2003年宁夏固原市农村5岁以下儿童生长发育监测

目的 收集宁夏固原不同地区儿童营养状况的连续资料.方法 2003年7月对固原市东郊乡大堡、明庄两村415名5岁以下儿童及其住户进行了现场监测(5岁以下儿童身高、体重的测量)与儿童生长发育相关因素的问卷调查.结果 5岁以下儿童的生长迟缓率(身高不足)为13.25%,低体重率为8.67%;调查前两周儿童呼吸系统疾病的患病率为16.87%,腹泻患病率为14.46%;2岁以下儿童辅食添加率分别是,谷类66.09%,乳类25.86%,蔬菜水果类61.49%,蛋类67.24%,禽畜肉类47.70%.鱼虾类30.46%,豆类24.71%;测定21名5岁以下儿童血红蛋白含量,贫血率21.33%;儿童低体重率和腹泻患病率高于2001年监测结果(P＞0.01,P＞0.05.结论 农村儿童由于经济收入、文化水平、育儿观念等因素的制约,低体重和生长发育迟缓占较高比例,呼吸系统疾病和腹泻仍是主要疾病,影响儿童的生长发育.     

广西壮族自治区平果县5岁以下儿童营养状况调查报告

采用WHO推荐的参考标准，对2002、2003年广西壮族自治区平果县部分5岁以下儿童的健康状况进行调查。调查结果显示，2003年该县5岁以下儿童低体质量、生长发育迟缓发生率较2002年显著降低（P〈0.05），两年的消瘦、贫血发生率无统计学差异（P均〉0．05），6个月内婴儿纯母乳喂养率2003年较2002年提高5个百分点（P〈0．05）。提示2003年儿童总体营养状况明显改善，通过对儿童父母进行营养知识宣传教育改变儿童喂养行为，是改善儿童营养不良的有效途径。     

新疆两监测县(市)5岁以下儿童营养状况监测分析

目的及时、动态地掌握新疆5岁以下儿童营养与健康状况,为制定儿童卫生策略和健康干预措施提供科学依据。方法根据全国儿童营养与健康监测方案要求,选择库尔勒市(城市监测点)和鄯善县(农村监测点)作为监测点,2012─2016年共调查5岁以下儿童19 394人,按2006年WHO儿童生长发育标准和Z评分法对其身高、体重和血红蛋白等指标进行评价。结果 2012─2016年新疆2个监测县(市)5岁以下儿童低体重率、生长迟缓率和消瘦率下降明显,儿童低体重率城市监测点(1.07%)高于农村(0.45%),差异无统计学意义(χ2=0.92,P>0.05);超重率(χ2=2.59)和肥胖率(χ2=5.97)农村儿童高于城市,差异有统计学意义(P<0.05);儿童贫血以轻度为主,尤以1岁以下幼儿居多。结论新疆两监测县(市)5岁以下儿童生长发育状况有所好转,仍存在超重和贫血现象;应进一步加大健康教育宣传力度,提高家长科学育儿水平,改善儿童生长发育状况。     

新近诊断为成年肺结核病人对生活在同一家庭5岁以下儿童影响的前瞻性评估

背景:南非一个结核病高发病率(>800/10万)的郊区。目的:确定肺结核成年病人对家庭5岁以下密切接触者的结核感染率和发病率。设计:前瞻性临床研究。对象:成年结核病病人家庭周围5岁以下儿童接触者(其中>98％在新生儿时期接种过卡介苗)。检查项目:临床检查,结核菌素皮内试验,胸部X线摄影,胃液结核分支杆菌培养。结果:在与80名已登记病人(83％涂片阳性)有接触的155名5岁以下儿童中,感染率为14%,发病率为34％。2岁以下儿童病变更重(支气管内结核和支气管压迫症)。在154名年龄超过5岁的受检家庭成员中,17人培养确诊为肺结核(13人涂片阳性),并根据X线所见对16人进行抗结核治疗。结论:在结核高发区对肺结核成年病人家庭接触的儿童进行评估和采用药物预防是一项有价值的措施。在家庭青春期和成年人涂片和培养阳性肺结核的检出应强调对接触者的追踪以检出肺结核传染病人和防止结核病的扩散。     

卫生部发布我国0至6岁儿童营养发展报告

2012年5月31日,卫生部召开新闻发布会,发布《中国0-6岁儿童营养发展报告（2012）》。报告显示：我国5岁以下儿童死亡归因于儿童营养不良的比例由2000年的22%降为2010年的13%;儿童营养状况的改善促进了5岁以下儿童死亡率的下降,2010年全国5岁以下儿童死亡率为16.4%。提前实现了联合国千年发展目标。     

