Epidemiological analysis of accidental death among children under 5 years old in Guangdong Province from 2018 to 2022 / 中国儿童保健杂志

【Objective】 To investigate the main causes of accidental death of children under 5 years old and their epidemiological distribution in Guangdong Province from 2018 to 2022, it provides theoretical basis for formulating further preventive measures and intervention methods. 【Methods】 Children under 5 years of age who died in Guangdong Province from 2018 to 2022 were selected as the study subjects. The International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes S00-T98 and V01-Y98 were used to classify cases of accidental death, and the related rate and composition ratio were calculated to analyze the causes of accidental death in children and their distribution. 【Results】 From 2018 to 2022, the total mortality rate in Guangdong Province was 2.94‰, with a total of 21 329 deaths. Among these deaths, 3 819 were accidental deaths (0.53‰), the sex ratio of males to females was 1.29∶1, and the sex distribution of accidental death among all age groups showed significant difference (χ2=16.38, P<0.01). The top 3 causes for accidental deaths were accidental suffocation (1 590/3 819), drowning (926/3 819) and traffic accident (527/3 819). The accidental death rate of boys at all ages was higher than that of girls, although the difference was not statistically significant (χ2=13.68, P=0.19). The cause of death varied significantly among different age groups (χ2=1 723.28, P<0.01), and the treatment before death was statistically significant (χ2=174.31, P<0.01). 【Conclusion】 Accidental suffocation and drowning are the main causes of death in children under 5 years old in Guangdong Province. Age-specific preventive measures should be implemented to enhance the identification and prevention of accidental injuries among children and their parents, thus reducing the accidental death rate in this age group.

Deaths of children under 5 years old in Changsha in 2016 - 2021 / 公共卫生与预防医学

Objective To analyze the death status and main causes of death among children under 5 years old in Changsha from 2016 to 2021, and to provide a scientific basis for formulating preventive measures for children's health care. Methods The data of 1 761 deaths of children under 5 years old in Changsha City from 2016 to 2021 were collected, and the mortality trend, the order of causes of death and the utilization of pre-death medical care services were retrospectively analyzed. Results The 7-day neonatal mortality, 28-day neonatal mortality, 0-1-year-old neonatal mortality, and the mortality rate of children under 5 years old (U5MR) in Changsha City from 2016 to 2021 were 0.76‰, 1.28‰, 2.41‰, and 3.86‰, respectively. All the mortality rates showed a decreasing trend (P<0.05). U5MR in males was significantly higher than that in females (P<0.05), and U5MR in rural areas was significantly higher than that in urban areas (P<0.05). The top five causes of U5MR were drowning, premature delivery or low birth weight, pneumonia, other congenital anomalies, and accidental asphyxia, respectively. The death places of children under 5 years old were mainly medical and health institutions, and 81.72% of them were treated in hospitals before death. Conclusion From 2016 to 2021, the mortality rate of children under the age of 5 in Changsha City has gradually decreased. Preventing congenital malformations, reducing preterm birth or low birth weight, improving the treatment level of pneumonia, and preventing accidents such as drowning and accidental suffocation are the key to reducing the mortality rate of children under 5 years old.

Death among children under five years of age in Huzhou City from 2012 to 2021 / 预防医学

Objective@# To analyze the death among children under 5 years of age in Huzhou City, Zhejiang Province from 2012 and 2021, so as to provide insights into reduction of mortality among children. @*Methods@#The mortality surveillance data among children under 5 years of age in Huzhou City from 2012 to 2021 were collected from Children Death Report Cards and Surveillance Report among Children under 5 Years of Age, including gender, place of residence, date of death and death diagnosis. The trends in mortality and cause of death were analyzed among children under 5 years of age in Huzhou City from 2012 to 2021.@*Results@#A total of 1 262 deaths occurred among children under 5 years of age in Huzhou City from 2012 to 2021, with mean annual mortality of 4.39‰, and the mortality appeared a tendency towards a decline (χ2trend=132.695, P<0.001). A total of 899 infants died, with mean annual mortality of 3.13‰, and 363 children at ages of 1 to <5 years died, with mean annual mortality of 1.26‰. The mortality appeared a tendency towards a decline among both infants (χ2trend=117.778, P<0.001) and children at ages of 1 to <5 years (χ2trend=19.201, P<0.001). A total of 724 local children died, with mean annual mortality of 3.33‰, and there were 538 deaths among floating children, with mean annual mortality of 7.65‰. The mortality appeared a tendency towards a decline among both local (χ2trend=43.728, P<0.001) and floating children (χ2trend=94.038, P<0.001). The five most common causes of death included preterm birth or low birth weight (207 deaths, 16.40%), drowning (155 deaths, 12.28%), accidental asphyxia (138 deaths, 10.94%), other congenital abnormalities (126 deaths, 9.98%), and congenital heart diseases (113 deaths, 8.95%). @*Conclusions @#The mortality appeared a tendency towards a decline among children under 5 years of age in Huzhou City from 2012 to 2021, and preterm birth or low birth weight was the predominant cause of death.

