Recomanacions per a la prevenció i el control de la tuberculosi pediàtrica a Catalunya

Tuberculosi pediàtrica; Diagnòstic de malalties; TractamentsTuberculosis pediátrica; Diagnóstico de enfermedades; TratamientosPediatric tuberculosis; Disease diagnosis; TreatmentsLa finalitat d’aquest document és revisar, des d’una perspectiva multidisciplinària, els reptes en el diagnòstic i el tractament de la TB pediàtrica, l’optimització de la realització dels estudis de contactes, la integració del cribratge de la infecció tuberculosa en el Programa de seguiment del nen sa de l’atenció primària (AP) i el model d’organització assistencial, amb l’objectiu de realitzar recomanacions pràctiques que contribueixin a millorar les respostes que cal articular per a la prevenció i el control de la TB pediàtrica al territori

Recomanacions per a la prevenció de la transmissió vertical del VIH

Transmissió vertical; Transmissió mare-fill; VIHTransmisión vertical; Transmisión madre-hijo; VIHVertical transmission; Mother-son transmission; HIVLa transmissió vertical o mare-fill del virus de la immunodeficiència humana (VIH) és la principal via d’infecció en l’edat pediàtrica. Es pot produir durant la gestació, el part i durant el postpart a través de l’alletament matern. En aquest document s’exposen les recomanacions per a la prevenció de la transmissió vertical del VIH a Catalunya. Parteix de la necessitat d’establir l’estat serològic de la futura mare, tant si ja està embarassada i el desconeix, com si es tracta d’una dona infectada pel VIH que es planteja tenir un fill. Analitza en primer lloc el procediment que cal seguir perquè la gestant conegui el seu estat serològic i també què han de tenir en compte les dones infectades pel VIH abans d’iniciar un embaràs. A continuació s’exposen els controls i tractaments que ha de seguir la gestant infectada, en quines condicions s’ha de desenvolupar el part i a quins controls i procediments s’ha de sotmetre el nadó per protegir-lo de la infecció. Aquest material té l’objectiu de millorar i facilitar la informació necessària en el moment del part, als professionals sanitaris de la xarxa de centres hospitalaris de Catalunya, especialment els pediatres, ginecòlegs, obstetres, infermeres i llevadores, que habitualment estan treballant a la sala de parts i facilitar la presa de decisions en el dia a dia.La transmisión vertical o madre-hijo del virus de la inmunodeficiencia humana (VIH) es la principal vía de infección en la edad pediátrica. Se puede producir durante la gestación, el parto y durante el posparto a través de la lactancia materna. En este documento se exponen las recomendaciones para la prevención de la transmisión vertical del VIH en Cataluña. Parte de la necesidad de establecer el estado serológico de la futura madre, tanto si ya está embarazada y desconoce, como si se trata de una mujer infectada por el VIH que se plantea tener un hijo. Analiza en primer lugar el procedimiento a seguir para que la gestante conozca su estado serológico y también que deben tener en cuenta las mujeres infectadas por el VIH antes de iniciar un embarazo. A continuación se exponen los controles y tratamientos que debe seguir la gestante infectada, en qué condiciones se debe desarrollar el parto y en qué controles y procedimientos se someterá al bebé para protegerlo de la infección. Este material tiene el objetivo de mejorar y facilitar la información necesaria en el momento del parto, a los profesionales sanitarios de la red de centros hospitalarios de Cataluña, especialmente los pediatras, ginecólogos, obstetras, enfermeras y matronas, que habitualmente están trabajando en la sala de partes y facilitar la toma de decisiones en el día a día

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Recomanacions per a la prevenció i el control de la tuberculosi pediàtrica a Catalunya

Tuberculosi pediàtrica; Diagnòstic de malalties; TractamentsTuberculosis pediátrica; Diagnóstico de enfermedades; TratamientosPediatric tuberculosis; Disease diagnosis; TreatmentsLa finalitat d’aquest document és revisar, des d’una perspectiva multidisciplinària, els reptes en el diagnòstic i el tractament de la TB pediàtrica, l’optimització de la realització dels estudis de contactes, la integració del cribratge de la infecció tuberculosa en el Programa de seguiment del nen sa de l’atenció primària (AP) i el model d’organització assistencial, amb l’objectiu de realitzar recomanacions pràctiques que contribueixin a millorar les respostes que cal articular per a la prevenció i el control de la TB pediàtrica al territori

Recomanacions per a la prevenció de la transmissió vertical del VIH

Transmissió vertical; Transmissió mare-fill; VIHTransmisión vertical; Transmisión madre-hijo; VIHVertical transmission; Mother-son transmission; HIVLa transmissió vertical o mare-fill del virus de la immunodeficiència humana (VIH) és la principal via d’infecció en l’edat pediàtrica. Es pot produir durant la gestació, el part i durant el postpart a través de l’alletament matern. En aquest document s’exposen les recomanacions per a la prevenció de la transmissió vertical del VIH a Catalunya. Parteix de la necessitat d’establir l’estat serològic de la futura mare, tant si ja està embarassada i el desconeix, com si es tracta d’una dona infectada pel VIH que es planteja tenir un fill. Analitza en primer lloc el procediment que cal seguir perquè la gestant conegui el seu estat serològic i també què han de tenir en compte les dones infectades pel VIH abans d’iniciar un embaràs. A continuació s’exposen els controls i tractaments que ha de seguir la gestant infectada, en quines condicions s’ha de desenvolupar el part i a quins controls i procediments s’ha de sotmetre el nadó per protegir-lo de la infecció. Aquest material té l’objectiu de millorar i facilitar la informació necessària en el moment del part, als professionals sanitaris de la xarxa de centres hospitalaris de Catalunya, especialment els pediatres, ginecòlegs, obstetres, infermeres i llevadores, que habitualment estan treballant a la sala de parts i facilitar la presa de decisions en el dia a dia.La transmisión vertical o madre-hijo del virus de la inmunodeficiencia humana (VIH) es la principal vía de infección en la edad pediátrica. Se puede producir durante la gestación, el parto y durante el posparto a través de la lactancia materna. En este documento se exponen las recomendaciones para la prevención de la transmisión vertical del VIH en Cataluña. Parte de la necesidad de establecer el estado serológico de la futura madre, tanto si ya está embarazada y desconoce, como si se trata de una mujer infectada por el VIH que se plantea tener un hijo. Analiza en primer lugar el procedimiento a seguir para que la gestante conozca su estado serológico y también que deben tener en cuenta las mujeres infectadas por el VIH antes de iniciar un embarazo. A continuación se exponen los controles y tratamientos que debe seguir la gestante infectada, en qué condiciones se debe desarrollar el parto y en qué controles y procedimientos se someterá al bebé para protegerlo de la infección. Este material tiene el objetivo de mejorar y facilitar la información necesaria en el momento del parto, a los profesionales sanitarios de la red de centros hospitalarios de Cataluña, especialmente los pediatras, ginecólogos, obstetras, enfermeras y matronas, que habitualmente están trabajando en la sala de partes y facilitar la toma de decisiones en el día a día

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified