Bmc Pediatr
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Using population-based linked records of births, deaths, birth defects and hospital admissions for children born 1980-1999 enables profiles of hospital morbidity to be created for each child. ⋯ To gain a true picture of the burden of hospital-based morbidity in childhood, admission records need to be linked for each child. We have been able to do this at a population level using birth defect cases ascertained by a birth defects registry. Our results showed a greater mean LOS and mean number of admissions per child admitted than previous studies. The results suggest there may be an opportunity for the children with a major birth defect to be monitored and seen earlier in the primary care setting for common childhood illnesses to avoid hospitalisation or reduce the LOS.
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Comparative Study
Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia.
Adequate nutrition is needed to ensure optimum growth and development of infants and young children. Understanding of the risk factors for stunting and severe stunting among children aged less than five years in North Maluku province is important to guide Indonesian government public health planners to develop nutrition programs and interventions in a post conflict area. The purpose of the current study was to assess the prevalence of and the risk factors associated with stunting and severe stunting among children aged less than five years in North Maluku province of Indonesia. ⋯ Programmes aimed at improving stunting in North Maluku province of Indonesia should focus on children under two years of age, of male sex and from families of low socioeconomic status.
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Randomized Controlled Trial Comparative Study
Improving the outcome of infants born at <30 weeks' gestation--a randomized controlled trial of preventative care at home.
Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. ⋯ ACTRN12605000492651.
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Integrated Management of Childhood Illness (IMCI) is a strategy to reduce mortality and morbidity in children under-5 years by improving management of common illnesses at primary level. IMCI has been shown to improve health worker performance, but constraints have been identified in achieving sufficient coverage to improve child survival, and implementation remains sub-optimal. At the core of the IMCI strategy is a clinical guideline whereby health workers use a series of algorithms to assess and manage a sick child, and give counselling to carers. IMCI is taught using a structured 11-day training course that combines classroom work with clinical practise; a variety of training techniques are used, supported by comprehensive training materials and detailed instructions for facilitators. ⋯ The IMCI training course was reported to be an effective method of acquiring skills, but more time is required, either during the course, or with follow-up, to improve IMCI implementation. Innovative solutions may be required to ensure that adequate skills are acquired and maintained.
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Pneumonia is one of the leading causes of morbidity and mortality in under fives. We carried out a comprehensive study to identify factors influencing both mortality and morbidity for children less than 5 years of age hospitalized with severe pneumonia. ⋯ Children hospitalized with severe community acquired pneumonia [as defined by World Health Organization (WHO)] who had not received exclusive breast feeding, had stayed in an overcrowded homes and had an abnormal chest radiograph were more likely to fail to respond with primary antibiotic regimen and require change of antibiotics and prolonged hospital stay. In children with radiographically confirmed pneumonia, lack of breast feeding and low birth weight was associated with need for change in antibiotics.