Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.

Design and Production of Infant Flours Based on Pumpkin Pulp Enriched with Cakes Extracted from Its Seeds

The inclusion of composite flours in infant food at weaning time should be a priority for mothers. The aim of this project is to formulate infant flour based on pulp flour enriched with oilcake from these grains after extraction of the oil. To do this, the elements were combined to obtain a regulatory formulation. Micro- and macronutrients, minerals, vitamins and tasting of the prepared porridge were determined. The results obtained were satisfactory. The moisture content of the fruit pulp was determined using oven-drying techniques: 92.2%, carbohydrates 6.00%, lipids 0.3%, ash 0.80%, proteins 1.10%, calcium 19.8%, phosphorus 42.6% and iron 0.4%. Furthermore, the carbohydrate content of flours composed of 5% insertion is 62.9 g to 48.8 g per 100 g, and the protein content of compound flours with 5% insertion is 15.9 g to 28.25 g per 100 g. On the other hand, the vitamin C and E contents of fresh pulp and oilcake are 25 mg, 13 mg and 21 mg respectively. However, only copper and β-carotene from 5% to 30% insertion remain invariant to the different insertion rates, with a value of 25 mg for copper and 0 µg for β-carotene. In addition, a variation in the degree of swelling of weaning flours compared with the standard from 3.95% at 5% insertion to 3.58 at 30% insertion was observed. The solubility of flours increases on the one hand with increases in the degree of insertion of the cakes. Flour formulated so many toward basicity. But the presence of traces of oil containing fatty acids can reduce this basicity. This study may be an alternative of industrial flours in infant nutrition.

Research Progress on the Prevention of Premature Infant Lung Injury and Neonatal Respiratory Support

In the past 40 years,advances in neonatal intensive care unit(NICU)technology have enabled premature infants with lower birth weight and younger gestational age to survive.But with it comes an increase in the incidence of long-term respiratory dysfunction,mainly in the form of bronchopulmonary dysplasia(BPD).Preventing lung injury is crucial for preventing BPD and improving the long-term prognosis of premature infants.Therefore,how to avoid ventilator-associated lung injury has become a focus of clinical and scientific research in premature infants in recent years.This article will elaborate on the susceptibility and pathophysiology of premature infant lung injury,ventilation strategies for preventing lung injury,and new advances in neonatal respiratory support.

Global,regional and national burdens of bipolar disorders in adolescents and young adults:a trend analysis from 1990 to 2019

Background Bipolar disorder is identified as a cause of severe damage to the physical,psychological and social functioning of adolescents and young adults.Aims The aim of this study is to ascertain the trends in the burden of bipolar disorder among individuals aged 10-24 years at global,regional and national levels from 1990 to 2019.Methods The data analysed in this study were from the Global Burden of Diseases 2019.The numbers,rates per 100000 population,average annual percentage changes(AAPCs)of incidence,prevalence and years lived with disability(YLDs)of bipolar disorder are reported at the global,regional and national levels among individuals aged 10-24 years.Global trends by age,sex and Social Development Index(SDI)were further analysed.Results Globally,the incidence of bipolar disorder among adolescents and young adults increased from 79.21 per 100000 population(95%uncertainty interval(Ul):58.13 to 105.15)in 1990 to 84.97 per 100000 population(95%Ul:61.73 to 113.46)in 2019,AAPC 0.24(95%confidence interval(Cl):0.22 to 0.26).In the past three decades,there has been an increase in incidence,prevalence and YLDs in both males and females.The largest increase in incidence between 1990 and 2019 was observed in those aged 20-24 years old from 51.76 per 100000 population(95%Ul:26.81 to 87.20)in 1990 to 58.37 per 100000 population(95%UI:30.39 to 98.55)in 2019;AAPC 0.42(95%Cl:0.38 to 0.47).By the SDI quintile,the largest increase in incidence was observed in the middle SDl;however,the high SDI countries had the highest incidence.Regionally,the largest increase in incidence was observed in southern Latin America.At the national level,the most pronounced increase in the incidence was in Greenland.Conclusions The global increase in incidence among adolescents and young adults between 1990 and 2019 indicates that strategies to improve their mental health still need to be emphasised.