Analysis for trends in disease burden of congenital birth defects among children under 5 years old in China / 中南大学学报(医学版)

OBJECTIVES@#Congenital birth defects are the main source of disease burden among children under 5 years old in China. This study aims to compare the trends in disease burden of different congenital birth defects among Chinese children under 5 years old from 1990 to 2019, and to provide a scientific basis for strengthening the comprehensive prevention and control of birth defects.@*METHODS@#Based on data from the Global Burden Disease (GBD) in 2019, the incidence mortality rate, and disability-adjusted life years (DALYs) rate of congenital birth defects among Chinese children under 5 years old from 1990 to 2019 were selected as evaluation indicators. The Joinpoint regression model was used to analyze the trends in disease burden of different types with congenital birth defects over three decades. The study also compared the differences in disease burden of congenital birth defects among children under 5 years old by gender.@*RESULTS@#Compared to 1990, the DALYs rates of congenital heart anomalies (1 931.91/100 000), digestive congenital anomalies (364.63/100 000), neural tube defects (277.20/100 000), congenital musculoskeletal and limb anomalies (133.33/100 000), and Down syndrome (128.22/100 000) in children under 5 years old in China in 2019 were decreased 70.78%, 71.61%, 86.21%, 36.84% and 73.65%, respectively. From 1990 to 2019, the mortality rates and DALYs rates of different congenital birth defects showed an overall downward trend, but the incidence of digestive congenital anomalies and Down syndrome showed an upward trend after 2005 and 2001, respectively. Except for congenital musculoskeletal and limb anomalies, incidence of the remaining categories of birth defects were higher in boys than that in girls.@*CONCLUSIONS@#The disease burden of congenital birth defects in children under 5 years old in China is decreased substantially from 1990 to 2019, but the burden of congenital heart anomalies is still serious and the incidence of some birth defect diseases is on the rise, and it is still crucial to strengthen the prevention and treatment for birth defects in children and propose targeted measures according to their gender characteristics.

Analysis on death of children under 5 years in Chongming District， Shanghai from 2011 to 2020 / 上海预防医学

ObjectiveTo analyze the mortality data of children under 5 years in Chongming District， Shanghai， and to analyze the main causes of death of children under 5 years， so as to provide scientific basis for reducing the mortality of children under 5 years in Chongming District. MethodsData of children under 5 years in Chongming District from 2011 to 2020 were collected from the Maternal and Child Health Information System of Chongming District， Shanghai. The mortality rate and main causes of death of children under 5 years in Chongming District were analyzed retrospectively. ResultsFrom 2011 to 2020， the average mortality rate of children under 5 years in Chongming District was 6.51‰， and the overall trend was stable. The mortality rate of children under 5 years with non-local household registration （11.44‰） was significantly higher than that of children under 5 years of age with local household registration （4.88‰） （P<0.05）. The main causes of death for children under 5 years were accidental deaths （drowning， accidental asphyxia， traffic accidents）， while the main causes of death for infants were congenital heart disease， premature birth or low birth weight， congenital abnormalities， birth asphyxia and pneumonia. ConclusionIt is necessary to strengthen safety education for children and their guardians and strengthen safety management for children who are not registered in this city. Departments of obstetrics and gynecology and the departments of pediatrics should be expanded， and prenatal examination should be strenthened for high risk or elderly parturient women to further reduce the death rate of children under 5 years old.

Problématique de la prise en charge du paludisme chez les enfants de 0 à 5 ans dans le district sanitaire d'Abidjan: cas du versant gourou au plateau Dokui / Malaria management issues for children aged 0-5 years in the Abidjan health district the case of the guru slope in Dokui plateau

La présente étude analyse les réalités sociales de la prise en charge du paludisme chez les enfants de 0 à 5 ans vivants aux abords du versant gourou d'Abobo Plateau Dokui. Elle a permis de mettre en évidence d'une part, les déterminants sociaux du maintien des populations aux abords du versant gourou mais aussi les mécanismes de prévention voire de protection existant contre le paludisme. D'autre part, elle expose les perceptions socio-sanitaires des riverains du versant gourou face aux insuffisances de la prise en charge du paludisme des enfants de 0 à 5 ans. En outre, selon le principe de la saturation en recherche qualitative, les participants à ce travail ont été sélectionnés selon un recrutement direct et aléatoire sur place. Ainsi, 35 chefs de ménage ou leur représentant légitime, 08 leaders et/ou responsables communautaires et 05 professionnels de santé ont participé à la production des données. Les entretiens de type semi-directif ont été nécessaires pour la collecte des données sur le terrain. Diverses documentations écrites ont également été exploitées afin de circonscrire le problème de recherche. Précédés d'une transcription au terme de leur collecte, les données ont été traitées à travers l'analyse de contenu. Comme résultats, il ressort que les mesures de prévention se résument à la distribution et à la sensibilisation sur leur usage de moustiquaires imprégnées, mais aussi le recours des insecticides. Toutefois, la prise en charge médicale reste limitée car ce sont les parents eux-mêmes qui assurent les frais d'hospitalisation et de médications de leurs enfants.

This study analyzes the social realities of malaria management in children aged 0-5 living on the Abobo Plateau Dokui Guru Slope. It highlighted the social determinants of keeping people near the guru, as well as the prevention and protection mechanisms against malaria. On the other hand, it exposes the socio-health perceptions of residents living on the guru side of the river in the face of the inadequacies of malaria management for children aged 0 to 5 years. In addition, according to the principle of saturation in qualitative research, the participants in this work were selected according to adirect and random recruitment on the spot. For example,35 heads of households or their legitimate representatives, 08 community leaders and/or leaders and 05 health professionals were involved in the production of the data. Semi-directive interviews were required for field data collection. Various written documents have al so been used to identify the research problem. The data was processed through content analysis and was then transcribed when it was collected. The results show that prevention measures are limited to distributing and raising awareness about their use of insecticide-treated nets and also the use of insecticides. However, medical care remains limited as the parents themselves pay for their children's hospitalization and medication.

Unintentional injury deaths among children under five in Suzhou during 2016-2020 / 公共卫生与预防医学

Objective To understand the epidemiology and trends of of unintentional injury deaths of children 2=16.44 , χ2=5.284 , P＜0.05）. The three leading causes of unintentional injury deaths were drowning (2.30/10000), suffocation (1.90/10000), and traffic accidents (1.42/10 000). Drowning among boys was 8.74 per cent, which was significantly higher than in girls（χ2=9.36，P＜0.05）. Drowning was the leading cause in boys, while suffocation was the leading cause of accidental death in girls. Accidents accounted for 57.49% of all deaths among children aged 1 to 4 years. Suffocation was the leading cause in children <1 year of age, but drowning（38.62%）was more prominent in children 1-4 years of age. Suffocation has high incidence in the winter, and drowning has high incidence in the summer season（P＜0.05）. Conclusions Effective childhood injury prevention may require different prevention policies combination depending on epidemiological characteristics such as genders, age groups，household register and seasons. The prevention programs should be carried especially the floating population.

Analysis of child mortality under 5 years old in Liuyang City from 2013 to 2020 / 中南大学学报(医学版)

