BMC Pediatrics[JOURNAL]
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200 papers
Comparative study of hemoglobin changes following transfusion of fresh and old blood in patients with thalassemia referred to Bahrami Hospital.
Moghadm MA, Salimi Z, Yazdi MK
BMC Pediatr · 2026 Jun · PMID 42243761 · Full text
INTRODUCTION: Thalassemia major is a severe hemoglobinopathy that requires blood transfusion; however, long term blood transfusion might increase morbidity and mortality. Hemoglobin (Hb) after transfusion determines the...
INTRODUCTION: Thalassemia major is a severe hemoglobinopathy that requires blood transfusion; however, long term blood transfusion might increase morbidity and mortality. Hemoglobin (Hb) after transfusion determines the need for next transfusion. There is controversy regarding the effect of fresh packed RBC compared to old packed RBC transfusion on Hb. This study compared hemoglobin changes following transfusion between fresh and old packed RBC in transfusion-related thalassemia (TRT) patients. MATERIALS AND METHODS: In this cohort study, 140 TRT patients (age > 5years) referred to Bahrami Children's Hospital in mid-2013 were included. Equal number (n = 70) of age and gender matched TRT patients with exposure to fresh (stored for less than 7 days) and old (stored for more than 7 days) packed RBC transfusion were followed for 14 days. In both groups, demographic information (age, sex) were recorded at enrolment. Physical examination data and blood parameters, including red blood cells (RBC), white blood cells (WBC), platelets (PLT), Hb, ferritin, transferrin, total iron binding capacity and bilirubin at baseline and follow up. RESULTS: Time-group interaction was significant only for WBC (p < 0.001) and Hb (p = 0.029) indicating that fresh packed RBC transfusion resulted in higher Hb and lower WBC at follow up compared to baseline levels. Among the baseline variables only fresh packed RBC transfusion was found to increase the odds of having Hb of at least 1 mg/dL higher than baseline (OR = 15.465, p < 0.001). CONCLUSIONS: Fresh packed RBC transfusion might increase the interval between transfusions due to more Hb elevation rate after transfusion in thalassemia major.
Effectiveness of serial C-reactive protein point-of-care testing in optimizing antibiotic treatment in neonates and children in Zanzibar: an open-label, individual randomized controlled clinical trial protocol.
Joshua D, Seni J, Rahimi H … +8 more , Ally MS, Omar M, Ali FS, Joshi J, Ali SM, Poulsen A, Lund S, ZAN-TOTO Collaborators
BMC Pediatr · 2026 Jun · PMID 42243746 · Full text
INTRODUCTION: Antimicrobial resistance is increasing globally. Children are disproportionately affected due to the overuse and misuse of antibiotics which is linked to lack of prompt diagnostics for suspected bacterial i...
INTRODUCTION: Antimicrobial resistance is increasing globally. Children are disproportionately affected due to the overuse and misuse of antibiotics which is linked to lack of prompt diagnostics for suspected bacterial infections, limited access to health care facilities and financial constraints. The C-reactive protein (CRP) point-of-care test (POCT) presents an opportunity for quick and cost-effective diagnosis to establish the likelihood of a bacterial infection. However, information on the effectiveness of point-of-care CRP testing in hospitalized children in Zanzibar, Tanzania is limited. METHODS AND ANALYSIS: This multicenter, open-label, individual randomized controlled trial with 28 days follow-up is conducted at four hospitals in Zanzibar. Well-appearing neonates at risk of early onset sepsis, neonates (0 - 28 days) with clinical signs of infection on admission and children (6 months - 12 years) with febrile illness and/or diarrhea on admission are eligible for participation if their caretakers provide informed consent. The hospitals are supplied with CRP POCT equipment as well as a training session on CRP interpretation to aid in the clinical evaluation and antibiotic management of neonates and children. The primary outcome is the duration of antibiotic treatment within 14 days of the admittance of included neonates and children in each study arm and days to relapse of infection (defined as reinstitution of antibiotics within 72 h after completion of treatment). ETHICS AND DISSEMINATION: The study is approved by the Zanzibar Health Research Ethics Committee Ref. No. ZAHREC/04/AMEND/DEC/2023/11. The findings from this study will be used to generate policy briefs and technical reports to inform rational antimicrobial prescriptions' clinical practices and guide future research. Findings will be presented at global conferences and published in peer-reviewed medical journals to foster access to wider communities within Tanzania and beyond. TRIAL REGISTRATION: This trial was registered with ISRCTN registry (ISRCTN25937092) on 22/01/2024.
Child feeding practices and nutritional status of children aged 6-23 months in Nigeria: a multi-site survey.
Iheme GO, Hajara I, Adebare AF … +7 more , Edafioghor LO, Ortutu BF, Uche CP, Owoyemi TL, Egechizuorom IM, Oyebamiji EA, Ogbonna OC
BMC Pediatr · 2026 Jun · PMID 42243737 · Full text
BACKGROUND: Poor nutrition during early childhood affects growth/development and increases the risk of morbidity and mortality. This study assessed child feeding practices and the nutritional status of children from sele...