Etiologies and Prognostic Factors of Dyspnea in Infants at the University Hospital Center (CHU) of Bouaké (Ivory Coast)

Identify the epidemiological characteristics, etiologies and evolutionary aspects of dyspnea in infants. This was a retrospective study of infants hospitalized for dyspnea from January 1 to December 31, 2020. The parameters studied were sex, age, origin, vaccination status, existence of underlying pathology. Underlying, the diagnosis and the evolutionary modalities. Data analysis and processing were possible using Word, Excel and EPI info version 7 software. We retained 152 infants. The sex ratio was 1.34 and the median age was 4 months. Vaccines according to expanded immunization program (EPI) were up to date in 76.32%. The main antecedents with risk identified were malnutrition, hypotrophy at birth, interventricular communication. The pathologies observed were low acute respiratory diseases in 90.79%, ENT diseases in 04.60% and cardiac diseases in 03.95%. The median length of hospitalization was 4 days. Infants who died accounted for 15.13%. The median age of infants who died was 4 months. The median time to onset of death was 1.63 days. The risk factors for death were age < 6 months (p = 0.003;CI [1.27;9.33]), outdated vaccines (p = 0.012;CI [1.18;5.17]), history with risk (p = 0.031;CI [1.02;4.54]). Dyspnea in infants remains a concern in our service. Reducing mortality involves developing procedures for the management of lower respiratory ailments, continuous staff training and strengthening the technical platform.

Assessment of Nutritional Status and Associated Factors in Infants Aged 6 to 23 Months in Rural Burundi

This study was carried out in the Health districts of Kayanza and Gahombo. Its aim was to assess the nutritional status and associated factors of infants aged between 6 and 23 months. This descriptive and cross-sectional study was carried out in the health centers of the action zone during medical consultations in community medicine from 13 to 22 February 2023. For this purpose, 53.0% of a sample of 398 mothers of infants aged 6 - 23 months were male, and the most represented age group was 12 - 23 months with 53.8%. Mothers were asked about the diet of their children. All the children involved in this study were vaccinated, whereas 99.2% were given vitamin A supplements. The most frequent illnesses in this age group were acute respiratory infection (ARI) (73.4%), fever (66.6%), diarrhea (53.8%), and vomiting (40.5%). Analysis of nutritional status showed that infants had severe (8.3%) and moderate (70.4%) acute malnutrition. Factors associated with infant nutritional status comprised the occupation of mother (P = 0.009), level of education of mother (P = 0.0625), and prolonged diarrhea (P = 0.004). To remedy this problem, concrete nutritional and educational interventions are needed to promote optimal infant nutrition during the first two years of life.

Rare Etiology of Reversible Hypokinetic Dilatated Heart Disease in Infants: Bland-White-Garland Syndrome (ALCAPA)

Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilated heart disease in infants. We report through this clinical case, the fourth case of infantile ALCAPA diagnosed in Senegal in a 7-month-old infant. The symptomatology began around the age of 2 months, with a grumpy state associated with more marked crying and moaning during feedings and bowel movements. The mother reported hospitalization for a severe lung infection when she was 6 months old. The examination noted an infant in poor general condition, retarded growth and weight, and a 3/6th holosystolic murmur at the apex. Troponinemia was positive at 43.90 ng/L. The electrocardiogram showed Q waves on the lower side, a sub endocardial lesion on the upper side and a ST segment elevation in aVR. Doppler echocardiography showed dilated cardiomyopathy with a mean alteration of systolic function of the left ventricle at 37%, a mean mitral insufficiency and a strong suspicion of a birth anomaly of the left coronary artery. The CT scan confirmed the diagnosis of ALCAPA. Surgicalreimplantation of the left coronary artery at the aortic level was performed at 10 months of life with a favourable outcome at D50 postoperative.