OBJECTIVES@#To provide reference basis for reducing the mortality for children under 5 years old and promote the healthy development, the mortality for children under 5 years old and the main causes for death in Liuyang City from 2013 to 2020 are analyzed.@*METHODS@#The data of 725 cases of death for children under 5 years old in Liuyang City from 2013 to 2020 were collected.The causes and difference of death among the children were analyzed retrospectively by descriptive statistic methods.@*RESULTS@#There were a total of 144 516 live births in Liuyang City from 2013 to 2020. The mortality for children under 5 years old was 5.01‰, for infants was 3.39‰, and for newborns was 1.63‰. The male child mortality was 5.28‰, and the female child mortality rate was 4.72‰, with significant difference (P>0.05). The mortality for children under 5 years old was seasonal fluctuation, without significant difference among seasons (P>0.05). For the past 5 years, the top 3 causes for death among children under 5 years old were preterm birth and low birth weight, congenital heart disease, and pneumonia. Before death, 341 cases (47.04%) were treated in provincial hospitals, 198 cases (27.31%) in county-level hospitals, 56 cases (7.72%) in village-level hospitals, and 130 cases (17.93%) were not treated.@*CONCLUSIONS@#The mortality for children under 5 years old in Liuyang City is gradually reduced in the past 5 years. The main causes for death are premature birth and low birth weight, congenital heart disease and pneumonia. We should develop healthy education, improve the rate of prenatal diagnosis, promote the construction of obstetrics and paediatrics, and fundamentally reduce the mortality for children under 5 years old.

Common sleep disorders in children between 0 and 5 years old / 中国小儿急救医学

There has been a large number of related literature reports on sleep disorders, but in pediatrics, especially for children aged 0-5 years old, sleep disorders have not received enough attention.In order to raise pediatricians′ awareness of sleep disorders in children aged 0-5 years old, the relevant studies during the past 10 years have been reviewed, and the clinical manifestations and treatments were summarized.The clinical manifestations of sleep disorders in infants aged 0-5 years old are not typical and the incidence is high.Sleep disorders have profound effects on the cognitive and behavioral development of children aged 0-5 years old.

Struggling to Get through the Bitterness of Life - An Experience of Women with Spinal Cord Injury in the First 5 Years after Injury - A Content Analysis Study.

Spinal cord injury (SCI) causes widespread disorders in the sensory, motor, mental, and sexual systems. This injury imposes a significant burden on the healthcare system during the first 5 years. Previous relevant researches have rarely focused on SCI in women. Quantitative research methods lack the capacity and capability to address such issues. Therefore, we wanted to evaluate the experiences of SCI women in the first 5 years of injury using content analysis method. MethodsThis was a qualitative study with conventional content analysis approach. Purposeful sampling was performed on 6 female SCI patients. Data was collected through in-depth semi-structured interviews. The recorded interviews were transcribed verbatim. Content analysis was used to reduce the data, name the data, obtain analytical codes, and finally detect the theme. ResultsAnalysis of the data collected from the participants resulted in the extraction of 4 themes and 2 sub-themes including, bitter memory of physical sufferings, emotional bitterness of a numb body, struggle to keep on living, and paradoxical forces of life (inhibitors and facilitators). ConclusionsInvestigating the experiences of SCI women in the first 5 years of injury showed that SCI causes these women to suffer from various physical sufferings, and experience many bitter feelings despite physical numbness. However, despite these bitter experiences, these women are struggling to keep on living, but there are facilitators and inhibitors and these women are struggling to control these inhibitors by relying on facilitators and to get through these bitter events by their own efforts. Therefore, struggle to get through the bitterness of life can be considered as the essence of the experience of SCI women in the first 5 years after injury in the present study.

Chemical Constituents of Ginseng Radix et Rhizoma with Different Growth Years and Different Origins Based on LC-MS / 中国实验方剂学杂志

Objective::To study the components of Ginseng Radix et Rhizoma of different origins and growth years. Method::Rapid liquid chromatography-time of flight mass spectrometry (RRLC-Q-TOF-MS) was applied to detect the raw data of Ginseng Radix et Rhizoma.After peak extraction, alignment, and normalization, the multivariate statistical analysis was made for the resulted dataset to find out the different compounds.The compounds were identified by using accurate molecular weight and tandem mass spectra, and the standard references were used to further confirm the identification.The changing trends of these components in different ginseng samples were observed. Result::The ginseng samples of different growth years and different origins were divided into different groups in the score plot of PLS-DA, and the variables with the variable importance in projection (VIP) value of more than 1 were considered to contribute more to the separations, then the t-test was applied to determine whether potential biomarkers were statistically significant (P<0.05) between the two groups.The contents of eleven compounds, including ginsenoside Rb1, Rh4, and Rk2, were significantly different between ginseng samples aged 3 and 5 years, and the contents of these compounds increased as the rise of the ginseng growth years.Ginsenosides Rg1, Rf, Rh1, Rb1, and other six compounds were significantly different in ginseng samples from Jilin and Heilongjiang province. Conclusion::LC-MS is a rapid and accurate method for the analysis of ginseng samples, and could help to find out the different components among samples.

