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  1. Łuniewska M, Wodniecka Z, Miller CA, Smolík F, Butcher M, Chondrogianni V, et al.
    PLoS One, 2019;14(8):e0220611.
    PMID: 31393919 DOI: 10.1371/journal.pone.0220611
    We present a new set of subjective Age of Acquisition (AoA) ratings for 299 words (158 nouns, 141 verbs) in seven languages from various language families and cultural settings: American English, Czech, Scottish Gaelic, Lebanese Arabic, Malaysian Malay, Persian, and Western Armenian. The ratings were collected from a total of 173 participants and were highly reliable in each language. We applied the same method of data collection as used in a previous study on 25 languages which allowed us to create a database of fully comparable AoA ratings of 299 words in 32 languages. We found that in the seven languages not included in the previous study, the words are estimated to be acquired at roughly the same age as in the previously reported languages, i.e. mostly between the ages of 1 and 7 years. We also found that the order of word acquisition is moderately to highly correlated across all 32 languages, which extends our previous conclusion that early words are acquired in similar order across a wide range of languages and cultures.
    Matched MeSH terms: Child; Child, Preschool
  2. van der Werf ET, Redmond NM, Turnbull S, Thornton H, Thompson M, Little P, et al.
    Br J Gen Pract, 2019 Apr;69(681):e236-e245.
    PMID: 30858333 DOI: 10.3399/bjgp19X701837
    BACKGROUND: Severity assessments of respiratory tract infection (RTI) in children are known to differ between parents and clinicians, but determinants of perceived severity are unknown.

    AIM: To investigate the (dis)agreement between, and compare the determinants of, parent and clinician severity scores.

    DESIGN AND SETTING: Secondary analysis of data from a prospective cohort study of 8394 children presenting to primary care with acute (≤28 days) cough and RTI.

    METHOD: Data on sociodemographic factors, parent-reported symptoms, clinician-reported findings, and severity assessments were used. Kappa (κ)-statistics were used to investigate (dis) agreement, whereas multivariable logistic regression was used to identify the factors associated with illness severity.

    RESULTS: Parents reported higher illness severity (mean 5.2 [standard deviation (SD) 1.8], median 5 [interquartile range (IQR) 4-7]), than clinicians (mean 3.1 [SD 1.7], median 3 [IQR 2-4], P<0.0001). There was low positive correlation between these scores (+0.43) and poor inter-rater agreement between parents and clinicians (κ 0.049). The number of clinical signs was highly correlated with clinician scores (+0.71). Parent-reported symptoms (in the previous 24 hours) that were independently associated with higher illness severity scores, in order of importance, were: severe fever, severe cough, rapid breathing, severe reduced eating, moderate-to-severe reduced fluid intake, severe disturbed sleep, and change in cry. Three of these symptoms (severe fever, rapid breathing, and change in cry) along with inter/subcostal recession, crackles/crepitations, nasal flaring, wheeze, and drowsiness/irritability were associated with higher clinician scores.

    CONCLUSION: Clinicians and parents use different factors and make different judgements about the severity of children's RTI. Improved understanding of the factors that concern parents could improve parent-clinician communication and consultation outcomes.

    Matched MeSH terms: Child
  3. van den Oever SR, Pluijm SMF, Skinner R, Glaser A, Mulder RL, Armenian S, et al.
    J Cancer Surviv, 2022 Dec;16(6):1390-1400.
    PMID: 35020136 DOI: 10.1007/s11764-021-01120-9
    PURPOSE: Long-term follow-up (LTFU) care is essential to optimise health outcomes in childhood cancer survivors (CCS). We aimed to assess the impact of the COVID-19 pandemic on LTFU services and providers.

    METHODS: A COVID-19 working group within the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) distributed a questionnaire to LTFU service providers in 37 countries across Europe, Asia, North America, Central/South America, and Australia. The questionnaire assessed how care delivery methods changed during the pandemic and respondents' level of worry about the pandemic's impact on LTFU care delivery, their finances, their health, and that of their family and friends.

    RESULTS: Among 226 institutions, providers from 178 (79%) responded. Shortly after the initial outbreak, 42% of LTFU clinics closed. Restrictions during the pandemic resulted in fewer in-person consultations and an increased use of telemedicine, telephone, and email consultations. The use of a risk assessment to prioritise the method of LTFU consultation for individual CCS increased from 12 to 47%. While respondents anticipated in-person consultations to remain the primary method for LTFU service delivery, they expected significantly increased use of telemedicine and telephone consultations after the pandemic. On average, respondents reported highest levels of worry about psychosocial well-being of survivors.

