Predictors of Death in Under-Five Children with Sepsis Attending an Urban Diarrheal Treatment Centre in Bangladesh

SETTING: Special Care Ward (SCW) of the Dhaka Hospital of icddr,b, Bangladesh. OBJECTIVE: To evaluate the clinical and laboratory predictors of death in under-five children with clinically defined sepsis presenting with diarrhea. METHODS: We prospectively enrolled all the diarrheal children (n = 151) aged 0 to 59 months with clinical sepsis admitted in the SCW during September’2007 through December’2007. Comparison was made between deaths (n = 23) and survivors (n = 128). Sepsis is defined as presence of inflammation [abnormal WBC count (>11 × 109/L or

Sociodemographic, Epidemiological, and Clinical Risk Factors for Childhood Pulmonary Tuberculosis in Severely Malnourished Children Presenting With Pneumonia: Observation in an Urban Hospital in Bangladesh

We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB) in children presenting with severe acute malnutrition (SAM) and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF) (cases = 27) and without PTB (controls = 81; randomly selected from 378 children) were compared. The cases more often had the history of contact with active PTB patient (P < .01) and exposure to cigarette smoke (P = .04) compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother (P = .05) and positive tuberculin skin test (TST; P = .02). Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings

Experience With Nosocomial Infection in Children Under 5 Treated in an Urban Diarrheal Treatment Center in Bangladesh

We aimed to evaluate the factors associated with nosocomial infections (NIs) in under-5 children and in bacterial isolates from their blood, urine, and stool. We reviewed all under-5 hospitalized children with clinically diagnosed NIs in the inpatient ward at Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, between January and December 2012. Comparison was made among the children with (cases = 71) and without NI (controls = 142). NI was defined as the development of new infection 48 hours after admission. Bacterial isolates in urine, blood, and stool were found in 11/52 (21%), 9/69 (13%), and 2/16 (12%) respectively. In logistic regression analysis, the children with NI were independently associated with severe acute malnutrition, congenital anomaly, invasive diarrhea, urinary tract infection on admission, and use of intravenous cannula during hospitalization. Thus, identification of these simple clinical parameters may help in preventive measures being taken to reduce the rate of NIs in such children

Consequences of Lack of Neonatal Breastfeeding in Infants Hospitalized for Diarrhea at an Urban Hospital, Bangladesh: A Case Control Design

. Exclusive breastfeeding is important for immunity and lack of breastfeeding during the neonatal age impedes that. Our aim was to assess the consequences of lack of breastfeeding on infants with diarrhea in the neonatal period. . In this design, infants from DDSS (Diarrheal Disease Surveillance System) from 2009 to 2013 were studied. Those who did not have breastfeeding or had cessation of breastfeeding at the neonatal age constituted the cases, whereas infants who continued breastfeeding since birth or for at least 6 months since birth constituted the controls. . The cases more often presented at a younger age, had an illiterate mother, frequently presented with complicated diarrhea, had severe wasting, and had abnormal mental status compared with the controls. In logistic regression, after adjusting for potential confounders, infants who lacked breastfeeding at the neonatal period had an independent association with dehydrating diarrhea. . The results of our analyses suggest that infants with diarrhea who did not have breastfeeding at the neonatal age are prone to develop some or severe dehydration

Factors Associated With Pneumonia Among Overweight and Obese Under-Five Children in an Urban Hospital of a Developing Country

To our knowledge, there are no data on the role of overweight and obesity in childhood pneumonia. We sought to determine that impact of overweight and obesity in such children. In this retrospective chart analysis, we enrolled hospitalized children aged 6 to 59 months in the Dhaka Hospital of the icddr,b, Bangladesh (International Centre for Diarrhoeal Disease Research, Bangladesh), from January 2010 to June 2014. Children with pneumonia having overweight and obesity (body mass index score [BMIZ] >2.00) constituted cases (n = 25), and those who had pneumonia without overweight and obesity (BMIZ -2.00 to 2.00) constituted controls (n = 75). Controls were 3-fold of the cases and were randomly selected. Demographic, clinical, and laboratory data of the cases and the controls were compared. The cases more often had diarrhea and dehydration (36% vs 12%, = .013), hypoxemia (SpO < 90% in room air; 28% vs 7%, = .009) on admission, and required to change antibiotics (32% vs 11%, = .023) during hospitalization compared to the controls. However, in logistic regression analysis the cases were independently associated with diarrhea ( < .001) and hypoxemia ( = .024) on admission. Our data suggest that overweight and obesity in children with pneumonia is prone to be associated with hypoxemia on admission, which may guide clinicians in promptly managing pneumonia in order to evade its ramification in such children. However, future research with larger samples is imperative to consolidate or refute our observation

Sociodemographic, Epidemiological, and Clinical Risk Factors for Childhood Pulmonary Tuberculosis in Severely Malnourished Children Presenting With Pneumonia

We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB) in children presenting with severe acute malnutrition (SAM) and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF) (cases = 27) and without PTB (controls = 81; randomly selected from 378 children) were compared. The cases more often had the history of contact with active PTB patient ( P < .01) and exposure to cigarette smoke ( P = .04) compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother ( P = .05) and positive tuberculin skin test (TST; P = .02). Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings

Results of the logistic regression analysis revealing the independently associated factors with ileus in children below five years of age with severe acute malnutrition and diarrhea.

<p>Results of the logistic regression analysis revealing the independently associated factors with ileus in children below five years of age with severe acute malnutrition and diarrhea.</p

Results of logistic regression analysis identifying the independent predictors of death after adjusting for potential confounders in the study population.

<p>Results of logistic regression analysis identifying the independent predictors of death after adjusting for potential confounders in the study population.</p

Association of ileus with bacterial pathogens from stool in children aged under five years with severe acute malnutrition and diarrhea.

<p>Association of ileus with bacterial pathogens from stool in children aged under five years with severe acute malnutrition and diarrhea.</p