Weitere Untersuchungsergebnisse zur Frage der unterschiedlichen Verteilung der ABO-Blutgruppen bei erstgeborenen und nachgeborenen Kindern

Summary The ABO blood group distribution among 1284 first-born children is compared with the frequency of the blood groups among 2388 later-born children. Among the later-born children the blood group O is more frequent, whereas the blood groups B and AB are rarer. From the fifth child on both the increase of the blood group O and the decrease of the groups B and AB become more evident. The total frequency of boys is practically the same both in the different blood groups and in the sum of all first and later-born children. Within the blood group O, however, boys are predominating among the first-born children, but are less numerous among the later-born children. Within the blood group AB on the contrary there is a lack of boys among the first-born children and an excess of boys among the later-born children. The same distribution but to a smaller extent might be found within the blood group B among a not selected material. In the same way the change of the sexual distribution seems to rise with the increasing number of children, as it appears from the rate from the fifth child onward.

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(Ärztl. Leiter: Prim. Dr. W. Kircher)     

Study on genetic diversity of genes encoding main adhesins among nontypeable Haemophilus influenzae strains isolated from children in Poland

The study was based on hypothesis that in the nontypeable population of H. influenzae strains isolated from children there are some genetically predisposed to induce symptomatic infection in children and that they might be divided into different groups depending on profiles of genes encoding main adhesins synthesis. The work aimed at analysis of distribution of genes encoding adhesins and evaluation of domination possibility of some strains representing particular adhesins genes profiles among NTHi population. Results of the study revealed that among population of NTHi strains, distribution of genes encoding main adhesins are differing. Among children, NTHi strains harbouring genes encoding HA and HMW1/HMW2 adhesins were more prevalent in healthy children and in children with symptomatic infections, respectively. Analysis of strains harbouring main adhesins profiles might be a useful screening method in monitoring strains circulating among children, in order to determine the most invasive NTHi strains.     

To be an immigrant: a risk factor for developing overweight and obesity during childhood and adolescence?

Childhood overweight and obesity, especially among migrant children, are current health problems in several European countries. In the present study the prevalence of overweight and obesity among migrant children from Turkey and the former Yugoslavia was documented and compared with that of Austrian children in Vienna. Anthropometric data from 1,786 children were collected at the ages of 6, 10 and 15 years. Body mass was estimated by means of the body mass index and percentile curves were used to determine weight status. The prevalence of overweight and obesity was found to be significantly higher among migrant children. Children and adolescents from the former Yugoslavia and Turkish girls exhibited especially high rates of overweight and obesity. Biosocial and cultural factors are discussed as causes of these observations.     

Estimates of Dengue Force of Infection in Children in Colombo,Sri Lanka

Dengue is the most important vector-borne viral disease worldwide and a major cause of childhood fever burden in Sri Lanka, which has experienced a number of large epidemics in the past decade. Despite this, data on the burden and transmission of dengue virus in the Indian Subcontinent are lacking. As part of a longitudinal fever surveillance study, we conducted a dengue seroprevalence survey among children aged <12 years in Colombo, Sri Lanka. We used a catalytic model to estimate the risk of primary infection among seronegative children. Over 50% of children had IgG antibodies to dengue virus and seroprevalence increased with age. The risk of primary infection was 14.1% per year (95% CI: 12.7%–15.6%), indicating that among initially seronegative children, approximately 1 in 7 experience their first infection within 12 months. There was weak evidence to suggest that the force of primary infection could be lower for children aged 6 years and above. We estimate that there are approximately 30 primary dengue infections among children <12 years in the community for every case notified to national surveillance, although this ratio is closer to 100∶1 among infants. Dengue represents a considerable infection burden among children in urban Sri Lanka, with levels of transmission comparable to those in the more established epidemics of Southeast Asia.     

Are there differences in body dimensions among children from matings at different exogamic levels?

The aim of this study was to investigate if there are differences in body dimensions among children from matings of different levels of exogamy. The cross-sectional sample consisted of 285 children, 136 males and 149 females, 6 to 10 years old, attending elementary schools in Tortoli, a town in east-central Sardinia. The children were divided into four groups according to the level of exogamy. One of them included the children of parents born in the same Sardinian village is highly endogamous. For each sex, the Kruskal-Wallis test revealed no significant differences among the four groups of children for the 35 anthropometric variables considered, with the exception of head circumference in the male sample. In particular, there were no significant differences among the four groups of children for some anthropometric variables that are considered to be indirect indicators of nutritional status: sum of skinfolds, waist/hip ratio, body mass index, total upper arm area, upper arm muscle area, upper arm fat area. We conclude that Sardinian children from marriages of different levels of exogamy do not differ in body dimensions if they have similar nutritional conditions.     

