Malnutrition in women has been a long-standing public health concern, with serious effects on child survival and development. Maternal body mass index (BMI) is an important maternal nutritional indicator. There are few published studies although child anthropometric failures do not occur in isolation and identifying children with single versus several co-occurring failures can better capture cases of growth failure in combination: stunting, wasting, and underweight. In the context of multiple anthropometric failures, traditional markers used to assess children’s nutritional status tend to underestimate overall undernutrition. Using the composite index of anthropometric failure (CIAF), we aimed to assess the association between maternal undernutrition and child undernutrition among children with diarrhea under the age of two and to investigate the correlates. Using 1431 mother-child dyads from the Antibiotic for Children with Diarrhea (ABCD) trial, we extracted children’s data at enrollment and on day 90 and day 180 follow-ups. ABCD was a randomized, multi-country, multi-site, double-blind, placebo-controlled clinical trial. The Bangladesh site collected data from July 2017 to July 2019. The outcome variable, CIAF, allows combinations of height-for-age, height-for-weight, and weight-for-age to determine the overall prevalence of undernutrition. The generalized estimating equation was used to explore the correlates of CIAF. After adjusting all the potential covariates, maternal undernutrition status was found to be strongly associated with child undernutrition using the CIAF [aOR: 1.4 (95% CI: 1.0, 1.9), p-value = 0.043] among the children with diarrhea under 2 years old. Maternal higher education had a protective effect on CIAF [aOR: 0.7 (95% CI: 0.5, 0.9), p-value = 0.033]. Our study findings highlight the importance of an integrated approach focusing on maternal nutrition and maternal education could affect a reduction in child undernutrition based on CIAF.

Despite the beneficial effect of bubble continuous positive airway pressure (BCPAP) oxygen therapy for children with severe pneumonia under the supervision of physicians that has been shown in different studies, effectiveness trials in developing country settings where low-flow oxygen therapy is the standard of care are still needed. Thus, the aim of this study is to assess the effectiveness of bubble CPAP oxygen therapy compared to the WHO standard low-flow oxygen therapy among children hospitalized with severe pneumonia and hypoxemia in Ethiopia. This is a cluster randomized controlled trial where six district hospitals are randomized to BCPAP and six to standard WHO low-flow oxygen therapy. The total sample size is 620 per arm. Currently, recruitment of the patients is still ongoing where the management and follow-up of the enrolled patients are performed by general physicians and nurses under the supervision of pediatricians. The primary outcome is treatment failure and main secondary outcome is death. We anticipate to complete enrollment by September 2022 and data analysis followed by manuscript writing by December 2022. Findings will also be disseminated in December 2022. Our study will provide data on the effectiveness of BCPAP in treating childhood severe pneumonia and hypoxemia in a real-world setting.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected millions of people globally, resulting in more than six million deaths as of 18 October 2023. Although it is no longer classified as a global health emergency, the disease still poses a significant threat. Recent reports indicate that […]

Due to the significant number and its effects on quality of life, depression is becoming a major concern worldwide. Though its prevalence among junior healthcare professionals is also increasing day by day, still very few data are available regarding this. So, we’ve conducted a study to find out the prevalence and associated factors of depression among this vulnerable population. A total of 218 participants were enrolled from two public teaching tertiary-level hospitals in Dhaka, Bangladesh from October 2018 to April 2019. Data were collected by using a self-administered questionnaire including the WHO-5 well-being index. Prevalence of major depression was found at 17.9% and poor-emotional well-being was 25.2%. Factors associated independently with major depression were those thinking to be a doctor as the wrong decision (aRRR: 6.85, 95% CI: 1.40-33.45, p=0.017) and taking sedative or anxiolytic drugs (aRRR: 4.54, 95% CI: 1.50-13.73, p=0.007). On the other hand, doing physical exercise (aRRR: 0.32, 95% CI: 0.12-0.89, p=0.028) and being satisfied in their current job position (aRRR: 0.07, 95% CI: 0.02-0.29, p<0.001) had significantly less chance of being suffering of major depression. Suicidal and self-hurting ideation was also found among 23.4% of participants. If these modifiable factors can be addressed properly and by taking necessary steps against these simply identifiable factors, unwanted incidences can be prevented especially in low- and middle-income countries. What is already known on this topic Depression is common among healthcare professionals but is still neglected especially in low- and middle-income countries. What this study adds Thinking of being a doctor as the wrong decision, taking sleeping pills, not doing physical exercise, and being not satisfied in their current job position are associated with depression among junior healthcare professionals. Suicidal and self-hurting ideation were also found high among the participants. How this study might affect research, practice or policy Early identification of major depression by simple factors may help to initiate prompt strategies that will reduce the burden of depression among junior healthcare professionals and may improve the healthcare services of low- and middle-income countries.

Background: Antibiotic exposure in the pediatric intensive care unit (PICU) is very high, although 50% of all antibiotics may be unnecessary. We aimed to determine the utility of simple bedside screening tools and predicting factors to avoid antibiotic overuse in the ICU among children with diarrhea and critical illness. Methods: We conducted a retrospective, single-center, case-control study that included children aged 2–59 months who were admitted to PICU with diarrhea and critical illness between 2017 and 2020. Results: We compared young children who did not receive antibiotics (cases, n = 164) during ICU stay to those treated with antibiotics (controls, n = 346). For predicting the ‘no antibiotic approach’, the sensitivity of a negative quick Sequential Organ Failure Assessment (qSOFA) was similar to quick Pediatric Logistic Organ Dysfunction-2 (qPELOD-2) and higher than Systemic Inflammatory Response Syndrome (SIRS). A negative qSOFA or qPELOD-2 score calculated during PICU admission is superior to SIRS to avoid antibiotic overuse in under-five children. The logistic regression analysis revealed that cases were more often older and independently associated with hypernatremia. Cases less often had severe underweight, altered mentation, age-specific fast breathing, lower chest wall in-drawing, adventitious sound on lung auscultation, abdominal distension, developmental delay, hyponatremia, hypocalcemia, and microscopic evidence of invasive diarrhea (for all, p < 0.05). Conclusion: Antibiotic overuse could be evaded in PICU using simple bedside screening tools and clinical characteristics, particularly in poor resource settings among children with diarrhea.

Tuberculosis (TB) is a leading cause of morbidity and death in all ages globally. An estimated 1.3 million children (80%) of paediatric TB deaths occur in young children <5 years [1]. Mycobacterium tuberculosis infection can cause severe TB disease in young children, particularly […]