BACKGROUND: Poor nutrition during early childhood affects growth/development and increases the risk of morbidity and mortality. This study assessed child feeding practices and the nutritional status of children from selected Nigerian tertiary health institutions. METHODS: This study employed a descriptive cross-sectional design to digitally elicit responses from 1,295 mothers and child pairs accessing welfare services at four tertiary health institutions in Nigeria. Harmonized indicators such as Infant and Young Child Feeding Index (ICFI), WHO/UNICEF Infant and Young Child Feeding (IYCF) Practices Indicators, and WHO growth standards were used to evaluate the children's feeding practices and anthropometric status. All descriptive and bivariate analysis (Fisher-Exact test) were done using IBM SPSS for Windows 25. RESULTS: The study revealed that while 80.7% and 86.9% of the children met the minimum meal frequency and age-appropriate complementary feeding introduction criteria, breastfeeding initiation (48.5%), exclusive breastfeeding (EBF) rates (68.4%) and diversified food intake were suboptimal. However, 44.1% of children with stunting and 44.1% of children with overweight/obesity were identified. Exclusive breastfeeding was positively associated with BMI-for-age (OR = 1.51; 95% CI: 1.06-2.16; p = 0.02). Current breastfeeding status was also significantly associated with height-for-age (OR = 0.54; 95% CI: 0.37-0.78; p < 0.001) and BMI-for-age (OR = 1.78; 95% CI: 1.23-2.58; p = 0.002). CONCLUSIONS: Several aspects of the children's feeding practices were sub-optimal, nutritional status was polarized, with many children affected by stunting and overweight/obesity. Interventions tailored towards strengthening breastfeeding and complementary feeding practices are critical for improving nutrition outcomes.
Process, outcomes and feasibility of implementing universal newborn screening programme in Sri Lanka.
Mettananda S, Thenuwara N, Madushith R … +4 more , Samarakoon Y, Lucas N, Herath H, Danansuriya M
BMC Pediatr · 2026 Jun · PMID 42243713 · Full text
BACKGROUND: The universal newborn screening detects clinically occult but potentially serious conditions, enabling timely treatment to reduce child morbidity and mortality. The World Health Organisation recommends incorp...
BACKGROUND: The universal newborn screening detects clinically occult but potentially serious conditions, enabling timely treatment to reduce child morbidity and mortality. The World Health Organisation recommends incorporating universal newborn screening into routine newborn care. In early 2025, Sri Lanka launched a universal newborn screening package including screening for eye abnormalities, congenital hypothyroidism, critical congenital heart diseases and hearing impairment in five pilot hospitals. Here, we aim to describe the process, outcomes, and technical and operational feasibility of implementing the universal newborn screening package in Sri Lanka. METHODS: A descriptive study was conducted in five hospitals that piloted the universal newborn screening package in Sri Lanka from January to March 2025. All neonates born during the study period were recruited. Data on the screening process were obtained from maternal interviews and patient records. Telephone interviews were done 4-6 weeks post-discharge to capture screening outcomes. Neonates who had abnormal results of the screening tests were identified as 'Refer' for the test. RESULTS: A total of 3860 newborns (males-51.0%) were recruited. Eye screening was performed in > 99% of neonates, with 76 (1.9%) being 'Refer' predominantly (74/76) due to the presence of risk factors. The screening rate for congenital hypothyroidism was 99.8%, which detected six (0.15%) with congenital hypothyroidism. Pulse oximetry screening was performed in 98.5%, of which eight (0.2%) were 'Refer' and one subsequently confirmed to have a critical congenital heart disease. Overall, 79.1% of neonates underwent hearing screening, of which 325 (10.6%) were 'Refer' in the first test, and 20 were 'Refer' in the second test and referred for further evaluation. CONCLUSIONS: The pilot implementation of the Universal Newborn Screening package in Sri Lanka demonstrated high coverage exceeding 98% for screening of congenital hypothyroidism, critical congenital heart disease, and eye abnormalities, highlighting operational feasibility. In contrast, screening for hearing impairment remained suboptimal, largely attributable to logistical and system-level challenges. The congenital hypothyroidism screening detected six (0.15%) cases, and pulse oximetry screening detected one with a critical congenital heart disease. These findings suggest that universal newborn screening is a feasible and potentially sustainable intervention that can be effectively integrated into the existing health system in Sri Lanka.
Late diagnosis of RAPSN mutation-associated congenital myasthenic syndrome with obstructive sleep apnea in a 5-year-old girl.
Kurian GS, Frio TR, Ruchonnet-Métrailler I … +1 more , Fluss J
BMC Pediatr · 2026 Jun · PMID 42237298 · Full text
BACKGROUND: Congenital myasthenic syndromes represent a heterogenous group of rare genetic disorders that affect the neuromuscular junction. They present with variable combinations of extraocular, facial, bulbar, and lim...
BACKGROUND: Congenital myasthenic syndromes represent a heterogenous group of rare genetic disorders that affect the neuromuscular junction. They present with variable combinations of extraocular, facial, bulbar, and limb muscle weakness with typical diurnal fluctuations of symptoms, with increased risk of sleep-related disorders. Due to the variable course, clinical diagnosis can be challenging and delayed, sometimes for decades. CASE PRESENTATION: We present the case of a 5-year-old girl presumed to have benign infantile hypotonia, who exhibited head drop during intercurrent illnesses and increased evening fatigue. Intermittent bilateral ptosis, initially unreported by the family and not observed during early morning examinations, became evident during a late afternoon visit. Given the clinical suspicion of a congenital myasthenic syndrome, genetic testing was performed and identified a homozygous pathogenic variant in the RAPSN gene responsible for a post-synaptic form of congenital myasthenia. Due to the complaints of excessive night-time snoring, overnight polygraphies (PG) were performed, revealing obstructive sleep-apnoea secondary to oropharyngeal muscle weakness. Symptomatic treatment with pyridostigmine, including a night-time dose, was followed by drastic improvement and near-complete resolution of nocturnal symptoms. CONCLUSION: Congenital myasthenia may be more prevalent than recognised, with milder phenotypes still frequently overlooked or misdiagnosed. Sleep apnea is an important comorbidity that should be actively investigated. Optimised pyridostigmine therapy, including nocturnal dosing, can significantly alleviate symptoms and improve quality of life.
Physical activity enjoyment as a mediator between weight status and physical activity in children and adolescents: results of the MoMo 2.0-Study.