Epidemiology of childhood leukemia in the presence and absence of Down syndrome

Down syndrome (DS) is a common congenital anomaly, and children with DS have a substantially higher risk of leukemia. Although understanding of genetic and epigenetic changes of childhood leukemia has improved, the causes of childhood leukemia and the potential role of environmental exposures in leukemogenesis remain largely unknown. Although many epidemiologic studies have examined a variety of environmental exposures, ionizing radiation remains the only generally accepted environmental risk factor for childhood leukemia. Among suspected risk factors, infections, exposure to pesticides, and extremely low frequency magnetic fields are notable. While there are well-defined differences between leukemia in children with and without DS, studies of risk factors for leukemia among DS children are generally consistent with trends seen among non-DS (NDS) children.We provide background on DS epidemiology and review the similarities and differences in biological and epidemiologic features of leukemia in children with and without DS. We propose that both acute lymphoblastic and acute myeloblastic leukemia among DS children can serve as an informative model for development of childhood leukemia. Further, the high rates of leukemia among DS children make it possible to study this disease using a cohort approach, a powerful method that is unfeasible in the general population due to the rarity of childhood leukemia.     

Pediatric trauma: differences in pathophysiology,injury patterns and treatment compared with adult trauma.

Although multiple trauma remains the leading cause of death among children, fewer resources and less attention have been directed to treatment of the injured child than to treatment of the injured adult. Insufficient training of medical personnel and hence lack of expertise in the management of injured children are factors contributing to disability and death in such children. Although the principles of resuscitation of injured children are similar to those for adults, appreciation of the differences in cardiorespiratory variables, airway anatomy, response to blood loss, thermoregulation and equipment required is essential for successful initial resuscitation. Cerebral, abdominal and thoracic injuries account for most of the disability and death among injured children. Cerebral damage may be due to secondary injuries to the brain and is potentially preventable. The need to preserve the spleen in children complicates the management of abdominal trauma. Although children usually have large cardiorespiratory reserves, they are likely to need airway control and ventilation with thoracic injuries. The psychologic effect of trauma may pose long-term problems and needs close follow-up.     

Prevalence of down syndrome among children and adolescents in metropolitan Atlanta

BACKGROUND: Down syndrome (DS) prevalence estimates beyond infancy are needed to assess health service needs among those with DS. METHODS: Children with DS born in metropolitan Atlanta from 1979 through 2003 were ascertained from a population-based birth defects registry. Vital status through 2003 was obtained using case records, vital records, and the National Death Index. Prevalence was calculated by dividing the children surviving with DS by the population derived from U.S. Census estimates. Variations in DS prevalence by race, heart defects, age, birth cohort, and time period were examined using Poisson regression. RESULTS: In metropolitan Atlanta in 2003, there were 67 livebirths with DS (13.0 per 10,000 livebirths) and 738 0- to 19-year-olds surviving with DS (8.3 per 10,000 population). Over time, births to mothers 35 years and older and DS birth prevalence increased. Birth prevalence was higher among Whites, did not vary by sex, and was higher for infants without heart defects. DS prevalence among 0- to 14-year-olds increased over time (p < .05). Within each 5 year birth cohort, prevalence decreased with age: this decrease was greater among Blacks than among Whites and among children with heart defects than among children without heart defects. CONCLUSIONS: DS prevalence increased among livebirths and among young children. Further studies are warranted to determine whether health services are meeting the needs of an increasing number of children with DS.     

Parental perceptions of costs and benefits of children as correlates of fertility in Kuwait

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4.2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti women's desired and achieved fertility is analysed. Data from a nationally representative survey of Kuwaiti households held in 1999 are used. Bivariate analyses show that the mean desired number of children is significantly higher among those who rank higher on the perceived value of children, and lower among those who are concerned about the cost of raising children. Achieved fertility (children ever born) shows a similar pattern. In the multivariate analysis, however, large family values emerge as the only significant predictor of (higher) desired as well as achieved fertility, net of the respondent's demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother's perceptions of the benefits and costs of children are analysed and it is concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour.     

Negligible Egg Positive Rate of Enterobius vermicularis and No Detection of Head Lice among Orphanage Children in Busan and Ulsan,Korea (2014)

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.     

High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico

Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05) than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8%) and genotype A (4%). In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.     

