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Anthropometric measures are simple and accurate paediatric weight-prediction proxies in resource-poor settings with a high HIV prevalence
Conclusion The development of nomograms using these equations is warranted to allow for rapid and accurate weight prediction from these simple anthropometric measures in HIV-endemic, resource-constrained settings.
Source: Archives of Disease in Childhood - December 13, 2016 Category: Pediatrics Authors: Whitfield, K. C., Wozniak, R., Pradinuk, M., Karakochuk, C. D., Anabwani, G., Daly, Z., MacLeod, S. M., Larson, C. P., Green, T. J. Tags: Immunology (including allergy), HIV/AIDS, Child health, Sexual health Original article Source Type: research

Post-exposure prophylaxis guidelines for children and adolescents potentially exposed to HIV
UK guidelines for HIV post-exposure prophylaxis (PEP) in adults have recently been updated. Indications for PEP have been modified and there has been a change in the recommended antiretroviral therapy for adults to a combination of raltegravir with tenofovir and emtricitabine (Truvada). Raltegravir and tenofovir are now available in paediatric formulations and offer improved safety and tolerability over previously recommended ritonavir-boosted lopinavir with zidovudine. This guideline provides recommendations for those caring for children potentially exposed to HIV and other bloodborne viruses in primary care, emergency de...
Source: Archives of Disease in Childhood - December 13, 2016 Category: Pediatrics Authors: Bamford, A., Tudor-Williams, G., Foster, C. Tags: Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Adolescent health, Child health, Sexual health Guideline Source Type: research

Dilemma of managing asymptomatic children referred with 'culture-confirmed drug-resistant tuberculosis
Conclusions Bacteriological evaluation should not be performed in the absence of any clinical indication. If drug-resistant Mycobacterium tuberculosis is detected in an asymptomatic child with a normal chest radiograph, close observation may be an appropriate strategy, especially in settings where potential laboratory error and poor record keeping are constant challenges.
Source: Archives of Disease in Childhood - June 16, 2016 Category: Pediatrics Authors: Loveday, M., Sunkari, B., Marais, B. J., Master, I., Brust, J. C. M. Tags: Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Radiology, Sexual health, Clinical diagnostic tests, Radiology (diagnostics) Original article Source Type: research

Visceral leishmaniasis: a forgotten epidemic
Visceral leishmaniasis (VL or kala-azar) is most endemic in Asia and Africa and commonly affects young children. It is usually caused by Leishmania donovani or Leishmania infantum that are transmitted by Phlebotomine sand flies. Transmission may be anthroponotic or zoonotic or both, depending on the endemic area. Clinical features include fever, hepatosplenomegaly, weight loss and pancytopenia. Younger age, malnutrition and immunosuppression (HIV infection, use of immunosuppressive drugs) are risk factors. Many infections remain asymptomatic. Diagnosis is made by demonstration of the Leishmania parasite in aspirates of lym...
Source: Archives of Disease in Childhood - May 17, 2016 Category: Pediatrics Authors: Zijlstra, E. E. Tags: Oncology, Immunology (including allergy), ADC Global child health, HIV/AIDS, Travel medicine, Tropical medicine (infectious diseases), Child health, Sexual health Source Type: research

Characteristics of admissions and variations in the use of basic investigations, treatments and outcomes in Kenyan hospitals within a new Clinical Information Network
Conclusion Developing clinical networks is feasible with appropriate support. Early data demonstrate that hospital mortality remains high in Kenya, that resources to investigate severe illness are limited, that care provided and outcomes vary widely and that adoption of effective interventions remains slow. Findings suggest considerable scope for improving care within and across sites.
Source: Archives of Disease in Childhood - February 18, 2016 Category: Pediatrics Authors: Ayieko, P., Ogero, M., Makone, B., Julius, T., Mbevi, G., Nyachiro, W., Nyamai, R., Were, F., Githanga, D., Irimu, G., English, M., on behalf of the Clinical Information Network authors, on behalf of the Clinical Information Network authors, Tuti, Gathara Tags: Epidemiologic studies, Open access, Immunology (including allergy), ADC Global child health, HIV/AIDS, Meningitis, Pneumonia (infectious disease), TB and other respiratory infections, Travel medicine, Tropical medicine (infectious diseases), Infection (ne Source Type: research