Tschuschke L, Volk C, Jekauc D … +4 more , Hanssen-Doose A, Niessner C, Woll A, Fiedler J
BMC Pediatr · 2026 Jun · PMID 42237283 · Full text
BACKGROUND: Children with underweight or overweight show different physical activity (PA) levels than their peers with normal weight, and PA enjoyment may explain this difference. This cross-sectional study examined whet...
BACKGROUND: Children with underweight or overweight show different physical activity (PA) levels than their peers with normal weight, and PA enjoyment may explain this difference. This cross-sectional study examined whether PA enjoyment mediates the association between weight status and PA in children and adolescents who are overweight or underweight compared to those with normal weight. METHODS: We analysed questionnaire-based data from 3,718 participants (52.4% male, mean age 10.4 ± 3.7 years) and accelerometer-based data from 1,531 participants (52.1% male, mean age 10.7 ± 3.6 years) of the nationwide MoMo 2.0-Study in Germany (2023-2024). Weight status was categorized according to cut-offs of the International Obesity Task Force into underweight, normal weight, and overweight. PA enjoyment was measured with the short version of the Physical Activity Enjoyment Scale, PA was assessed via MoMo-Physical Activity Questionnaire and with accelerometers (activPAL4). Mediation analyses were performed using Hayes PROCESS mediation macro for total, direct, and indirect effects, adjusted for age, sex, and socioeconomic status. RESULTS: PA enjoyment fully mediated the relationship between overweight and PA in questionnaire-based (indirect effect = - 0.104, 95% CI [-0.135, - 0.075]) and accelerometer-based data (indirect effect = - 0.065, 95% CI [-0.100, - 0.034]), compared to children with normal weight. For underweight, a small indirect effect emerged for questionnaire-based (-0.035, 95% CI [-0.068, - 0.003]), but not for accelerometer-based data (-0.025, 95% CI [-0.055, 0.003]). CONCLUSIONS: These findings suggest that reduced PA enjoyment partly contributes to lower PA levels among children with overweight, emphasizing the role of motivational factors in this pathway. For underweight, findings were less consistent. Interventions to promote PA in children with overweight may benefit from targeting PA enjoyment as a key motivational pathway.
Incidence and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit of Wallaga University Comprehensive Specialized Hospital, Nekemte Town, East Wallaga, Oromia, Ethiopia: a retrospective cohort study.
Abera M, Enkosa F, Merdassa E
BMC Pediatr · 2026 Jun · PMID 42237251 · Full text
BACKGROUND: Preterm neonatal mortality remains a major public health challenge worldwide. Despite the availability of modifiable risk factors and cost effective interventions, data on incidence of mortality of preterm ne...
BACKGROUND: Preterm neonatal mortality remains a major public health challenge worldwide. Despite the availability of modifiable risk factors and cost effective interventions, data on incidence of mortality of preterm neonates in the study area is lacking. Generating local data is essential to inform tailored interventions, strengthen neonatal care services, and support national efforts to reduce neonatal mortality. OBJECTIVE: To assess incidence and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit of Wallaga University Comprehensive Specialized Hospital, Nekemte Town, Oromia, Ethiopia, from July 1, 2022, to June 30, 2024. METHODS: An institution-based retrospective cohort study was conducted among 264 preterm neonates admitted to the NICU from July 1, 2022 to June 30, 2024 and study subjects were selected using systematic random sampling technique. Data were collected using a structured checklist, key variables including ANC follow up, place of delivery, gestational age, and birth weight were extracted from medical records. Data entered via EpiData version 4.6, and subsequently analyzed using STATA version 14.0. The Cox proportional hazards model assumption was checked. A bivariable Cox regression analysis was fitted and those variable with p < 0.2 were included in the multivariable analysis. Finally, statistical significance was declared at a p-value < 0.05. RESULTS: Of the 259 preterm neonates included in the study, 42 died during the follow-up period, with an incidence proportion of 16.2%. The median survival time was 28 days (IQR: 22-30), with a total follow-up of 2,737 neonate-days. The overall incidence rate of mortality was 15.3 per 1,000 neonate-days (95% CI: 11.3-20.7). In the multivariable Cox proportional hazards regression analysis, lack of ANC follow-up (AHR: 2.27; 95% CI: 1.13-4.57), home delivery (AHR: 7.74; 95% CI: 1.99-30.03), and neonatal hypothermia (AHR: 4.11; 95% CI: 1.55-10.85) were significantly associated with increased risk of mortality, while antenatal steroid use reduced the risk of death by 56% (AHR: 0.44; 95% CI: 0.21-0.92). CONCLUSION AND RECOMMENDATION: Lack of ANC follow-up, home delivery, and neonatal hypothermia were significant predictors of preterm neonatal mortality, while antenatal steroid use reduced the risk of death. Strengthening antenatal care utilization, promoting institutional delivery, improving thermal care, and ensuring appropriate antenatal corticosteroid administration may help improve survival among preterm neonates.
Epidemiological characteristics and seasonal dynamics of six respiratory pathogens in children: a 2-year retrospective cross-sectional study in Chengdu, China.
Chen H, Fan Y, Huang Y
BMC Pediatr · 2026 Jun · PMID 42237243 · Full text
BACKGROUND: Adenovirus (AdV), influenza A virus (FluA), influenza B virus (FluB), respiratory syncytial virus (RSV), rhinovirus (RV), and Mycoplasma pneumoniae (MP) are the primary pathogens causing acute respiratory inf...