Childhood Overweight Prevalence in the United States: The Impact of Parent‐reported Height and Weight

Parent‐reported height and weight are often used to estimate BMI and overweight status among children. The quality of parent‐reported data has not been compared to measured data on a national scale for all race/ethnic groups in the United States. Parent‐reported height and weight for 2–17‐year‐old children in two national health interview surveys—the 1999–2004 National Health Interview Survey (NHIS) and the 2003–2004 National Survey of Children's Health (NSCH)—were compared to measured values from a national examination survey—the 1999–2004 National Health and Nutrition Examination Survey (NHANES). Compared to measured data, parent‐reported data overestimated childhood overweight in both interview surveys. For example, overweight prevalence among 2–17‐year‐olds was 25% (s.e. 0.2) using parent‐reported NHIS data vs. 16% (s.e. 0.6) using measured NHANES data. Parent‐reported data overestimated overweight among younger children, but underestimated overweight among older children. The discrepancy between reported and measured estimates arose mainly from reported height among very young children. For children aged 2–11 years, the mean reported height from NHIS was 3–6 cm less than mean measured height from NHANES (P < 0.001) vs. no difference among children aged 16–17 years. Measured data remains the gold standard for surveillance of childhood overweight. Although this analysis compared mean values from survey populations rather than parent‐reported and measured data for individuals, the results from nationally representative data reinforce previous recommendations based on small samples that parent‐reported data should not be used to estimate overweight prevalence among preschool and elementary school–aged children.     

Trends of overweight and obesity among white and american indian school children in south dakota, 1998–2010

Objective:

To investigate the prevalence of overweight and obesity among white and American Indian children in a predominantly rural state.

Design and Methods:

Using a repeated, cross‐sectional design of school children's height and weight, the study sample included 361,352 measures of children who were 5.0–19.9 years, attending school across 13 academic calendar years. Trained staff measured height, weight, and recorded gender, age, and race. Data were voluntarily reported to the State Department of Health.

Results:

American Indian children consistently had higher rates of overweight and obesity compared to white children. Across the years, 16.3% of white students were overweight, whereas 19.3% of American Indian students were overweight. In addition, 14.5% of white children were obese and 25.9% of American Indian children were obese. Examining by rural versus urban schools, prevalence of overweight had been increasing among white male and female students and American Indian female students living in rural areas. Obesity is also increasing among rural white females and male and female American Indian children.

Conclusions:

The findings here suggest that although American Indian children are at higher risk, in general, compared to white children, rural populations in general are experiencing increases in childhood overweight and obesity. Targeted rural interventions beginning at an early age are necessary to improve the health of rural children, especially in American Indian communities.     

The epidemiological aspects of campylobacteriosis in children in arid area]

Specific epidemiological features of Campylobacter infection in children in Samarkand Province during the period of 1987-1990 are discussed. The specific proportion of this infection in the total structure of acute enteric infections was, on the average, 8.5%, and Campylobacter carriership among healthy children, 7.0%. Among children with Campylobacter infection, children aged up to 1 year constituted 71.5%. The results of the study of the biological properties of Campylobacter strains isolated from sick and healthy children and their difference from strains isolated in other regions are discussed.     

Fatty Liver Through the Ages: Nonalcoholic Steatohepatitis

ObjectiveThe global epidemic of obesity and type 2 diabetes mellitus is the main driver of the growing global prevalence of nonalcoholic fatty liver disease (NAFLD). We aimed to review the current literature on NAFLD and nonalcoholic steatohepatitis (NASH) as it impacts children and adults.MethodsWe performed a literature search on fatty liver specifically NAFLD and NASH among children and adults.ResultsThe prevalence of NAFLD in children ranges from 8% to 12%, while the prevalence in adults ranges 25% to 48%. The prevalence of NASH among children with NAFLD is 23%, while it ranges from 13% to 65% in adults. There are similar risk factors for NAFLD among children and adults. However, in children, the diagnostic tests in the studies of NAFLD are limited to the elevation of the alanine aminotransferase level or a liver biopsy. In adults, additional diagnostic modalities, including noninvasive tests, have been used. From the spectrum of NAFLD, patients with NASH are predominantly at risk of progressive liver disease to cirrhosis and liver-related mortality. NAFLD is associated with impairment of health-related quality of life and substantial economic burden.ConclusionThe comprehensive burden (clinical, health-related quality of life, and economic) of NAFLD is high and increasing.     

Prevalence of pediculosis and scabies in preschool nursery children of Afyon, Turkey

Scabies and pediculosis are ubiquitous, contagious, and debilitating parasitic dermatoses. The tendency of high prevalence of pediculosis and scabies among school and preschool age children has prompted us to conduct a head louse and scabies prevalence survey among preschool nursery children in our district. A school-based, crosssectional study was performed, with 1,134 children chosen for evaluation. All cases were evaluated by physical examination and a detailed, structured questionnaire. The infestation was found in 14 (1.2%) of 1,134 children; 9 (0.8%) with pediculosis capitis and 5 (0.4%) with scabies. We found that infestations were more frequent in children with mothers whose education levels were low. This indicates the necessity of an improvement in the economic and sociocultural status of the community and the promotion of hygiene concepts and practices in order to improve health of preschool age children.     

