Now showing items 41-60 of 81

    • Call for Preventive Care for Rheumatic Heart Disease in Refugee Children

      Rossi, G; Lee, VS (BMJ Publishing Group - We regret that this article is behind a paywall., 2016-04-26)
    • Low-Tech, High Impact: Care for Premature Neonates in a District Hospital in Burundi. A Way Forward to Decrease Neonatal Mortality

      Ndelema, B; Van den Bergh, R; Manzi, M; van den Boogaard, W; Kosgei, R J; Zuniga, I; Juvenal, M; Reid, A (Springer Link, 2016-01-16)
      Death among premature neonates contributes significantly to neonatal mortality which in turn represents approximately 40 % of paediatric mortality. Care for premature neonates is usually provided at the tertiary care level, and premature infants in rural areas often remain bereft of care. Here, we describe the characteristics and outcomes of premature neonates admitted to neonatal services in a district hospital in rural Burundi that also provided comprehensive emergency obstetric care. These services included a Neonatal Intensive Care Unit (NICU) and Kangaroo Mother Care (KMC) ward, and did not rely on high-tech interventions or specialist medical staff.
    • Task Sharing Within a Managed Clinical Network to Improve Child Health in Malawi

      O'Hare, B; Phiri, A; Lang, H-J; Friesen, H; Kennedy, N; Kawaza, K; Jana, C E; Chirambo, G; Mulwafu, W; Heikens, G T; et al. (BioMed Central, 2015-07-21)
      Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health.
    • Enteric bacterial pathogens in children with diarrhea in niger: diversity and antimicrobial resistance

      Langendorf, C; Le Hello, S; Moumouni, A; Gouali, M; Mamaty, A-A; Grais, RF; Weill, F-X; Page, A-L (Public Library of Science, 2015-03-23)
      Although rotavirus is the leading cause of severe diarrhea among children in sub-Saharan Africa, better knowledge of circulating enteric pathogenic bacteria and their antimicrobial resistance is crucial for prevention and treatment strategies.
    • Getting it right for children: improving tuberculosis treatment access and new treatment options

      Brigden, Grania; Furin, Jennifer; Van Gulik, Clara; Marais, Ben (Informa Healthcare/Expert Reviews - We regret that this article is behind a paywall., 2015-03-05)
      Children were often the forgotten victims of the global tuberculosis (TB) epidemic, neglected by traditional TB services as well as maternal and child health initiatives. Luckily this is changing with a greater focus on children and the issues regarding their optimal management. A common misconception is that children with TB are always difficult to diagnose and treat. New diagnostic tools are urgently needed, but most children with TB in high-burden settings can be diagnosed with available approaches and treatment outcomes are generally excellent. Increased TB awareness, appropriate training of health care workers and inclusion in integrated management of childhood illness strategies will improve the access and quality of care that children receive. This review highlights what needs to be done to ensure that no child unnecessarily dies from TB and provides a brief overview of new advances in the field.
    • Screening for psychological difficulties in young children in crisis: complementary cross-cultural validation

      Marquer, C; Barry, C; Mouchenik, Y; Djibo, D M; Manzo, M L; Trujillo Maza, E M; Githaiga, S; Casas, G; Kirubi, B W; Marichez, H; et al. (Oxford University Press, 2015-03-04)
      Detection of children's psychological difficulties in crises and low resource settings is challenged by the lack of a validated, rapid and simple tool. We present the results of two confirmatory validations of the Psychological Screening for Young Children aged 3 to 6 years (PSYCa 3-6) scale.
    • A Retrospective Analysis of Pediatric Cases Handled by the MSF Tele-Expertise System

      Martinez Garcia, D; Bonnardot, L; Olson, D; Roggeveen, H; Karsten, J; Moons, P; Schaefer, M; Liu, J; Wootton, R (Frontiers Media, 2014-12-08)
      We conducted a retrospective analysis of all pediatric cases referred by Médecins Sans Frontières (MSF) field doctors via the MSF telemedicine system during a 4-year period from April 2010. A total of 467 pediatric cases were submitted, representing approximately 40% of all telemedicine cases. The median age of the patients was 4 years. The median response time (i.e., the interval between the case being submitted and the first response from a specialist) was 13 h (interquartile range 4-32 h). We selected a random sample of 12 pediatric cases in each of four age categories for detailed analysis by an experienced MSF pediatrician. In the 48 randomly selected cases, the mean rating for the quality of information provided by the referrer was 2.8 (on a scale from 1 = very poor to 5 = very good), and the mean rating for the appropriateness of the response was 3.3 (same scale). More than two-thirds of the responses were considered to be useful to the patient, and approximately three-quarters were considered to be useful to the medical team. The usefulness of the responses tended to be higher for the medical team than for the patient, and there was some evidence that usefulness to both groups was lower in newborns and adolescent patients. The telemedicine system allows the quality of the medical support given to medical teams in the field to be controlled objectively as there is a record of all cases and answers. Telemedicine has an important role in supporting the aims of medical humanitarian organizations such as MSF.
    • Description of 3,180 Courses of Chelation with Dimercaptosuccinic Acid in Children ≤5 y with Severe Lead Poisoning in Zamfara, Northern Nigeria: A Retrospective Analysis of Programme Data

