Pediatrics Commons^™

Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali

Brain and Mind Institute

INTRODUCTION: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer’s disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

METHODS: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

RESULTS: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access …

Early Life Exposure To Fine Particulate Matter And Fine Motor Function, Attentional Function, And Working Memory Among Spanish School-Aged Children, Kristina W Whitworth, Aitana Lertxundi, Mingze Yuan, Alison Rector-Houze, Wei-Jen Chen, Mònica Guxens, Jordi Julvez, Michael Swartz, Elaine Symanski, Antonia Valentin, Carmen Iniguez, Llúcia L González-Safont, Jesús Ibarluzea

Faculty, Staff and Student Publications

Background: Evidence of the association between fine particulate matter (PM2.5) exposure and child neuropsychological function is equivocal. We examined early life PM2.5 exposure in relation to fine motor function, attention, and working memory in early childhood.

Methods: We used data from the Spanish INfancia y Medio Ambiente Project, 2003-2008. Exposure to PM2.5 (μg/m3) was assessed using spatiotemporal land-use random forest models and assigned based on residential address histories. Around age six, children completed the finger tapping test, attentional network test (ANT), and n-back task to evaluate fine motor speed, attention, and working memory, respectively. A total of 1,310 children had …

Epidemiology Of Shigella Species And Serotypes In Children: A Retrospective Substudy Of The Mal-Ed Observational Birth Cohort Study, Elizabeth T. Rogawski Mcquade, Jie Liu, Mustafa Mahfuz, Alexandre Havt, Furqan Kabir, Adil Kalam, Fatima Aziz, Sahrish Muneer, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Shigellosis is a leading cause of diarrhoea in children globally. We aimed to assess the burden of specific Shigella species and Shigella flexneri serotypes, characterise their clinical syndromes and natural immunity, and evaluate their relevance as causes of diarrhoea and linear growth faltering.
Methods: In the MAL-ED birth cohort study, children younger than 17 days were enrolled from Nov 3, 2009, to Feb 29, 2012, in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, Tanzania, and South Africa and were followed up for 2 years. In this retrospective substudy, we retested Shigella quantitative PCR-positive diarrhoeal and non-diarrhoeal stool samples with molecular …

Ophthalmology Examinations In Children With Skull Fractures And Underlying Focal Hemorrhage, Karli Breeden, Cindy W Christian, Joanne N Wood, Gil Binenbaum, Daniel M Lindberg, Angela Bachim, Colleen J Bressler, Lori Frasier, Terra Frazier, Nicole R Johnson, Natalie Laub, Megan M Letson, Tagrid Ruiz-Maldonado, Matthew Valente, Jenna Kiely, Jan Leonard, M Katherine Henry

Faculty, Staff and Students Publications

Objectives: To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage.

Methods: This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal …

Rethinking Congenital Cytomegalovirus: A Narrative Review Of The Clinical, Public Health, And Ethical Challenges Of A Preventable Cause Of Childhood Hearing Loss, M. Peyton Simons, Gauri Mankekar

School of Medicine Faculty Publications

Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of pediatric sensorineural hearing loss, affecting approximately tens of thousands of infants annually in the United States. While cCMV may present symptomatically at birth, many infants are asymptomatic initially and later develop progressive or fluctuating hearing loss, which is often undiagnosed without early screening. Despite advances in diagnostic methods such as polymerase chain reaction (PCR) testing, the absence of a national screening policy in the U.S. results in significant variability in early detection and follow-up care. This narrative review provides an overview of the clinical manifestations, diagnostic strategies, and treatment options …

Reducing Antibiotic Duration For Pneumonia And Sinusitis In The Emergency Department: A Quality Improvement Approach, Joshua Saucedo, Leslie Hueschen, Amanda Nedved, Marsha Dannenburg, Patricia Phillips, Jennifer Floyd, Alaina N. Burns, Rana El Feghaly

Research Days

Background: Our aim is to increase the percentage of children discharged home from the ED with a diagnosis of CAP or ABRS treated with an optimal antibiotic duration (3-5 days for CAP, 5-7 days for ABRS) from 13% to 70% by July 25.

