Traumatic experience and sleep disturbance in refugee children from the Middle East

BACKGROUND: Sleep disturbance is frequently reported in children after traumatic experiences associated with organised violence. The aim of this study was to identify specific traumatic risk indicators and modifying factors for sleep disturbance among recently arrived refugee children from the Middle East. METHODS: The study group comprises 311, 3-15 year old refugee children from the Middle East. On arrival in Denmark, their parents participated in a structured interview about their childrens' health and history of exile and eventual exposure to war, organised violence and human rights violation. RESULTS: A family history of violence (grandparent's violent death before the birth of the child or parental exposure to torture) as well as a stressful present family situation (father scolds the child more than previously) were the strongest predictors of prevalent sleep disturbance in the children. Arriving in Denmark with both parents rather than one was a modifying factor, so the effect of traumatic experience on sleep patterns later in childhood was mediated through parental presence and behaviour. CONCLUSION: This study indicates that the family environment is of primary importance for childhood sleep disturbance following traumatic experiences connected with war and other organised violence.     

MERS Coronaviruses in Dromedary Camels,Egypt

We identified the near-full-genome sequence (29,908 nt, >99%) of Middle East respiratory syndrome coronavirus (MERS-CoV) from a nasal swab specimen from a dromedary camel in Egypt. We found that viruses genetically very similar to human MERS-CoV are infecting dromedaries beyond the Arabian Peninsula, where human MERS-CoV infections have not yet been detected.     

上海市浦东新区幼托儿童细菌和病毒感染性腹泻流行特征分析

目的 了解浦东新区幼托儿童细菌和病毒感染性腹泻流行特征,为幼托儿童感染性腹泻病的防控提供科学依据。方法 依托6家医院,按照1∶5~1∶20不等的抽样间距,采集儿童腹泻初诊病例粪便标本并收集流行病学资料,开展细菌和病毒检测分析。结果 381例粪便标本中,细菌和病毒阳性检出率60.89%,民办幼儿园病例阳性检出率高于公办幼儿园(χ²=6.53,P＜0.05)。单纯细菌阳性检出率10.24%,主要为致泻性大肠埃希菌;单纯病毒阳性检出率33.33%,主要为诺如病毒和轮状病毒;混合感染阳性检出率17.59%,主要为2种病毒混合感染。单纯细菌感染夏季高,单纯病毒感染冬春季高(χ²=34.00,P＜0.05)。单纯病毒和细菌感染病例中,出现呕吐症状的构成比分别为42.06%和17.95%,病毒组高于细菌组(χ²=7.48,P＜0.05)。结论 上海市浦东新区幼托儿童感染性腹泻病原中细菌和病毒季节高峰明显,民办幼托机构儿童感染较重,应针对不同季节和不同人群开展防控措施。     

武汉市学龄前儿童VA缺乏及其营养状况调查

对武汉市两所幼儿园２～７岁学龄前儿童进行了营养状况调查。膳食调查结果：蛋白质、脂肪及热能摄入量基本正常；视黄醇摄入量明显不足，占我国推荐量标准４４．５％～６５．１％；钙摄入量不足。实验室检测：贫血率１６．９％；血清ＶＡ缺乏率１０．９０％，亚临床缺乏率２１．９６％；血清ＶＡ水平与血红蛋白呈正相关，相关系数ｒ＝０．１５４。     

明光市 5 岁以下住院儿童腹泻轮状病毒感染监测分析简

目的了解和掌握明光市5岁以下住院儿童腹泻轮状病毒感染情况。方法收集明光市人民医院2012年5~11月5岁以下住院儿童腹泻粪便标本,采用酶联免疫法检测A组轮状病毒,阳性者反转录-聚合酶链反应进行G/P分型鉴定。结果 A组轮状病毒感染率35.33%,A组轮状病毒P分型以P4为主,G分型以G2为主。结论轮状病毒感染是明光市5岁以下住院儿童腹泻的重要病因。     

