When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a s...When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.展开更多
Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities whi...Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities which provided In-secticide Treated Bed-Nets (ITNs) to resident children under five years and Artemisinin Combination Therapies (ACTs) for the management of malaria were introduced into the Hohoe Municipality. Before the introduction of the control programme, baseline surveys were carried out in communities in the Hohoe municipality to determine the prevalence of malaria, fever, anaemia, malaria parasite density, gametocytaemia and ITN ownership and use in June and November 2006 ahead of the intervention programme. Similar surveys were conducted in 2010 after the intervention to assess changes in the earlier indicators in the same communities. This report presents an evaluation of the intervention by comparing findings before and after the malaria control interventions. Methods: In 2010, two community-based surveys were carried out in thirty communities among children aged five years and below. The first one was at the beginning of the rainy and high malaria transmission season in June and the other was in November at the end of the rainy season. The surveys were to determine the prevalence of malaria, fever, anaemia and ITN ownership, use and effectiveness among children less than 5 years. Data were collected in the form of interviews using questionnaire and collection of biological samples. Findings were compared to those similar surveys conducted in the same communities and age groups in 2006. Pr-testi was used to analyze two sample tests for proportions and t-test was used for means. Findings: Malaria prevalence decreased by 20% [9.0% vs. 7.2%;p = 0.0.40], fever decreased by 47.8% [2.3% vs. 1.2%;p = 0.008] and anaemia decreased by 32.9% [7.8% vs. 5.3%;p = 0.002]. ITN ownership increased by 67.9% [20.8% vs. 64.8%;p < 0.001], ITN use increased by 64.2% [15.1% vs. 42.2%;p < 0.001] and ITN effectiveness increased by 41.7% [20.0% vs. 34.3%;p < 0.001]. The proportion of children with high density parasitaemia reduced by 17.9% [2.8% vs. 2.3%;p = 0.223]. Gameto-cytaemia decreased by 82.5% [0.8% vs. 0.14%;p = 0.002. Similarly data comparing 2006 and 2010 post-rainy season showed that malaria prevalence decreased by 16.8% [40.4% vs. 33.6%;p < 0.001], fever decreased by 14% [5.0% vs. 4.3%;p = 0.347] and anaemia decreased by 64.2% [12% vs. 4.3%;p < 0.001]. The proportion of children with high density parasitaemia also reduced by 69.5% [10.5% vs. 3.2%;p < 0.001] and gametocytaemia decreased by 78.5% [0.8% vs. 0.17%;p = 0.008]. Conclusion: This study suggested that there was an association between the current intervention and reduction in the prevalence of malaria, fever and anaemia. High parasite density and gametocytaemia prevalence have also significantly reduced over the five years of the introduction of the control measures. There has also been a significant increase in the ownership and use of ITNs.展开更多
Brucellosis is the most common zoonotic infection that causes diseases in humans and is continuously a gross public health issue worldwide. Generally, physical examinations are normal or only minimally abnormal and th...Brucellosis is the most common zoonotic infection that causes diseases in humans and is continuously a gross public health issue worldwide. Generally, physical examinations are normal or only minimally abnormal and the diagnosis is made on the basis of the history and serologic studies. Disease can be mild and self-limited or fulminant with severe complications. Here is reported a case of a seven years old boy hospitalized for Fever of Unknown Origin. He had no clues on medical history and physical examination. No changes were found on laboratory parameters;normal blood count and normal inflammatory indicators resulted. After a careful investigation, the diagnose of Brucellosis was concluded. Persistent or prolonged fever may be the only presenting symptom in children. The growing phenomena of international tourism and migration have directed interest in Brucellosis as it is increasingly recorded in non-endemic countries.展开更多
Objectives: This study investigates the prevalence of obesity in children with familial Mediterranean fever (FMF). Material and Methods: We retrospectively reviewed the medical records of 70 patients with FMF whose ca...Objectives: This study investigates the prevalence of obesity in children with familial Mediterranean fever (FMF). Material and Methods: We retrospectively reviewed the medical records of 70 patients with FMF whose cases had been followed in our Pediatric Nephrology and Rheumatology Unit. The height and weight measurements of children with FMF were obtained and body mass index was calculated. Results: The mean body mass index was 16.7± 2.4 in the boys, and 17.4±2.9 in the girls. Nine of the children (five boys, four girls) were found to be overweight, a rate of 12.8% in FMF patients. Obesity was not detected in FMF patients. Conclusions: We think that there are some unligteening molecular mechanisms that prevent obesity in FMF patients. Due to the limited number of patients in this study, further research involving more patients are needed.展开更多
文摘When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.