    CONCLUSIONS: The pandemic necessitated changes in LTFU service delivery, including greater use of virtual LTFU care and risk-stratification to identify CCS that need in-person evaluations.

    IMPLICATIONS FOR CANCER SURVIVORS: Increased utilisation of virtual LTFU care and risk stratification is likely to persist post-pandemic.

    Matched MeSH terms: Child
  4. van Huizen AM, Menting SP, Gyulai R, Iversen L, van der Kraaij GE, Middelkamp-Hup MA, et al.
    JAMA Dermatol, 2022 May 01;158(5):561-572.
    PMID: 35353175 DOI: 10.1001/jamadermatol.2022.0434
    IMPORTANCE: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.

    OBJECTIVE: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.

    DESIGN, SETTING, AND PARTICIPANTS: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience).

    MAIN OUTCOMES AND MEASURES: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree.

    RESULTS: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients.

    CONCLUSIONS AND RELEVANCE: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

    Matched MeSH terms: Child
  5. ldanerina, M.S., Aniza, I., Jamsiah, M., Mohd. Hasni, J., Idayu, B.
    MyJurnal
    Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
    involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.
    Matched MeSH terms: Child
  6. de Weerth C, Aatsinki AK, Azad MB, Bartol FF, Bode L, Collado MC, et al.
    Crit Rev Food Sci Nutr, 2023;63(26):7945-7982.
    PMID: 35352583 DOI: 10.1080/10408398.2022.2053058
    Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions.
    Matched MeSH terms: Child
  7. de Vries M, de Ruiter MA, Oostrom KJ, Schouten-Van Meeteren AYN, Maurice-Stam H, Oosterlaan J, et al.
    Child Neuropsychol, 2018 08;24(6):844-858.
    PMID: 28693404 DOI: 10.1080/09297049.2017.1350262
    Pediatric brain tumor survivors (PBTS) suffer from cognitive late effects, such as deteriorating executive functioning (EF). We explored the suitability of the Behavior Rating Inventory of Executive Function (BRIEF) to screen for these late effects. We assessed the relationship between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher, and we explored the clinical utility. Eighty-two PBTS (8-18 years) were assessed with EF tasks measuring attention, cognitive flexibility, inhibition, visual-, and working memory (WM), and with the BRIEF-Parent and BRIEF-Teacher. Pearson's correlations between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher were calculated. The BRIEF-Parent related poorly to EF tasks (rs < .26, ps > .01), but of the BRIEF-Teacher the WM-scale, Monitor-scale, Behavioral-Regulation-Index, and Meta-cognition-Index, and Total-score (rs > .31, ps < .01) related significantly to some EF tasks. When controlling for age, only the WM scale and Total score related significantly to the attention task (ps < .01). The inhibit scales of the BRIEF-Parent and BRIEF-Teacher correlated significantly (r = .33, p < .01). Children with clinically elevated scores on BRIEF scales that correlated with EF tasks performed worse on all EF tasks (ds 0.56-1.23, ps < .05). The BRIEF-Teacher Total and Index scores might better screen general EF in PBTS than the BRIEF-Parent. However, the BRIEF-Teacher is also not specific enough to capture separate EFs. Solely relying on the BRIEF as a screening measure of EFs in BPTS is insufficient. Questionnaires and tasks give distinctive, valuable information.
    Matched MeSH terms: Child
  8. de Azevedo JP, Nascimento LR, Cortinovis MC, Oliveira SS, da Costa EV, da Silva EE
    J Clin Virol, 2004 Dec;31(4):248-52.
    PMID: 15494264 DOI: 10.1016/j.jcv.2004.04.007
    BACKGROUND: Human adenoviruses are classified into six species, A-F, and 51 serotypes are recognized. Adenoviruses can cause a broad range of diseases. Serotypes 3, 7 and 21 are most commonly associated with CNS disease. Serotype 21 (specie B) was isolated from brain tissue and CSF of patients with acute flaccid paralysis (AFP) in Malaysia.
    OBJECTIVES: Characterize, by molecular methods, species B adenoviruses isolated from poliomyelitis-suspected cases and investigate the possible etiological role of adenoviruses in acute flaccid paralysis (AFP).
    STUDY DESIGN: 622 virus isolates, including Sabin-related polioviruses, non-polio enteroviruses (NPEV) and adenoviruses, were recovered from fecal specimens in our laboratory during the period of 1997-2002 from AFP cases occurring in Brazil, Peru and Bolivia. Negative controls consisted of 528 fecal specimens collected from healthy children <==5 of age. Of these, 478 were contacts of AFP negative cases and 50 were from a day-care center.
