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Acta Paediatr ; 111(12): 2424-2425, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2136660

Child Health , Paint , Child , Humans , Ukraine
Acta Paediatr ; 111(12): 2422, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2136655

Refugees , Child , Humans , Child Health , Family
BMC Pregnancy Childbirth ; 22(1): 806, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2098325


BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was revised in 2009 to be more congruent with national dietary guidelines. There is limited research examining effects of the revision on women's and children's health. The objective of this study was to evaluate whether the revised WIC food package was associated with various indicators of physical and mental health for women and children. METHODS: We used 1998-2017 waves of the National Health Interview Survey (N = 81,771 women and 27,780 children) to estimate effects of the revised WIC food package on indicators of health for both women (self-reported health and body mass index) and children (anemia, mental health, and parent-reported health). We used difference-in-differences analysis, a quasi-experimental technique that assessed pre-post differences in outcomes among WIC-recipients while "differencing out" the secular underlying trends among a control group of non-recipients. RESULTS: For all outcomes evaluated for women and children, we were unable to rule out the null hypothesis that there was no effect of receiving the revised WIC food package. These findings were confirmed across several secondary analyses conducted to assess heterogeneity of effects and robustness of results. CONCLUSION: While we did not find effects of the revised WIC food package on downstream health indicators, studies using similarly robust methods in other datasets have found shorter-term effects on more proximal outcomes related to diet and nutrition. Effects of the modest WIC revisions may be less impactful on longer-term indicators of health, and future studies should examine the larger COVID-19-era expansion.

COVID-19 , Food Assistance , Infant , Child , Female , Humans , Child Health , Women's Health , Food
Int J Environ Res Public Health ; 19(19)2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-2066008


Children's health can be affected by the interrelated characteristics of the physical and social environment where they live, including housing quality, neighbourhood characteristics and the local community. Following a systems-based approach, this exploratory project sought to understand how the needs and aspirations associated with the home environment can work in synergy with, or be exacerbated by, other aspects of the local area. The study recruited parents of children aged 2-12 years old from two local authorities in England with high levels of child poverty: Tower Hamlets in East London, and Bradford District in West Yorkshire. Thematic analysis of participant interviews highlighted ten themes and opportunities for improvements. The evidence presented in this research emphasises how environmental quality issues within and outside the home, compounded further by delays in repairs and reduction in service standards, as well as affordability issues, are likely to deeply affect the wellbeing of an entire generation of disadvantaged children whose parents can feel disempowered, neglected and often isolated when attempting to tackle various dimensions of inequalities. Interventions which can improve the quality of housing, and access to space and services, are urgently needed, including initiatives to support and empower families and local communities, especially those prioritising opportunities for action.

Child Health , Housing , Child , Child Poverty , Child, Preschool , England , Humans , Residence Characteristics
Rev. latinoam. enferm. (Online) ; 29: e3422, 2021. tab
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-2054531


Objective: to analyze the vulnerabilities of children in the access to primary health care during the COVID-19 pandemic in Brazil and Portugal. Method: documentary study based on Brazilian and Portuguese governmental guidelines issued between March and August 2020 regarding access of children to primary health care. Thematic analysis was based on the precepts of health vulnerability. Results: 13 documents were issued in both countries addressing access to vaccination and childcare. Due to the SARS-CoV-2, restrictions were imposed on the circulation of people in social environments, health services, and social protection, decreasing the demand for health services. Both countries continued programs to promote the health of breastfeeding infants. In-person childcare consultations were suspended for low-risk children in both countries. Portugal maintained routine vaccination while Brazil interrupted vaccination in the first 15 days of the pandemic. The countries adopted remote care strategies - telemonitoring, teleconsultation, and mobile applications - to maintain the bond between children and health services. Conclusion: longitudinality was affected due to restricted access of children to health promotion actions, determining greater programmatic vulnerability. Individual vulnerabilities are related to exposure to preventable and primary health care-sensitive diseases.

