Day 2 :
- Pediatric Nursing | Pediatric Adolescent medicine
Location: Mai
Session Introduction
Mamta Jajoo
Chacha Nehru Bal Chikitsalaya, India
Title: To study the association of vitamin D level in late onset neonatal sepsis in level III out born NICU of India
Biography:
Mamta Jajoo is currently working as Associate Professor of Pediatrics and In-charge of level III NICU at Chahcha Nehru Bal Chikitsalaya, Delhi (Associated hospital of Maulana Azad Medical College, Delhi). She has more than 20 publications in the fi eld of neonatology and also Principal Investigator for many national and International multi-centric trials.
Abstract:
Introduction & Aim: Systemic infection is one of the leading causes of mortality and morbidity in the neonates and is responsible for about 30-50% of the total neonatal deaths in developing countries. Vitamin D is a steroid hormone and has important eff ect on immune functions as it enhances innate immunity and also regulates the acquired immune response: (1) To assess vitamin D level in neonates with late onset sepsis and compare it with the vitamin D levels of healthy controls and also see the correlation of Vitamin D levels with sepsis and (2) to study the correlation of maternal and infant vitamin D level.
Methods: Th is observation study was conducted from September 2015 to February 2016 in a neonatal intensive care unit (NICU) of a tertiary care hospital. Out born term and late preterm neonates of >7 days and less than 28 days, with signs and symptoms of severe sepsis with positive sepsis screen were enrolled as cases and neonates with the same gestational age and/or weight without sepsis were enrolled as controls. Neonates in whom there was history of previous hospitalization for more than 48 hours and whose calcium profi le was abnormal were excluded. At the time of admission sepsis screen, blood culture, urine C/S, CSF culture and chest X-ray was done. Levels of 25-OHD were assessed by chemiluminescent immunoassays method, by using Beckman Access 2 Immunoassay System (Germany). All neonates were further evaluated as pneumonia, meningitis, UTI or blood culture +ve sepsis and followed till discharge or death. Odds ratios were used to measure the association between vitamin D defi ciencies in neonatal sepsis in comparison to healthy controls.
Results: Total 421 neonates admitted to NICU from September 2015 to February 2016, out of which 120 fulfi lled the inclusion criteria. Only 60 consecutive neonates were included in the study as cases and 60 neonates with same gestational age and or weight with septic screen negative were enrolled as controls. Out of 120 infants, 77 (64%) were male and 42 (36%) were female. Th e mean age of presentation for study and control group was 15.53±6.429 days and 13.48 ±6.738 days, respectively. Mean weight and gestation age in both case and control group were comparable. Mean duration of hospital stay for study group was 10.68±8.11 days and for controls it was 3.30±0.77 days. Mean gestation age at admission for case and control was 37.78±1.66 and 37.68±1.82 weeks, respectively. Th e mean serum 25(OH)D concentrations in neonates with LOS (study group) was lower (15.37±10) than those of the healthy neonates (21.37±9.53) (p<0.05) with an Odd’s Ratio of 1.7. Maternal vitamin D level was also statistically signifi cant in both study and control group.
Conclusion: Vitamin D levels <30 ng/ml has high association with late onset sepsis. Treatment should be aimed for early detection of vitamin D defi ciency and timely supplementation in neonates with sepsis.
Henok Tadele
Hawassa University, Ethiopia
Title: Determinants of exclusive breastfeeding in infants less than six months of age in Hawassa, an urban setting, Ethiopia
Biography:
Henok Tadele has completed his Speciality training in Pefi atrics and child health in 2012 at the age of 27 years from Addis Ababa University. He is an Assitant Professor of Pediatrics at Hawassa University. He has published 8 papers in reputed journals and has been serving as reviewer of reputable journals.
Abstract:
Background: Th e World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the fi rst six months of life. However, the proportion of EBF in Ethiopia is 58%. Th e EBF practice and factors aff ecting it have not been studied in Hawassa, Southern Ethiopia. Th e aim of this study was to assess the prevalence and determinants of EBF practice among infants less than six months age in Hawassa city, Ethiopia.
Methods: A total of 529 mothers with infants aged 0–6 months were involved in this study between November 2015 and January 2016. Trained interviewers collected data from the mothers of the infants. Exclusive breastfeeding was assessed based on infant feeding practice in the prior 24 h. Multivariable logistic regression analysis was conducted.