Methods: Outcome metric is the percentage of patients receiving recommended antibiotic duration for CAP and ABRS. Process metrics include use of order set, "Quick Discharge” order set, and clinical pathway QR codes. Balancing metric is the number of return visits with the same diagnosis < 14 days. Plan-Do-Study-Act methodology was used. In Aug 23, our ASP disseminated a handbook that emphasized shorter durations. A new multidisciplinary team (infectious diseases, ED, and urgent care physicians, advanced practice providers, nurses, and pharmacy) formed in Dec 23. We utilized cause-and-effect analysis, driver diagram, and prioritization matrix, which helped identify other impactful interventions, including implementation of new internal CAP clinical pathway order set (April 24) and “Quick Discharge” order sets (May 24). Next, we surveyed prescriber comfort (June 24) with shorter duration identifying barriers and providing education, leading to posted evidence for lower duration treatment in practitioner workrooms and developing a new ABRS clinical pathway (Sept 24). Top prescribers providing optimal duration received email acknowledgement (Oct 24) and resident rotators received antibiotic handbook and CAP clinical pathway QR codes (Nov 24). New best treatment practices for ABRS were elucidated and disseminated through clinical pathway and internal article publishing to our hospital and associated clinics (Dec 24).

Results: We saw shifts in the outcome metric’s center line in Sept 23 …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Pediatric Asthma Subspecialty Referral Practices In Rural Maine, Paras Patnaik, John Dipalazzo, James Bohnhoff

Costas T. Lambrew Research Retreat 2025

Over 7.2 million children in the United States have asthma.

• >300,000 asthma-related ED visits & hospitalizations yearly
• Both PCP’s and pediatric asthma subspecialists (allergist/immunologists and pediatric pulmonologists) provide long-term asthma care

Socio-Medical Factors Associated With Neurodevelopmental Disorders On The Kenyan Coast, Patricia Kipkemoi, Jeanne E. Savage, Joseph Gona, Kenneth Rimba, Martha Kombe, Paul Mwangi, Collins Kipkoech, Beatrice Mkubwa, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Neurodevelopmental disorders (NDDs) are a group of conditions with their onset during the early developmental period and include conditions such as autism and intellectual disability. Occurrence of NDDs is thought to be determined by both genetic and environmental factors, but data on the role of environmental factors for NDD in Africa is limited. This study investigates environmental influences on NDDs in children from Kenya. This case-control study compared children with NDDs and typically developing children from two studies on the Kenyan coast. We included 172 study participants from the Kilifi Autism study and 151 from the NeuroDev study who had …

Small For Gestational Age Sub-Groups Have Differential Morbidity, Growth And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Méndez, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, James A. Berkley

Paediatrics and Child Health, East Africa

Background :Small for Gestational Age (SGA) is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birth weight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterise distinct SGA sub-groups and assess their neonatal and early childhood health trajectories.

Objectives: To refine the classification of SGA by identifying sub-groups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

Study Design: Prospective Cohort Study. In six …

Maternal Responsiveness To Infant Hunger Cues: Is It Possible To Mitigate Risk Of Obesity Starting In Infancy?, Arrianna A. Powers

Rowan-Virtua Research Day

Background: Childhood obesity is becoming a predominant health concern with over 37 million children under the age of 5 being overweight. Instances of rapid weight gain in infancy correlate to greater risk for obesity later on in life.

Methods: This study aimed to look at feeding modality and style for their impact on maternal responsiveness to infant hunger cues and RWG. A database search identified 21 studies eligible to be included in the review out of 150.

Discussion: Key findings showed breast-feeding mothers were most responsive to hunger cues, breastfed infants expressed greater cues than their formula-fed peers, and responsive …

Adherence To Follow-Up Among High-Risk Nicu Patients, Iryna Muryn, Susan Mbullah Ndimah, Lisa Renee Eiland, Tara Lozy

Rowan-Virtua Research Day

Background:

Preterm infants, especially those ≤32 weeks' gestational age (GA) are at increased risk of vision and hearing loss. Risks of both vision and hearing loss can be ameliorated and in some cases prevented by conscientious screening, follow up and treatment. Universally, infants ≤32 weeks are cared for in neonatal intensive care units and there is considerable confidence that screenings and treatment occur according to established guidelines. At hospital discharge, follow up responsibility shifts to infant caretakers likely resulting in reduced compliance.

Objective:

We aimed to determine if preterm infants at risk for vision and hearing loss, attended follow up …

Children Born To Mothers With Inflammatory Bowel Disease: A Review Of Pediatric Outcomes, Simran Gandhi, Kush Patel, Harmann Singh

Rowan-Virtua Research Day

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies.

Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation.