A study on screen time use in children between 24 to 60 months of age in Tamil Nadu, India

Background: This study was done with the objective of finding the average daily duration and pattern of screen time use in children in the age group of 24 to 60 months in the state of Tamilnadu, India and to find the correlation between screen time and demographic parameters.Methods: This cross-sectional observational study was conducted at the state of Tamilnadu, India from June 2019 to August 2019 among 148 children in play school and kindergarten classes in the age group of 24 to 60 months fulfilling the inclusion and exclusion criteria. Details regarding screen time use were collected from the parents using a predesigned questionnaire and analyzed using suitable statistical methods.Results: A total of 148 children (77(52.0%) male and 71(48.0%) female) were studied. The average daily screen time in the study group was 139.4 minutes (SD: 1.6). Majority of the children had a screen time duration between 61 to 120 minutes (48.6%). Only 14.2% had a screen time of ?60 minutes as per AAP and WHO recommendations. Majority of the screen time was used to watch children's entertainment programs and play games (67.6%). 83.1% of the children were using 2 or more screen types. Television and smart phones were the commonest screen types used by children in this age group. The percentage of children with average daily screen time ? 60 minutes was found to be more in joint families (16.3%) compared to nuclear families (10%). But this difference was not statistically significant. No statistically significant correlation was found between screen time duration in children and age, gender, parent's socioeconomic status, education and occupation.Conclusions: Increasing screen time activity in early childhood is an emerging problem of the digital age which requires interventions at family, social and healthcare levels.

Study of risk factors for severe pneumonia among children between 2 months to 5 years of age

Background: Acute respiratory illness is responsible for 19% of all deaths in children in below five years of age and 8.2% of all disability as measured by DALY. Recent studies have added other risk factors to the list including large family size, poor socioeconomic status, family history of bronchitis, advanced birth order, crowding, young age, air pollution, and the use of non-allopathic treatment in early stages of illness. Also, indoor air pollution is one of the major risk factors for acute lower respiratory tract infection in children in developing countries. The objectives of this study were to identify and compare the risk factors associated with severe and very severe pneumonia.Methods: A prospective observational study. Children between 2 months to 5 years with clinical features of severe pneumonia were included in the study. Socioeconomic history like the type of house, family size, sanitary facilities and fuel-based cooking was recorded. Detailed history about immunization, feeding practice and degree of malnutrition was recorded. Chi Square test was used to determine significant differences between two groups.Results: Total 150 patients could be included in the study. Immunization status shows that 74% were completely immunized, 9% were unimmunized and 17% were partially immunized. Most of the children were breast fed 95.33% and only 4.67% were bottle fed. 30% of the cases were grade 3 and 4 PEM and anemic. The socioeconomic status showed 84% were belonged to grade 3,4 and 5 and 16% belonged to grade 1 and 2. 96.67% were living in ill ventilated kutcha house with poor sanitation facilities and nearly 94% were living in house with fuel other than LPG.Conclusions: Factors like previous history of similar illness, inappropriate immunization for age, anemia, PEM grade 3 and 4, poor housing condition, and indoor air pollution were significantly associated with severity of pneumonia. While severity of illness, PEM grade 3 and 4 and associated illness were the important risk factors for mortality.

Tuberculosis in Children Aged 0-5 Years at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria - How Common is HIV in Children with Tuberculosis