精河县2004～2006年5岁以下儿童死亡原因调查分析

目的 为了解精河县2004～2006年5岁以下儿童死亡变化趋势及主要死亡原因、特点和规律,进一步采取干预措施,有效降低儿童死亡率.方法 对精河县3年来5岁以下儿童死亡监测情况进行回顾性调查分析.结果 5岁以下儿童的死亡率总体呈下降趋势,各年龄组儿童死亡率城镇明显低于农村,汉族低于少数民族,早产、低体重儿,新生儿窒息,新生儿肺炎为精河县5岁以下儿童死亡的主要原因.结论 5岁以下儿童死亡日益成为危害儿童生存、保护、发展的主要原因,在5岁以下儿童死亡中新生儿死亡比例较高,今后儿童保健的重要对象仍是围产儿和新生儿,儿童保健工作的重点在农村,牧区和少数民族儿童人群.     

2005～2009年新疆拜城县5岁以下儿童死因分析

目的了解2005-2009年新疆拜城县5岁以下儿童死亡的主要原因及相关因素,并提出相应的干预措施。方法对全县16个乡镇卫生院上报的2005-2009年374例死亡的5岁以下儿童死亡监测数据及资料进行分析。结果拜城县5岁以下儿童死亡率呈逐年下降趋势,儿童死因依次为：早产和低体重、出生窒息、肺炎、腹泻。结论做好孕期保健、推广新生儿窒息复苏技术、加强儿童的保健管理、提高农牧民卫生保健意识是降低拜城县5岁以下儿童死亡率的关键。     

营养不良与儿童结核病

目的探讨营养状况与儿童结核病患者的关系。方法对2007年1月～12月在本院住院治疗的结核病患儿营养状况分析。结果婴幼儿患结核较多（39．0％）;结核性脑膜炎在学龄前儿童较多（41．7％,P〈0．05）,而肺结核以学龄期儿童多见（71．1％,P〈0．05）;儿童结核病并营养不良70．0％;在低体重患儿中,男性57．8％,女性86．0％,（P〈0．01）。结论儿童结核病与营养不良有密切的关系。对于低体重儿童,特别女性近期出现不能解释的消瘦,应注意结核病的发生。     

2000～2004年新疆乌苏市5岁以下儿童死亡相关因素分析

目的分析了解新疆乌苏市2000~2004年5岁以下儿童死亡率及死亡原因相关因素,为采取相应的干预措施和提高本市儿童生存质量提供科学依据。方法对2000~2004年乌苏市5乡11镇5个牧场5岁以下儿童连续5年的死亡情况回顾调查,所有调查资料进行汇总分析。结果通过在全市实施1996~2000年联合国儿童基金会妇幼卫生合作项目,新生儿、婴儿、5岁以下儿童死亡率与1995年执行项目前相比明显下降,各年龄组儿童死亡率呈逐年下降趋势,死亡儿童年龄越小所占比例越高;早产和低体重、出生窒息为近年来儿童死亡的第1、2位死因。结论今后儿童保健的重点在农牧区,重点保健对象是围产儿和新生儿。     

母乳喂养与儿童哮喘的关系

目的研究母乳喂养对儿童哮喘的影响。方法对6个月到4岁的164例哮喘儿童和1763名非哮喘儿童进行问卷调查,收集母乳喂养情况,并分析母乳喂养与儿童哮喘的关系。结果 1927名儿童中母乳喂养〈4月组的儿童有818例（42.4%）,母乳喂养≥4月组的儿童有1109例（57.6%）。母乳喂养≥4月组的儿童哮喘发生率显著低于母乳喂养〈4月组（χ2=6.456,P=0.011）,同时母乳喂养可以降低儿童发生哮喘的危险（OR=1.512;95%CI：1.097-2.083）。进一步分析发现：年龄〈3岁组、女性儿童组、孕周≥37周组、体重〈2500 g组、出生时母亲年龄≥30岁组以及父母亲没有过敏史组的儿童母乳喂养≥4月组的哮喘发生率均明显低于母乳喂养〈4月组（P〈0.05）,其他各组的儿童哮喘发生率差异均没有显著性差异（P〉0.05）。结论母乳喂养可能减少感染和特应性变态反应,因此可以明显降低儿童的哮喘发生率。     

Childhood feeding practices and their effects on nutrition in a rural area of The Gambia