Simultaneous Determination of 2- and 3-MCPD Esters in Infant Formula Milk Powder and Edible Vegetable Oils by Gas Chromatography-Mass Spectrometry

Esters of 2- and 3-monochloropropane-1,2-diol (MCPD) are significative contaminants of processed edible oils used as foods or food ingredients. The aim of this study was to develop and validate a new method by GC-MS for the simultaneous quantification of 2 and 3-MCPD esters in infant milk powder and edible vegetable oils. The developed protocol included fat fraction in infant milk powder and edible vegetable oils samples was extracted and treated with sodium methylate-methanol to cleave the ester bonds of the 2- and 3-MCPD esters, moreover, standard samples of deuterium isotope-labeled 2- and 3-MCPD palmitic acid double esters and stearic acid double esters were used as the internal standards. Furthermore, this method was validated when it was applied to food products, concrete manifestation in its good accuracy (the recovery of MCPD esters ranged from 86% to 114%), high sensitivity (the LOD of 3-MCPD and 2-MCPD esters were 0.025 and 0.020 mg/kg, LOQ were 0.075, 0.060 mg/kg, respectively) and satisfactory repeatability (RSD below 6.8%) for all analytes. In the 150 commercial edible vegetable oils and infant formula milk powder samples, we obtained a preliminary profile of MCPD ester contamination.

Pharmacogenomics-based individualized treatment of hypertension in preterm infants: A case report and review of the literature

BACKGROUND Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and treatment.Pharmacogenomics can help guide individualized drug therapy and improve outcomes.CASE SUMMARY We report a case of a preterm infant with multiple complications,including bronchopulmonary dysplasia(BPD),sepsis,intracranial hemorrhage,and hypertension.The infant was treated with various drugs,including dexamethasone and amlodipine.The infant was diagnosed with neonatal hypertension based on blood pressure measurements exceeding the 95th percentile for his age and sex.The possible causes of hypertension included dexamethasone,hydrochlorothiazide,spironolactone,and BPD.The infant was treated with oral amlodipine to lower his blood pressure.A pharmacogenomic test was performed to evaluate the genetic polymorphisms of ABCB1 and CYP3A5,which are involved in the metabolism and transport of dexamethasone and amlodipine.The infant’s blood pressure was well controlled after the dose of amlodipine was reduced according to the pharmacogenomic results.The infant had a stable general condition and was discharged on the 100th d after birth.CONCLUSION This case illustrates the importance of regular blood pressure monitoring and etiological investigation in preterm infants with hypertension.Pharmacogenomics can provide useful information for individualized drug therapy and safety in this population.

Comparison of the treatment duration and nursing requirements of the EarWell infant ear correction system for different types of auricle deformities

Objective:To observe whether the Ear Well infant ear correction system makes any difference in terms of the treatment effect,duration,complication rate,and nursing care requirements in different types of infant auricle deformities.Methods:A total of 93 infant patients with auricular deformity(age:<3 months of age)who were diagnosed and treated in Guangzhou Children and Women’s Medical Center from April 2018 to September 2020 were selected and treated with the Ear Well infant ear correction system.We observed and recorded the effects of the Ear Well infant ear correction system,the treatment duration,the number of rebound cases,and complications that are likely to occur during treatment,and noted the related factors causing complications and the relative requirements for nursing care.Results:The Earwell infant ear correction system could effectively correct infant auricle deformities.Among the 93 cases,90 cases had positive therapeutical outcome and the effective rate was 96.77%.The treatment duration for lop ear and protruding ear was longer than for other auricle deformities;the deformity recoil and the treatment compilation rates were much higher for these 2 deformity types,and the difference was statistically significant(P<0.05).Conclusions:The treatment suggestion for the wearing duration of the Ear Well infant ear correction system for lop ear and protruding ear is a prolonged duration compared with that for other infant auricle deformities.Fur ther,the requirements for nursing care intensity and infant patient’s guardian’s nursing knowledge and skill are obviously increased for these 2 types of auricle deformities.