Methods: A literature review was conducted using PubMed and Google Scholar. Search terms …

Is Increased Screen Time Associated With A Higher Prevalence Of Myopia In Elementary-Aged Children Globally?​, Katerina Kasatkin, Sree Gowri Sudharshan, Lakumi Dias, Adira Brenner, Emily Reilly, Maikel Mansour

Rowan-Virtua Research Day

Background: The onset of myopia in children has emerged as a significant public health concern, especially with increased screen time and reduced outdoor activity following the COVID-19 pandemic. The global prevalence of myopia is expected to rise significantly, with children being particularly vulnerable. Various studies have explored how screen time, near-work activities, and outdoor exposure influence the increasing prevalence of myopia in pediatric populations worldwide.

Hypothesis: This paper aims to evaluate whether increased screen time, especially following the COVID-19 pandemic, is associated with a higher prevalence of myopia in young children, providing a more robust understanding of this relationship across …

The Repercussions Of Race-Based Egfr On The Morbidity & Mortality Of Black Children With Renal Disease, Angelina Siino

Rowan-Virtua Research Day

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays …

Chemical Exposures In Utero: Phthalates And Congenital Heart Defects, Demi Poulathas

Rowan-Virtua Research Day

Background: Congenital heart defects (CHDs) are the most common type of birth defect. Approximately 80% of CHDs have unknown causes, and phthalates may play a contributing role. Phthalates are ubiquitous environmental chemicals used as plasticizers in a wide range of products, including cosmetics and electronic devices. After entering the body, phthalates bind to the progesterone receptor, which is necessary for fetal development. While multiple studies have explored environmental factors in CHD development, few have examined the effects of phthalates on CHDs in humans. Methods: A literature review was conducted to investigate the relationship between parental occupational phthalate exposure and the …

Examining The Relationship Between Nutritional Access And Childhood Obesity In Low-Resource South Jersey Communities, Anastasiya Matveyenko, Saul Madrid-Flores, Arleen Fortuna, Kirsten Marie Carlberg

Rowan-Virtua Research Day

BACKGROUND: Childhood obesity is defined as a child considered to have obesity when their body mass index falls in the top 5% compared to other children of the same age and gender. Unhealthy eating habits formed during childhood have been associated with diseases such as obesity and diabetes. We aim to examine the relationship between childhood obesity and barriers to optimal nutrition in our local South Jersey community.

METHODS: We conducted a literature review through Google, Google Scholar, and PubMed utilizing the key terms, “low socioeconomic status (SES),” “Childhood obesity in NJ,” “Nutritional Intervention,” and “Health Risks.”

RESULTS: Our study …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

The Role Of Responsive Feeding In Childhood Development And Clinical Implications: A Comprehensive Literature Review, Alexander Burbach

Capstone Experience: Master of Public Health

Responsive feeding refers to caregiver-infant feeding interactions that encourage healthy eating behaviors and support the child’s autonomy by responding to their hunger and satiety cues. Responsive feeding supports healthy early childhood development, influencing self-regulation in eating behaviors and long-term health outcomes, particularly in obesity prevention. A comprehensive literature review was conducted to examine the impact of responsive feeding practices on childhood development in the United States and its clinical implications. The objectives were to explore the role of parental feeding practices in shaping childhood eating behaviors, understand the relationship between responsive feeding and obesity, and determine literature daps. Articles for …

Testing For Bleeding Disorders In Child Abuse: Aap Recommendation Adherence And Testing Results, Lyndsey Hultman, Angela Doswell, Henry T Puls, Shannon L Carpenter, Angela Bachim, Caitlin R Mcnamara, Farah W Brink, Lori D Frasier, Nancy S Harper, Natalie Laub, Kristine A Campbell, Daniel M Lindberg, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Objectives: Using a multicenter child abuse pediatrics research network (CAPNET), the study objectives were to characterize the adherence to American Academy of Pediatrics (AAP) recommendations for bleeding disorder testing and the frequency of bleeding disorder identification.

