Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009-2014: a single center experience

OBJECTIVE: To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. METHODS: A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded. RESULTS: Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05). CONCLUSION: Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens.

Mothers’ caregiving resources and practices for children under 5 years in the slums of Hyderabad, India: a cross-sectional study.

Background: The extended care model of the United Nations Children’s Fund (UNICEF) identifies knowledge/beliefs, nutritional status, mental health, control of resources/autonomy, workload/time constraints and social support as important caregiver resources for childcare. The aim of this paper is to examine the role of mothers’ caregiving resources in child-care practices in slums. Methods: A cross-sectional study was conducted in 10 slums of Hyderabad, to appraise the caregiving practices and health status of children under 5 years. Data were collected from 506 households, selected through multistage stratified random sampling, and data relating to 451 children aged 6–59 months were analysed. Four caregiving practices were studied: psychosocial stimulation, as assessed by the Home Observation Measurement of the Environment inventory; hygienic care rated by spot-check observation; and meal frequency and dietary diversity based on maternal recall. The role of the mother’s caregiving resources was examined using bivariate and multivariate logistic regression analyses. Results: More than 50% of the children received good psychosocial stimulation and close to 60% had good hygienic care. About 75% of the children aged 6–23 months had the recommended minimum meal frequency and 13% had the recommended dietary diversity. Mother’s media exposure (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.35–3.77), participation in household budgeting (OR 2.19, CI 1.25–3.83) and husband’s support (OR 2.04, CI 1.28–3.24) were predictors of psychosocial stimulation. Mother’s younger age (OR 1.11, CI 1.04– 1.18), poor media exposure (OR 1.95, CI 1.15–3.29), dissatisfaction with life (OR 1.84, CI 1.05–3.24), workload (OR 1.79, CI 1–3.18) and having no money for their own use (OR 1.52, CI 0.95–2.45) placed children at higher odds for receiving poor hygienic care. Leisure time (OR 2.75, CI 1.25–6.06) and participation in budgeting (OR 1.97, CI 1–3.86) were predictors of meal frequency. Conclusion: Mother’s workload, poor media exposure, dissatisfaction with life, lack of husband’s support and absence of economic autonomy are constraints to good child care in slums.