Objetivo: : analisar as vulnerabilidades da criança no acesso aos cuidados na atenção primária durante a pandemia da COVID-19 no Brasil e em Portugal. Método: pesquisa documental baseada em diretrizes governamentais brasileiras e portuguesas, expedidas entre março e agosto de 2020, sobre o acesso de crianças à atenção primária. A análise temática fundamentou-se nos preceitos da vulnerabilidade em saúde. Resultados: expediram-se 13 documentos nos dois países sobre acesso à vacinação e à puericultura. A restrição à circulação do SARS-CoV-2 nos ambientes sociais, serviços de saúde e de proteção social reduziu a demanda de atendimento. Mantiveram-se, nos dois países, os programas de promoção da saúde do lactente. O acompanhamento de puericultura presencial, para crianças de baixo risco, foi suspenso nos dois países. Portugal manteve a vacinação rotineira e o Brasil a interrompeu nos primeiros 15 dias da pandemia. Os países adotaram estratégias remotas de atenção - telemonitoramento, teleconsulta e aplicativos móveis - mantendo o vínculo da criança com os serviços de saúde. Conclusão: a longitudinalidade foi afetada pela redução do acesso à promoção da saúde da criança, determinando maior vulnerabilidade programática. As vulnerabilidades individuais relacionaram-se à exposição a doenças evitáveis e sensíveis à atenção primária.

Objetivo: analizar las vulnerabilidades del niño en el acceso a los cuidados en la atención primaria, durante la pandemia del COVID-19 en Brasil y Portugal. Método: investigación documental basada en directrices gubernamentales brasileñas y portuguesas, expedidas entre marzo y agosto de 2020, sobre el acceso de niños a la atención primaria. El análisis temático se fundamentó en los preceptos de la vulnerabilidad en la salud. Resultados: fueron encontrados 13 documentos, expedidos en los dos países, sobre el acceso a la vacunación y puericultura. La restricción de circulación del SARS-CoV-2 - en los ambientes sociales, servicios de salud y de protección social - redujo la demanda de la atención. En los dos países se mantuvieron los programas de promoción de la salud del lactante. El acompañamiento de puericultura presencial, para niños de bajo riesgo, fue suspendido en los dos países. Portugal mantuvo la vacunación de rutina y Brasil la interrumpió en los primeros 15 días de la epidemia. Los países adoptaron estrategias de atención a distancia (telemonitoreo, teleconsulta y aplicativos móviles) manteniendo el vínculo del niño con los servicios de la salud. Conclusión: la longitudinalidad fue afectada por la reducción del acceso a la promoción de la salud del niño, determinando mayor vulnerabilidad programática. Las vulnerabilidades individuales se relacionaron a la exposición a enfermedades evitables y sensibles a la atención primaria.

Humans , Male , Female , Infant , Child, Preschool , Portugal/epidemiology , Primary Health Care , Brazil/epidemiology , Child Care , Child Health , Vaccination , Immunization Programs , Coronavirus Infections , Continuity of Patient Care , Disaster Vulnerability , Severe Acute Respiratory Syndrome , Health Vulnerability , Pandemics , Betacoronavirus , COVID-19
Int J Health Plann Manage ; 37(6): 3372-3376, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2027347


A humanitarian crisis started in Afghanistan after the United States and international Allies withdrew in August 2021, causing numerous challenges and have especially impacted children. Children in Afghanistan have been affected by a long history of suffering from violence, war, and poverty. The US withdraw and COVID-19 pandemic have caused an economic crisis causing high rates of child malnutrition and prevented them from receiving healthcare and education. In the long run, the impacts of the current situation will significantly affect the child growth, education, and psychological health. There is a need for international organizations to intervene now to ensure children do not further suffer and have the option for a bright future. In turn, ensuring a brighter future for Afghanistan.

