Open Access. Powered by Scholars. Published by Universities.®

Medical Specialties Commons

Open Access. Powered by Scholars. Published by Universities.®

Department of Paediatrics and Child Health

Discipline
Keyword
Publication Year
File Type

Articles 271 - 300 of 571

Full-Text Articles in Medical Specialties

A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman Nov 2018

A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman

Department of Paediatrics and Child Health

Introduction: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multisite surveillance study designed to capture morbidity and mortality burden of enteric fever (typhoid and paratyphoid) in Bangladesh, Nepal, and Pakistan. We aim to describe enteric fever disease burden, severity of illness, and antimicrobial resistance trends in Pakistan.
Methods: In this retrospective, cross-sectional study, laboratory records of hospitalized patients who received a blood culture in any of 3 Aga Khan University hospitals in Karachi and Hyderabad, Pakistan, from 2012 to 2014 were reviewed. A case was defined as having a positive blood culture for Salmonella Typhi (S. Typhi) …


Integrating Facility-Based Surveillance With Healthcare Utilization Surveys To Estimate Enteric Fever Incidence: Methods And Challenges, Jason R. Andrews, Caitlin Barkume, Alexander T. Yu, Samir K. Saha, Farah Qamar, Denise Garrett, Stephen P. Luby Nov 2018

Integrating Facility-Based Surveillance With Healthcare Utilization Surveys To Estimate Enteric Fever Incidence: Methods And Challenges, Jason R. Andrews, Caitlin Barkume, Alexander T. Yu, Samir K. Saha, Farah Qamar, Denise Garrett, Stephen P. Luby

Department of Paediatrics and Child Health

Cohort studies and facility-based sentinel surveillance are common approaches to characterizing infectious disease burden, but present trade-offs; cohort studies are resource-intensive and may alter disease natural history, while sentinel surveillance underestimates incidence in the population. Hybrid surveillance, whereby facility-based surveillance is paired with a community-based healthcare utilization assessment, represents an alternative approach to generating population-based disease incidence estimates with moderate resource investments. Here, we discuss this method in the context of the Surveillance for Enteric Fever in Asia Project (SEAP) study. We describe how data are collected and utilized to adjust enteric fever incidence for blood culture sensitivity, facility-based enrollment, …


Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret Nov 2018

Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret

Department of Paediatrics and Child Health

Objective: The objective of Phase I of the Surveillance for Enteric Fever in Asia Project (SEAP), a multiphase surveillance study characterizing the burden of disease in South Asia, was to inform data collection for prospective surveillance and to capture clinical aspects of disease.
Methods: Through a retrospective record review conducted at hospitals in Bangladesh, India, Nepal, and Pakistan, we examined laboratory and clinical records to assess the culture positivity rate for Salmonella Typhi and Salmonella Paratyphi, age and sex distribution, and antimicrobial susceptability in each country.
Results: Of all blood cultures performed in Bangladesh, India, Nepal, and Pakistan, 1.5%, 0.43%, …


Oral Ondansetron Administration To Nondehydrated Children With Diarrhea And Associated Vomiting In Emergency Departments In Pakistan: A Randomized Controlled Trial, Stephen B. Freedman, Sajid Bashir Soofi, Andrew R. Willan, Sarah Williamson Urquhart, Noshad Ali, Jianling Xie, Fady Dawoud, Zulfiqar Ahmed Bhutta Nov 2018

Oral Ondansetron Administration To Nondehydrated Children With Diarrhea And Associated Vomiting In Emergency Departments In Pakistan: A Randomized Controlled Trial, Stephen B. Freedman, Sajid Bashir Soofi, Andrew R. Willan, Sarah Williamson Urquhart, Noshad Ali, Jianling Xie, Fady Dawoud, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Study objective: We determine whether single-dose oral ondansetron administration to children with vomiting as a result of acute gastroenteritis without dehydration reduces administration of intravenous fluid rehydration.
Methods: In this 2-hospital, double-blind, placebo-controlled, emergency department–based, randomized trial conducted in Karachi Pakistan, we recruited children aged 0.5 to 5.0 years, without dehydration, who had diarrhea and greater than or equal to 1 episode of vomiting within 4 hours of arrival. Patients were randomly assigned (1:1), through an Internet-based randomization service using a stratified variable-block randomization scheme, to single-dose oral ondansetron or placebo. The primary endpoint was intravenous rehydration (administration of 20 …