Results: Infants aged 0–5.9 months were studied with comparable gender composition (51.4% females). Th e exclusive breastfeeding prevalence was 60.9% (95% CI 56.6, 65.1). Mothers with infants aged 0–1.9 months and 2–3.9 months practiced EBF more likely than mothers with infants aged 4–6 months (Adjusted odds ratio [AOR] 3.59; 95% CI 2.07, 6.2) and (AOR 2.08; 95% CI 1.23, 3.5), respectively. Married mothers practiced EBF more likely than singles (AOR 2.04; 95% CI 1.03, 4.06). Housewives practiced EBF more likely than employed mothers (AOR 2.57; 95% CI 1.34, 4.9). Mothers who had a vaginal birth were more likely to practice EBF than mothers who gave birth via Cesarean section (AOR 2.8; 95% CI 1.7, 4.6). Mothers who gave birth at a healthcare facility were more likely to practice EBF than mothers who gave birth at home (AOR 8.8; 95% CI 5.04, 15.4). Mothers without a breast complication practiced exclusive breastfeeding more than mothers with breast complications (AOR 2.05; 95% CI 1.5, 4.1).
Conclusions: Th is study showed a low prevalence of exclusive breastfeeding. Younger infants, babies born to married women, who are housewives, having a vaginal birth in a health facility, and whose mother’s breasts were healthy, were predictors for EBF. Th e promotion of an institutional delivery, optimal breastfeeding practices, and designing strategies to better support employed mothers are recommended.
Keywords: Less than six months of age, Determinants, Ethiopia, Exclusive breastfeeding
Cherry Ann Garcia
University of the Philippines, Philippines
Title: Maternal Perspectives on Probiotics, Intake of Probiotic Food and Occurrence of Atopic Dermatitis among Children in Selected Urban Communities in Laguna, Philippines
Biography:
Cherry Ann Garcia is a nurse and an educator. She is passionate in conducting free public health teachings in rural communities in their province. Her expertise is on medical-surgical nursing and psychotherapy and counseling. She is a pastor’s wife.
Abstract:
Introduction: Atopic dermatitis (AD), also known as eczema, is the most common chronic relapsing skin disease in children, aff ecting approximately 10% to 30% of children worldwide. For this reason, the research community investigated possible innovative prevention and treatment strategies for AD. One of these strategies was the manipulation of the intestinal fl ora through probiotics.
Method: Th is study is a cross-sectional, analytic study on 680 mothers and 680 children recruited in selected urban communities in Laguna, Philippines.
Results: Most mothers (92%, n=625) had highly positive attitude to probiotics. Composite scores were computed and statistical data revealed that attitude is signifi cantly correlated with behavioral control (r=0.2087, p-value <0.001) and intention (r=0.2934, p-value <0.001). Furthermore, it was found out that both intention (r=0.3703, p-value <0.001) and perceived control (r=0.2355, p-value <0.001) were signifi cantly correlated to total amount of intake of probiotic food. Female children (42.43%) have higher intake than males (30.61%). High intake was also noted among children of mothers with educational attainment of Vocational (45.45%) and College and higher (41.09%); among low- (38.92%) and middle-income families (44.06%); and among those without family history of AD (38.55%). As for the frequency of consumption of probiotic food, 3 out of 10 of the respondents reported daily intake of at least one bottle of the probiotic foods enumerated. Among 680 respondents, 18.09% (n=123) were diagnosed as having atopic dermatitis, while 81.91% (n=557) were without AD. Th is study showed that the odds of having atopic dermatitis was 2.4 times higher among those with low intake status and 4.3 times higher among those with no intake compared to children with high intake status.
Conclusion: Intake of probiotics are positively correlated with maternal education, income, highly positive attitude, high perceived control, and intention of mothers. Consumption of probiotics is a protective factor against atopic dermatitis.
Emmanuel A
Griffi th University, Australia
Title: The impact of training on newborn care and neonatal survival in sub Saharan Africa
Biography:
Andy Emmanuel is a PhD candidate at Griffi th University and had his masters degree from University of Cape Town South Africa. He is a lecturer in the Department of nursing, University of Jos , Nigeria. He has published more than 10 articles in peer review journals.
Abstract:
Background: Sub-Saharan Africa has the highest child mortality in the world (WHO, 2016). For instance, in 2014, UNICEF expressed concern that 1 in 11 children dies before the age of fi ve in sub-Saharan Africa and that one in every three neonates died on the day they were born (UNICEF, 2014). Th e aim of this review was to determine the impact of training on essential newborn care and neonatal survival in sub-Saharan Africa
Method: A systematic review of the literature was performed by searching databases including PubMed, Web of science, Scopus, CINALH, Cochrane library and Trip. Furthermore, the World Health Organization’s reproductive health library and reference checking for related articles was done. Th e Search was limited to English language and articles published from 2007 to 2017
Results: Nine articles were included aft er assessment. Findings revealed that training programs were generally diff erent in terms of duration and implementation. Th ere was between 8 to 400% increase in performance following test of knowledge. Th ere was an increase in performance by 19 to 34%. Th e frequency of inappropriate and potentially harmful practices reduced as a result of training. Neonatal mortality reduced by 15-45% while perinatal mortality reduced by 30%
Conclusions: Training health care workers on essential newborn care can improve newborn care and neonatal survival in Africa. However, there is need for additional evidence to support this because no study assessed the impact of training according to trainees’ satisfaction with training, knowledge and skills developed and health outcome at the same time.