We have studied the nutritional status of 118 children of the Serahuli tribe aged 0-5 years from Badjakunda, a village in North Bank, Upper River Division (URD) of The Gambia. Throughout the 9 month study period malnutrition was identified in a larger proportion of children than in similar recent studies elsewhere in The Gambia. We have found a relationship in villages in North Bank URD between the percentage of Serahulis in the population and the percentage of children with malnutrition. Serahulis in Badjakunda generally do not introduce weaning foods until the child is aged 1 year, while Mandinkas in the same area usually start such foods before their children are 6 months old. Children aged between 6 months and 2 years were at particular risk of malnutrition, this may be attributable to the feeding practices of Serahulis.     

Catch-up growth after the introduction of a gluten-free diet in children with celiac disease

The rhythm of nutritional recovery in 11 children with celiac disease after the introduction of a gluten-free diet was studied. The mean age of the patients at the moment of the diagnosis was 2.8 +/- 1.2 years and they were followed up for a period of 3.4 +/- 1.9 years. The nutritional status was evaluated by the utilization of the following parameters: the weight-for-age, height-for-age and weight-for-height. It was verified that none child was well nourished at the moment of the diagnosis and during the evolution 9 of them reached a complete recovery of their nutritional status for the weight in a mean period of time of 5.8 +/- 2.7 months; 5 of these children remained well nourished during the follow-up, 3 for 33 months and 1 for just a month. The other 2 children were initially classified as PCM II and turned to PCM I. The height-for-age index revealed that only 6 children had recovered from malnutrition and only 4 remained like this during all the follow-up. The other 2 children suffered nutritional aggravation and turned to be PCM I, but after a mean time of 18.4 months both resumed the rhythm of growth. Nutritional dwarfsism in 45.45% and chronic evoluted malnutrition in 54.55% were the patterns of malnutrition observed in this group of patients.     

Nutritional risk and malnutrition determination by anthropometry in cirrhotic children and adolescents

BACKGROUND: The malnutrition is a frequent finding in adults with cirrhosis, but the prevalence of nutritional risk and malnutrition is little known in pediatric patients. AIM: To evaluate through anthropometry the presence of nutritional risk and malnutrition in cirrhotic pediatric patients regularly attended at the Pediatric Gastroenterology Service of "Hospital de Clínicas" of Porto Alegre, RS, Brazil. METHODS: Cross-sectional study with 42 cirrhotic children and adolescents aged between 3 months and 18 years. The nutritional evaluation was made by the determination of the weight/age, height/age, body mass index and triceps skinfold thickness and arm muscle circumference measurements. Patients considered in nutritional risk were < or = -1,28 Z score which corresponds to < or = 10th percentile, and those under -2,0 Z and < or = 3th percentile were in malnutrition status. According to Child-Pugh criteria, 22 patients were classified as A (mild severity), 15 (moderate) B and 5 C (intense). RESULTS: The mean weight/age, height/age and body mass index Z scores were, respectively, - 0,38 +/- 1,4 SD, - 0,83 +/- 1,16 SD and 0,17 +/- 1,3 SD. Patients in nutritional risk were 3/42 (weight/age), 8/42 (height/age), 12/37 (triceps skinfold thickness), 9/37 (arm muscle circumference), 2/38 (body mass index); in malnutrition status were 6/42 (weight/age), 7/42 (height/age), 4/37 (triceps skinfold thickness) and 4/37 (arm muscle circumference) and 3/38 (body mass index). CONCLUSION: The prevalence of nutritional risk was 32.4% and chronic malnutrition was 16.7%. The index which better reflected the nutritional risk in these patients was triceps skinfold thickness. Chronic malnutrition status occurrence was greater in the height/age index.     

Investigation of small-intestinal transit time in normal and malnourished children

We aimed to establish whether there was a variation in orocecal transit time (OCTT) in Myanmar children and whether shortened transit time correlated with malnutrition. OCTT was measured in 90 healthy Myanmar children aged 1–5 years, using the hydrogen breath test (10 g in 10% aqueous solution). The relationships between OCTT, sex, age, and malnutrition status were assessed. OCTT for 1 to 5-year old children was 90.2 ± 20 min (mean ± SD). There was no significant difference in mean OCTT between boys and girls, breast-fed and weaned children, malnourished and non-malnourished children. There was also no difference between age groups (1–2 years, 2–3 years, 3–4 years, and 4–5 years), and no correlation was found between age and orocecal transit time. The assessment of OCTT using the lactulose breath hydrogen test was found to be feasible and acceptable in the field setting. The OCTT of Myanmar children with rice as a staple food is similar to that of children from developed countries having a different diet, and no shortening of transit time was demonstrated in children with malnutrition. Received: December 11, 1998 / Accepted: May 28, 1999     