Novel Public-Private Partnerships To Address The Double Burden Of Malnutrition, Adam Drewnowski, Benjamin Caballero, Jai K. Das, Jeff French, Andrew M. Prentice, Lisa R. Fries, Tessa M Van Koperen, Petra Klassen-Wigger, Barbara J. Rolls Nov 2018

Novel Public-Private Partnerships To Address The Double Burden Of Malnutrition, Adam Drewnowski, Benjamin Caballero, Jai K. Das, Jeff French, Andrew M. Prentice, Lisa R. Fries, Tessa M Van Koperen, Petra Klassen-Wigger, Barbara J. Rolls

Department of Paediatrics and Child Health

Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private …


Spectrum, Management And Outcomes Of Structural And Functional Uropathies In Children Attending A Tertiary Care Center In Karachi; Pakistan, Arshalooz Rahman, Saima Hanif, Noor Ul-Ain Baloch, Abdul Rehman, Tauqeer Sheikh, Mohammad Irfan Ladhani Nov 2018

Spectrum, Management And Outcomes Of Structural And Functional Uropathies In Children Attending A Tertiary Care Center In Karachi; Pakistan, Arshalooz Rahman, Saima Hanif, Noor Ul-Ain Baloch, Abdul Rehman, Tauqeer Sheikh, Mohammad Irfan Ladhani

Department of Paediatrics and Child Health

Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low utilization of antenatal ultrasonography remain unexplored. We performed a retrospective, crosssectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, clinical features, etiologies and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 (17.9%) were neonates and infants respectively. Congenital urinary tract pathologies were noted in 192(72.2%) patients, of which only 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after …


Development And Internal Validation Of The Multivariable Cipher (Collaborative Integrated Pregnancy High-Dependency Estimate Of Risk) Clinical Risk Prediction Model, Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar Ahmed Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte Oct 2018

Development And Internal Validation Of The Multivariable Cipher (Collaborative Integrated Pregnancy High-Dependency Estimate Of Risk) Clinical Risk Prediction Model, Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar Ahmed Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte

Department of Paediatrics and Child Health

Background: Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations is contentious. The aim of the CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) study was to develop and internally validate a multivariable prognostic model calibrated specifically for pregnant or recently delivered women admitted for critical care.
Methods: A retrospective observational cohort was created for this study from 13 tertiary facilities across five high-income and six low- or middle-income countries. Women admitted to an ICU for more than 24 h …


Alma Ata And Primary Healthcare: Back To The Future, Zulfiqar Ahmed Bhutta, Rifat Atun, Navjoyt Ladher, Kamran Abbasi Oct 2018

Alma Ata And Primary Healthcare: Back To The Future, Zulfiqar Ahmed Bhutta, Rifat Atun, Navjoyt Ladher, Kamran Abbasi

Department of Paediatrics and Child Health

No abstract provided.


Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta Oct 2018

Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings.
Methods: We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained …


Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq Oct 2018

Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq

Department of Paediatrics and Child Health

Objective: Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity.
Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return …


Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta Oct 2018

Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Optimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study.
Methods: We re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included active …


Reducing Micronutrient Deficiencies In Pakistani Children: Are Subsidies On Fortified Complementary Foods Cost-Effective?, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta Oct 2018

Reducing Micronutrient Deficiencies In Pakistani Children: Are Subsidies On Fortified Complementary Foods Cost-Effective?, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Objective: To estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children.
Design: The study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by …


Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali Sep 2018

Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali

Department of Paediatrics and Child Health

Objective: To identify maternal factors associated with intrauterine growth restriction (IUGR).
Study Design: A case-control study.
Place and Duration of Study: Neonatal Unit of The Aga Khan Hospital for Women (AKHW), Karimabad, from January 2014 to December 2015.
Methodology: Cases were IUGR live born babies (n=90), while control were appropriate-for-gestational age (AGA) babies (n=180). Information recorded in pre-designed proforma included gestational age and birth weight of baby, demographics of mothers, pregnancy related medical and obstetric complications. Data were analysed through SPSS-19. Multivariable logistic regression was used to determine the maternal factors associated with the intrauterine growth restriction.
Results: Maternal factors …


Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim Sep 2018

Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim

Department of Paediatrics and Child Health

In order to make and sustain changes in the curriculum, needs assessment is the key. We conducted a need assessment survey using a questionnaire based on a 7 point Likert Scale by residents and alumni. Over all response rate in the study was 77.5%. Fifty eight percent participants were females. Highest level of agreement (mean score 5.7) was found between the alumni and residents regarding the need to revise the content, teaching and assessment strategies in the programme. Twenty seven alumni (n= 38, 71%) had cleared their FCPS exams. The alumni thought that the existing teaching and assessment strategies do …


Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly Sep 2018

Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly

Department of Paediatrics and Child Health

Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines. In this review, we describe the pathophysiology of EED and examine the evidence linking EED and oral vaccine failure. This evidence is far from conclusive. …


Invasive Community Acquired Methicillin-Resistant Staphylococcal Aureus (Ca-Mrsa) Infections In Children, Muhammad Khalid, Samina Junejo, Fatima Mir Sep 2018

Invasive Community Acquired Methicillin-Resistant Staphylococcal Aureus (Ca-Mrsa) Infections In Children, Muhammad Khalid, Samina Junejo, Fatima Mir

Department of Paediatrics and Child Health

Staphylococci are gram-positive bacteria divided into coagulase positive and coagulase negative classes, Staphylococcus aureus is the most important bacterium of this class. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has changed a lot. It is no more the problem of only hospitalised patients. Children coming from community has also been increasingly affected by MRSA-called community acquired methicillin-resistant (CA-MRSA) infection. The higher severity of CA-MRSA is due to its ability to produce the toxin Panton-Valentine Leukocidin (PVL) associated with staphylococcal cassette chromosome mec (SCCmec) type IV gene. Here, we are presenting five cases of CA-MRSA infection in children having age range 0.5 …


Reducing Typhoid Burden Within A Generation, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Tikki Pangestu Sep 2018

Reducing Typhoid Burden Within A Generation, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Tikki Pangestu

Department of Paediatrics and Child Health

No abstract provided.


Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali Sep 2018

Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali

Department of Paediatrics and Child Health

Chronic granulomatous disease (CGD) is the most common of the primary immunodeficiency in children. It is caused by single gene defect resulting in dysfunctional nicotinamide adenine dineucleotide phosphate (NADPH) oxidase complex causing recurrent bacterial and fungal infections. Here we present the case of a 9 year old boy who was a known case of CGD since three years of age. He presented with recent history of fever, left sided pain in the scapular region and difficulty in breathing. Chest imaging revealed developing left upper lobe consolidation and erosion of the 3rd posterior rib. The child underwent video assisted thoracoscopic surgery …


Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan Aug 2018

Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan

Department of Paediatrics and Child Health

Background: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan.
Methods: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants’ chief complaints and medical care were documented. Patients were followed-up at 48-h and 14-days via telephone. Results: Of 3115 participants, 1846 were triaged to the outpatient department and 1269 to the ED. Patients triaged to the ED had …


Global Trends In Typhoidal Salmonellosis: A Systematic Review, Daina Als, Amruta Radhakrishnan, Paul Arora, Michelle F. Gaffey, Susan Campisi, Russanthy Velummailum, Farhana Zareef, Zulfiqar Ahmed Bhutta Jul 2018

Global Trends In Typhoidal Salmonellosis: A Systematic Review, Daina Als, Amruta Radhakrishnan, Paul Arora, Michelle F. Gaffey, Susan Campisi, Russanthy Velummailum, Farhana Zareef, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Typhoid and paratyphoid fever continue to significantly contribute to global morbidity and mortality. Disease burden is higher in low-and middle-income settings where surveillance programs are rare and little systematic information exists at population level. This review evaluates national, regional, and global trends in the incidence of typhoid fever and of related morbidity and mortality. A literature search in Medline, Embase, and Web of Science was conducted in June 2016, followed by screening and data extraction in duplicate. Studies reporting blood culture estimates of typhoid or paratyphoid morbidity and mortality were included in the analysis. Five thousand five hundred sixty-three unique …


Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed Jul 2018

Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed

Department of Paediatrics and Child Health

Background: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.
Methods: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate …


Subacute Sclerosing Panencephalitis – Current Perspectives, Sidra K. Jafri, Raman Kumar, Shahnaz H. Ibrahim Jun 2018

Subacute Sclerosing Panencephalitis – Current Perspectives, Sidra K. Jafri, Raman Kumar, Shahnaz H. Ibrahim

Department of Paediatrics and Child Health

Subacute sclerosing panencephalitis is a progressive neurodegenerative disease. It usually occurs 7–10 years after measles infection. The clinical course is characterized by progressive cognitive decline and behavior changes followed by focal or generalized seizures as well as myoclonus, ataxia, visual disturbance, and later vegetative state, eventually leading to death. It is diagnosed on the basis of Dyken’s criteria. There is no known cure for subacute sclerosing panencephalitis to date, but it is preventable by ensuring that an effective vaccine program for measles is made compulsory for all children younger than 5 years in endemic countries.


Slaying Little Dragons: The Impact Of The Guinea Worm Eradication Program On Dracunculiasis Disability Averted From 1990 To 2016, Elizabeth A. Cromwell, Sharon Roy, Dieudonne P. Sankara, Adam Weiss, Jeffrey Stanaway, Ellen Goldberg, David M. Pigott, Heidi Larson, Stein Emil Vollset, Zulfiqar Ahmed Bhutta Jun 2018

Slaying Little Dragons: The Impact Of The Guinea Worm Eradication Program On Dracunculiasis Disability Averted From 1990 To 2016, Elizabeth A. Cromwell, Sharon Roy, Dieudonne P. Sankara, Adam Weiss, Jeffrey Stanaway, Ellen Goldberg, David M. Pigott, Heidi Larson, Stein Emil Vollset, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The objective of this study was to document the worldwide decline of dracunculiasis (Guinea worm disease, GWD) burden, expressed as disability-adjusted life years (DALYs), from 1990 to 2016, as estimated in the Global Burden of Disease study 2016 (GBD 2016). While the annual number of cases of GWD have been consistently reported by WHO since the 1990s, the burden of disability due to GWD has not previously been quantified in GBD.
Methods: The incidence of GWD was modeled for each endemic country using annual national case reports. A literature search was conducted to characterize the presentation of GWD, translate …


Prevalence Of Overweight And Obesity Based On The Body Mass Index; A Cross-Sectional Study In Alkharj, Saudi Arabia, Sameer Al-Ghamdi, Mamdouh M. Shubair, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Khaled K. Aldossari, Mowafa Househ, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally Jun 2018

Prevalence Of Overweight And Obesity Based On The Body Mass Index; A Cross-Sectional Study In Alkharj, Saudi Arabia, Sameer Al-Ghamdi, Mamdouh M. Shubair, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Khaled K. Aldossari, Mowafa Househ, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally

Department of Paediatrics and Child Health

Background: Obesity and overweight are accompanied with several different chronic diseases. Overweight and obesity can be measured by using body mass index (BMI) and is also used widely as an index of relative adiposity among any population. The aim of the study is to evaluate the prevalence of overweight and obesity among general population in Al-Kharj, Saudi Arabia.
Methods: Cross-sectional analysis was undertaken from a representative sample (N = 1019) of the Al Kharj population. Anthropometric measurements including the waist circumference (in centimeters), height (in meters), and weight (in kilograms) of the subjects were undertaken by means of standard apparatus. …


Environmental Enteropathy In Undernourished Pakistani Children: Clinical And Histomorphometric Analyses, Sana Syed, Sunil Yeruva, Jeremy Herrmann, Anne Sailer, Kamran Sadiq, Najeeha Talat Iqbal, Furqan Kabir, Kumail Ahmed, Shahida Qureshi, Syed Asad Ali Jun 2018

Environmental Enteropathy In Undernourished Pakistani Children: Clinical And Histomorphometric Analyses, Sana Syed, Sunil Yeruva, Jeremy Herrmann, Anne Sailer, Kamran Sadiq, Najeeha Talat Iqbal, Furqan Kabir, Kumail Ahmed, Shahida Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocytosis, and graft-versus-host disease patients. Of the 11 children biopsied, EE was found in 10 (91%) with one subject with celiac disease. Morphometry demonstrated decreased …