BACKGROUND: Adenovirus (AdV), influenza A virus (FluA), influenza B virus (FluB), respiratory syncytial virus (RSV), rhinovirus (RV), and Mycoplasma pneumoniae (MP) are the primary pathogens causing acute respiratory infections in children. However, comprehensive and multifactorial analyses of their epidemiological features, such as seasonality and age specificity, remain limited. METHODS: We performed a retrospective analysis of 68,982 children (aged 0-18 years) with acute respiratory infections who underwent multiplex PCR testing at Chengdu Women and Children's Central Hospital between March 1, 2023, and February 28, 2025. Single-pathogen positivity rates were compared using Pearson's chi-square test. Multivariate logistic regression was used to evaluate the associations between age group, season, sex, and care setting and pathogen detection, reporting adjusted odds ratios (ORs) and 95% confidence intervals (CIs) with adolescence, autumn, female sex, and inpatient status as reference categories. Co-infection patterns were analyzed by constructing a network based on pairwise co-detection frequencies, calculating node degrees and edge weights to identify predominant mixed-infection combinations. RESULTS: Overall PCR positivity was 53.1% (36,677/68,982). The positivity rate increased from 38.8% in infants to 63.5% in school-aged children (χ² = 2276.7; P < 0.001). Among all pathogens, RV remained common across all age groups, with an overall positivity rate of 18.1%. Compared to adolescents, infants had significantly higher odds of RSV detection (OR = 7.82; 95% CI 5.53-11.04); school-aged children had higher odds of MP detection (OR = 2.82; 95% CI 2.39-3.32). Males exhibited slightly higher overall positivity than females (53.6% vs. 52.6%; χ² = 7.41; P = 0.007). Positivity was higher in winter and autumn than in summer (58.1% vs. 46.6%; χ² = 628.6; P < 0.001). Outpatients had higher positivity rates than inpatients (63.2% vs. 51.1%; χ² = 586.7; P < 0.001). Seasonal analysis showed that AdV peaked in summer (OR = 1.46; 95% CI 1.38-1.55); RV peaked in autumn and spring (summer OR = 0.62; 95% CI 0.59-0.65); MP peaked in autumn; and RSV and influenza B virus peaked in winter (RSV OR = 2.82; 95% CI 2.63-3.03; FluB OR = 4.70; 95% CI 3.94-5.60). Co-infection analysis revealed that the most common co-infection pattern was RV + MP, with 1,009 cases identified in hospitalized patients. CONCLUSIONS: Age, season, and care setting significantly affect pediatric respiratory pathogen detection. These findings may inform targeted public health surveillance and respiratory infection prevention strategies.
Determinants of delay in treatment-seeking for under-five pneumonia among caregivers in public health facilities in waliso town, Ethiopia: an unmatched case-control study.
Chuko BM, Darega J, Dibaba N … +4 more , Edea G, Kebata D, Taye N, Ayana M
BMC Pediatr · 2026 Jun · PMID 42237142 · Full text
BACKGROUND: Pneumonia is one of the lower respiratory tract infections. It is defined as an infection of the lung tissue. Delayed treatment of pneumonia in under-five children is health care Seeking after 24 h from the r...
BACKGROUND: Pneumonia is one of the lower respiratory tract infections. It is defined as an infection of the lung tissue. Delayed treatment of pneumonia in under-five children is health care Seeking after 24 h from the recognition sign of pneumonia. Delayed, health seeking for sick children with pneumonia is associated with high morbidity/mortality of under-five children. OBJECTIVE: To identify the determinants of delay in treatment-seeking for under-five pneumonia among caregivers at public health facilities in Waliso Town, Ethiopia, 2025. METHODS: A facility based un-matched case- control study among 381(127 case and 254 control) with 1:2 ratios were conducted from December 10, 2024 - February 10, 2025 among under-five children at public health facility in Waliso Town, Ethiopia. Consecutive and systematic sampling technique was employed to select cases and controls respectively. Data were collected by face-to-face interview and entered into Epi info version 7.25 and exported to SPSS version 25 for analysis. Factors having p-value < 0.25 in the bivariable analysis was entered into logistic regression model for multivariable analysis. Statistical significance on the final model was declared at p-value < 0.05. Adjusted odds ratio along with 95% confidence interval was used to show strength of association. The results were presented using text, table and graphs. RESULTS: In this study 378 caregivers (126 cases and 252 controls) were completed the interview giving the response rate of 99.48% and 0.52% non-response rates. After multivariable logistic regression analysis, significant determinants of delay in treatment seeking for under-five pneumonia were home delivery [AOR = 2.38, 95% CI (1.37-4.14)], self-medication [AOR = 2.21, 95% CI (1.23-3.95)], non-use of community health insurance [AOR = 2.36, 95% CI (1.43-3.87)], poor knowledge of child danger sign[AOR = 2.77, 95% CI (1.39-5.5)], not heard child treatment information from media [AOR = 1.71, 95% CI (1.05-2.78)]. CONCLUSION: Home delivery, self-medication, non-use of community health insurance, poor knowledge of child danger sign and not heard child treatment information from media were significantly associated with delay in treatment seeking for under-five pneumonia. Health facility and Health care providers should focus on these determinants, and strengthening early diagnosis and treatment.
Early motor inequities: how birth conditions and social context shape motor development in the first five years of life.
Ferreira KS, Zanella LW, Nobre GC … +1 more , Valentini NC
BMC Pediatr · 2026 Jun · PMID 42237135 · Full text
This study investigated the influence of individual factors (gestational age, birth weight, and body length) and contextual factors (socioeconomic status, school attendance, and region of residence) on motor development...