杭州地区腹泻患儿轮状病毒感染流行病学特征分析

【目的】 探讨杭州地区腹泻儿童感染A组轮状病毒的流行病学特征,指导临床防治。 【方法】 对2007-2011年门诊和住院的急性腹泻儿童的大便进行轮状病毒抗原检测,并采用统计方法分析流行病学特征。 【结果】 杭州地区2007-2011年腹泻儿童A组轮状病毒平均阳性率为29.25%。阳性率从2007年的39.42%下降到2011年的19.61%,其中每年11-12月份为儿童轮状病毒感染高峰期;且以6~18月的患儿感染率最高。腹泻儿童中门诊轮状病毒阳性率为32.28%,住院儿童的阳性率为20.70%。 【结论】 杭州地区儿童A组轮状病毒感染率低于全国平均水平,而且有逐年下降趋势。在今后应加快安全高效的轮状病毒疫苗的开发,从根本上解决儿童轮状病毒的危害。     

Prevalence and determinants of Campylobacter infection among under five children with acute watery diarrhea in Mwanza,North Tanzania

Background

Campylobacteriosis, a zoonotic bacterial disease observed world-wide, is becoming the most commonly recognized cause of bacterial gastroenteritis in humans. This study was done to determine the prevalence and determinants of Campylobacter infection among under-fives with acute watery diarrhea in Mwanza City, Tanzania.

Method

This cross-sectional hospital-based study was conducted at Bugando Medical Centre (BMC) and Sekou Toure Hospital in Mwanza City. All inpatients and outpatients under-fives who met the inclusion criteria from October 2012 to April 2013 were enrolled in the study. Demographic and clinical data were obtained using standardized data collection tools. Stool samples were collected for gram staining and culture for Campylobacter spp. on Preston selective agar media. In addition, blood slides for malaria and HIV tests were done to all patients.

Results

A total of 300 children were enrolled with a median age of 12 [interquartile range, 8–19] months. Of these, 169 (56.5%) were from BMC and 131 (43.7%) from Sekou-Toure hospital. One hundred and seventy (56.7%) of the participating children were male. Of 300 under-fives with acute watery diarrhea, 29 patients (9.7%) were found to have Campylobacter infection. A significant higher number of children with Campylobacter infection were found in Sekou Toure hospital compared to BMC [16.0% (21/29) versus 4.7% (8/29), p = 0.002)]. Age above 2 years was independently found to predict campylobacter infection (OR: 2.9, 95% CI 1.1-7.7, p = 0.0037). Of 30 patients with a positive blood slide for Plasmodium falciparum, 20.0% were also positive for Campylobacter infection (OR: 3.9, 95% CI 1.2-10.1, p = 0.021).

Conclusion

Campylobacter infection shows a comparatively low prevalence in under-fives with acute watery diarrhea in Mwanza city and is independently associated with positive slides for malaria and an age above 2 years. Further studies are needed to type the most prevalent Campylobacter species and to determine their antibiotic susceptibility pattern.     

小儿抗菌药物相关性腹泻的相关因素

目的了解住院患儿使用抗菌药物后发生抗菌药物相关性腹泻的因素,以加强防治。方法对某院2008年6月-2010年6月住院发生抗菌药物相关性腹泻患儿的病历资料进行分析。结果共调查患儿4 368例;抗菌药物使用率为84.96%（3 711/4 368）,抗菌药物相关性腹泻发生率为29.21%（935/3 201）。抗菌药物相关性腹泻发生率：≤1岁者为35.14%,显著高于其他年龄组（P＜0.01）;普通病例和危重病例分别为27.63%和41.60%,两者比较,差异有统计学意义（P＜0.01）;使用抗菌药物时间≤7 d和＞7 d者分别为26.39%、34.01%,两者比较,差异有统计学意义（P＜0.01）;使用4种及以上抗菌药物者为40.45%,显著高于使用1～3种抗菌药物者（P＜0.01）。结论年龄小、使用抗菌药物时间长、病情重、使用抗菌药物种类多者,容易发生抗菌药物相关性腹泻。应规范、合理使用抗菌药物,以减少抗菌药物相关性腹泻的发生。     