      Thurtle, N; Greig, J; Cooney, L; Amitai, Y; Ariti, C; Brown, M J; Kosnett, M J; Moussally, K; Sani-Gwarzo, N; Akpan, H; et al. (Public Library of Science, 2014-10-07)
      In 2010, Médecins Sans Frontières (MSF) discovered extensive lead poisoning impacting several thousand children in rural northern Nigeria. An estimated 400 fatalities had occurred over 3 mo. The US Centers for Disease Control and Prevention (CDC) confirmed widespread contamination from lead-rich ore being processed for gold, and environmental management was begun. MSF commenced a medical management programme that included treatment with the oral chelating agent 2,3-dimercaptosuccinic acid (DMSA, succimer). Here we describe and evaluate the changes in venous blood lead level (VBLL) associated with DMSA treatment in the largest cohort of children ≤5 y of age with severe paediatric lead intoxication reported to date to our knowledge.
    • Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

      Edwards, J K; Thiongo, A; Van den Bergh, R; Kizito, W; Kosgei, R J; Sobry, A; Vandenbulcke, A; Zuniga, I; Reid, A J (The Union, 2014-06-21)
    • Association of blood lead level with neurological features in 972 children affected by an acute severe lead poisoning outbreak in zamfara state, northern Nigeria.

      Greig, J; Thurtle, N; Cooney, L; Ariti, C; Ahmed, A O; Ashagre, T; Ayela, A; Chukwumalu, K; Criado-Perez, A; Gómez-Restrepo, C; et al. (2014-04-16)
      In 2010, Médecins Sans Frontières (MSF) investigated reports of high mortality in young children in Zamfara State, Nigeria, leading to confirmation of villages with widespread acute severe lead poisoning. In a retrospective analysis, we aimed to determine venous blood lead level (VBLL) thresholds and risk factors for encephalopathy using MSF programmatic data from the first year of the outbreak response.
    • Diagnostic and Prognostic Value of Procalcitonin and C-Reactive Protein in Malnourished Children

      Page, A-L; de Rekeneire, N; Sayadi, S; Aberrane, S; Janssens, A-C; Dehoux, M; Baron, E (American Academy of Pediatrics, 2014-01-20)
      Early recognition of bacterial infections is crucial for their proper management, but is particularly difficult in children with severe acute malnutrition (SAM). The objectives of this study were to evaluate the accuracy of C-reactive protein (CRP) and procalcitonin (PCT) for diagnosing bacterial infections and assessing the prognosis of hospitalized children with SAM, and to determine the reliability of CRP and PCT rapid tests suitable for remote settings.
    • Mortality in a pediatric secondary-care hospital in post-conflict Liberia in 2009

      Couto, T B; Farhat, S C L; Reid, T; Schvartsman, C (Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2013-12)
      To describe and analyze the causes of death in a pediatric secondary-care hospital (run by Médecins sans Frontières), in Monrovia, Liberia, 6 years post-civil war, to determine the quality of care and mortality in a setting with limited resources.
    • Characteristics and mortality of neonates in an emergency obstetric and neonatal care facility, rural Burundi

      Zuniga, I; Van den Bergh, R; Ndelema, B; Bulckaert, D; Manzi, M; Lambert, V; Zachariah, R; Reid, A J; Harries, A D (International Union Against TB and Lung Disease, 2013-12)
    • Primary school compliance with school canteen guidelines in Fiji and its association with student obesity

      Varman, S; Bullen, C; Tayler-Smith, K; Van Den Bergh, R; Khogali, M (Public Health Action, 2013-10-16)
    • Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

      Page, A-L; de Rekeneire, N; Sayadi, S; Aberrane, S; Janssens, A-C; Rieux, C; Djibo, A; Manuguerra, J-C; Ducou-le-Pointe, H; Grais, RF; et al. (Public Library of Science, 2013-07-17)
      Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger.
    • Non-adherence to standard treatment guidelines in a rural paediatric hospital in Sierra Leone

      De Bruycker, M; Van den Bergh, R; Dahmane, A; Khogali, M; Schiavetti, B; Nzomukunda, Y; Alders, P; Allaouna, M; Cloquet, C; Enarson, D A; et al. (2013-06)
    • Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality? [Short communication]

      Ngoy, B B; Zachariah, R; Hinderaker, S G; Khogali, M; Manzi, M; van Griensven, J; Ayada, L; Jemmy, J P; Maalim, A; Amin, H (2013-06)
    • Is mid-upper arm circumference alone sufficient for deciding admission to a nutritional programme for childhood severe acute malnutrition in Bangladesh?

      Ali, E; Zachariah, R; Shams, Z; Vernaeve, L; Alders, P; Salio, F; Manzi, M; Allaouna, M; Draguez, B; Delchevalerie, P; et al. (Oxford University Press, 2013-05)
      Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2. Report on morbidity and mortality.
    • Effectiveness of blood transfusions and risk factors for mortality in children aged from 1 month to 4 years at the Bon Marche Hospital, Bunia, Democratic Republic of Congo

      Mueller, Y; Bastard, M; Ehounou, G; Itama, J; Quéré, M; de la Tour, R; Vala, L; Etard, J-F; Bottineau, M-C; Epicentre, Paris, France  Médecins Sans Frontières, Geneva, Switzerland  National Program for Blood Transfusion, Bunia, Democratic Republic of the Congo. (2012-10-11)
      Objective  To assess the effectiveness of blood transfusions in a hospital of north-eastern Democratic Republic of the Congo. Methods  Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression. Results  Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance. Conclusion  Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.