This study investigated the influence of individual factors (gestational age, birth weight, and body length) and contextual factors (socioeconomic status, school attendance, and region of residence) on motor development in children aged 0 to 5 years. A total of 626 preterm and full-term children were assessed using the Peabody Developmental Motor Scales-Second Edition (PDMS-2). Most children (77.8%) demonstrated average motor performance, while 17.7% scored below average. Full-term children showed higher total motor quotients and fine-motor grasping scores compared with preterm children, and children with low birth weight performed more poorly in object manipulation tasks. Significant socioeconomic disparities were identified: children from higher-income families exhibited better gross motor and stationary balance scores. School attendance was associated with higher total motor quotients and superior performance in stationary balance, grasping, and visuomotor integration, underscoring the developmental value of early educational environments. Children residing in urban areas demonstrated higher scores across most PDMS-2 subscales compared with those living in rural regions. Overall, the findings reveal that both biological vulnerabilities and social environments play important roles in shaping early motor development. Early identification of risk and implementation of targeted interventions across health, education, and community settings are essential for reducing motor development inequities during early childhood.
Assessing pediatricians' readiness for artificial intelligence: a cross-sectional study in Istanbul, Türki̇ye.
Güzeloğlu E, Ateş B, Özgür FA … +3 more , Kök S, Dağ H, Arica V
BMC Pediatr · 2026 Jun · PMID 42237120 · Full text
BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare, including pediatrics, offering new opportunities for diagnosis, management, and decision support. However, the effective implementation...
BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare, including pediatrics, offering new opportunities for diagnosis, management, and decision support. However, the effective implementation of AI depends largely on healthcare professionals' knowledge, attitudes, and readiness to adopt these technologies. This study aimed to evaluate pediatricians' general attitudes toward artificial intelligence and their level of readiness for medical AI in Istanbul, Türkiye at tertiary hospital. Distinct from previous research focusing primarily on medical students, this study investigates the AI readiness of practicing pediatricians within a major tertiary hospital in Istanbul, addressing a critical gap in professional clinical workforce assessment. METHODS: This descriptive cross-sectional study was conducted between August 1 and November 1, 2025, at Prof. Dr. Cemil Taşcıoğlu City Hospital. A total of 130 pediatricians participated. Data were collected using a sociodemographic questionnaire, the GAAIS (General Attitudes toward Artificial Intelligence Scale), and the MAIRS-MS (Medical Artificial Intelligence Readiness Scale for Medical Students). The validity and reliability of scales in Turkish have been previously investigated in various studies. The internal consistency of the scales was excellent, with a Cronbach's alpha coefficient of 0.972 in our study. Statistical analyses were performed using SPSS 27. Correlation, t-test, ANOVA, and non-parametric tests were applied where appropriate. RESULTS: The mean age of participants was 37.47 ± 9.31 years, and 58.5% were female. The mean AI positive attitude score was 3.81 ± 0.74, and the negative attitude score was 2.83 ± 0.81. The total MAIRS-MS score was 74.97 ± 13.01, indicating a moderate-to-high level of AI readiness. Age was negatively correlated with AI positive attitude and total MAIRS score (p < 0.05). Participants with ≥ 21 years of professional experience had significantly lower AI readiness and positive attitude scores than younger participants (p < 0.05). A strong positive correlation was found between AI positive attitude and total MAIRS-MS score (r = 0.764, p < 0.01). Multiple regression analysis revealed that "Ability" (β = 0.516, p < 0.001) and "Cognition" (β = 0.323, p < 0.001) factors were the strongest predictors of a positive attitude toward AI (R = 0.658). A strong positive correlation was found between AI positive attitude and total MAIRS-MS score (r = 0.764, p < 0.01). These results suggest that clinical AI implementation must be accompanied by tailored institutional support and age-specific training to bridge the generational digital divide in pediatric care. CONCLUSION: Pediatricians generally demonstrated positive attitudes and moderate-to-high readiness for artificial intelligence in our study. However, advanced age and longer professional experience were associated with lower readiness levels. These findings highlight the need for a structured AI education and training program, especially targeting senior physicians, to ensure effective and ethical integration of AI into pediatric practice.
A young girl with partial chromosome 15q11.2 microduplication: a case report in Cameroon.
Betoko RM, Dahoun S, Ntsoli G … +4 more , Sloan-Bena F, Bodieu AC, Nengom JT, Sap S
BMC Pediatr · 2026 Jun · PMID 42237104 · Full text
BACKGROUND: The 15q11.2 BP1-BP2 microduplication is a rare copy number variant associated with neurodevelopmental disorders, dysmorphic features, and variable expressivity. Unlike complete trisomy 15, this microduplicati...
BACKGROUND: The 15q11.2 BP1-BP2 microduplication is a rare copy number variant associated with neurodevelopmental disorders, dysmorphic features, and variable expressivity. Unlike complete trisomy 15, this microduplication involves a 300 kb segment containing four genes: NIPA1, NIPA2, CYFIP1, and TUBGCP5. Few cases have been reported in sub-Saharan Africa. CASE PRESENTATION: We report a case of a nine-year-old girl born small for gestational age who presented with feeding difficulties, dysmorphic signs, failure to thrive, and learning disabilities. Silver-Russell syndrome was initially considered as a differential diagnosis. Chromosomal microarray analysis (CMA) using Agilent 44 K oligonucleotide array-CGH (GRCh37/hg19 genome build) revealed an interstitial 15q11.2 microduplication of 300.5 kb between breakpoints BP1 and BP2, classified as arr[GRCh37] 15q11.2(22784523_23085096)x3. Parental testing confirmed maternal origin. She received nutritional support and levothyroxine for central hypothyroidism. After a 3-year follow-up, she showed improvement in growth parameters and school performance. CONCLUSION: The 15q11.2 BP1-BP2 microduplication may be underdiagnosed in Africa due to limited access to genetic testing. This case highlights the importance of chromosomal microarray analysis in children presenting with developmental delay and failure to thrive in resource-limited settings.
Prevalence of sight-threatening ocular abnormalities identified by retinal examination in neonates: a systematic review and meta-analysis.
Anne RP, Mathai SS, S S
BMC Pediatr · 2026 Jun · PMID 42231307 · Full text
BACKGROUND: Red reflex testing for newborn screening detects only a fifth of disorders requiring intervention. In this systematic review and meta-analysis, we assessed the prevalence of sight-threatening disorders detect...
