Tecnologias para a autoeficácia materna na prevenção da diarreia infantil: ensaio clínico / Tecnologías para la autoeficacia materna en la prevención de la diarrea infantil: ensayo clínico / Technologies for maternal self-efficacy in preventing childhood diarrhea: a clinical trial

Resumo Objetivo: Avaliar os efeitos de duas tecnologias educativas, vídeo e cartilha, associadas à entrevista motivacional para promover a autoeficácia materna na prevenção da diarreia infantil. Métodos: Ensaio clínico com 122 mães de crianças menores de 5 anos, randomizadas aleatoriamente em dois grupos: vídeo educativo ("Diarreia Infantil: você é capaz de prevenir") aliado à Entrevista Motivacional Breve ou cartilha ("Você é capaz de prevenir a diarreia no seu filho!") aliada à Entrevista Motivacional Breve. A coleta ocorreu presencialmente no primeiro contato com as mães, na unidade de atenção primária à saúde, aplicando-se a Escala de Autoeficácia Materna para prevenção da Diarreia Infantil e um formulário sociodemográfico. O segundo e terceiro momentos de coleta de dados ocorreram por telefone, após um e dois meses, respectivamente, utilizando-se a escala e um formulário de investigação da diarreia. Resultados: Constatou-se que um mês após as intervenções, a maioria das participantes dos dois grupos foram consideradas com autoeficácia elevada para prevenção da diarreia infantil, sendo 78,4% das mães no grupo vídeo e entrevista motivacional e; 83,0% no grupo cartilha e entrevista motivacional. Dois meses após as intervenções, as médias dos escores de autoeficácia materna elevaram-se e tiveram redução nos casos de diarreia infantil, em ambos os grupos. Conclusão: Comprovou-se que essas tecnologias educativas aliadas à entrevista motivacional breve elevaram a autoeficácia para prevenir a diarreia infantil. Logo, podem ser utilizadas pelos enfermeiros que atuam na Atenção Primária à Saúde, como uma ferramenta educativa.

Resumen Objetivo: Evaluar los efectos de dos tecnologías educativas, video y cartilla, junto con la encuesta motivacional, para promover la autoeficacia materna en la prevención de la diarrea infantil. Métodos: Ensayo clínico con 122 madres de niños menores de 5 años, aleatorizadas en dos grupos: video educativo ("Diarrea infantil: tú puedes prevenirla") junto con la encuesta motivacional breve o cartilla ("¡Tú puedes prevenir la diarrea de tu hijo!") junto con la encuesta motivacional breve. La recolección se realizó presencialmente en el primer contacto con las madres, en la unidad de atención primaria de salud, mediante la implementación de la Escala de Autoeficacia Materna para la Prevención de la Diarrea Infantil y un formulario sociodemográfico. El segundo y tercer momento de recolección de datos fue por teléfono, luego de uno y dos meses, respectivamente, mediante la escala y un formulario de investigación de la diarrea. Resultados: Se constató que, un mes después de las intervenciones, la mayoría de las participantes de los dos grupos fueron consideradas con autoeficacia elevada para la prevención de la diarrea infantil, de las cuales el 78,4 % pertenecían al grupo video y encuesta motivacional y el 83,0 % al grupo cartilla y encuesta motivacional. Dos meses después de las intervenciones, el promedio de la puntuación de autoeficacia materna aumentó y se redujeron los casos de diarrea infantil en ambos grupos. Conclusión: Se comprobó que estas tecnologías educativas, junto con la encuesta motivacional breve, aumentaron la autoeficacia para prevenir la diarrea infantil. Por lo tanto, pueden ser utilizadas por los enfermeros que actúan en la atención primaria de salud, como herramienta educativa.

Abstract Objective: To assess the effects of two educational technologies, video and booklet, associated with Motivational Interviewing to promote maternal self-efficacy in preventing childhood diarrhea. Methods: A clinical trial conducted with 122 mothers of children under 5 years old; mothers were randomly randomized into two groups: educational video ("Child's diarrhea: you are able to prevent it") combined with Brief Motivational Interviewing or booklet ("You are able to prevent diarrhea in your child!") combined with Brief Motivational Interviewing. Data collection took place in the first contact with the mothers at the Primary Health Care unit; the Maternal Self-Efficacy Scale for preventing childhood diarrhea and a sociodemographic form were applied. The second and third moments of data collection occurred through telephone, after one and two months, respectively, using the scale and a form for investigating diarrhea. Results: It was found that one month after the interventions, most of the participants in both groups were considered to have high self-efficacy in preventing childhood diarrhea, with 78.4% of mothers in the video and Motivational Interviewing group; 83.0% in the booklet and Motivational Interviewing group. Two months after the interventions, mean maternal self-efficacy scores increased and decreased in cases of childhood diarrhea in both groups. Conclusion: It has been proved that these educational technologies, combined with Brief Motivational Interviewing, increased self-efficacy to prevent childhood diarrhea. Therefore, they can be used by nurses working at Primary Health Care as an educational tool.

Umbilical therapy combined with moxibustion for autumn diarrhea in children / 中国针灸

OBJECTIVE@#To observe the efficacy differences between moxibustion combined with umbilical therapy and oral administration of montmorillonite powder (smecta) on diarrhea symptoms in children of different ages.@*METHODS@#A total of 120 children were randomly divided into an observation group and a control group, 60 cases in each group. In the observation group, the children aged under 3 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12) and Tianshu (ST 25), and each acupoint was treated for less than 3 min, and the total treatment duration was no more than 10 min; the children aged between 3 to 7 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Dachangshu (BL 25), each acupoint was treated for less than 3 min, and the total treatment duration was no more than 20 min. After moxibustion, traditional Chinese medicine patch (clove, cinnamon, rhizoma zingiberis, fructus evodiae, hawthorn, rhizoma atractylodis) was applied at Shenque (CV 8). For the children under 1 year old, the medical bag with 30 g powder was heated to 50 ℃ and used for about 30 min; for children over 1 year old, 2-5 g powder was mixed with vinegar and used for 4-8 h each time. The treatment was given once a day, three times as a course of treatment, and a total of one course of treatment was given. The children in the control group were treated with oral administration of montmorillonite powder, 3 g per day for children under 1 year old, 3-6 g per day for children aged 1-2 years old and 6-9 g per day for children over 2 years old. The montmorillonite powder was taken three times a day for 3 days. The diarrhea symptom scores before and after treatment were observed and the clinical efficacy was evaluated. From the first treatment, the recovery cases and recovery time in the two groups were recorded, the recovery cases and recovery time in acute and chronic stages were compared between different age groups. The recurrence was observed 3 months after treatment.@*RESULTS@#Compared before treatment, the diarrhea symptom score after treatment was decreased in the observation group (0.05). After treatment, the score of diarrhea symptoms in the observation group was lower than that in the control group (0.05). The recovery time of different age stages and average recovery time in the observation group were shorter than those in the control group (1 year old and ≤5 years old and average recovery time in the observation group were shorter than those in the control group (<0.05), while the average recovery time of children in chronic stage in the observation group was shorter than that in the control group (<0.05). Three months after treatment, the recurrence rate was 0% (0/36) in acute phase and 4.8% (1/21) in chronic phase in the observation group, which were superior to 9.7% (3/31) in acute phase and 46.7% (7/15) in chronic phase in the control group (<0.05).@*CONCLUSION@#The umbilical therapy combined with moxibustion could improve the symptoms of diarrhea and shorten the recovery time in children of different ages with autumn diarrhea, which have better efficacy than montmorillonite powder.

Effect of bifidobacteria combined with zinc on serum CRP level and clinical efficacy in children with diarrhea / 中国生化药物杂志

Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.

A Perspective Study on the Etiology of Diarrhea in Children Less than 12 Years of age attending Kanti Children’s Hospital.

Introduction: Diarrhea is the most common illness among children causing highest number of mortality and morbidity in the developing countries. Objective: This study was conducted to determine the etiological agents of diarrhea in children less than 12 years of age. Methods: The study was carried out in Tribhuvan University Teaching Hospital, Health Research Laboratory and stool specimen were collected from Kanti Children’s Hospital between February 2007 and August 2007. The specimens were processed by standard microbiological methods, serological diagnosis for the complete identification of bacterial isolate and use of Rotaclone for diagnosis for Rotavirus. Results: A total 500 specimen were processed and 312 (62.4%) cases were identified with enteropathogens. Out of 500, 165 (33%) showed significant bacterial growth, 110 (22%) single or multiple parasitic infestation, and 167 (21.4%) Rotavirus. Among the bacterial isolate, Escherichia. coli (20.2%) were highest in number, Entamoeba. histolytica (10%), among the protozoa and Ascaris lumbricoide (1.4%) among the helminth. Age group 0-2 years showed most number of cases. The prevalence of Rotavirus infection was more in Inpatient (65.4%) than Outpatient (34.6%) (P>0.05). Ethnicgroup wise distribution showed that Gurung/Magar/ Rai/Tamang were highly infected (34.6%) (P>0.05). Conclusion: The results showed that bacteria were the major etiological agents of diarrhea in children than parasites and Rotavirus. E. coli among the bacteria, E. histolytica among the parasite and Rotavirus constituted the major causative agents identified. The age group 0-2years was the most vulnerable group where most of the enteropathogens were detected.

Prevalence and associated risk factors for Giardia lamblia infection among children hospitalized for diarrhea in Goiânia, Goiás State, Brazil

The objective of this study was to determine the prevalence and to identify risk factors associated with Giardia lamblia infection in diarrheic children hospitalized for diarrhea in Goiânia, State of Goiás, Brazil. A cross-sectional study was conducted and a comprehensive questionnaire was administered to the child's primary custodian. Fixed effects logistic regression was used to determine the association between infection status for G. lamblia and host, sociodemographic, environmental and zoonotic risk factors. A total of 445 fecal samples were collected and processed by the DFA methodology, and G. lamblia cysts were present in the feces of 44 diarrheic children (9.9 percent). A variety of factors were found to be associated with giardiasis in these population: age of children (OR, 1.18; 90 percent CI, 1.0 - 1.36; p = 0.052), number of children in the household (OR 1.45; 90 percent CI, 1.13 - 1.86; p = 0.015), number of cats in the household (OR, 1.26; 90 percent CI, 1.03 -1.53; p = 0.059), food hygiene (OR, 2.9; 90 percent CI, 1.34 - 6.43; p = 0.024), day-care centers attendance (OR, 2.3; 90 percent CI, 1.20 - 4.36; p = 0.034), living on a rural farm within the past six months prior hospitalization (OR, 5.4; CI 90 percent, 1.5 - 20.1; p = 0.03) and the number of household adults (OR, 0.59; 90 percent CI, 0.42 - 0.83; p = 0.012). Such factors appropriately managed may help to reduce the annual incidence of this protozoal infection in the studied population.

O objetivo desse estudo foi estimar a prevalência e identificar fatores de risco associados à infecção por Giardia lamblia em crianças hospitalizadas com diarréia no município de Goiânia, Estado de Goiás, Brasil. Foi realizado um estudo transversal e um questionário estruturado foi administrado ao responsável pela criança. Análise multivariada foi realizada por meio de regressão logística para se determinar a associação entre infecção por G. lamblia e as variáveis sociodemográficas, ambientais e zoonóticas relacionadas ao hospedeiro. Das 445 amostras de fezes coletadas e processadas pelo método de imunofluorescência direta (DFA), 44 (9,9 por cento) apresentaram cisto de G. lamblia. Uma variedade de fatores de risco foi encontrada associada à giardíase: idade da criança (OR, 1,18; 90 por cento CI, 1,0 - 1,36; p = 0,052), número de crianças na família (OR, 1,45; 90 por cento CI, 1,13 - 1,86; p = 0,015), número de gatos pertecentes à família (OR, 1,26; 90 por cento CI, 1,03 - 1,53; p = 0,059), higiene alimentar (OR, 2,9; 90 por cento CI, 1,34 - 6,43; p = 0,024), usuários de creches (OR, 2,3; 90 por cento CI, 1,20 - 4,36; p = 0,034), ter residido em área rural seis meses precedendo à hospitalização (OR, 5,4; 90 por cento CI, 1,5 - 20,1; p = 0,03) e número de adultos na família (OR, 0,59; 90 por cento CI, 0,42 - 0,83; p = 0,012). Tais fatores, devidamente controlados podem contribuir para redução anual da incidência desta parasitose na população estudada.

Fournier's Gangrene in a Boy of Three Years Old

Fournier's gangrene is a rare disease characterized by an aggressive necrotizing fascitis of perineum and genitalia which is caused by mixed bacterial infection. The cornerstone of therapy consists of immediate recognition, wide debridement of devitalized tissues, antibiotic therapy, search for the primary source and occasionally urinary and fecal diversion. Although Fournier's gangrene has been reported in almost all ages, most cases have been reported in adults and occurrence in children is very unusual. Despite advancement in management, morbility and mortality remain significantly high. We report a case of Fournier's gangrene in a boy of 3 years old preceded by diarrhea and upper respiratory tract infection.