Effect Of Life Skills Building Education And Micronutrient Supplements Provided From Preconception Versus The Standard Of Care On Low Birth Weight Births Among Adolescent And Young Pakistani Women (15–24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta May 2018

Effect Of Life Skills Building Education And Micronutrient Supplements Provided From Preconception Versus The Standard Of Care On Low Birth Weight Births Among Adolescent And Young Pakistani Women (15–24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation.
Methods: The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate …


Effect Of Life Skills Building Education And Micronutrient Supplements Provided From Preconception Versus The Standard Of Care On Low Birth Weight Births Among Adolescent And Young Pakistani Women (15–24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta May 2018

Effect Of Life Skills Building Education And Micronutrient Supplements Provided From Preconception Versus The Standard Of Care On Low Birth Weight Births Among Adolescent And Young Pakistani Women (15–24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception carefrom adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation.
Methods: The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the …


Feasibility And Effect Of Life Skills Building Education And Multiple Micronutrient Supplements Versus The Standard Of Care On Anemia Among Non-Pregnant Adolescent And Young Pakistani Women (15-24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta May 2018

Feasibility And Effect Of Life Skills Building Education And Multiple Micronutrient Supplements Versus The Standard Of Care On Anemia Among Non-Pregnant Adolescent And Young Pakistani Women (15-24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Adolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased. Health and health behaviours correspond strongly from adolescence to adulthood. Developing a preconception care package for adolescent and young women in resource-limited settings could serve to empower them to make informed decisions about their nutrition, health, and well-being, as well as function as a platform for the delivery of basic nutrition-related interventions to address undernutrition.
Methods: In this population-based two-arm, cluster-randomized, controlled trial of life skills building education (provided bi-monthly) and multiple micronutrient supplementation (provided twice-weekly; UNIMMAP composition), we …


Childhood-Onset Systemic Lupus Erythematosus: A Cohort Study, Shakeel Ahmed, Syed Rehan Ali, Farida Karim, Sidra Ishaque, Iman Qaiser, Kanwal Nayani, Ayesha Ahmed May 2018

Childhood-Onset Systemic Lupus Erythematosus: A Cohort Study, Shakeel Ahmed, Syed Rehan Ali, Farida Karim, Sidra Ishaque, Iman Qaiser, Kanwal Nayani, Ayesha Ahmed

Department of Paediatrics and Child Health

Objective: To determine the clinical and immunological characteristics and short-term outcome of children with systemic lupus erythematosus (SLE).
Study Design: A descriptive cohort study.
Place and Duration of Study: Paediatric Rheumatology Clinic, The Aga Khan University Hospital, Karachi, from January 2011 to December 2015.
Methodology: Clinical and immunological profile and short-term outcome of children less than 16 years of age admitted in the paediatric ward, with the diagnosis of SLE was studied. Demographic data, clinical presentation, laboratory findings, immunological profile and treatment regimens of these children were evaluated.
Results: Thirty-two children, satisfying the criteria of American College of Rheumatology (ACR) …


Prevalence Of Prediabetes, Diabetes, And Its Associated Risk Factors Among Males In Saudi Arabia: A Population-Based Survey, Khaled K. Aldossari, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Sameer H. Al-Ghamdi, Mohammed Abdelrazik, Mohammed Ali Batais, Sundas Javad, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally Apr 2018

Prevalence Of Prediabetes, Diabetes, And Its Associated Risk Factors Among Males In Saudi Arabia: A Population-Based Survey, Khaled K. Aldossari, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Sameer H. Al-Ghamdi, Mohammed Abdelrazik, Mohammed Ali Batais, Sundas Javad, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally

Department of Paediatrics and Child Health

Objectives: The study aims at determining the prevalence of prediabetes and diabetes and at ascertaining some concomitant risk factorsamong males in Saudi Arabia.
Methods: A population-based cross-sectional study including 381 Saudi adult males from different institutions was recruited. Odds ratios for diabetes risk and risk factors were calculated using log-binomial and multinomial logistic regression, using STATA version 12.
Results: The participants included 381 diabetic males with a median age of 45 years, average body mass index of 25 ± 40 kg/m2, whereas waist circumferences ranged from 66 to 180 cm in the male study population. In addition, 27.82% …