RESUMO
Diphtheria is an infection that has been unreported for more than two decades in Mahajanga. A child, aged 4, presented with a pseudomembranous pharyngitis was associated with a dysphagia. He was from a rural municipality of Ambato Boeny at Mahajanga province and was admitted to the Pediatric Unit of the University Hospital Center. The child was not immunized against diphtheria. A throat swab was performed and cultured, from which Corynebacterium diphtheriae was identified. The strain, of biovar Mitis, was confirmed as diphtheria toxin (DT)-gene positive and produced DT (Elek test). Unfortunately, the child developed cardiac and neurological complications and died of respiratory and heart failure.
Assuntos
Corynebacterium diphtheriae , Difteria , Faringite , Criança , Pré-Escolar , Corynebacterium diphtheriae/genética , Difteria/diagnóstico , Família , Humanos , Madagáscar , MasculinoRESUMO
BACKGROUND: Little is known about viral co-infections in African human immunodeficiency virus (HIV)-infected children. We examined the prevalence of seromarkers for cytomegalovirus (CMV), herpes simplex virus type 2 (HSV-2) and hepatitis B virus (HBV) infections among HIV-infected, antiretroviral treatment (ART)-naïve children in Lilongwe, Malawi. METHODS: Ninety-one serum samples were tested for IgG and IgM antibodies to CMV, and IgG antibodies to HSV-2 and hepatitis B surface antigen (HBsAg). Baseline demographic, clinical and laboratory data were abstracted from electronic records. RESULTS: CMV IgG was the most common positive result in all age groups (in 73% of children <1 year, and 100% in all other groups). Three patients were CMV IgM positive (3.3%), suggesting acute infection. HSV-2 IgG was positive in four patients (4.4%), and HBsAg in two (2.2%). CONCLUSIONS: CMV infection occurred early in life, and few children had specific signs of CMV infection at the time of ART initiation. Unrecognized HBV infection represents opportunities for testing and treatment of HIV/HBV co-infected children.
Assuntos
Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/isolamento & purificação , Infecções por HIV/complicações , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Herpes Simples/epidemiologia , Herpesvirus Humano 2/isolamento & purificação , Adolescente , Anticorpos Antivirais/sangue , Biomarcadores/sangue , Criança , Pré-Escolar , Coinfecção/epidemiologia , Estudos Transversais , Citomegalovirus/imunologia , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/virologia , DNA Viral/sangue , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Hepatite B/sangue , Hepatite B/virologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Herpes Simples/sangue , Herpes Simples/virologia , Herpesvirus Humano 2/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Malaui/epidemiologia , Masculino , Prevalência , Estudos SoroepidemiológicosRESUMO
AIM: To examine the long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. METHODS: A randomized controlled trial with long-term follow-up was performed in LBW infants in Madagascar. Earlier continuous KMC (intervention group) was initiated as soon as possible within 24 h postbirth, and later continuous KMC (control group: conventional care) was initiated after complete stabilization. Outcome measures were mortality or readmission, nutritional indicators at 6-12 months postbirth and feeding condition at 6 months postbirth (ClinicalTrials.gov, NCT00531492). RESULTS: A total of 72 infants were followed for mortality or readmission at 6-12 months postbirth. There was no difference between the two groups (7/36 vs. 7/36, Risk ratio (RR), 1.00; 95% CIs, 0.39-2.56; p = 1.00). The proportion of exclusive breast feeding (EBF) at 6 months postbirth was significantly higher with earlier KMC than later KMC (12/29 vs. 4/26; RR 2.69; 95% CIs, 1.00-7.31; p = 0.04). There were no differences in nutritional indicators between the two groups at 6-12 months postbirth. CONCLUSION: Earlier initiated continuous KMC results in a significantly higher proportion of EBF at 6 months postbirth. Further larger-scale long-term evaluations of earlier initiated continuous KMC for LBW infants are needed.
Assuntos
Aleitamento Materno , Recém-Nascido de Baixo Peso/fisiologia , Método Canguru , Relações Mãe-Filho , Feminino , Seguimentos , Idade Gestacional , Transtornos do Crescimento , Humanos , Lactente , Mortalidade Infantil , Transtornos da Nutrição do Lactente , Recém-Nascido , Madagáscar , Masculino , Avaliação de Resultados em Cuidados de Saúde , Readmissão do Paciente/estatística & dados numéricos , TempoRESUMO
Foreign bodies in the ear are common in children but they rarely lead to complications. We here report a rare case of homolateral facial palsy in a 4-year old female child that occurred 15 days after introduction of toxic foreign body (Abrus precatorius seed) in her ear. The patients had signs of local necrosis associated with external otitis, without systemic involvement. Foreign body extraction was performed using micro-hook. Local and general treatments as well as corticosteroid therapy and physiotherapy were started with good outcome after three weeks. Prolonged stay of the foreign body in the ear can cause local infection resulting in potential functional complications. Early extraction and local treatment are the basis for treatment.