Human immunodeficiency virus type-1 (HIV-1) and the associated clinical features among sero-positive Nigerian subjects

Enzyme Linked Immunosorbent Assay (ELISA) and Westernblot were employed to analyze sera collected from one thousand and fifty (1050) patients who tested HIV positive type-1. Out of this, 95 (9.1%) of the patients were less than 2 years old, 102 (10.0%) were aged between 2-15 years old while 813 (77.4%) were aged above 15 years. For any age group, the ratio of male to female was 1:1 except that there was excess of males below 5 years. There were four (4) most frequent signs and symptoms observed. These were loss of weight or malnutrition, generalized lymphadenopathy, chronic watery diarrhoea and chronic chest infections. Loss of weight was recorded in 65.0% of the seropositive patients in all age groups. Generalized lymphadenopathy was seen in 35.0% of all the age groups but was most frequent in 36.1% of those less than 2 years. Chronic watery diarrhoea (42.8%) was frequent in patients less than 2 years and less frequent in 18.0% of older children between 1-15 years. Chronic chest infections were least frequent in 25.0% of adults above 15 years old and highest frequency was observed in 53.0%, children less than 2 years. Forty patients had incomplete documentations and children of pediatric ages had acutely overt clinical manifestation of HIV (1&11) attributable to undeveloped immune competence.     

Nutritional status of patients hospitalized in pediatric clinic.

BACKGROUND/AIMS: The aim of this study was to evaluate the nutritional status of children at the moment of their hospitalization and to investigate whether there is a relation between the diagnosis and nutritional status. METHODS: Patients hospitalized in the Children's Clinic of Cerrahpasa Medical Faculty (excluding emergency, newborn intensive care and newborn special care units) between December 2003 and August 2004 were included in the study. All patients' height, weight, weight for height head circumference, arm circumference, triceps skin-fold thickness, and Z results of the height and weight were measured and, in accordance with the anthropometric measurements at the moment of hospitalization, each patient's nutritional status was evaluated. The average of the values was compared to diagnosis. RESULTS: 223 (42.2%) of a total of 528 patients were female. Patients' ages varied from one month to 23 years (5.8+/-5.3). The evaluated average height and weight Z scores of the patients were -0.6+/-1.9 and -0.7+/-1.5. Evaluation of height for age showed that in 27% of cases there was chronic malnutrition. Evaluation of weight for age and weight for height showed that in 52.4% and 40.9% of the cases, respectively, there was acute malnutrition. In 45.7% of the cases the body mass index was below -2 standard deviations. The evaluation of patients' diagnoses revealed 83 cases (15.7%) diagnosed as acute or chronic respiratory system disease. Malnutrition was most common among patients suffering from diseases from the following groups: chronic kidney insufficiency, genetic diseases, immune insufficiency and cystic fibrosis. CONCLUSION: Malnutrition among hospitalized children and especially those with chronic diseases is worth attention. Evaluation of the nutritional status and nutritional support are elements of the diagnostic and treatment process. In particular, closer observation and nutritional support are required in the cases of patients diagnosed with chronic kidney insufficiency, immune insufficiency, neurological diseases, and cystic fibrosis.     

The nutritional status of children in resettlement villages in Kelantan

A cross-sectional survey of the nutritional status of children aged 1-10 years old from the Kuala Betis resettlement villages was carried out. A total of 620 children were examined, of which 329 were preschool children and 291 were schoolchildren. The age was determined and anthropometric measurements such as weight, height and MUAC were taken. The nutritional status was assessed by looking at the distributions of the z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) in relation to the growth charts of the National Center for Health Statistics reference population. It was found that the nutritional status of the Orang Asli children was poor, with a prevalence of 33.7-65.3% underweight, 55.3-74.4% stunting and 4.4-29.7% wasting based on the NCHS reference values. The prevalence of malnutrition among the Malay children was lower, underweight--7.3-34.1%, stunting--9.8-34.1% and wasting--1.7-17.1%. The nutritional status of the Orang Asli children were poorer compared to the Malay children. More preschool Orang Asli children were stunted compared to the Orang Asli schoolchildren. This may be due to the poor economic base of the Orang Asli community during the transformation period after resettlement. A comprehensive primary health care program is essential, especially targeting the preschool Orang Asli children in these resettlement villages.     