COVID-19 , Child Health , Child , Humans , Afghanistan , Pandemics/prevention & control , Poverty
JAMA Netw Open ; 5(9): e2231798, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2027282


Importance: Closure of day care centers (DCCs) to contain the COVID-19 pandemic has been associated with negative effects on children's health and well-being. Objective: To investigate the acceptance of self-sampling methods for continuous SARS-CoV-2 surveillance among asymptomatic children and childcare workers (CCWs) in DCCs. Design, Setting, and Participants: This nonrandomized pilot study included children and CCWs at 9 DCCs in Wuerzburg, Germany, from May to July 2021. Interventions: Twice weekly testing for SARS-CoV-2 was conducted by self-sampled mouth-rinsing fluid (saliva sampling [SAL], with subsequent pooled polymerase chain reaction test) plus nasal rapid antigen self-test (RAgT) (group 1), SAL only (group 2), or RAgT only (group 3) in children and CCWs. Main Outcomes and Measures: Main outcomes were rates for initial acceptance and successful (≥60% of scheduled samples) long-term participation. The probability of SARS-CoV-2 introduction into DCCs was modeled as a function of age-adjusted background incidence and DCC size. Results: Of 836 eligible children, 452 (54.1%; 95% CI, 50.7%-57.4%) participated (median [IQR] age: 4 [3-5] years; 213 [47.1%] girls), including 215 (47.6%) in group 1, 172 (38.1%) in group 2, and 65 (14.4%) in group 3. Of 190 CCWs, 139 (73.2%; 95% CI, 66.4%-79.0%) participated (median [IQR] age: 30 [25-46] years; 128 [92.1%] women), including 96 (69.1%) in group 1, 29 (20.9%) in group 2, and 14 (10.1%) in group 3. Overall, SARS-CoV-2 PCR tests on 5306 SAL samples and 2896 RAgTs were performed in children, with 1 asymptomatic child detected by PCR from SAL. Successful long-term participation was highest in group 2 (SAL only; children: 111 of 172 [64.5%]; CCWs: 18 of 29 [62.1%]). Weekly participation rates in children ranged from 54.0% to 83.8% for SAL and from 44.6% to 61.4% for RAgT. Participation rates decreased during the study course (P < .001). The probability of SARS-CoV-2 introduction into a DCC with 50 children was estimated to reach at most 5% for an age-adjusted SARS-CoV-2 incidence below 143. Conclusions and Relevance: Self-sampling for continuous SARS-CoV-2 testing was well accepted, with SAL being the preferred method. Given the high number of negative tests, thresholds for initiating continuous testing should be established based on age-adjusted SARS-CoV-2 incidence rates. Trial Registration: German Registry for Clinical Trials Identifier: DRKS00025546.

COVID-19 , SARS-CoV-2 , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Child , Child Care , Child Health , Child, Preschool , Day Care, Medical , Female , Humans , Male , Pandemics , Pilot Projects
J Pediatr Health Care ; 36(5): 401-403, 2022.
Article in English | MEDLINE | ID: covidwho-2008020
Front Cell Infect Microbiol ; 12: 873253, 2022.
Article in English | MEDLINE | ID: covidwho-1987468


Pregnancy causes physiological and immunological adaptations that allow the mother and fetus to communicate with precision in order to promote a healthy pregnancy. At the same time, these adaptations may make pregnant women more susceptible to infections, resulting in a variety of pregnancy complications; those pathogens may also be vertically transmitted to the fetus, resulting in adverse pregnancy outcomes. Even though the placenta has developed a robust microbial defense to restrict vertical microbial transmission, certain microbial pathogens have evolved mechanisms to avoid the placental barrier and cause congenital diseases. Recent mechanistic studies have begun to uncover the striking role of the maternal microbiota in pregnancy outcomes. In this review, we discuss how microbial pathogens overcome the placental barrier to cause congenital diseases. A better understanding of the placental control of fetal infection should provide new insights into future translational research.

Placenta , Pregnancy Complications, Infectious , Child , Child Health , Female , Humans , Infectious Disease Transmission, Vertical , Pregnancy
BJOG ; 129(12): 2002-2009, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1985533


