The attitudes and expectation of caregivers of febrile child receiving medical services: a multicenter survey in Thailand.

BACKGROUND: Most caregivers may visit pediatric outpatient clinics with high concern of fever and improper antipyretic use. However, studies of concern about fever in Asian countries are still limited. OBJECTIVES: This study aimed to explore caregivers' attitudes, management of their child's fever, factors associated with their high concern, and expectation from medical services. METHODS: A cross-sectional 26-item self-administered questionnaire was used to survey caregivers of 1-month to 15-year-old febrile infants/children/teenagers visiting outpatient clinics in 9 government hospitals from July 2018 to August 2019. RESULTS: One thousand two hundred and six caregivers (67% response rate) completed self-administered questionnaire. The median age of the caregivers and the pediatric patients were 34 years (interquartile range [IQR] 28-40) and 3.3 years (IQR 1.8-6.1), respectively. Approximately 70% of them believed that fever could harm a child, resulting in brain damage or death. Also, 2% managed high doses of acetaminophen and overdosed the child. The high level of concern was significantly associated with acetaminophen overdose (P < 0.001, Kruskal-Wallis test). Caregivers of nonhealth care providers and children's history of febrile seizure were factors related to higher score of concern. Most caregivers expected definite diagnosis (70.7%), antipyretic drugs (67.4%), and blood tests (48.9%). CONCLUSION: Caregivers' high concern of fever existed in Thailand. This may lead to unnecessary high doses of antipyretics. In clinical practice, the high concern of fever is a challenge for caregivers and pediatric health care providers. A better understanding of fever and its consequence should be advocated for proper management of the child's fever.

Adherence to Screening for Anemia in 9-Month-Old Full-Term Infants in Bangkok, Thailand.

OBJECTIVES: To determine adherence to the screening for anemia in 9-month-old full-term infants and factors associated with non-adherence to the screening for anemia. METHODS: A descriptive cross-sectional study was conducted in 9-month-old full-term healthy infants who visited the General Pediatric and Well Child Care Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Demographic data, adherence to the screening, and factors associated with non-adherence to the screening were analyzed using percentage, χ2 test, and bivariate logistic regression. RESULTS: A total of 234 full-term infants, aged 9 months, were included in the study between January and December 2019. The prevalence of adherence to the screening for anemia was 76.1% (95% CI 0.70-0.81). The most common cause of non-adherence to the screening was the waiting time for laboratory results (39.3%). Factors associated with non-adherence to the screening were low education of caregiver (AOR 2.684; 95% CI 1.451-4.966), low socio-economic status (AOR 2.26; 95% CI 1.568-3.258), and inadequate complementary food (AOR 1.961; 95% CI 1.107-3.473). CONCLUSION: The most common cause of non-adherence to the screening for anemia is the waiting time for laboratory results. Pediatricians and general practitioners should ensure the importance of anemia screening in infants and plan on anemia screening with parents.

Long COVID and Hybrid Immunity among Children and Adolescents Post-Delta Variant Infection in Thailand.

This study aimed to assess long COVID, and describe immunogenicity against Omicron variants following BNT162b2 vaccination. A prospective cohort study was conducted among children (aged 5-11) and adolescents (aged 12-17) who had SARS-CoV-2 infection from July to December 2021 (Delta predominant period). Long COVID symptoms were assessed by questionnaires at 3 months after infection. Immunogenicity was evaluated by using a surrogate virus-neutralizing antibody test (sVNT) against the Omicron variant. We enrolled 97 children and 57 adolescents. At 3 months, 30 children (31%) and 34 adolescents (60%) reported at least one long COVID symptom, with respiratory symptoms prevailing (25% children and 32% adolescents). The median time from infection to vaccination was 3 months in adolescents and 7 months in children. At 1 month following vaccination, in children who received one-dose and two-dose BNT162b2 vaccines, the median (IQR) sVNT against Omicron was 86.2% inhibition (71.1-91.8) and 79.2% inhibition (61.5-88.9), respectively (p = 0.26). Among adolescents who received one-dose and two-dose BNT162b2 vaccines, the median (IQR) sVNT against Omicron was 64.4% inhibition (46.8-88.8) and 68.8% inhibition (65.0-91.2) (p = 0.64). Adolescents had a higher prevalence of long COVID than children. Immunogenicity against the Omicron variant after vaccination was high and did not vary between one or two doses of the vaccine in either children or adolescents.