2015年韩国中东呼吸综合征疫情流行病学特征分析

目的 分析2015年韩国中东呼吸综合征(MERS)疫情的流行特征, 利于中国医疗卫生业务人员了解相关信息。方法 收集韩国政府、WHO等官方网站及韩国权威媒体信息, 进行疫情流行特征相关分析。结果 2015年5月20日至7月13日韩国共报告186例MERS确诊病例, 其中死亡36例。除2例可能为家庭内感染外, 其余病例均在医疗机构相关场所感染。首发病例1例, 二代病例29例、三代病例125例、四代病例25例, 6例代数不详。5个道(市)11个区域的16家医院报告了病例, 病例中包括39名医院工作人员。病例年龄M=55岁, 男性占60%。死亡病例年龄M=70岁, 男性占67%;78%的死亡病例有慢性基础性疾病。除首发病例外, 有12例发生了续发病例, 其中1例传播了84例。中国5月29日确诊1例韩国输入病例, 未发生二代病例。从韩国病例和中国输入性病例中获得的病毒与从中东地区获得的病毒相比无明显变化。结论 2015年韩国MERS疫情特点和传播模式与以往中东地区暴发疫情类似。     

湖北省农村5岁以下儿童腹泻状况调查

目的 了解湖北省农村地区5岁以下儿童腹泻两周患病率状况,为制定有针对性的干预措施提供科学依据。方法 在湖北省农村地区采用整群随机抽样的方法,随机抽取8个市(县)调查2 330名5岁以下儿童。结果 2009年湖北省农村5以下儿童腹泻两周患病率为8.1%,男童(8.2%)和女童(7.9%)腹泻两周患病率差异无统计学意义。总体上,两周患病率随儿童月龄的增长而下降,但有先上升后下降的变化过程,最低的为46～59月龄组(2.2%),最高的为6~11月龄组(13.8%);中收入地区两周患病率最高(13.5%),高收入地区最低(4.6%);出生时母亲年龄>25岁的儿童两周患病率高于出生时母亲年龄≤25岁的儿童(10.4%>6.7%);母亲文化程度在小学及以下的儿童两周患病率最高(11.9%),母亲文化程度为初中者最低(6.9%);母亲外出打工的儿童两周患病率高于母亲未外出打工的儿童(9.9% vs 7.2%);过去一年家庭人均收入≤3 000元的儿童两周患病率最高(11.7%),>6 000元者最低(7.1%)。结论 湖北农村地区5岁以下儿童腹泻两周患病率较高,其受儿童月龄、儿童出生时母亲年龄、文化程度、是否外出打工、家庭经济状况等多因素影响。     

天津市0～18岁儿童腹泻流行病学调查

【目的】了解天津市城乡0~18岁儿童夏秋季腹泻发病率、腹泻相关因素以及腹泻儿童家庭治疗行为。【方法】对123个调查点全部0~18岁儿童进行回顾性调查,在调查日前28 d内曾发生腹泻的儿童进行详细问卷调查。【结果】本次调查天津市58 346名0~18岁儿童,3 168人在调查日前28 d内发生腹泻,发病率为5.4%;腹泻发病率乡镇高于城市,男童高于女童,0岁~组高于其它年龄组,差异均有显著性(P<0.05);共有22.0%家长或儿童选择到医院就诊,53.6%应用药物治疗,83.3%的腹泻儿童经过一次处置后即告痊愈。【结论】腹泻仍然是儿童常见病之一。加强健康教育,增强对儿童腹泻正确处置,有效提高儿童腹泻的治愈率是至关重要的。     

Novel Betacoronavirus in Dromedaries of the Middle East, 2013

In 2013, a novel betacoronavirus was identified in fecal samples from dromedaries in Dubai, United Arab Emirates. Antibodies against the recombinant nucleocapsid protein of the virus, which we named dromedary camel coronavirus (DcCoV) UAE-HKU23, were detected in 52% of 59 dromedary serum samples tested. In an analysis of 3 complete DcCoV UAE-HKU23 genomes, we identified the virus as a betacoronavirus in lineage A1. The DcCoV UAE-HKU23 genome has G+C contents; a general preference for G/C in the third position of codons; a cleavage site for spike protein; and a membrane protein of similar length to that of other betacoronavirus A1 members, to which DcCoV UAE-HKU23 is phylogenetically closely related. Along with this coronavirus, viruses of at least 8 other families have been found to infect camels. Because camels have a close association with humans, continuous surveillance should be conducted to understand the potential for virus emergence in camels and for virus transmission to humans.     

