Prevalence of malnutrition & anemia in preschool children; a single center study.

BACKGROUND: Malnutrition including undernutrition, overnutrition, and micronutrient deficiencies are considerable problems worldwide, with variable burdens among different communities. Its complications include physical and cognitive impairment, with the probability of irreversible lifelong consequences. We aimed to assess the prevalence of undernutrition, overweight, obesity, and anemia in preschoolers, being a risk group for developmental adverse events. METHODS: We recruited 505 healthy preschool children, with a male: female ratio of 1.05:1. Children with chronic diseases were excluded. We used anthropometry and complete blood count to screen for malnutrition and anemia. RESULTS: The mean age of the study group was 3.8 ± 1.4 years (1.02-7). The screening results were average in 228 (45.1%) children, while 277 (54.9%) children had either abnormal anthropometry, anemia, or both. We observed undernutrition in 48 (9.5%) children; among them, 33 (6.6%) were underweight, 33 (6.6%) wasted, and 15 (3%) were stunted, with no significant difference between children aged below or above five. We identified overnutrition in 125 (24.8%); 43 (8.5%) were overweight, 12 (2.4%) were obese, and 70 (13.9%) had a high body mass index Z score, not qualifying the definition of overweight. Anemia was diagnosed in 141 (27.9%) children and was significantly more frequent among older children without gender discrimination. About 10% (50 children) had both anemia and abnormal anthropometry. The frequency of abnormal anthropometry was comparable between children with anemia and those with normal hemoglobin. CONCLUSION: Malnutrition and anemia in preschoolers are still a heavy burden affecting about half of our study group, with an upward trend towards the overnutrition side. Anemia is still a moderate public health problem in preschoolers.

The Effectiveness of Ledipasvir/Sofosbuvir in Youth With Genotype 4 Hepatitis C Virus: A Single Egyptian Center Study.

BACKGROUND: Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in adolescents was based on clinical trials on patients mainly with genotype 1. We aimed to evaluate the effectiveness and short-term safety of this newly approved antiviral in adolescents with HCV genotype 4. METHODS: This was a study of 51 HCV-infected adolescents, who received the adult dose of ledipasvir/sofosbuvir, once daily for 12 weeks, and were followed-up for 12 weeks post-treatment. Laboratory tests, quantitation of HCV RNA, HCV genotyping, IL-28rs gene polymorphism and transient elastography were performed at baseline. Follow-up visits were done for blood testing and adverse events recording. RESULTS: The mean age was 14.7 ± 1.5 years (11-17.5), with a male to female ratio of 1.7:1. All patients were genotype 4a, and 76.5% had the CC IL-28 gene polymorphism. About 50% gave a history of HCV-infected mother, and 31% were treatment-experienced. Liver stiffness was F0 in 72.5%, F0-F1 in 13.7% and F1-F2 in 13.7%. Adverse events were mainly abdominal pain in 72.5%, headache in 64.7% and diarrhea in 53% of patients; these were mild. A reversible increase in creatinine level with a concomitant decline in estimated glomerular filtration rate was observed in the first month of treatment. By the end of week 12, a significant decline in liver enzymes was observed. All patients achieved an early, end of treatment, and a sustained virologic response. CONCLUSIONS: Adolescent patients with genotype 4 chronic HCV infection achieved a good response rate with good ontreatment tolerability for ledipasvir/sofosbuvir therapy.

Paediatric chronic hepatitis B virus infection: are children too tolerant to treat?

AIM: Guidelines for managing the hepatitis B (HB) virus infection in children are still evolving. We aimed to assess the eligibility of children with HB virus infections for treatment based on the current guidelines. METHODS: This observational study took place in 2016 and focused on children with isolated chronic HB infections, who attended the paediatric hepatology units at two centres in Egypt. We recruited all treatment-naïve children aged one year to 18 years who had completed at least 12 months of follow-up. RESULTS: The study comprised 103 children aged between 1.5-18 years. Of these, 51 (50%) had the HB e antigen-positive chronic infection, 28 (27%) had the HB-negative chronic infection, 11 (11%) had the HB e antigen-positive chronic hepatitis and none had the HB e antigen-negative chronic hepatitis. The remaining 13 (12%) children did not fulfil the criteria for chronic HB definitions. Only two of the children were candidates for treatment: both had HB e antigen-positive chronic hepatitis and had undergone liver biopsies. CONCLUSION: Only two of the 103 children with chronic HB were eligible for treatment according to the current guidelines and every measure should be taken to prevent the HB virus infection in children.