OBJECTIVES: We sought to determine the knowledge, attitudes and practices of pregnant women regarding COVID-19 vaccination in pregnancy in seven low- and middle-income countries (LMIC). DESIGN: Prospective, observational, population-based study. SETTINGS: Study areas in seven LMICs: Bangladesh, India, Pakistan, Guatemala, Democratic Republic of the Congo (DRC), Kenya and Zambia. POPULATION: Pregnant women in an ongoing registry. METHODS: COVID-19 vaccine questionnaires were administered to pregnant women in the Global Network's Maternal Newborn Health Registry from February 2021 through November 2021 in face-to-face interviews. MAIN OUTCOME MEASURES: Knowledge, attitude and practice regarding vaccination during pregnancy; vaccination status. RESULTS: No women were vaccinated except for small proportions in India (12.9%) and Guatemala (5.5%). Overall, nearly half the women believed the COVID-19 vaccine is very/somewhat effective and a similar proportion believed that the COVID-19 vaccine is safe for pregnant women. With availability of vaccines, about 56.7% said they would get the vaccine and a 34.8% would refuse. Of those who would not get vaccinated, safety, fear of adverse effects, and lack of trust predicted vaccine refusal. Those with lower educational status were less willing to be vaccinated. Family members and health professionals were the most trusted source of information for vaccination. CONCLUSIONS: This COVID-19 vaccine survey in seven LMICs found that knowledge about the effectiveness and safety of the vaccine was generally low but varied. Concerns about vaccine safety and effectiveness among pregnant women is an important target for educational efforts to increase vaccination rates.

COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Child , Child Health , Developing Countries , Female , Health Knowledge, Attitudes, Practice , Humans , Infant, Newborn , Pregnancy , Pregnant Women , Prospective Studies , Vaccination
Int J Environ Res Public Health ; 19(15)2022 08 07.
Article in English | MEDLINE | ID: covidwho-1979236


The coronavirus disease 2019 (COVID-19) pandemic can affect children's well-being through mothers' avoidance of health checkups for children due to media portrayal of the disease. This study investigated the association between the type of information source for COVID-19 received by mothers and the avoidance of their children's health checkups. The study was an online-based survey, and the participants comprised 5667 postpartum women with children aged under 2 years during the study period. We analyzed the analytic sample and three groups of women with children aged 0-3 months, 4-6 months, and 6 months or older according to the timing of children's health checkups in Japan. Among the participants, 382 women (6.7%) avoided their children's health checkups. Multivariate logistic regression analysis revealed that mothers with children over 6 months who used magazines as an information source about COVID-19 tended to avoid their children's health checkups (adjusted odds ratio (aOR): 3.19; 95% confidence interval (CI): 1.68-6.05) compared with those who did not. In contrast, those using public websites were less likely to avoid their children's health checkups (aOR 0.58, 95% CI 0.43-0.77). This study showed that specific types of information source on COVID-19 could have varying effects on mothers' decisions about their children's health checkups.

COVID-19 , COVID-19/epidemiology , Child , Child Health , Female , Humans , Japan/epidemiology , Mothers , Pandemics
Acad Pediatr ; 21(8S): S134-S139, 2021.
Article in English | MEDLINE | ID: covidwho-1971916


One in three American Indian/Alaska Native (AI/AN) children live in poverty. This rate is higher in some reservation communities. The alarming rates of physical, mental, and social health inequities (eg, poverty) experienced by AI/AN children are symptoms of genocide, a legacy of inhumane Federal Indian policy, and ongoing structural violence. The chronically underfunded Indian Health Service (IHS) is just one example where AI/AN children are not universally guaranteed equitable health care or opportunity to thrive. Poverty is highly predictive of educational achievement, employment opportunities, violence, and ultimately health outcomes. COVID-19 has not only exacerbated physical and mental health inequities experienced by AI/AN communities, but has also intensified the economic consequences of inequity. Thus, it is vital to advocate for programs and policies that are evidence based, incorporate cultural ways of knowing, and dismantle structurally racist policies.