BACKGROUND: Red reflex testing for newborn screening detects only a fifth of disorders requiring intervention. In this systematic review and meta-analysis, we assessed the prevalence of sight-threatening disorders detected by screening newborn babies with retinal examination. METHODS: We searched PubMed, Embase, Web of Science and Scopus databases for studies assessing newborn retinal examination and reporting treatable sight-threatening abnormalities (cataract, glaucoma and retinoblastoma) and treatable potentially sight-threatening abnormalities (retinitis, vitreous hemorrhage, ROP-like retinopathy and familial exudative vitreoretinopathy). We excluded studies on preterm neonates reporting only ROP and on term neonates reporting only retinal hemorrhages. We adhered to MOOSE guidelines and used the JBI tool for quality assessment and R software for analysis (double arcsine transformation model). RESULTS: Thirteen observational studies (250,513 neonates) published between 2015 and 2024 were included in the meta-analysis. The studies were from China, India, Brazil, Malaysia, Indonesia, Turkey and New Zealand. Eleven studies used wide-field retinal imaging by RetCam and its variants, and one study each used indirect ophthalmoscopy and smartphone-based fundus imaging devices. On quality assessment, five studies were at increased risk of bias due to small sample size and/or not including consecutive births. The prevalence of treatable sight-threatening abnormalities was 6.1 per 10,000 neonates (13 studies, 250,513 neonates, 95% CI: 1, 14.1), and the prevalence of treatable potentially sight-threatening abnormalities was 42.2 per 10,000 neonates (12 studies, 250,167 neonates, 95% CI: 19.8, 71.9). No adverse effects were reported. CONCLUSIONS: Eye screening of neonates with retinal examination can detect several sight-threatening abnormalities amenable to intervention. TRIAL REGISTRATION: PROSPERO database with registration number CRD42023448129.
Exclusion diet vs. exclusion diet plus partial enteral nutrition in management of pediatric Crohn's disease.
Shaygantabar M, Dianati Z, Ledari SM … +3 more , Sohouli MH, Rohani P, Hekmatdoost A
BMC Pediatr · 2026 Jun · PMID 42231250 · Full text
BACKGROUND AND AIMS: Exclusive enteral nutrition (EEN) induces remission in children with active mild to moderate Crohn's disease (CD), while partial enteral nutrition (PEN) with a free diet have failed to be effective i...
BACKGROUND AND AIMS: Exclusive enteral nutrition (EEN) induces remission in children with active mild to moderate Crohn's disease (CD), while partial enteral nutrition (PEN) with a free diet have failed to be effective in these patients. The effects of CD exclusion diet (CDED) alone has not yet been evaluated in pediatric CD. The current study aimed to compare the effects of CDED alone vs. CDED plus PEN on children and adolescents with mild to moderate CD. METHODS: A prospective randomized trial was conducted on children with mild to moderate Crohn's Disease (CD), aged 4-18 years. Eligible children were included in the study based on the inclusion and exclusion criteria and after the approval of the diagnosis by a pediatric gastroenterologist. Patients were assigned to receive either CDED + PEN, or only CDED. The study evaluated remission, disease activity, inflammatory markers, anthropometric measurements, quality of life, fecal calprotectin (FC), and albumin after 8 weeks of intervention. RESULTS: Sixty patients were randomly assigned to two groups (30 to CDED + PEN group and 30 to CDED) and included in the analysis. At eight weeks, our analysis showed no significant difference in response (P = 0.92) and remission (P = 0.71) between two groups. However, both groups experienced remission rates of over 60%. The study found no differences in anthropometric measurements, inflammatory markers, disease activity and FC between groups, while CDED + PEN significantly improved quality of life. CONCLUSION: CDED is as effective as CDED plus PEN in induction of remission in active mild to moderate pediatric CD. TRIAL REGISTRATION: The study has been registered in protocol ID gov (NCT06353633, with a registration date of 20240204).
Women's empowerment and child stunting in Peru: a nationally representative analysis.
Chumán-Sánchez M, Ortiz-Saavedra B, Uribe-Cavero LJ … +3 more , Llamo-Vilcherrez AP, Moxey JW, Toro-Huamanchumo CJ
BMC Pediatr · 2026 Jun · PMID 42231220 · Full text
BACKGROUND: Child stunting remains a persistent public health challenge in Peru. Although women's empowerment has been linked to improved child health, evidence on its domain-specific relationship with stunting remains l...
BACKGROUND: Child stunting remains a persistent public health challenge in Peru. Although women's empowerment has been linked to improved child health, evidence on its domain-specific relationship with stunting remains limited. The objective of this study was to assess the association between women's empowerment, across attitudes towards violence, social independence, and decision-making, and child stunting in Peru. METHODS: We conducted an analytical cross-sectional study using nationally representative data from the 2021 Demographic and Family Health Survey (ENDES), including 16,650 mother-child pairs. Analyses of women's empowerment were conducted in a sub-sample with complete SWPER data (n = 12,696). Stunting was defined as height-for-age below - 2 standard deviations of WHO standards. Women's empowerment was measured using the SWPER Global index and categorised into tertiles. All analyses accounted for the complex survey design, including sampling weights. Crude and adjusted logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The overall prevalence of child stunting was 11.3%. Stunting disproportionately affected disadvantaged groups, particularly children living in rural areas and from lower wealth quintiles. In adjusted analyses, higher maternal decision-making was associated with lower odds of stunting (medium vs. low: aOR 0.65; 95% CI 0.46-0.92; high vs. low: aOR 0.48; 95% CI 0.34-0.69). No significant associations were found for attitudes towards violence or social independence after adjustment. CONCLUSIONS: Maternal decision-making empowerment is associated with lower odds of child stunting in Peru. These findings suggest that strategies aimed at improving child nutrition may benefit from incorporating interventions that strengthen women's agency within household decision-making.