北京地区79例婴幼儿诺如病毒腹泻的临床特点分析

目的分析婴幼儿诺如病毒腹泻的发病特点，为临床诊断提供依据。方法对2002年1月至2006年12月在首都儿科研究所附属儿童医院就诊的318例急性腹泻患儿采集粪便标本，用酶联免疫吸附试验（ELISA）检测粪便诺如病毒抗原，同时用聚丙烯酰胺凝胶电泳（PAGE）检测轮状病毒。结果经检测的318份粪便标本中，诺如病毒阳性标本共79份，阳性检出率为24．8％（79/318）。其中有48例在10-12月份检出，占阳性标本的60．8％（48/79）。2岁以内患儿占91．2％。有16例同时合并轮状病毒感染。经统计学分析，轮状病毒混合感染组与单纯诺如病毒感染组在发热的严重程度上有差异，但是在腹泻严重程度上的差异无统计学意义。诺如病毒阳性患儿中有14例是以其他疾病住院，分别于住院1-11d出现腹泻。结论诺如病毒是引起婴幼儿急性腹泻的病原之一，也是医院内感染性腹泻的病因之一。     

Human rotavirus G9 and G3 as major cause of diarrhea in hospitalized children, Spain

In Spain, diarrhea remains a major cause of illness among infants and young children. To determine the prevalence of rotavirus genotypes and temporal and geographic differences in strain distribution, a structured surveillance study of hospitalized children <5 years of age with diarrhea was initiated in different regions of Spain during 2005. Rotavirus was detected alone in samples from 362 (55.2%) samples and as a coinfection with other viruses in 41 samples (6.3%). Enteropathogenic bacterial agents were detected in 4.9% of samples; astrovirus and norovirus RNA was detected in 3.2% and 12.0% samples, respectively; and adenovirus antigen was detected in 1.8% samples. Including mixed infections, the most predominant G type was G9 (50.6%), followed by G3 (33.0%) and G1 (20.2%). Infection with multiple rotavirus strains was detected in >11.4% of the samples studied during 2005.     

2020年郑州某哨点医院儿童致泻性大肠埃希菌流行特征及分子分型分析

目的 了解郑州市某哨点医院儿童致泻性大肠埃希菌(diarrheagenic Escherichia coli, DEC)的流行特征及分子分型特征,为今后本地区科学防控儿童DEC感染提供依据。 方法 对2020年收集的230份腹泻儿童和187份非腹泻儿童粪便标本进行常规细菌培养,采用多重PCR技术检测DEC的毒力基因和脉冲场凝胶电泳(pulsed field gelelectrophoresis, PFGE)技术进行分子分型。 结果 DEC在腹泻儿童与非腹泻儿童中的检出率分别为8.26%(19/230)和14.97%(28/187),腹泻儿童中检出的型别及检出率分别为典型黏附性大肠埃希菌(typical enteroaggregative Escherichia coli, tEAEC)(3.48%)、肠致病性大肠埃希菌(enteropathogenic Escherichia coli, EPEC)(2.61%)、非典型黏附性大肠埃希菌(atypical enteroaggregative Escherichia coli, aEAEC)(2.17%)和肠侵入性大肠埃希菌(enteroinvasive Escherichia coli, EIEC)(0.43%),非腹泻儿童中检出的型别为aEAEC(8.02%)、tEAEC(4.28%)、EPEC(3.74%)和产肠毒素大肠埃希菌(enterotoxigenic Escherichia coli, ETEC)(0.53%)。在腹泻儿童中黏液便的检出率高于稀便的检出率(χ²=47.332,P＜0.001),在不同性别、不同年龄段中检出率无显著性差异。46株DEC分为44个带型,种内最高相似度为100.00%,最低相似度为24.54%,腹泻儿童与非腹泻儿童之间并未检测出带型一致的条带。 结论 DEC在郑州市腹泻儿童与非腹泻儿童中优势型别是tEAEC、aEAEC和EPEC,提示DEC为机会致病菌。常见DEC型别的PFGE指纹图谱呈高度多态性,腹泻儿童与非腹泻儿童未发现同源克隆菌株的感染。