文摘Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities which provided In-secticide Treated Bed-Nets (ITNs) to resident children under five years and Artemisinin Combination Therapies (ACTs) for the management of malaria were introduced into the Hohoe Municipality. Before the introduction of the control programme, baseline surveys were carried out in communities in the Hohoe municipality to determine the prevalence of malaria, fever, anaemia, malaria parasite density, gametocytaemia and ITN ownership and use in June and November 2006 ahead of the intervention programme. Similar surveys were conducted in 2010 after the intervention to assess changes in the earlier indicators in the same communities. This report presents an evaluation of the intervention by comparing findings before and after the malaria control interventions. Methods: In 2010, two community-based surveys were carried out in thirty communities among children aged five years and below. The first one was at the beginning of the rainy and high malaria transmission season in June and the other was in November at the end of the rainy season. The surveys were to determine the prevalence of malaria, fever, anaemia and ITN ownership, use and effectiveness among children less than 5 years. Data were collected in the form of interviews using questionnaire and collection of biological samples. Findings were compared to those similar surveys conducted in the same communities and age groups in 2006. Pr-testi was used to analyze two sample tests for proportions and t-test was used for means. Findings: Malaria prevalence decreased by 20% [9.0% vs. 7.2%;p = 0.0.40], fever decreased by 47.8% [2.3% vs. 1.2%;p = 0.008] and anaemia decreased by 32.9% [7.8% vs. 5.3%;p = 0.002]. ITN ownership increased by 67.9% [20.8% vs. 64.8%;p < 0.001], ITN use increased by 64.2% [15.1% vs. 42.2%;p < 0.001] and ITN effectiveness increased by 41.7% [20.0% vs. 34.3%;p < 0.001]. The proportion of children with high density parasitaemia reduced by 17.9% [2.8% vs. 2.3%;p = 0.223]. Gameto-cytaemia decreased by 82.5% [0.8% vs. 0.14%;p = 0.002. Similarly data comparing 2006 and 2010 post-rainy season showed that malaria prevalence decreased by 16.8% [40.4% vs. 33.6%;p < 0.001], fever decreased by 14% [5.0% vs. 4.3%;p = 0.347] and anaemia decreased by 64.2% [12% vs. 4.3%;p < 0.001]. The proportion of children with high density parasitaemia also reduced by 69.5% [10.5% vs. 3.2%;p < 0.001] and gametocytaemia decreased by 78.5% [0.8% vs. 0.17%;p = 0.008]. Conclusion: This study suggested that there was an association between the current intervention and reduction in the prevalence of malaria, fever and anaemia. High parasite density and gametocytaemia prevalence have also significantly reduced over the five years of the introduction of the control measures. There has also been a significant increase in the ownership and use of ITNs.
文摘Brucellosis is the most common zoonotic infection that causes diseases in humans and is continuously a gross public health issue worldwide. Generally, physical examinations are normal or only minimally abnormal and the diagnosis is made on the basis of the history and serologic studies. Disease can be mild and self-limited or fulminant with severe complications. Here is reported a case of a seven years old boy hospitalized for Fever of Unknown Origin. He had no clues on medical history and physical examination. No changes were found on laboratory parameters;normal blood count and normal inflammatory indicators resulted. After a careful investigation, the diagnose of Brucellosis was concluded. Persistent or prolonged fever may be the only presenting symptom in children. The growing phenomena of international tourism and migration have directed interest in Brucellosis as it is increasingly recorded in non-endemic countries.
文摘Objectives: This study investigates the prevalence of obesity in children with familial Mediterranean fever (FMF). Material and Methods: We retrospectively reviewed the medical records of 70 patients with FMF whose cases had been followed in our Pediatric Nephrology and Rheumatology Unit. The height and weight measurements of children with FMF were obtained and body mass index was calculated. Results: The mean body mass index was 16.7± 2.4 in the boys, and 17.4±2.9 in the girls. Nine of the children (five boys, four girls) were found to be overweight, a rate of 12.8% in FMF patients. Obesity was not detected in FMF patients. Conclusions: We think that there are some unligteening molecular mechanisms that prevent obesity in FMF patients. Due to the limited number of patients in this study, further research involving more patients are needed.