Question 1: Co-trimoxazole dosing dilemma: what is the right dose?
Scenario While covering the paediatric haematology–oncology ward, you are asked to prescribe co-trimoxazole for prophylaxis against Pneumocystis jirovecii pneumonia (PJP). You refer to your usual drug resources discovering a variety of different dosing options and wonder which regimen you should prescribe. Structured clinical question In immunocompromised children and adolescents without HIV infection (patient), which co-trimoxazole dosing regimen (intervention) is most effective in preventing PJP and best tolerated (outcome)? Search strategy and outcome We searched Medline (1946 to current) and Embase (1974 to curre...
Source: Archives of Disease in Childhood - October 19, 2015 Category: Pediatrics Authors: Boast, A., Osowicki, J., Cole, T., Curtis, N., Gwee, A. Tags: ADC Archimedes, Oncology, Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Pneumonia (infectious disease), TB and other respiratory infections, Adolescent health, Child health, Infant health, Pneumonia (respirat Source Type: research

Virtual support for paediatric HIV treatment decision making
Conclusions Combined multidisciplinary virtual input with adult expertise in resistance and newer agents, paediatric knowledge of pill swallowing, childhood formulations/weight banding and parental support, assists complex treatment decision making in paediatric HIV infection. The Virtual Clinic model could be applied to the management of other rare complex diseases of childhood within a clinical network.
Source: Archives of Disease in Childhood - May 18, 2015 Category: Pediatrics Authors: Le Doare, K., Mackie, N. E., Kaye, S., Bamford, A., Walters, S., Foster, C. Tags: Liver disease, Open access, Immunology (including allergy), Hepatitis and other GI infections, HIV/AIDS, Adolescent health, Child and adolescent psychiatry (paedatrics), Child health, Sexual health Original article Source Type: research

Question: Is breastfeeding useful in the management of neonatal abstinence syndrome?
Case scenario A 23-year-old woman is admitted to the postnatal ward after she gave birth to a term infant of 3 kg. During pregnancy, she is known to have used methadone. There is no known use of other illicit drugs or prescription medication. The midwife who is taking care of this woman and her baby asks if she can encourage the mother to breastfeed her child. Structured clinical question Can a mother who used methadone during pregnancy (patient) breastfeed her newborn (intervention) to help the management of neonatal abstinence syndrome (NAS) (outcome)? Search Search strategy: terms used: Breastfeeding AND neonatal a...
Source: Archives of Disease in Childhood - March 17, 2015 Category: Pediatrics Authors: Lefevere, J., Allegaert, K. Tags: ADC Archimedes, Liver disease, Immunology (including allergy), Hepatitis and other GI infections, HIV/AIDS, Childhood nutrition, Pregnancy, Reproductive medicine, Child health, Infant health, Infant nutrition (including breastfeeding), Neonatal health, Un Source Type: research

Management of severe acute malnutrition in low-income and middle-income countries
Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environmental enteropathy, poor complementary feeding practices, and chronic and acute infections, contribute to the development of SAM. Careful anthropometry is key to making an accurate diagnosis of SAM and can be performed by village health workers or even laypeople in rural areas. The majority of children can be treated at home...
Source: Archives of Disease in Childhood - February 18, 2015 Category: Pediatrics Authors: Trehan, I., Manary, M. J. Tags: Editor's choice, Immunology (including allergy), ADC Global child health, HIV/AIDS, Malnutrition, Child health, Sexual health Source Type: research

Paediatric HIV grows up: recent advances in perinatally acquired HIV
This review is an update focusing on the current status of paediatric HIV in the UK and Ireland. Successes in prevention of mother to child transmission are highlighted. The changing epidemiology of the UK cohort is summarised and the shift in emphasis of treatment guidelines beyond limiting short-term morbidity and mortality to ensuring optimal health status in adult life is discussed. Current and future challenges relating to an aging cohort, successful transition to adult services and the prospect of a lifetime on antiretroviral therapy (ART), as well as the possibility of ART-free survival are also considered. While nu...
Source: Archives of Disease in Childhood - January 20, 2015 Category: Pediatrics Authors: Bamford, A., Lyall, H. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Sexual health, Guidelines Review Source Type: research

