Neural tube defects: Prevalence, mortality, and maternal characteristics in two departmental hospitals in the northwestern region of Nicaragua, 2006-2018.

BACKGROUND: Congenital anomalies are the fifth most common cause of neonatal mortality in Nicaragua, and neural tube defects (NTDs) are the most common of all cases of lethality associated with a birth defect. Prevalence and mortality estimates are needed to propose effective intervention strategies that prevent NTDs over time. METHODS: A cross-sectional study was carried out in northwestern Nicaragua from January 2006 to December 2018. All cases of NTDs (anencephaly, spina bifida, and encephalocele) were registered in hospital surveillance systems, and the medical histories of the mothers and newborns were reviewed. Prevalence was calculated by considering the number of live births and stillbirths older than 20 weeks of gestation with NTDs, divided by the total number of live births and stillbirths in each study year. Neonatal mortality rate (NMR) for NTD, and case fatality for spina bifida was calculated. RESULTS: Two hundred fifty cases of NTDs were identified from 178,498 deliveries (177,316 live births and 1,182 stillbirths). The prevalence of NTDs during this time period was 14.01 (95% CI: 12.27-15.74) per 10,000 births. The prevalence of spina bifida (n = 140), anencephaly (n = 97), and encephalocele (n = 13) was 7.84, (95% CI: 6.54-9.14), 5.43 (95% CI: 4.30-6.45), and 0.73 (95% CI: 0.33-1.12) per 10,000 births, respectively. Mothers with fetus or newborns affected with NTDs did not use folic acid prior to conception, and 11% experienced periods of hyperthermia during the first trimester of pregnancy. NMR for NTDs was 0.55 per 1.000 livebirths. Case fatality for all NTDs and for spina bifida were 55% and 18%, respectively. CONCLUSION: The prevalence and mortality of NTDs in the northwestern region of Nicaragua present peaks and troughs during the study period. Spina bifida was the most frequent type of NTD. We believe that these findings could be of use by health policy makers to strengthen the primary prevention of NTDs in the region through the monitoring of the food fortification policy and folic acid supplementation to women of childbearing age. Additional etiologic studies of NTDs should be considered to identify additional prevention measures.

Prevalence of microcephaly: the Latin American Network of Congenital Malformations 2010-2017.

Objective: The Latin American Network of Congenital Malformations: ReLAMC was established in 2017 to provide accurate congenital anomaly surveillance. This study used data from ReLAMC registries to quantify the prevalence of microcephaly from 2010 to 2017 (before, during and after the Zika virus epidemic). Design: Nine ReLAMC congenital anomaly registries provided case-level data or aggregate data for any live births, still births or terminations of pregnancy with microcephaly. Births to pregnant women infected with Zika virus first occurred in Brazil in 2015, and in the remaining registry areas in 2016 with the exception of Chile that did not experience Zika virus. Therefore the prevalence of microcephaly for 2010-2014 and individual years 2015, 2016 and 2017 was estimated using multilevel random effect Poisson models. Clinical classification and characteristics of the cases were compared pre and post Zika for all centres providing individual case-level data. Results: The prevalence of microcephaly for all registries excluding Brazil was 2.3 per 10 000 (95% CI 2.0 to 2.6) for 2010-2014 rising to 5.4 (95% CI 4.8 to 6.0) in 2016 and 5.9 (95% CI 5.3 to 6.6) in 2017. Brazil had a prevalence of 0.6 per 10 000 (95% CI 0.5 to 0.6) in 2010-2014, rising to 5.8 (95% CI 5.6 to 6.1) in 2015, 8.0 (95% CI 7.6 to 8.3) in 2016 and then falling in 2017. Only 29 out of 687 cases of microcephaly were reported as congenital Zika syndrome in countries excluding Brazil. Conclusions: The prevalence of microcephaly was influenced both by Zika causing congenital Zika syndrome and by increased reporting awareness.

Epidemiología de las infecciones de vias urinarias en pediatría. Incluido patrón de resistencia Hospital Escuela Oscar Danilo Rosales Arguello, León junio 2002 - enero 2004 / Epidemiology of the infections of seen urinary in pediatrics. Included resistance standard School Hospital ++Oscar Danilo Rosebushes Arguello, June Lion 2002 January 2004

El obejtivo de estudio es describir características clínicas y e pidemiológicas, de los niños y niñas con infeccion de vias urinarias, incluyendo patron de resistencia de los microorganismos aislados, en el Departamento de Pediatría del Hospital Escuela Dr. Oscar Danilo Rosales, Junio 2002- Enero 2004. Se realizo un estudio descriptivo de serie de casos, a cerca de la Epidemiologia de las infecciones de Vias Urinarias y Patron de resistencia antibiótica, en 130 niños que acudieron al Hospital Escuela Dr. Oscar DaniloRosales durante el periodo de Junio 2002 a enero 2004 Fueron incluidos los niños y niñas con datos clínicos sugestivos de infección de vías urinarias y losniños menores de dos años con fiebre sin foco infeccioso aparente Se tomo como criterio de exclusión el uso de antibióticos durante la última semana. El 20 pOrciento de los niños con datos clinicos de infeccion de vias urinarias mostro crecimiento bacteriano El grupo de edad mas afectado fueron los lactantes. En el grupo menor de un año, las infecciones de vias urinarias fueron mas frecuentes en el sexo masculino y en el resto de grupos etereos hubo un claro incremento en el sexo femenino a medida se incrementaba en edad, con una relacion H M1 6 La fiebre fue la manifestacion clinica predominante en todos los grupos de edad, presentando ademas manifestaciones uretrovesicales en los preescolares y escolares Las bacterias aisladas con mayor frecuencia fueron la seguida de E.coli seguida de Enterobacter sps y Kllsiellas las cuales mostraron alta resistencia a laampicilina y al TMP/SMZ, siendo sensibles a ceftriaxone, ciprofloxacina, gentamicina y nitrofurantoina