Methods: We performed a descriptive study of bleeding disorder evaluations among children younger than 10 years of age who presented with bruising and/or intracranial hemorrhage (ICH) concerning for abuse from February 2021-May 2022 utilizing CAPNET. Cases were classified as bruising without ICH or ICH with or without bruising. Based on AAP guidance, testing was not recommended in cases with concomitant suspicious injuries, inflicted injury …

Editorial: Promoting Patient-Centered Care For Pediatric Rheumatology Across Africa, Wafa Hamdi, Angela Migowa

Paediatrics and Child Health, East Africa

Pediatric rheumatology remains an evolving field in Africa, where challenges such as limited specialist availability, diagnostic delays, and inadequate public awareness hinder optimal patient care (1). Similarly, research in this field remains scarce, with a significant lack of data needed to define the spectrum and clinical expression of these diseases. Capturing real-world experiences and field reports is invaluable, as it provides critical insights to identify key areas for action and develop strategies to advance research in Africa. This collection of six manuscripts offers valuable perspectives on various aspects of pediatric rheumatic diseases, including caregiver experiences, diagnostic challenges, therapeutic patient education, …

A Survey On The Use Of Continuous Positive Airway Pressure In Newborn Care In Kenya In 2017–2018, Jemma L. Wright, Emma Haddon, Helen Nabwera, Fiona M. Dickinson, Mary Jo Hoare, Pamela Godia, Judith Maua, Mercy K. Sammy, Bridget C. Naimoi, Onesmus Muchemi

Centre of Excellence in Women and Child Health

Background

Globally, complications of preterm birth are the leading cause of under-5-mortality. Respiratory distress syndrome (RDS) is a common and life-threatening complication among preterm infants. Continuous positive airway pressure (CPAP) is a relatively simple and effective intervention that is recommended for RDS treatment. However, appropriate infrastructure and processes are required to ensure that it is used safely, effectively and sustainably. This study describes how CPAP was used in newborn care in Kenya between 2017–2018. Our aim was to identify enablers, barriers and gaps in CPAP use.

Methods

A cross-sectional survey was carried out across all newborn baby units in Kenya …

Factors Associated With Shock At Presentation In Kawasaki Disease Versus Multisystem Inflammatory Syndrome In Children Associated With Covid-19., Supriya S. Jain, Ashraf S. Harahsheh, Simon Lee, Geetha Raghuveer, Nagib Dahdah, Michael Khoury, Michael A. Portman, Melissa Wehrmann, Arash A. Sabati, Marianna Fabi, Deepika Thacker, Nilanjana Misra, Mark D. Hicar, Nadine F. Choueiter, Matthew D. Elias, Audrey Dionne, William B. Orr, Jacqueline R. Szmuszkovicz, Seda Selamet Tierney, Luis Martin Garrido-Garcia, Frederic Dallaire, Balasubramanian Sundaram, Deepa Prasad, Tyler H. Harris, Elizabeth Braunlin, Elisa Fernandez Cooke, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: While clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.

METHODS: The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023. Demographics, clinical features and presentation, management, laboratory values, and outcomes were compared between the diagnosis and shock groups.

RESULTS: Shock at presentation was noted for 19 of 672 KD patients (2.8%) and 653 of …

Liver Transplantation In 3 Cholestatic Infants With History Of Covid Exposure, Shruti Sakhuja, Kalyani R Patel, Matthew Goss, Flor M Munoz, Garrett Wortham, Megan Crawford, John A Goss, Nhu Thao Galvan

Faculty, Staff and Students Publications

The COVID-19 pandemic presents several challenges during pregnancy including thromboembolic complications, direct placental infection, transplacental transmission, and systemic hyperinflammatory state. The liver is the second most commonly affected organ in SARS-CoV-2 infection after the lungs. Mechanisms of liver injury in COVID-19 patients can include: direct viral cytopathic effect, worsening of underlying liver disease, cytokine storm, hypoxic ischemic injury, and cholangiopathy leading to persistent marked cholestasis. Here we describe 3 infants at Texas Children's Hospital with perinatal SARS-CoV-2 exposure with persistent cholestasis and histologic evidence of extrahepatic biliary obstruction suggesting underlying biliary atresia (BA) with some atypical features possibly exacerbated by …

Neonatal Outcomes In Periviable Births Weighing ≤ 500 Grams, Bijan Morshedi, Diego Maurente, Ursula Griffiths-Randolph, Elisabeth Kamano, Katharine Hopkins, Dana Baraki, Juliana Martins, Steven Warsof

Eastern Virginia Medical Journal

Background: The average rate of preterm birth in the US in 2021 was 10.1%. Although the rate of mortality from preterm birth has been decreasing, complications remain the leading cause of death in infants under the age of 5 years worldwide. Gestational age (GA) and birth weight (BW) remain the 2 most important variables for predicting survivability in preterm births, and lower GA and BW are both correlated with lower survivability.

Objective: To explore outcomes of neonates born in the periviable period (20 weeks and 0 days to 25 weeks and 6 days) with BW ≤ 500 g and to …

A Bland–Altman Comparison Of The Lead Care® System And Inductively Coupled Plasma Mass Spectrometry For Detecting Low-Level Lead In Child Whole Blood Samples, Christina Sobin, Tanner Schaub, Natali Parisi, Eva De La Riva

Departmental Papers (PH)

Chronic childhood lead exposure, yielding blood lead levels consistently below 10 μg/dL, remains a major public health concern. Low neurotoxic effect thresholds have not yet been established. Progress requires accurate, efficient, and cost-effective methods for testing large numbers of children. The LeadCare® System (LCS) may provide one ready option. The comparability of this system to the “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS) for the purpose of detecting blood lead levels below 10 μg/dL has not yet been examined. Paired blood samples from 177 children ages 5.2–12.8 years were tested with LCS and ICP-MS. Triplicate repeat tests …

Utilidad De La Combinación De Los Biomarcadores: Procalcitonina, Proteína C Reactiva Y Volumen Plaquetario Medio En El Diagnóstico Temprano De Sepsis Neonatal [Usefulness Of The Combination Of Biomarkers: Procalcitonin, C-Reactive Protein And Mean Platelet Volume In The Early Diagnosis Of Neonatal Sepsis], Oscar Manuel Berlanga Bolado Jr, Patricia Rivera Vazquez, Arely Socorro Hernández García, Angelica Lizbeth Martinez Ortiz

Research Symposium

Introducción: La sepsis neonatal es una causa frecuente de morbilidad y mortalidad infantil. Se le ha definido como un síndrome clínico caracterizado por signos sistémicos de infección, acompañado de bacteriemia en el primer mes de vida. Por lo tanto, el diagnóstico temprano es fundamental.

Objetivo: Conocer la sensibilidad y especificidad de la combinación de biomarcadores séricos como procalcitonina, proteína C reactiva y volumen plaquetario medio en el diagnóstico temprano de sepsis neonatal.

Material y métodos: Estudio clínico, de tipo prospectivo, predictivo, observacional, analítico, longitudinal y conveniencia. Se analizaron los biomarcadores como PCT, PCR, VPM para diagnosticar sepsis neonatal. Se incluyeron …

Neurocognitive Gains Among Ugandan Children With Sickle Cell Anemia On Hydroxyurea: 18-Month Trial Interim Results, Shubaya Kasule Naggayi, Dennis Kalibbala, Vincent Mboizi, John M. Ssenkusu, Zhezhen Jin, Caterina Rosano, Deogratias Munube, Bill Wambaka, Ruth Namazzi, Robert Opoka

Paediatrics and Child Health, East Africa

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month singlearm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized …

The Feasibility Of Pharmacokinetic-Based Dosing Of Hydroxyurea For Children With Sickle Cell Anaemia In Uganda : Baseline Results Of The Alternative Dosing And Prevention Of Transfusions Trial, Alexandra Power Hays, Ruth Namazzi, Min Dong, Caroline Kazinga, Charles Kato, Sadat Aliwuya, Kathryn Mcelhinney, Andrea L. Conroy, Adam Lane, Robert Opoka

Paediatrics and Child Health, East Africa

Pharmacokinetic (PK)-guided dosing of hydroxyurea for children with sickle cell anaemia (SCA) could optimize dosing and improve outcomes, but its feasibility has not been demonstrated in low-resource settings where the majority of affected children live. Alternative Dosing And Prevention of Transfusions (ADAPT) is a prospective trial evaluating blood transfusions and the feasibility of determining PK-guided, hydroxyurea maximum tolerated doses (MTD) for children with SCA in Uganda, using portable high-performance liquid chromatography (HPLC) and a novel PK software programme (HdxSim). ADAPT enrolled 106 participants, and 100% completed PK testing. PK-guided doses were generated for 78%, of which 38% were within the …

Sociodemographic Factors Associated With Prenatal Care Utilization In Arkansas, United States., Pearl A Mcelfish, Aaron Caldwell, Donya Watson, Jonathan Langner, Jennifer Callaghan-Koru, Austin Porter, Don E Willis, Jennifer A Andersen, Nicola L Hawley, James P Selig, Amir Forati, Maria R Alcala, Lanita White, Enrique Gomez-Pomar, Clare C Brown

Pediatrics Faculty Publications

OBJECTIVES: This study examines prenatal care utilization differences in Arkansas.

METHODS: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal education, and parity for payer, race/ethnicity, and rural/urban residence.

RESULTS: Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times …