Management and retrospective analysis of postoperative femoral fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip.
Deng S, Wang C, Shi Q
BMC Pediatr · 2026 Jun · PMID 42231219 · Full text
INTRODUCTION: Proximal femoral osteotomy (PFO) with locking compression plates (LCPs) is effective for treating developmental dysplasia of the hip (DDH) in children. However, plate insertion or removal has a risk of post...
INTRODUCTION: Proximal femoral osteotomy (PFO) with locking compression plates (LCPs) is effective for treating developmental dysplasia of the hip (DDH) in children. However, plate insertion or removal has a risk of postoperative femoral fractures. The goal of this study was to identify and analyse the association between postoperative femoral fractures after PFO and potential risk factors for these fractures. METHODS: Six patients with DDH and postoperative femoral fractures were retrospectively reviewed at our hospital from June 2014 to October 2020. There were 2 boys and 4 girls whose ages ranged from 2 to 8 years (mean 3 years and 8 months). The timing, circumstances, fracture location, and refixation method were recorded for all patients. Four patients sustained fractures after plate removal: 3 after a fall and 1 spontaneously. Moreover, 2 patients experienced fractures early postoperatively after open reduction and PFO. The mean follow-up time was 31.6 months (25-57 months). RESULTS: After 153 patients underwent open reduction and PFO at our institution, six (3.9%) experienced postoperative femoral fractures. In children who underwent implant removal, all fractures (n = 4/4) occurred at the osteotomy site, whereas in those with retained implants (n = 1/2), fractures occurred at the screw hole. Three fractures were treated with reduction under general anaesthesia and spica casting, and three were treated with ESIN. CONCLUSIONS: Injuries from PFO, prolonged immobilization, or LCPs can result in postoperative femoral fractures in children with DDH. After PFO, the implants should be removed when solid union is achieved at the osteotomy site. Moreover, high-intensity activity should not be permitted until moderate or extensive remodelling at the osteotomy site is confirmed after plate removal.
Association between the systemic immune-inflammation index within 1 h after birth and the risk of neonatal respiratory distress syndrome in preterm infants.
Li J, Fang L, Tan C
BMC Pediatr · 2026 Jun · PMID 42231215 · Full text
BACKGROUND: Neonatal respiratory distress syndrome (NRDS) is a common and potentially life-threatening complication in preterm infants. Current diagnosis relies largely on imaging modalities such as chest X-ray and lung...
BACKGROUND: Neonatal respiratory distress syndrome (NRDS) is a common and potentially life-threatening complication in preterm infants. Current diagnosis relies largely on imaging modalities such as chest X-ray and lung ultrasound, which may not be immediately available after birth. Therefore, accessible biomarkers for early risk stratification are clinically needed. This study investigated the association between the systemic immune-inflammation index (SII), derived from routine complete blood count within 1 h after birth, and the risk of NRDS in preterm infants. METHODS: This retrospective study reviewed clinical data from 451 preterm infants admitted to a tertiary maternal and child health-care hospital in eastern China between January and December 2024. Infants were classified into NRDS and non-NRDS groups. Variables associated with NRDS were screened using univariate analysis and entered into multivariate logistic regression to identify independent predictors, with particular emphasis on SII as a predictive biomarker rather than a direct risk factor. Predictive models incorporating SII with established clinical predictors-gestational age (GA) and birth weight (BW)-were constructed, and their performance was evaluated using receiver operating characteristic (ROC) curve analysis. Gestational age-stratified analyses were further performed (28-32, 32-34, and 34-36 weeks). In infants born at 28-32 weeks, the modifying effect of infection-related factors was explored using premature rupture of membranes (PROM > 18 h). RESULTS: A total of 403 preterm infants met the inclusion criteria. Multivariate analysis identified GA, peripheral blood glucose, mild asphyxia, HDP, and SII as independent predictors of NRDS (P < 0.05). The combined model including GA, BW, and SII demonstrated the best predictive performance (AUC = 0.809). Gestational age-stratified analysis showed that SII had the highest predictive value in infants born at 28-32 weeks (AUC = 0.771), with declining performance at higher gestational ages. In this subgroup, SII levels and the incidence of premature rupture of membranes (PROM) differed significantly between NRDS and non-NRDS infants, indicating gestational age-specific effects. CONCLUSION: SII is independently associated with NRDS in preterm infants and serves as a valuable predictive biomarker, with its predictive value predominantly observed in those born at 28-32 weeks of gestation. Incorporating SII with gestational age and birth weight improves early risk stratification for NRDS.
Neonate screening for glucose-6-phosphate dehydrogenase deficiency in South Kivu, eastern Democratic Republic of Congo.
Francisca IN, Ghislain BB, Gaylord AN … +4 more , Francois B, Vincent B, Oreste B, Richard MK
BMC Pediatr · 2026 Jun · PMID 42231214 · Full text
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzymatic disorder and an important risk factor for severe neonatal hyperbilirubinemia. In the Democratic Republic of the Congo (DRC),...