Background: Tuberculosis (TB) is a leading cause of death in young children and the risk of progression from infection to disease is higher in the very young especially among those with Human Immunodeficiency Virus (HIV) infection. This study therefore aimed to examine the method of TB diagnosis and how common HIV infection is among children 0-5 years with tuberculosis at the University of Port Harcourt Teaching Hospital (UPTH).Methods: Information of children aged 0-5 years from 1stJanuary, 2011 to 31stDecember 2014 were retrieved from the TB register of the Directly Observed Treatment Short course (DOTS) clinic of UPTH. This included the age, sex, HIV status, Sputum AFB status, method of diagnosis of tuberculosis and the treatment outcome of the patients.Ethical approval for the study was obtained from the Research and Ethics committee of the University of Teaching Hospital. Results:Three hundred and thirty five children were treated for TB and 179 (53.43%) of them were aged 0-5 years. There were 93 (51.96%) males and 86 (48.04%) females, with male: female ratio of 1.08:1. Their mean age was 1.96 ±1.45. The sputum or gastric lavage of 21 (11.73%) were positive for acid fast bacilli (AFB). The common method of TB diagnosis was clinical/ radiological method and this constituted 158 (88.27%) of the patients with TB. Ninety (50.28%) children with TB were less than one year of age and there was no statistical significant relationship between age and method of TB diagnosis (x2= 2.78, p= 0.249). More males 93 (51.96%) than females 86 (48.04%) had TB but more females 13 (61.90%) than males 8 (38.10%) were AFB positive, however, these were not statistically significant. (x 2 =1.26 p-value=0.262). Seventy two (40.22%) of the children with TB were HIV positive. One hundred and thirty five (75.42%) of the children recovered following treatment while 44 (24.58%) were referred to Dots centres closest to the patients. No child died. Conclusion: The prevalence of TB among under-fives especially among infants is high. Clinical and radiological methods were the common methods of TB diagnosis. HIV prevalence among children with TB was lower than expected by the authors, however, the treatment outcome was good. Re-training of clinicians to improve their expertise on clinical diagnosis of TB and a more in depth search of TB in the community among children 0-5 years who are HIV sero-negative with persistent cough is advocated

Prácticas pa ra la prevención de accidentes en el hogar en cuidadores de niños de 1 a 5 años en un barrio de Cartagena (Colombia) / Practices for the prevention of accidents in the home in caregivers of children from 1 to 5 years in a district of Cartagena (Colombia)

Introducción: los accidentes en la población infantil constituyen una importante causa de morbilidad y mortalidad convirtiéndose hoy día en un problema de salud pública mundial, principalmente la población más afectada son los niños en etapa preescolar, por la vulnerabilidad y dependencia del cuidador. Objetivos: describir las prácticas para la prevención de accidentes en el hogar en cuidadores de niños de 1 a 5 años en un barrio de Cartagena (Colombia). Materiales y métodos: estudio cuantitativo descriptivo transversal. Constituido por 354 cuidadores de niños menores de 5 años, se utilizó la técnica de observación y la aplicación del instrumento con base a la práctica N° 15 de AIEPI (Atención Integrada a las Enfermedades Prevalentes de la Infancia). Resultados: socio demográficamente los cuidadores fueron principalmente de género femenino (87%), con 20 ­ 29 años de edad (44,9%), madres de los niños (61,3%), conviven en unión libre (54,2%), son bachilleres (50,3%), de estrato uno (91,8%), amas de casa (62,7%), con hijos (93,8%), residen en casas (54,5%). Los niños de 1 a 5 años fueron mayoritariamente de género masculino (51,7%), y han presentado accidentes (75,1%), sobre todo, caídas (61,9%). El nivel de riesgo de accidentes en el hogar fue bajo (85%), y las prácticas de prevención suelen ser regulares (55,1%). Conclusión: los niños enfrentan relativamente bajo riesgo de accidente en el hogar, sin embargo, las prácticas para prevenirlos resultan ser regulares..(AU)

Introduction: accidents in children are an important cause of morbidity and mortality,becoming today a global public health problem, mainly the most affected population are children in preschool, for the vulnerability and dependence of the caregiver. Objectives:to describe the practices for the prevention of accidents at home in caregivers of children from 1 to 5 years of age, in a neighborhood of Cartagena (Colombia). Materials and methods: quantitative, descriptive and cross-sectional study. Consisting of 354 caregivers of children under 5 years of age, the technique of observation and the application of the instrument was used based on practice No. 15 of IMCI (Integrated Management of Childhood Illness). Results: demographic partner caregivers were mainly female (87%), with 20 - 29 years of age (44.9%), mothers of children (61.3%), live together in a free union (54.2%), are high school graduates (50.3%), of stratum one (91.8%), housewives (62.7%), with children (93.8%), reside in houses (54.5%). Children from 1 to 5 years old were male (51.7%), and had accidents (75.1%), especially falls (61.9%). The level of accident risk in the home was low (85%), and prevention practices are usually regular (55.1%). Conclusion: children face relatively low risk of accident in the home, however, practices to prevent them turn out to be regular..(AU)