Assessment of neonatal care in clinical training facilities in Kenya
Conclusions Basic resources are generally available, but there are deficiencies in key areas. Poor documentation limits the use of routine data for quality improvement. Significant opportunities exist for improvement in service delivery and adherence to guidelines in hospitals providing professional training.
Source: Archives of Disease in Childhood - December 15, 2014 Category: Pediatrics Authors: Aluvaala, J., Nyamai, R., Were, F., Wasunna, A., Kosgei, R., Karumbi, J., Gathara, D., English, M., Kamau, Kimani, Masasabi, Mogoa, Mueke, Mwinga, Kihuba, Njagi, Odongo, Todd, On behalf of the SIRCLE/Ministry of Health Hospital Survey Group Tags: Epidemiologic studies, Open access, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Physiotherapy, Sexual health, Resuscitation, Quality improvement Original article Source Type: research

Question 2: A pointed question: is a child at risk following a community-acquired needlestick injury?
Scenario You are asked to see a previously well 5-year-old boy who presented to the accident and emergency department. While playing in a public park he picked up a discarded 1 mL syringe with an attached 27-gauge needle and punctured the skin of his hand. His mother asks, "Will he catch AIDS? What should we do now?" Structured clinical question In a child with a community-acquired needlestick injury (CA-NSI) (patient, intervention), what is the risk of blood-borne virus (BBV) transmission (outcome)? Introduction CA-NSI in children causes significant parental anxiety. The risk of HIV and hepatitis virus transmission f...
Source: Archives of Disease in Childhood - November 13, 2014 Category: Pediatrics Authors: Osowicki, J., Curtis, N. Tags: ADC Archimedes, Liver disease, Epidemiologic studies, Immunology (including allergy), Hepatitis and other GI infections, HIV/AIDS, Child health, Sexual health, Trauma, Environmental issues, Guidelines, Health education, Injury, Health promotion Source Type: research

Severe manifestations of extrapulmonary tuberculosis in HIV-infected children initiating antiretroviral therapy before 2 years of age
Conclusions Severe TB manifestations were observed among young HIV-infected children on ART.
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Authors: Walters, E., Duvenhage, J., Draper, H. R., Hesseling, A. C., Van Wyk, S. S., Cotton, M. F., Rabie, H. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Meningitis, Drugs: cardiovascular system, Infection (neurology), Ophthalmology, Child health, Infant health, Sexual health Original article Source Type: research

Successful outcome of renal transplantation in a child with HIV-associated nephropathy
We report the successful outcome of living related renal transplantation in a vertically transmitted HIV-infected 8-year-old girl with end-stage kidney disease on haemodialysis due to HIVAN. The pretransplant preparations and post-transplant care, with particular emphasis on immunosuppression and avoidance of opportunistic infections, are discussed.
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Authors: Shroff, R. C., McCulloch, M., Novelli, V., Shingadia, D., Bradley, S., Clapson, M., Mamode, N., Marks, S. D. Tags: Urology, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Renal medicine, Sexual health, Artificial and donated transplantation Case report Source Type: research

Question 1: Should newborns of mothers with isolated antibodies to hepatitis B core antigen be immunised?
Scenario The midwife calls you to assess a newborn in the delivery room. The pregnancy was uneventful, but the mother's serology results show the following: hepatitis B surface antigen (HBsAg) negative, antibodies against hepatitis B surface antigen (anti-HBs) negative, but antibodies against hepatitis B core antigen (anti-HBc) positive. You wonder if the baby is at risk for perinatal transmission of hepatitis B virus (HBV) requiring preventive measures at this time. Structured clinical question Does a newborn of a mother with isolated antibodies against hepatitis B core antigen need immunisation (intervention) to prevent ...
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Authors: Pramana, I., Heininger, U., Ritz, N. Tags: ADC Archimedes, Liver disease, Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, Hepatitis and other GI infections, HIV/AIDS, Vaccination / immunisation, Pregnancy, Reproductive medicine, Child health, Infant health, Sexua Source Type: research

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