    RESULTS: Sixty-four adenovirus strains isolated in HEp2 (human laryngeal tumor cells) cells were confirmed as such by an adenovirus-group specific PCR. Nucleotide sequencing identified the following adenovirus species: A (3 isolates), B (20 isolates), C (38 isolates), D (2 isolates) and E (1 isolate). The following serotypes belonging to the species B were identified: Ad3 (1 strain), Ad7 (17 strains) and, Ad16 (2 strains).
    CONCLUSION: Other viral agents became more recognized in association with CNS diseases in areas where wild polioviruses have been eradicated. The possible role of species B adenoviruses in the etiology of AFP cases similar to that caused by wild poliovirus is discussed.
    Matched MeSH terms: Child, Preschool
  9. da Silva RE, Amato AA, Guilhem DB, de Carvalho MR, Lima EDC, Novaes MRCG
    Front Pharmacol, 2017;8:999.
    PMID: 29403381 DOI: 10.3389/fphar.2017.00999
    Background: Although policies and guidelines make use of the concept of vulnerability, few define it. The European Union's directive for clinical trials does not include explanations for or the reasoning behind the designation of certain groups as vulnerable. Emerging economies from lower middle-income countries have, in recent years, had the largest average annual growth rate, as well as increase, in number of clinical trials registered in the US government's database. Nevertheless, careful supervision of research activities has to be ensured. Objective: To describe and analyze the features of the clinical trials involving vulnerable populations in various countries classified by development status and geographic region. Methods: Retrospective study that involved analysis of data obtained from the International Clinical Trials Registry Platform (ICTRP) database between 01/2014 and 12/2014 from countries with (i) highest trial densities during 2005 to 2012, (ii) highest average growth rate in clinical trials, and (iii) greatest trial capabilities. Results: Statistical analysis of this study showed that patients incapable of giving consent personally are 11.4 times more likely to be vulnerable patients than patients who are capable, and that patients in upper-middle-income countries are 1.7 times more likely to be vulnerable patients than patients from high-income countries when participating in global clinical trials. Malaysia (21%), Egypt (20%), Turkey (19%), Israel (18%), and Brazil (17%) had the highest percentages of vulnerable populations involving children. Conclusions: Although the inability to provide consent personally was a factor associated with vulnerability, arbitrary criteria may have been considered when classifying the populations of clinical trials as vulnerable. The EU Clinical Trials Register should provide guidance regarding exactly what aspects or factors should be taken into account to frame given populations as vulnerable, because vulnerability is not applicable to all risk situations.
    Matched MeSH terms: Child
  10. Zyoud SH, Awang R, Sulaiman SA, Al-Jabi SW
    Pharmacoepidemiol Drug Saf, 2011 Feb;20(2):203-8.
    PMID: 21254292 DOI: 10.1002/pds.2060
    Acetaminophen overdose may be accompanied by electrolyte disturbances. The basis for electrolyte change appears to be due to increased fractional urinary electrolyte excretion.
    Matched MeSH terms: Child; Child, Preschool
  11. Zyoud S, Shalabi J, Imran K, Ayaseh L, Radwany N, Salameh R, et al.
    BMC Public Health, 2019 May 16;19(1):586.
    PMID: 31096949 DOI: 10.1186/s12889-019-6955-2
    BACKGROUND: Food serves as a vehicle for many pathogenic and toxigenic agents that cause food-borne diseases. Knowledge, attitude, and practices are key factors in reducing the incidence of food-borne diseases in food service areas. The main objective of this study was to evaluate knowledge, attitude, and practices related to food poisoning among parents of children in Nablus, Palestine.

    METHODS: A cross-sectional study was conducted in primary healthcare centers in Nablus district from May to July 2015. Data were collected using structured questionnaire interviews with parents to collect information on food safety knowledge, attitudes, and practices, alongside sociodemographic characteristics.

