Post-malarial anemia in Mozambican children treated with quinine or artesunate: A retrospective observational study.

OBJECTIVES: This retrospective analysis performed in Manhiça, Southern Mozambique, aimed to describe the frequency of post-malarial anemia (measured as a decrease of hematocrit ≥10%) and the need for blood transfusions in children with severe malaria treated with intravenous quinine or parenteral artesunate. METHODS: All children <15 years admitted with a parasitologically-confirmed diagnosis of malaria from 1st January 2003 to 31st December 2017, alive at hospital discharge, and with at least one measurement of hematocrit within 28 days after hospital discharge, detected by passive case detection, were included. RESULTS: The overall prevalence of post-malarial anemia observed in the study was 23.13%, with an estimated incidence rate of 288.84 episodes/1,000 children-month at risk in the follow-up period (28 days after discharge). There were no differences between treatment groups, although the study showed a higher association between blood transfusions and artesunate treatment. CONCLUSIONS: In this setting, children with severe malaria frequently present a meaningful decrease of hematocrit (>=10%) in the first weeks after their episode, sometimes requiring blood transfusions. Because of the high underlying prevalence of anemia in malaria-endemic settings, all children with severe malaria need to be actively followed up, irrespective of the treatment received.

Sneathia amnii and Maternal Chorioamnionitis and Stillbirth, Mozambique.

We report a case of Sneathia amnii as the causative agent of maternal chorioamnionitis and congenital pneumonia resulting in a late fetal death in Mozambique, with strong supportive postmortem molecular and histopathologic confirmation. This rare, fastidious gram-negative coccobacillus has been reported to infrequently cause abortions, stillbirths, and neonatal infections.

Rapid Influenza Testing in Infants and Children Younger than 6 Years in Primary Care: Impact on Antibiotic Treatment and Use of Health Services.

Influenza is often misdiagnosed in children because of the low sensitivity of clinical diagnosis because of nonspecific signs and symptoms. This can be overcome by using digital immunoassays or rapid molecular diagnostic tests with adequate sensitivity and specificity. When using these tests at the patient care site, antibiotic consumption and number of healthcare consultations were reduced.

Diagnòstic ràpid de grip en lactants i infants menors de 6 anys a l'atenció primària / Diagnóstico rápido de gripe en lactantes y niños menores de 6 años en atención primaria / Rapid diagnosis of influenza in infants and children younger than 6 years of age in primary care

Fonament: La taxa d'incidència de la grip en l'edat pediàtrica és la més elevada de la població, i el diagnòstic és difícil els primers anys de vida perquè té una simptomatologia inespecífica. Els tests de diagnòstic ràpid (TDR) de grip podrien millorar el maneig dels pacients en atenció primària. Objectiu: Estudiar si el diagnòstic de grip amb un TDR objectiu en lactants i infants menors de 6 anys disminueix el consum d'antibiòtics i el nombre de consultes successives. Mètode: Estudi longitudinal prospectiu descriptiu realitzat durant la temporada epidèmica 2016-2017 en quatre centres d'atenció primària de Barcelona, a lactants i infants fins als 6 anys. Amb una mostra de frotis nasofaringi es van fer dos tipus de TDR i al cap de 10 dies s'efectuava un seguiment telefònic demanant l'evolució de la simptomatologia, l'antibioteràpia rebuda, les consultes fetes i el contagi familiar produït. Resultats: Es van diagnosticar 55 casos de grip A, amb una edat mitjana de 33 mesos. La durada de la febre abans del diagnòstic va ser de 2,1 dies i de 3,2 dies després del diagnòstic, amb una temperatura mitjana de 38,9ºC. La simptomatologia més freqüent va ser la respiratòria, amb una durada mitjana després del diagnòstic de 6-7 dies. Van rebre antibioteràpia dos pacients, es van efectuar 18 reconsultes i es va objectivar un contagi de 50 persones en 29 famílies. Conclusions: La baixa prescripció antibiòtica i de consultes successives semblen confirmar que fer el diagnòstic en la consulta mateix és útil per aconseguir aquest objectiu

Fundamento: La tasa de incidencia de gripe en edad pediátrica es la más elevada de la población y su diagnóstico es difícil en los primeros años de vida por su sintomatología inespecífica. Los tests de diagnóstico rápido (TDR) de gripe podrían mejorar el manejo de los pacientes en atención primaria. Objetivo: Estudiar si el diagnóstico de gripe con un TDR en lactantes y niños menores de 6 años disminuye el consumo de antibióticos y el número de consultas sucesivas. Método: Se realizó un estudio longitudinal prospectivo descriptivo durante la temporada epidémica de 2016-2017 en cuatro centros de atención primaria de Barcelona, a lactantes y niños hasta los 6 años. Con una muestra de frotis nasofaríngeo se realizaron dos tipos de TDR y a los 10 días se efectuaba el seguimiento telefónico, preguntando por la evolución de la sintomatología, la antibioterapia recibida, las consultas realizadas y el contagio familiar producido. Resultados: Se diagnosticaron 55 casos de gripe A, con una edad media de 33 meses. La duración media de la fiebre antes del diagnóstico fue de 2,1 días y de 3,2 días después del diagnóstico, con una temperatura media de 38,9ºC. La sintomatología más frecuente fue la respiratoria, con una duración media tras el diagnóstico de 6-7 días. Recibieron antibioterapia dos pacientes, se efectuaron 18 reconsultas y se objetivó un contagio de 50 pacientes en 29 familias. Conclusiones: La baja prescripción antibiótica y del número de consultas sucesivas parecen confirmar que realizar el diagnóstico en la propia consulta es útil para conseguir este objetivo

Background: The incidence of influenza in children is the highest among all age groups, and its diagnosis may be difficult in the first years of life due to the non-specific symptoms. Rapid diagnostic tests (RDT) of influenza could improve the management of patients in the primary care setting. Objective: To investigate if the diagnosis of influenza using RDT in infants and children under 6 years resulted in a decrease in the prescription of antibiotics and in the number of follow-up medical visits. Method: We conducted a descriptive prospective longitudinal study during the 2016-2017 epidemic season in four primary care centers of Barcelona, with infants and children up to 6 years of age. Two types of RDT using a nasopharyngeal swab sample were performed, with a follow-up telephone call 10 days later to inquire about symptoms, antibiotic treatment received, additional medical visits, and family contagion noted. Results: A total of 55 cases of influenza A were diagnosed, at a median age of 33 months. The median duration of fever before and after the diagnosis was 2.1 and 3.2 days, respectively, with a median temperature of 38.9ºC. The most frequent symptomatology was respiratory, with a median duration after diagnosis of 6-7 days. Two patients received antibiotic therapy, 18 additional medical visits were carried out, and 50 individuals were reported to be infected among 29 families. Conclusions: The low antibiotic prescription and number of following medical visits seem to confirm that a rapid diagnosis performed during the initial consultation is useful for achieving those goals