Mortality analysis on children under 5 years old in Yuyao County from 2013 to 2017 / 中华疾病控制杂志

@# Objective To understand the status and main causes of death among children under five years old in Yuyao County from 2013 to 2017, and to provide scientific basis to formulate relevant intervention measures． Methods Data monitoring deaths among children under five years old from 2013 to 2017 in Yuyao were collected. Trend of death, death rank, regional difference and utilization of pre-death health care services for children under 5 years old were retrospectively analysed using SPSS 18.0. Results From 2013 to 2017, the mortality rate in newborns, infants, 1-4 years old children and children under 5 years old (U5MR) decreased in Yuyao county(P=0.016, 0.002, 0.038, ＜0.001). Based on monitored 263 cases of deaths,the majority of deaths of children under 5 years old occurred in infants, accounting for 68.82% (181/263). Congenital malformation and unintentional injury were the main causes of death for children under 5 years old. The deaths of children under 5 years old mainly occurred in medical institutions, and 93.54% of the children were treated before death. The mortality rate of boys under 5 years old was 10.50‰, which was 1.54 times of the mortality of girls ( χ2=11.693, P<0.001). The trend Chi-square test showed that the U5MR in local residents had no obvious downward trend in the past 5 years ( χ2trend =0.195, P=0.658), while the U5MR in floating population significantly decreased with fluctuation ( χ2trend =17.706, P<0.001). Conclusion The key to reduce U5MR in Yuyao is to reduce infant mortality, and the key content of death intervention is to prevent congenital malformations and unintentional injuries. Improving maternal and child health care and developing safety education for migrant children are two effective measures to reduce U5MR.

Prediction and analysis of death of children under 5 years old in Lanzhou based on time series model / 中华疾病控制杂志

Objective To analyze the death trend of children under 5 years old in Lanzhou and establish the time series model to predict the mortality and incidence of children under 5 years old in Lanzhou in 2019. Methods Descriptive epidemiological method was used to analyze the mortality of children under 5 years old in Lanzhou from January 2010 to December 2018. SPSS 21.0 software was used to construct time series analysis model, selecting the best model and predict the mortality of children under 5 years old in Lanzhou in 2019. Results A total of 1 650 deaths of children under 5 years old were reported in Lanzhou from 2010 to 2018. The number of deaths reported by boys and girls was 871 and 774 respectively, with an average annual mortality rate of 6.23‰. In recent years, the overall mortality rate of children under 5 years old in Lanzhou had declined. The majority of deaths among children under 5 years old were neonates, accounting for 65.27%. Simple seasonal model was the best model by comparing different models. The model could well fit the monthly death cases of children under 5 years old in Lanzhou from 2010 to 2018. It is predicted that the total number of deaths of children under 5 years old in Lanzhou will be 140 in 2019, which is similar to the number of deaths in 2018. Conclusions The mortality rate of children under 5 years old in Lanzhou is decreasing year by year. Simple seasonal model can better reflect the mortality trend of children under 5 years old in Lanzhou and make short-term prediction.

Long-term Survivorship of Breast Cancer Patients and Its Prognostic Factors: A Tertiary Oncological Center Experience in Penang

@#Introduction: Breast cancer is the most common cause of cancer death among women. The purpose of this study is to determine the 5-years survival rate and prognostic factors among breast cancer patients in a tertiary oncological centre in Penang, Malaysia. Methods: A retrospective cohort study was conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. All 214 cases of breast cancer diagnosed from 1st January 2008 until 31st December 2012 were selected and retrospectively followed-up until 31st December 2017. The survival status for this study was referring to the record of the National Registration of Malaysia. Kaplan-Meier with Log-rank test and Cox regression were used for the univariable and multivariable analysis, respectively. Results: The mean (SD) age at diagnosis was 50.98 (±10.75) years. The majority of the patients were Malay (55.7%) and married (96.5%). After controlling for the effect of underlying comorbidities, lymph nodes involvement, marital status, vascular involvement and adjuvant therapy; it was found that marital status (adj HR= 3.63, 95% CI 1.17-11.24) and lymph nodes involvement (adj HR=2.36, 95% CI 1.17-4.76) were the significant prognostic factors. Conclusion: This study re-emphasizes the role of marital status and lymph nodes involvement as independent predictors of the long-term survival of breast cancer patients. Further studies are needed to assess the promising benefit of personalized treatment and specific supportive care given to the patients with these risk factors for better cancer experience and survival.