Alaskan Natives , COVID-19 , Indians, North American , Child , Child Health , Humans , Poverty , SARS-CoV-2 , United States
Indian Pediatr ; 59(7): 519-520, 2022 07 15.
Article in English | MEDLINE | ID: covidwho-1958331
BMC Public Health ; 22(1): 1165, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-1951157


BACKGROUND: Edutainment aims to spread educational messages in an entertaining way, and often reaches large audiences. While studies increasingly report the impacts of edutainment interventions, there is limited context-specific evidence on the underlying processes and barriers to effective delivery, especially in rural areas. This article presents results from a process evaluation of a community-based edutainment intervention designed to improve knowledge, attitudes, and practices on gender-based violence (GBV), sexual and reproductive health (SRH), and maternal and child health. The intervention focused on the television series, C'est la Vie!, screened through biweekly film clubs in rural Senegal and included post-screening discussions and thematic workshops, meant to reinforce messages, increase knowledge, and change social norms. The objectives of this study were to assess intervention adaptation, implementation fidelity, participants' responsiveness or engagement, and series appropriateness. METHODS: The intervention was implemented from December 2019 to March 2020 in 120 villages in Kaolack and Kolda regions of Senegal, and targeted adolescent girls and young women aged 14 to 34. The process evaluation was carried out in March 2020 in 14 villages using: i) individual semi-structured interviews with implementers (n = 3), village chiefs (n = 8), married women (n = 9), adolescent girls (n = 8), and men (n = 8); ii) focus groups with men (n = 7, 29 participants) and women (n = 10, 100 participants); and iii) observations of screening sessions (n = 4) and post-screening discussions (n = 2). Data were analyzed using thematic and content analysis. RESULTS: The results highlight that adaptation of the intervention helped reach the target population and improved participant attendance, but might have compromised fidelity to original design, as intervention components were shortened and modified for rural delivery and some facilitators made ad hoc modifications. The screenings coverage and frequency were adequate; however, their duration was shortened due to COVID-19 restrictions in Senegal. Participant responsiveness was excellent, as was the series appropriateness for most topics, including GBV. SRH remains a sensitive topic for youth, especially when the film clubs included non-peers, such as slightly older women. CONCLUSIONS: This study showed that using film clubs to deliver sensitive edutainment content in rural areas is feasible and has potential for scale-up.

COVID-19 , Gender-Based Violence , Adolescent , Aged , Child , Child Health , Female , Humans , Male , Reproductive Health , Senegal
Nutrients ; 14(14)2022 Jul 12.
Article in English | MEDLINE | ID: covidwho-1938925


This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege's g = 0.60) and higher Role Model fidelity (Hedege's g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers' Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.

COVID-19 , Child Care , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child Health , Health Promotion/methods , Humans , Obesity/prevention & control
Int J Environ Res Public Health ; 19(13)2022 06 24.
Article in English | MEDLINE | ID: covidwho-1934041


This study aimed to investigate the relationship between media addiction levels among early school-aged children and their health status, self-esteem, and their fathers' parenting practices. Therefore, we analyzed the data from a total of 1149 fathers and children from the 10th year (2017) survey of the Panel Study on Korean Children (PSKC), by the Korean Children's Panel Research Institute. Specifically, a multinomial logistic analysis was conducted to identify the factors affecting children's media addiction. The media addiction levels were 68.8%, 24.9%, and 6.3%, in general, high-risk, and potential-risk users, respectively. When media addiction levels were used as the reference group for general users, the pattern observed in the data revealed a direct positive association between media use time and the probability of becoming a potential-risk user (79.4%, OR = 1.79, 95% CI: 1.20, 2.68). Furthermore, when general users were used as the reference group, the male gender accounted for the majority of high-risk users, at 99% (OR = 1.99, 95% CI: 1.46, 2.71). Within this group, the children's body mass index (BMI) was high (5%, OR = 1.05, 95% CI: 1.00, 1.11), their media use time increased by 1 h a day (145%, OR = 2.45, 95% CI: 1.93, 3.11), their self-esteem decreased (32%, OR = 0.68, 95% CI: 0.49, 0.95), the fathers' authoritative parenting practices were low (37%, OR = 0.63, 95% CI: 0.43, 0.92), and the permissive parenting practices were high (92%, OR = 1.92, 95% CI: 1.09, 3.37). Therefore, the results of this study highlight children's media use time and the risk factors related to high BMIs in order to prevent media addiction among early school-aged children. Our findings also suggest appropriate parenting practices and highlight the need to strengthen children's self-esteem.

Fathers , Parenting , Body Mass Index , Child , Child Health , Humans , Male , Republic of Korea