    RESULTS: Four-hundred and twelve parents were interviewed, 92.7% were mothers. The median knowledge score was 12.0 with an interquartile range (IQR) of 11.0-14.0. The median attitude score was 11.0 with IQR of 10.0-13.0, while the median practice score was 18.0 with IQR of 16.0-19.0. Significant modest positive correlations were found between respondents' knowledge and attitude scores regarding food poisoning (r = 0.24, p 

    Matched MeSH terms: Child
  12. Zurina Zainuddin, Zainab Jumai Kassim, Siti Norbaya Masri, Putri Yubbu, Norlijah Othman, Zainab Jumai Kassim
    MyJurnal
    Congenital pneumonia is one of the common causes of respiratory distress at birth with significant morbidity and mortality in infants. Estimates show that neonatal pneumonia including congenital pneumonia contributes to between 750 000 and 1.2 million neonatal deaths every year which accounts for 10% global child mortality. Etiological agents are many and vary but atypical bacterial causes are few. The commonest cause for atypical bacteria is Ureaplasma urealyticum. Congenital pneumonia is often clinically difficult to diagnose owing to poor specificity of clinical signs, with similarities in radiologic presentation with other respiratory conditions of the newborn. Isolation of causative organism (s) by culture from nasopharyngeal aspirates or tracheal aspirates obtained within 8 hours of life is the gold standard of its diagnosis. However, this technique is elaborate and time consuming in identifying atypical bacteria. Development of a more sensitive modality such as polymerase chain reaction (PCR) has dramatically altered the microbiological diagnosis of congenital pneumonia.
    Matched MeSH terms: Child; Child Mortality
  13. Zurina Z, Elizawaty O, Thevarajah S, Norlijah O
    Med J Malaysia, 2012 Feb;67(1):105-7.
    PMID: 22582558
    Dapsone syndrome is a potentially fatal hypersensitivity reaction to sulphone. We report a 12-year-old girl who developed high grade fever associated with intense jaundice, exfoliative skin rash and hepatomegaly after five weeks of starting the multidrug regimen for the treatment of Hansen's disease. Laboratory investigations revealed presence of leucocytosis with eosinophilia, deranged liver enzymes and an abnormal coagulation profile. Immediate cessation of the offending drug and administration of steroid proved successful. A high level of clinical awareness is fundamental for early diagnosis of dapsone syndrome as initiation of a prompt treatment may lead to rapid recovery.
    Matched MeSH terms: Child
  14. Zurin AA, Houkin K, Asano T, Ishikawa T, Abe H
    Neurol. Med. Chir. (Tokyo), 1997 Jul;37(7):542-5.
    PMID: 9259154
    An 8-year-old girl presented with fibromuscular dysplasia of the intracranial vessels manifesting as ischemic stroke. Neuroimaging showed infarction of the right putamen and ipsilateral frontal white matter. Angiography revealed "string of beads" sign involving the terminal portion of the right internal carotid artery and the horizontal segment of the ipsilateral middle cerebral artery. She was treated conservatively. Magnetic resonance angiography at 2 months post ictus showed similar findings in the middle cerebral artery but improvement of the stenosis of the internal carotid artery. Her neurological deficits had almost resolved. Fibromuscular dysplasia should be part of the differential diagnosis of ischemia in children.
    Matched MeSH terms: Child
  15. Zuridah H, Kirkwood CD, Bishop RF, Bogdanovic-Sakran N, Yap KL
    Med J Malaysia, 2009 Sep;64(3):193-6.
    PMID: 20527266 MyJurnal
    This retrospective study examined the G/P type of rotavirus in RNA samples that have previously been e-typed by RNA-PAGE in 1996. The results were then compared to 2007 samples to ascertain the extent of changes that may have occurred in this 11-years time interval. The G and P genotypes were determined by hemi-nested PCR and further analysed by phylogenetic study. In 1996, the G/P combination G1P[8], G(UT)P[8] and G1P(UT) prevalence rate were 81%, 9% and 7%, respectively. As expected, the G9 genotype which has already emerged worldwide was identified in 42% of the 2007 samples with the remaining 33% G1P[8] and 25% G1P(UT) Analysis of the RNA pattern showed that majority of the isolates were long e-type in both series, nevertheless minor differences within electropherotypes were observed. Genetic diversity in some strains of the human group A rotaviruses was analysed by phylogenetic methods. These findings will help in the decision to introduce rotavirus vaccines within the next decade.
    Matched MeSH terms: Child
  16. Zuridah H, Kirkwood CD, Bogdanovic-Sakran N, Bishop RF, Yap KL