Etiological profile of community-acquired pneumonia (CAP) and immunization status among children < 5 years in public and private sector

Background: Childhood pneumonia is the leading cause of morbidity in children < 5 years with most cases occurring in India (43million). Pneumonia contributes to 27.5% of total under five year mortality in India.Streptococcus pneumonia, Hemophilus influenzaand respiratory syncytial virus have been identified as responsible pathogens. India’s multi-year plan for immunization highlights needfor accelerated introduction of new and underutilized vaccines against diseases with significant morbidity and mortality. PneumococcalConjugate Vaccines (PCV) have been licensed in India since 2006. The objective of this study was to document the etiology andimmunization status of children < 5 years who were newly diagnosed cases of CAP in private and public sector.Material/Methods: This study was a retrospective review of inpatient records (n=532) of children <5 years diagnosed with CAP in 2hospitals- one private and other public multispecialty hospital that had pediatric ward, pediatric ICU (Intensive Care Unit) and NICU(Neonatal Intensive Care Unit) in Mumbai, India. Cases where primary diagnosis was not clearly documented were confirmed fordiagnosis with laboratory reports and X-rays. Using the electronic case report form, baseline demographic and clinical characteristicssuch as age, gender, date of diagnosis, primary diagnosis on admission, prior immunization, diagnostic and laboratory test, treatmentduring inpatient stay and advice on discharge were extracted.Results: The average age at admission was 1.95 ± 1.45 years in private hospital and 1.51 ± 1.17 years in public hospital. Etiology was notestablished in a majority of the clinical diagnosed CAP cases i.e. 92/105 (93.13 %) in private hospital and 62/67 (92.54 %) in publichospital. Considerable morbidity due to CAP with the average length of stay 5.87 ± 3.50 days in private hospital versus 7.97 ± 4.74 days inpublic hospital was observed. Also 100 % of the children in private hospital received antibiotics versus 95.52 % in the public hospital. Themean duration of antibiotics in private hospital was 4.38 ± 4.61 days and in public hospital 2.1 ± 3.26 days. The number of unvaccinatedchildren or children whose immunization status is not known was significantly higher in the public hospital (34.33 %) than the privatehospital (20.59 %) (p=0.0465)Conclusions:A greater proportion of cases of CAP were classified as unspecified pneumonia due to lack of adequate diagnostic facilitieswhich act as an impediment in establishing etiology of CAP in Indian setting leading to considerable antibiotic use. An important wayforward for India would be to consider a possible timeline to achieve universal childhood immunization through introduction ofvaccines directed against pneumonia in the national immunization program across the country in the remaining states

Serum TSH level stability after 5 years in euthyroid adults at low risk for thyroid dysfunction

ABSTRACT Objective: To evaluate changes in thyroid function after 5 years, the interval proposed for new assessment, in initially euthyroid adults. Subjects and methods: Initially, 1,426 apparently healthy adults considered low risk for thyroid dysfunction, were evaluated by measurement of TSH. After 5 years, 1,215 (85.2%) subjects were reevaluated. Results: After 5 years, four subjects were receiving levothyroxine (L-T4) replacement therapy and 25 others had TSH > 4 mIU/L, only two of them with TSH > 10 mIU/L. All of these subjects had TSH > 3 mIU/L in the initial evaluation. During reassessment, none of the subjects had been or was treated for hyperthyroidism and 22 had TSH < 0.4 mIU/L (none of them < 0.1 mIU/L). Nineteen of these subjects had TSH ≤ 0.6 mIU/L in the initial evaluation. Among the 1,098 subjects with TSH between 0.6 and 3 mIU/L in the initial evaluation, reassessment showed that none of the subjects was using L-T4; only three had TSH > 4 mIU/L (none of them > 10 mIU/L); none had been or was treated for hyperthyroidism, and only three had TSH < 0.4 mIU/L (none of them < 0.1 mIU/L). These results did not differ between men and women or between subjects ≤ 60 and > 60 years. Conclusion: Repeat TSH measurement within an interval of only 5 years would not be cost-effective in adults without known thyroid disease or risk factors for dysfunction who exhibit TSH between 0.6 and 3 mIU/L.