Clinical features of influenza C virus infection in children

BACKGROUND: Seroepidemiological studies have revealed that influenza C virus is widely distributed globally. However, because the isolation of this virus is difficult, there have been few reports on its clinical features. METHODS: Between December 1990 and November 2004, 84,946 respiratory-tract specimens were obtained from patients < or = 15 years old. On the basis of the results of isolation of virus, we examined the clinical data on children infected with influenza C virus. RESULTS: Of 170 children infected with influenza C virus, 157 (92.4%) were < 6 years old. Fever (frequency, 90.0%), cough (frequency, 74.1%), and rhinorrhea (frequency, 61.8%) were the most frequent symptoms. The mean duration of fever was 2.88 days (standard deviation, 1.66 days). Of the 170 children, 29 were hospitalized, and 21 (72.4%) of these 29 had lower-respiratory-tract illness such as pneumonia, bronchitis, and bronchiolitis. The rate of hospital admission was significantly higher in children < 2 years old than in children 2-5 years old (30.4% vs. 11.9%; P = .0043). CONCLUSIONS: Influenza C virus is a significant cause of upper-respiratory-tract illness in children < 6 years old, and the risk of complications with lower-respiratory-tract illness is particularly high in children < 2 years old.     

Seroprevalence of anti-human herpes virus-6 IgG antibody in children of Bangkok, Thailand

The prevalence of HHV-6 infection was surveyed by determining the presence of anti-human herpesvirus-6 IgG (Anti-HHV-6 IgG) using an ELISA method. Two hundred and ten sera collected from healthy Thai children aged between 0 to 12 years (mean +/- standard deviation = 3.35+/-3.33) indicated the prevalence of HHV-6 infection was 88.10% (185/210). Samples were classified into 7 groups, 30 samples each, according to their ages, ie, group 1: 0 - < 6 months; group 2: 6 - < 12 months; group 3: 12 - < 18 months; group 4; 18 - < 24 months; group 5: 2 - < 5 years; group 6: 5 - < 8 years and group 7: 8-12 years. The prevalence of HHV-6 infection was 63.33%, 70%, 96.67%, 93.33%, 100%, 100% and 93.33%, respectively. The mean level of anti-HHV-6 IgG among those positive for HHV-6 infection (185 samples) increased from 0 < 6 months old (17.47+/-6.32 units) to 27.57+/-8.42 units in 6 - < 12 months old, with the highest value found in the 18 - < 24 months old group (33.08+/-8.64 units). The level declined thereafter. A statistically significant difference of the mean level of anti-HHV-6 IgG among positive groups was found (p-value < 0.05). The important factor associated with HHV-6 infection was age (p = 0.002), while sex, socioeconomic status, number of children in the family and child rearing place did not show any association.     

Analysis of characteristics and related factors of tuberculosis resistance in children

目的 了解儿童结核病的耐药现况,发现儿童耐多药相关的危险因素。方法 收集沈阳市第十人民医院2017年1月31日至2019年12月31日收治的≤18岁的结核病患者314例,男178例,女136例,年龄1~18岁,中位年龄(四分位数)[M(Q₁,Q₃)]为17(15,18)岁,初治253例,复治61例。分析314例患者培养阳性且菌种鉴定为结核分枝杆菌(MTB)的临床分离株的药物敏感性试验结果。采用多因素非条件logistic回归分析儿童耐药结核病的危险因素。结果 314例患者的MTB临床分离株总耐药率、初治耐药率和复治耐药率分别为27.1%(85/314)、20.9%(53/253)和52.5%(32/61),复治耐药率明显高于初治耐药率(χ²=24.771,P=0.000);总耐多药率、初治耐多药率和复治耐多药率分别为10.8%(34/314)、6.3%(16/253)和29.5%(18/61),复治耐多药率明显高于初治耐多药率(χ²=27.360,P=0.000)。logistic多因素回归分析表明,复治(OR=5.671,95%CI=2.228~14.435,P=0.000)、14~18岁年龄组(OR=2.235,95%CI=1.568~3.562,P=0.032)、并发营养不良(OR=1.908,95%CI=1.337~2.447, P=0.034)、吸烟(OR=1.225,95%CI=1.013~2.740,P=0.046)是儿童患者发生耐多药结核病的危险因素。结论 儿童结核病耐药现状严峻,复治、14~18岁年龄组、并发营养不良、有吸烟史是儿童患者发生耐多药的危险因素。