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzymatic disorder and an important risk factor for severe neonatal hyperbilirubinemia. In the Democratic Republic of the Congo (DRC), neonatal data on G6PD deficiency remain limited. This study aimed to screen for G6PD deficiency among neonates in South Kivu, eastern DRC. METHODS: A cross-sectional hospital-based study was conducted from April to August 2022 in three maternity wards in South Kivu. Live-born neonates whose parents provided informed consent were screened within one hour of birth. G6PD activity was measured on dried blood spots using the fluorescent spot test. G6PD deficiency was defined as enzyme activity < 30% of normal activity. Prevalence estimates with 95% confidence intervals (CI) were calculated, and associations were assessed using bivariate analysis. RESULTS: Among 1,188 neonates screened, four had doubtful results. Among the 1,184 neonates with valid results, 73 were G6PD deficient, corresponding to an overall prevalence of 6.2% (95% CI: 4.9-7.7). Prevalence ranged from 2.9% to 7.7% across study sites, with no significant difference between maternity wards (p = 0.11). G6PD deficiency was more frequent among males than females (10.1% vs. 1.5%), and male sex was significantly associated with deficiency (odds ratio 7.49; 95% CI: 3.56-15.77). CONCLUSION: Neonatal G6PD deficiency is relatively common in South Kivu and exceeds thresholds commonly proposed for targeted neonatal screening. These findings support consideration of neonatal G6PD screening strategies in the DRC.
Quality and consistency of genetic newborn screening reports in China: insights from a multi-laboratory analysis using simulated samples.
Wu J, Feng P, Zhang J … +5 more , Zhou H, Tian W, Chen X, Hao C, He F
BMC Pediatr · 2026 Jun · PMID 42231211 · Full text
BACKGROUND: China currently lacks unified reporting standards for genetic newborn screening (gNBS), resulting in substantial variation in report content, structure, and variant interpretation across laboratories. This st...
BACKGROUND: China currently lacks unified reporting standards for genetic newborn screening (gNBS), resulting in substantial variation in report content, structure, and variant interpretation across laboratories. This study aims to evaluate the quality of gNBS reports nationwide and provide practical evidence to support the development of standardized reporting guidelines. METHODS: Through an external quality assessment (EQA) program organized by the National Center for Clinical Laboratories (NCCL), we collected reports generated by 34 laboratories for three bioinformatically simulated samples. A structured questionnaire, panel comparison, and content evaluation were employed to systematically assess differences in gene panel composition, consistency in variant detection and classification, approaches to distinguishing primary and secondary findings, completeness of key report elements, and the scope of genetic counseling recommendations. RESULTS: The number of genes included in screening panels varied substantially across laboratories, with only about one-third demonstrating high inter-laboratory similarity. Most laboratories achieved good consistency in detecting primary variants and classifying their pathogenicity, whereas considerable discrepancies were observed in the reporting of secondary findings, evidence grading, and specific descriptive details. Some reports lacked essential information, including testing purpose, laboratory signature, and submitting institution. Although most laboratories provided genetic counseling recommendations, these suggestions were generally not comprehensive. CONCLUSION: The gNBS reports in China exhibit a certain degree of consistency in presenting core information, yet further standardization is needed to improve report structure and completeness. This study provides practical support for developing unified reporting standards and highlights areas where observed variability may guide mutual learning and quality improvement across laboratories.
Clinical characteristics and in-hospital mortality outcomes of admitted neonates at the MSF-supported Al-Salam MOH Hospital, Amran Governorate, Yemen: A retrospective descriptive analysis.
Abdulmoghni R, Hafeez U, Ngamba-Mulebo A … +7 more , Sultan Y, Mohammed Z, Zelikova E, Hozjan-Gaudin M, Ledger E, Poulet E, Malaeb R
BMC Pediatr · 2026 Jun · PMID 42231205 · Full text
BACKGROUND: Globally, about 2.3 million neonates die annually, most of them in low-resource and conflict-affected countries. In Yemen, ongoing humanitarian crises put children at continued risk, with neonates being the m...
BACKGROUND: Globally, about 2.3 million neonates die annually, most of them in low-resource and conflict-affected countries. In Yemen, ongoing humanitarian crises put children at continued risk, with neonates being the most vulnerable group. This study aimed to assess the in-hospital neonatal mortality rate and to describe the demographic and clinical characteristics. METHODS: A retrospective cohort design reviewing all neonatal admissions to the Neonatal Inpatient Department (NIPD) at Al-Salam Hospital in Amran Governorate, January to December 2023. Data were extracted from hospital records entered REDCap and analyzed using R 4.3.1. Both descriptive and inferential statistics were applied: chi-square, t-tests for bivariate analysis, and logistic regression was used to identify predictors of neonatal mortality. Statistical significance at p < 0.05. RESULTS: A total of 882 neonates were included; 51% were inborn and 49% outborn. Median age was 1 day (IQR 0-6) and a median admission weight of 2,500 g (IQR 1,860-2,975), male neonates accounted for 57%. The commonest diagnoses were clinically suspected sepsis (72%), low birth weight (48%), prematurity (32%), perinatal asphyxia (20%), and meningitis (5%). Among neonates receiving oxygen (72%), HHFNC use was more common among mortalities (15% vs. 8%), no significant difference was observed for nasal cannula use (95% vs. 94%). Antibiotics were administered to 96% of neonates; among deaths, cefotaxime was most frequently used and for a shorter duration (37% vs. 17%; 1 vs. 5 days). Antibiotic regimen modification was more frequent among neonates with in-hospital mortalities (40% vs. 23%), particularly when escalating to vancomycin (27% vs. 7.2%) and meropenem (31% vs. 10%). Maternal risk factors, including PROM in 35% (45% lasting ≥18h), history of abortions, lower gestational age, and low hemoglobin, were associated with increased risk of in-hospital mortality. The overall mortality rate was 17.4%. In multivariable analysis, very low birth weight (VLBW; <1500 g), perinatal asphyxia, and meningitis were independent mortality predictors, whereas admission after 7 days of life and higher maternal hemoglobin were associated with improved survival. CONCLUSIONS: Neonatal mortality at Al-Salam Hospital remained high, and was associated with VLBW, prematurity, and perinatal asphyxia, highlighting the need to strengthen maternal care, neonatal resuscitation, Kangaroo Mother Care, and antibiotic stewardship in fragile humanitarian settings.
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