Paediatric anaemia at Kamuzu Central Hospital

This retrospective study assessed the outcome of children admitted during a six week period to Kamuzu Central Hospital (KCH) with anaemia. 19% of admissions had a primary discharge diagnosis of anaemia and there was a 12% mortality. Children who died were more likely than those who did not to have other diagnoses that may have contributed to mortality. 72% had a diagnosis that included both anaemia and malaria, but malaria was only documented in 36%. Malaria may be oveJlodiagnosed in that 57% of cases with a diagnosis that included malaria had negative blood smears for malaria. More data is required to determine whether delays in obtaining blood for transfusion influence mortality

Evaluation of a peer counselling programme to sustain breastfeeding practice in Hong Kong

<p>Abstract</p> <p>Background</p> <p>Peer counselling is reported to increase breastfeeding rates. We evaluated an intervention consisting of mainly telephone contact peer counselling programme on breastfeeding duration and exclusivity.</p> <p>Methods</p> <p>Peer counsellors (PCs) were mothers who had successfully breastfed and had received formal training. Following a postnatal visit, they provided scheduled telephone consultations (Days 1, 4, 7, Weeks 2, 4, 8, and Month 4) to PC group mothers (n = 100) who continued breastfeeding their infants after discharge. Control group mothers (n = 100) received routine care.</p> <p>Results</p> <p>After adjusting for mothers' previous breastfeeding experiences, mothers' working status and breastfeeding problems, no statistical differences in mothers' feeding methods (exclusive, almost exclusive or predominant breastfeeding) were noted at the three follow-up times for intervention and control mothers respectively (Day 5: 37%/38%, 46%/53%, 57%/63%; Month 3: 10%/9%, 17%/23%, 20%/26%; Month 6: 2%/1%, 18%/18%, 18%/19%). All differences between the groups were not significant. Also, there was no evidence to suggest that PC intervention prolonged breastfeeding duration.</p> <p>Conclusion</p> <p>The lack of effect of our PC intervention may reflect the low baseline breastfeeding rate and low value placed on breastfeeding in our population, the type of PC intervention or group allocation biases.</p> <p>Trial registration</p> <p>ISRCTN93605280.</p

Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination

© 2016 The Author(s). Published with license by Taylor & Francis. © GSK Biologicals SA.Variability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings

Intussusception trends in Hong Kong children

OBJECTIVES: To assess trends in intussusception and to validate the coding in Hong Kong's computerised discharge information system. DESIGN: Case notes were reviewed for all children under the age of 5 years who had a discharge diagnosis indicating intussusception or a procedure indicating reduction of intussusception during the 6-year period 1 July 1997 through 30 June 2003. RESULTS: Intussusception rates for infants under 1 year of age (108/100,000) and under 5 years of age (38/100,000) were slightly higher than previous estimates (78-100/100,000 and 27-32/100,000, respectively) that used passive discharge data alone. CONCLUSIONS: Hong Kong's passive computer data systems could be used to monitor rates of intussusception after the introduction of new rotavirus vaccines, provided readmissions, inter-hospital transfers, and hospital follow-ups for the same episode are taken into account.published_or_final_versio

Pooling and expanding registries of familial hypercholesterolaemia to assess gaps in care and improve disease management and outcomes : Rationale and design of the global EAS Familial Hypercholesterolaemia Studies Collaboration

Background: The potential for global collaborations to better inform public health policy regarding major non-hypercholesterolaemia (FH), a common genetic disorder associated with premature cardiovascular disease, is yet to be reliably ascertained using similar approaches. The European Atherosclerosis Society FH Studies Collaboration (EAS FHSC) is a new initiative of international stakeholders which will help establish a global FH registry to generate large-scale, robust data on the burden of FH worldwide. Methods: The EAS FHSC will maximise the potential exploitation of currently available and future FH data (retrospective and prospective) by bringing together regional/national/international data sources with access to individuals with a clinical and/or genetic diagnosis of heterozygous or homozygous FH. A novel bespoke electronic platform and FH Data Warehouse will be developed to allow secure data sharing, validation, cleaning, pooling, harmonisation and analysis irrespective of the source or format. Standard statistical procedures will allow us to investigate cross-sectional associations, patterns of real-world practice, trends over time, and analyse risk and outcomes (e.g. cardiovascular outcomes, all-cause death), accounting for potential confounders and subgroup effects. Conclusions: The EAS FHSC represents an excellent opportunity to integrate individual efforts across the world to tackle the global burden of FH. The information garnered from the registry will help reduce gaps in knowledge, inform best practices, assist in clinical trials design, support clinical guidelines and policies development, and ultimately improve the care of FH patients. (C) 2016 Elsevier Ireland Ltd.Peer reviewe

Dietary characteristics of Hong Kong young children: Implications for nutrition education

Objectives: To examine the dietary pattern of Hong Kong young children and its implication for nutrition education. Methods: Dietary patterns of 316 children aged 6-7-years (121 overweight, 130 middle-weight and 65 low-weight children), were assessed by a standardised questionnaire and a 3-day dietary record. Results: Macronutrient composition (carbohydrates: 53%; proteins: 16% and fats: 31%) was similar in the three weight groups and in line with recommendations. Our subjects mainly consumed proteins from animal sources. Seventy-nine percent of the subjects reported routine snacking during school breaks and fat from snacks (22%) was higher than that reported in 1993 (15%). An inadequate vegetable (84 g/day) intake was observed. Absence of vegetables during lunch was reported by 22% of subjects and this was associated with eating out. Conclusion: Further nutrition education in young children in Hong Kong should focus on healthy choices of snacks, balancing animal and plant sources of proteins and adequate consumption of vegetables and fruits. The need for healthy school lunch and snack programmes should be emphasised.link_to_subscribed_fulltex