    J Med Virol, 2010 Apr;82(4):707-11.
    PMID: 20166178 DOI: 10.1002/jmv.21717
    This study examined the temporal distribution of rotavirus genotypes in Malaysia. Rotaviruses from children with diarrhea admitted to hospitals in 1996 (n = 93) and 2007 (n = 12) in two different regions of Peninsular (West) Malaysia were analyzed for their G and P genotypes using a hemi-nested RT-PCR assay. In the 2007 samples, the dominant strain was G9P[8]. It was identified in 42% of the samples. Different strains all possessing the G1 genotype were identified in the rest of the samples. In contrast, 81% of the samples collected in 1996 were the G1P[8] strain. No strains with G9 genotype were detected in samples collected in 1996.
    Matched MeSH terms: Child, Preschool
  17. Zuridah H, Bahaman AR, Mohd Azmi ML, Mutalib AR
    Med J Malaysia, 2004 Jun;59(2):153-9.
    PMID: 15559163 MyJurnal
    A total of 157 stool samples were examined for Group A rotaviruses in diarrheic children admitted to 8 different major hospitals in Malaysia. The overall incidence rate in this study was 19.7% (31 of 157) with a variation of 9.5% to 39.1% in different locations. Majority of the infections detected were in those under 2 years of age and there were fewer admissions in the older age group. The stool samples were initially screened for rotavirus Group A by latex agglutination method and followed by RNA electrophoresis. The size and the characteristics wheel-shaped morphology of the viral preparations when examined by electron-microscopy further confirmed the presence of rotaviruses in the positive stool samples. Analysis of the RNA pattern showed that majority of the isolates, 51.6% (16 of 31) were Type IIC ('long' with comigration of RNA segments 7 and 8), 35.5% (11 of 31) with Type IIG ('long' with comigration of segments 7, 8, 9), 9.7% (3 of 31) with Type IG ('short' with comigration of RNA segments 7, 8, 9) and 3.2% (1 of 31) of mixed or atypical pattern. It appeared that over a 12 year interval, only one new or unusual rotavirus electropherotype was found. This is the first comprehensive report on the electropherotypes of rotaviruses covering eight different geographical locations in Malaysia and the data obtained is useful for understanding the geographic distribution and types of rotaviruses transmitting in Malaysia.
    Matched MeSH terms: Child, Preschool
  18. Zurainie Ablla, Karimah Hanim Abdul Aziz, Nurjasmine Aida Jamani
    MyJurnal
    Introduction: During pregnancy, increased acidity in the mouth increases the risk of antenatal mother to get dental caries. It is worsen if antenatal mother has morning sickness like vomiting during pregnancy. It can aggravate the problem by exposing the teeth to more gastric acid. In addition, antenatal mothers have hormonal changes that they are more susceptible to periodontal problems. Therefore, it is important for antenatal mother to get dental treatment and use oral health service. This study aim is to describe barriers to utilisation of oral health care services among antenatal mothers attending the Klinik Kesihatan Ibu dan Anak around Kuantan. Materials and Methods: A cross sectional study which was conducted among purposely selected 296 antenatal mothers aged 18-45 years from Kuantan, Pahang in 18 months duration. Study used validated self-administered questionnaire to obtain information on the variables of interest. Results: Common barriers to utilization of services among antenatal mothers are fear to dental pain (45.6%), time constraints- busy at workplace (36.5%) and feeling of not having any dental problems (36.1%). Meanwhile the least barrier to oral health care services among antenatal mothers is attitude of the dentist (0.7%), followed by attitude of the staff (1.4%) and condition of treatment room (1.7%) Conclusion(s): Fear of dental pain is the main barrier to utilization of service among antenatal mothers and dissatisfaction of the service provided is the least barrier among other factors.
    KEYWORDS: barriers, antenatal, pregnant mothers, dental caries, periodontal
    Matched MeSH terms: Maternal-Child Health Centers
  19. Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, et al.
    PLoS Negl Trop Dis, 2018 02;12(2):e0006263.
    PMID: 29415036 DOI: 10.1371/journal.pntd.0006263
    BACKGROUND: Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity.

    METHODS: We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI).

    FINDINGS: We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity.

    CONCLUSION: This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection.

    Matched MeSH terms: Child; Child, Preschool
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