Anemia status of infants and young children aged six to thirty-six months in Ma'anshan City:A retrospective study

BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development.In Ma'anshan City,China,there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo.Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region.AIM To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City,China.Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group.METHODS The study encompassed 37698 infants and young children,aged from 6 to 36 mo,who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study.Basic information,physical examination,and hemoglobin detection data were collected.Descriptive analysis was used to analyze the prevalence of anemia in children in the region,and univariate analysis was used to analyze the influencing factors of anemia.RESULTS The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age,and the anemia detection rate decreased with age.The anemia detection rate in rural infants aged 6,9,and 12 mo was higher than that in urban infants.Although the anemia detection rate was higher in 6-mo-old boys than girls,it was higher in 24-mo-old girls than boys.There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses(emaciation,overweight,obese,and normal).Moreover,there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages.Besides,the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants,with statistically significant differences.Finally,there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses.CONCLUSION The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City,China,is relatively prominent and influenced by various factors.Our result shown that attention should be paid to the anemic infant and young child population,with strengthened education and targeted prevention and dietary guidance to help them establish good living habits,improve nutritional status,and reduce the occurrence of anemia to improve children's health levels.

Availability, Accessibility and Contribution of Infant Flours to the Diet of Children Aged 6-59 Months in Benin

This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional survey based on food ethnography methods was used. A total of 61 marketplaces were visited in seven towns and rural districts as part of the availability and affordability survey, while 400 children (aged 6 to 59 months) were surveyed to track the uses of infant flours at the household level. The results obtained reveal that pre-manufactured infant flour is sold more in urban areas (Cotonou, Porto-Novo and Parakou) than in rural ones. The average infant flours price did not vary (p = 0.985) in any given year (regardless of abundance or lean periods) nor does it vary (p = 0.133) from one point of sale to another (drugstore or supermarkets). However, the average price is found to be expensive considering the purchasing power of the households surveyed. On the other hand, the amount of ingredients used in the production of the flour types found on the market complies with the recommendations of the Codex Alimentarius, unlike the homemade ones. Pre-manufactured infant flour is found to be outside of the economic reach of most households (92%) who rely heavily on the homemade ones to feed their children. In light of the above, public authorities should help improve geographic access and pricing affordability to quality infant flour for low-income households in urban and remote areas. Moreover, awareness should be raised among mothers relative to the importance of complementary feeding through education on good nutrition practices.

Intracranial infection and sepsis in infants caused by Salmonella derby:A case report

BACKGROUND Salmonella derby(S.derby)is a Gram-negative diplococcus that is common in the digestive tract.Infected patients generally experience symptoms such as fever and diarrhea.Mild cases are mostly self-healing gastroenteritis,and severe cases can cause fatal typhoid fever.Clinical cases are more common in children.The most common form of S.derby infection is self-healing gastroenteritis,in which,fever lasts for about 2 d and diarrhea for<7 d.S.derby can often cause bacterial conjunctivitis,pneumonia,endocarditis,peritonitis and urethritis.However,intracranial infections in infants caused by S.derby are rare in clinical practice and have not been reported before in China.CASE SUMMARY A 4-mo-old female infant had recurrent fever for 2 wk,with a maximum body temperature of around 39.4°C.Treatment for infectious fever in a local hospital was ineffective,and she was admitted to our hospital.Before admission,there was one sudden convulsion,characterized by unclear consciousness,limb twitching,gaze in both eyes,and slight cyanosis on the face.Cerebrospinal fluid(CSF)culture was positive for Gram-negative bacilli,which conformed to S.derby.After treatment with meropenem and ceftriaxone antibiotics,the patient was discharged home in a clinically stable state after 4 wk of treatment.CONCLUSION We reported a rare case of S.derby cultured in CSF.S.derby enters the CSF through the blood–brain barrier,causing purulent meningitis.If not treated timeously,it can lead to serious,life-threatening infection.