肺炎支原体肺炎患儿口咽部菌群的改变

目的比较健康儿童与肺炎支原体肺炎患儿口咽部菌群的差异,分析肺炎支原体感染对儿童口咽部菌群变化的可能影响。方法采用高通量测序技术,对30例肺炎支原体肺炎患儿及30例健康儿童16SrDNA进行测序分析,比较两组间的菌群多样性及在门、属水平上菌群结构差异。结果健康儿童与肺炎支原体肺炎患儿在性别、年龄、抗生素使用等方面差异无统计学意义。肺炎支原体肺炎患儿口咽部菌群多样性比健康儿童明显降低。在门水平上,Proteobacteria(变形菌门)、Bacteroidetes(拟杆菌门)和Fusobacteria(梭杆菌门)在健康儿童中相对丰度显著高于肺炎支原体肺炎患儿组,而Firmicutes(厚壁菌门)、Tenericutes(柔膜菌门)和Actinobacteria(放线菌门)在肺炎支原体肺炎患儿组中相对丰度均显著高于健康儿童组;在属水平上,两组排在相对丰度前10位的属差异具有统计学意义,共有6个属在肺炎支原体肺炎患儿中显著增加,分别为Staphylococcus(葡萄球菌)、Actinomyces(放线菌属)、Acinetobacter(不动细菌属)、Atopobium(阿托波菌属)、Corynebacterium(棒状杆菌)和Abiotrophia(营养缺陷菌属)。结论肺炎支原体肺炎患儿口咽部菌群存在明显的改变,其口咽部菌群多样性比健康儿童明显降低,在门、属水平肺炎支原体肺炎患儿与健康儿童差异均有统计学意义。     

Varicella morbidity in Czechoslovakia

Data are presented on varicella and herpes zoster morbidity notified in Czechoslovakia in the years 1970 to 1978. The notified varicella incidence is compared with serologically confirmed varicella incidence among the selected groups of children up to the age of 12 from the North-Moravia region. Comparative analysis revealed a considerable difference between the notified and serologically detected cases of varicella. The highest rate of notified varicella was recorded in children of 3 and 4 years of age, while the highest incidence of seropositive cases was detected among the 2-year-old children. The cumulative notified morbidity involved about 35% of 6-year-old and 45% of 12-year-old children, whereas specific antibodies against the varicella-zoster virus were found in about 60% of 6-year-old and 90% of 12-year-old children. The titres of virus-specific antibodies were determined by the method of indirect hemagglutination reaction. No serological methods are applicable for herpes zoster morbidity studies in the population.     

Differences in physical activity between non-overweight, overweight and obese children

The purpose of the study was to find out differences in moderate to vigorous physical activity among non-overweight, overweight and obese children, and between boys and girls. The sample included 364 children (179 boys and 185 girls), aged 6.4 years (+/- 0.3 SD). Physical activity was assessed by 7-day questionnaire. Age adapted BMI was used as overweight and obesity indicator. The children were divided into non-overweight, overweight and obese groups. It was found out, that there are significant differences in non-overweight, overweight and obese children (p < 0.05). Boys were significantly (p < 0.05) less moderate to vigorous physical active than girls, especially in indoor activities. There were also significant differences (p < 0.05) in moderate to vigorous physical activity among non-overweight and obese boys and among overweight and obese boys in weekends and total weekly activity. In girls there are significant differences (p < 0.05) in non-overweight, overweight and groups in weekends and total weekly activity. It is possible to conclude, that obese boys and overweight and obese girls, are prone to less physical activity.     

Determinants of contraceptive use in Nepal

This 1981 study is the 1st of its kind in Nepal. Analysis using a logit-linear model showed that contraceptive use in Nepal depends on many factors. Women aged 35-49 are 3 times more likely than women aged 15-24 to use contraceptives. Women with 4 or more children are 8 times more likely to use contraceptives than women with 1 or no children, and 2.5 times more likely than women with 2 or 3 children. The use of contraceptives is greatest among women whose offspring includes more sons than daughters, and least among women whose offspring are all daughters. Women who desire no more children are 5 to 6 times more likely to use contraceptives than women who desire more children. Women who have discussed desired family size with their husbands are more than 4 times more likely to use contraceptives than women lacking this type of communication. Women with some schooling are twice as likely to use contraceptives as women with no schooling. Contraceptive use is higher among women who do nonfarm work than farm work, and higher still among women who do not work. Urban women were almost twice as likely to use contraceptives as rural women. Women with less than 1 hour access to a family planning service outlet were 2 to 3 times more likely to use contraceptives than women whose access to these facilities was greater than 1 hour. The number of previous child losses per woman had no significant effect in contraceptive use. Conclusions are based on analysis of data from the Nepal Contraceptive Prevalence Survey, 1981.