothers studied nine years or more were more likely to have AO. The younger age group (11 to 14 years) was associated with greater chances for the simultaneous presence of EW and AO.

Objectively measured physical activity in one-year-old children from a Brazilian cohort: levels, patterns and determinants

Background The aim of this study is to describe objectively measured physical activity (PA) and its correlates in one-year-old children. Methods The current study includes participants from the 2015 Pelotas (Brazil) birth cohort. At age one, PA was assessed in a 24-h protocol during 4 days with a wrist-attached accelerometer (ActiGraph, wGT3X-BT), from which two complete days of data were analyzed, with 5-s epochs. Results A total of 2974 individuals provided valid accelerometry data. Infants able to walk independently spent on average 19 h per day below 50 mg of acceleration (including sleep time), and those who could not walk spent on average 21 h in this intensity category. Girls spent approximately 10 min more than boys below 50 mg daily in both walking status categories, and less activity than boys on higher intensity categories. Boys and infants whose mothers were more physically active during pregnancy presented more acceleration, regardless of walking status. Among infants who could walk by themselves, those with mothers with one to eight schooling years; adequate length-for-age (z-score); not attending daycare; and more physically active fathers also showed higher levels of acceleration. Conclusions Our findings demonstrate higher levels of PA among boys and those children with higher maternal PA during pregnancy, regardless of walking status. Also, among infants able to independently walk, 1–8 years of maternal schooling, adequate length-for-age (z-score), no daycare attendance and higher paternal PA are positive correlates of objectively measured PA early in life.

Impact of Maternal Education on Child Mortality

The purpose of study was to investigate the impact of maternal education on child mortality. A large frame of studies suggests that a causal relationship exists between maternal training and youth mortality. This paper seeks to shed some light at the influence of maternal schooling and youth mortality. The results show that acquisition of education leads to higher human, social and cultural capital amongst moms, that's associated with progressed baby survival. Moreover, this study show that better training of the mother is related to more physical and choice-making autonomy for her inside the household, which may also lead to higher fitness outcomes for the child.

The Causal Effect of Maternal Education on Child Mortality: Evidence From a Quasi-Experiment in Malawi and Uganda

Since the 1980s, the demographic literature has suggested that maternal schooling plays a key role in determining children’s chances of survival in low- and middle-income countries; however, few studies have successfully identified a causal relationship between maternal education and under-5 mortality. To identify such a causal effect, we exploited exogenous variation in maternal education induced by schooling reforms introducing universal primary education in the second half of the 1990s in Malawi and Uganda. Using a two-stage residual inclusion approach and combining individual-level data from Demographic and Health Surveys with district-level data on the intensity of the reform, we tested whether increased maternal schooling reduced children’s probability of dying before age 5. In Malawi, for each additional year of maternal education, children have a 10 % lower probability of dying; in Uganda, the odds of dying for children of women with one additional year of education are 16.6 % lower. We also explored which pathways might explain this effect of maternal education. The estimates suggest that financial barriers to medical care, attitudes toward modern health services, and rejection of domestic violence may play a role. Moreover, being more educated seems to confer enhanced proximity to a health facility and knowledge about the transmission of AIDS in Malawi, and wealth and improved personal illness control in Uganda.

Effortful control and attention as predictors of cognition in children born preterm

Background: Preterm childbirth increases the risk of developmental problems. The aim of the present study was to examine the effects of temperament and attention on the cognition of school-age children who were born preterm, controlling for socioeconomic variables. Material and Methods: The sample was composed of 50 six-year-old children who were born preterm with very low birth weight. The children were evaluated using the Wechsler Intelligence Scale for Children (WISC-III) and the Cancellation Attention Test. The mothers were interviewed using the Children’s Behavior Questionnaire (CBQ). Statistical multiple linear regression analyses were performed. Results: 70% of the children presented average or above-average full intellectual quotient (IQ). In the attention total score, 74% of the children were also within the average range or above. High verbal IQ associated with high maternal schooling explained 73% variability of the full IQ. High attention and maternal schooling, associated with children’s temperament with more effortful control, explained 35% variability of the verbal IQ. High attention, associated with high maternal schooling and socioeconomic level, explained 37% variability of the performance IQ. The neonatal clinical variables (gestational age, birth weight, 5th-minute Apgar, and length of stay in neonatal intensive care unit (NICU) and hospital) were not predictors of cognitive outcomes. Conclusion: The majority of the children who were born preterm presented average or above-average cognitive and attentional performances at school age, demonstrating potential resources for learning. Taken together, attention and temperament, associated with maternal schooling and socioeconomic status, were predictors of cognitive outcomes of children born preterm at school age.