Transcatheter Closure vs.Surgical Ligation in Preterm Infants with Patent Ductus Arteriosus:A Systematic Review and Meta-Analysis

Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)in preterm infants with pPDA.Methods:A literature search of Ovid Cochrane Library,Medline,Embase,Epub,Scopus,PMC Preprints,and ClinicalTrials.Gov was conducted from inception to May 06,2022.Eligible studies reported infants diagnosed with pPDA born at≤2000 g birth weight or at≤37 weeks’who underwent TC or SL as treatment.This review was registered in PROSPERO(CRD42022325944).Results:From 97 studies screened,8 studies met the eligibility criteria,with a total of 756 preterm infants undergoing either TC(n=366)or SL(n=390).Compared to TC,SL had higher mortality rates(OR=0.32,95%CI:0.16,0.66,I^(2)=0%).No difference was seen in post-procedural complication rate(OR=0.90,95%CI:0.18,4.44,I^(2)=79%),mean duration of post-procedural mechanical ventilation(MD=−2.21 days,95%CI:−4.88,0.47,I^(2)=60%),hospital stay length(MD=−8.30 days,95%CI:−17.03,0.44,I^(2)=0%)or neonatal intensive care unit stay length(MD=−3.50 days,95%CI:−10.27,3.27,I^(2)=0%).Conclusion:Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL.Despite the promising trends demonstrated in this meta-analysis,further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.

The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study

Objectives Growth retardation is a risk for premature infants.In addition to demographic and perinatal factors,preterm infants’physical growth may be affected by neonatal intensive care unit(NICU)stress,maternal postpartum depression,and mother-infant interaction.This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories.Methods A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai,China.Latent growth modeling was applied to identify the weight,length,and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics,infant stress during NICU stay,maternal postpartum depression,and mother-infant interaction on each trajectory.Results Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight,length,and head circumference until 4 months of corrected age.Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age(β=−0.43 and−0.19,respectively,P<0.05).The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length(β=−0.17,P=0.040),while between 2 and 3 months corrected postnatal age,there were lower growth rates of weight and head circumference(β=−0.15 and−0.19,respectively,P<0.05).The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight(β=−0.19,P=0.020).Conclusion The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay,maternal postpartum depression and mother-infant interaction.

Ionic Disorders Observed in Infants with Severe Wasting at the Yalgado Ouedraogo Teaching Hospital and the Charles de Gaulle Pediatric Teaching Hospital in Ouagadougou, Burkina Faso

Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m2. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.

Fournier gangrene in an infant, complicated with severe sepsis and liver dysfunction: A case report

BACKGROUND Fournier gangrene is a rare,life-threatening infection characterized by necrotizing fasciitis in the perineal,genital and/or lower abdominal regions.Despite its rarity,the unfavorable prognosis associated with this disease is dependent on the timing of medical care.CASE SUMMARY A 3-month-old boy was admitted to our pediatric intensive care unit in critical condition after a 5-day history of fever and scrotal erythema with breaching skin lesions and swelling.Despite ambulatory antibiotic treatment,the child’s clinical condition deteriorated.At the time of admission,the child had necrotizing scrotal fasciitis that had spread to the abdomen.Following reanimation,the surgeon decided on an immediate intervention to rule out testicular torsion and to debride the affected area.Despite optimal antibiotic and supportive therapy,the patient developed severe sepsis with liver dysfunction,making treatment more challenging.CONCLUSION Recognizing Fournier gangrene,prompt referral to pediatric surgery,and appropriate antibiotic coverage are critical for avoiding sepsis and multiorgan dysfunction.

SMRT sequencing and ddPCR reveal the complexity of developmental trajectories and temporal dynamics of gut bifidobacterial communities in infants

Infant intestinal microbiome is closely linked with health and risk of disease. Bifidobacterium are important components of the infant gut and are known to confer various health effects on the host. However, few studies have described the precise composition and dynamics of early infant gut bifidobacterial communities. Thus, this was a pilot study aiming to describe the developmental trajectories and temporal dynamics of bifidobacterial communities in infants before 6 months of age. A total of 28 fecal samples from 4 infants(GF, ZZ, QM, TN, respectively)were collected and analyzed after 5, 15, 30, 60, 90, 120, 150, and 180 days of birth by a bifidobacteria-target method(based on single-molecule real-time sequencing of partial bifidobacterial rpsK genes)in conjunction with droplet digital polymerase chain reaction(ddPCR). The infant fecal microbiota comprised a total of 11 bifidobacterial species, including 4 major species, i.e., B. dentium(37.35%), B. catenulatum(32.04%), B. breve(22.24%), and B. animalis(8.02%). The infant microbiota showed highly individualized developmental trajectories. The leading species for GF was B. catenulatum, with a relatively stable developmental trajectory. In ZZ, B. breve was enriched, and the developmental trajectory was rather fluctuating. The most abundant species for QM and TN was B. dentium. The developmental trajectory of B. dentium in QM showed a trend of gradual decrease, whereas an opposite trend was seen in samples of TN. The results of ddPCR confirmed large variations in quantities of bifidobacteria between infants and suggested discordances in temporal dynamics of bifidobacterial communities during the first half year of infancy. In conclusion, our results suggested that the early infant gut bifidobacterial microbiota was highly complex and temporal dynamics, with individualized developmental trajectories, which should be considered in future research of infant gut microbiota.

Generalized granuloma annulare in an infant clinically manifested as papules and atrophic macules:A case report

BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered generalized GA.CASE SUMMARY Herein,we describe the case of a pediatric patient who initially presented with papules and later developed generalized atrophic macules.Upon examination,two different morphologic lesions were histopathologically confirmed:Epithelioid nodular GA and scattered histiocytic infiltrative GA.This patient exhibited rare clinical manifestations that differed throughout the course of the disease.The varying histopathological types and clinical manifestations of GA may be linked to the different stages of the disease.CONCLUSION This rare case demonstrates the different histopathological features of different stages and clinical manifestations of granuloma annulare in an infant.

Nutrition Awareness and Knowledge and Body Mass Index in Adolescents in Public Junior Secondary Schools

Background: Non-communicable diseases are increasing among adolescents. The decision about diet is the foundation of eating habits that could persist to adulthood. Dietary decisions, which usually are hard to change later in life, make nutrition education at school paramount to prevent obesity and NCDs, and promote healthy eating. Objectives: To assess level of nutrition awareness and knowledge of healthy eating and food intake behaviors and association with Body Mass Index (BMI) and age. Methods: A cross sectional study that included measures such as age, gender, socioeconomic status, BMI, and nutrition knowledge was conducted in 264 respondents from 18th June 2015 to 9th July 2015. The nutrition knowledge questionnaire was composed of 24 questions divided into food nutrients, food contents, healthiest foods, and energy expenditure and nutrition benefits. CDC BMI chart for 2-20-year-olds was used to plot respondent’s weight and height. Results: The mean age of the respondents was 14.3 years (SD 0.79). Most of the respondents (153/252, 53.6%) had a low socio-economic status as categorized by the present study. The mean (SD) BMI was 20.08 (3.90). Most respondents (56.3%, 142/252) failed the knowledge test and scored below 50% and only two respondents (0.8%) had excellent nutrition knowledge. The mean percentage achieved was 46.1% (SD 15.91) ranging from 8.3% to 87.5%. There was a significant correlation between nutrition knowledge and BMI (p = 0.001). Conclusion: The study shows that adolescents do not have adequate nutrition knowledge, placing them at risk for developing non-communicable diseases later in life. Nutrition education programs are urgently needed for teachers, parents, and children.