Search Results (380)

Background/Objectives: A food allergy (FA) is an immune-mediated hypersensitivity reaction to specific food. FA reactions vary from mild to life-threatening anaphylaxis. Despite the effectiveness of epinephrine auto-injectors (EAIs), barriers such as lack of knowledge, limited access, and fear of needles hinder their use. This study explores EAI possession among children with parent-reported food allergies in Saudi Arabia. Methods: A cross-sectional study conducted from October 2023 to February 2024 included 296 parents of children with reported food allergies under the age of 18. Data were collected through a validated self-administered questionnaire. Results: Among 2102 respondents, 296 (14.1%) reported having a child with a food allergy. Most respondents were female (70%), with asthma being the most common comorbidity (26%). Common allergens included eggs, tree nuts, peanuts, milk, and sesame. Only 23.3% of children had an EAI. Higher EAI possession was associated with parental education, maternal allergy history, and access to specialist care. Conclusions: EAI possession among Saudi children with food allergies is suboptimal. Targeted educational interventions, increased access to allergists, and comprehensive management plans are essential to improve preparedness for anaphylaxis. Full article

(1) Background: Human Papillomavirus (HPV)-associated oropharyngeal cancer is the fastest-growing head and neck malignancy, yet vaccination coverage remains suboptimal. (2) Methods: In this cross-sectional survey conducted from April 2022 to April 2023, 400 parents of patients aged 8–18 years (mean ± SD = 12.8 ± 2.6; 59.3% female) reported their child’s HPV vaccination status and willingness to initiate or complete the vaccine series at a dental clinic. For those who were not fully vaccinated, reasons for refusal were documented. (3) Results: Over half (54.5%, n = 218) of the children were not fully vaccinated. Notably, 21% (46/218) of parents indicated an immediate willingness to vaccinate their child if the dentist offered it—a significant potential for improvement compared to general healthcare settings. Reported barriers included preference for a physician’s office (43.6%), indecision (20.3%), unspecified concerns (14.5%), safety worries (8.1%), and religious objections (5.2%). Male and younger patients (9–11 years) showed significantly lower vaccination coverage (p < 0.05). (4) Conclusions: Dentists can substantially impact public health by integrating immunization counseling, interprofessional collaboration, and vaccine administration, thereby addressing critical gaps in HPV-related cancer prevention. These findings highlight the opportunity for dental offices to enhance vaccination rates and prompt further research, education, and policy initiatives to advance the oral and general health of our patients. Full article

High rates of childhood vaccination defaulting remain a significant barrier to achieving full vaccination coverage in sub-Saharan Africa, contributing to preventable morbidity and mortality. This study evaluated the utility of machine learning algorithms for predicting childhood vaccination defaulters in Ghana, addressing the limitations of traditional statistical methods when handling complex, high-dimensional health data. Using a merged dataset from two malaria vaccine pilot surveys, we engineered novel temporal features, including vaccination timing windows and birth seasonality. Six algorithms, namely logistic regression, support vector machine, random forest, gradient boosting machine, extreme gradient boosting, and artificial neural networks, were compared. Models were trained and validated on both original and synthetically balanced and augmented data. The results showed higher performance across the ensemble tree classifiers. The random forest and extreme gradient boosting models reported the highest F1 scores (0.92) and AUCs (0.95) on augmented unseen data. The key predictors identified include timely receipt of birth and week six vaccines, the child’s age, household wealth index, and maternal education. The findings demonstrate that robust machine learning frameworks, combined with temporal and contextual feature engineering, can improve defaulter risk prediction accuracy. Integrating such models into routine immunization programs could enable data-driven targeting of high-risk groups, supporting policymakers in strategies to close vaccination coverage gaps. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Pregnancy-related cytomegalovirus (CMV) infection may have negative consequences on the developing fetus and child. In Romania, screening for CMV infection is included in the first prenatal evaluation. We aimed to evaluate the seroprevalence rates in pregnant women who underwent screening over 15 years (May 2008–February 2023). We evaluated 28,012 pregnant women, from whom 23,970 (85.57%) had an index CMV screening, and 4082 had at least two presentations during the same or consecutive pregnancies. A total of 32,290 paired anti-CMV IgM/IgG serological tests were performed. Passed infection with IgG positivity represented 90.15% (29,110) of all tests, corresponding to 28,649 women (88.72%). The seroprevalence increased with women’s age, was more frequently associated with rural residence, and decreased in time intervals. A total of 2322 women (9.69%) displaying an IgM/IgG negative pattern were at risk of acquiring the infection during pregnancy. Only 144 out of 2342 (6.14%) women at risk presented twice during the same pregnancy, of which 12 women (0.51%) displayed a pattern of primary infection. Our population from Northwest Romania shows a high rate of immunization against CMV infection and a low risk of primary infection. We found a low adherence to retesting in cases of probable primary CMV infections, which highlights the need for infection mitigation by hygiene measures and improvement of the existing protocols. Full article

Background/Objectives: This retrospective cohort study compared well-child visits (WCVs) and immunization encounters from birth to age three among rural and urban South Carolina (SC) Medicaid-enrolled children with neonatal opioid withdrawal syndrome (NOWS). Methods: We applied logistic and Poisson regression models to examine associations between rural status and the number of WCVs, WCV adherence, and immunization encounters. Results: The sample included 833 urban and 161 rural children with NOWS born between 2006 and 2014. Significant differences existed between groups in the number of WCVs and immunization encounters each year from birth to age three (p = < 0.01 for all the comparisons). After covariate adjustment, rural compared to urban status was associated with decreased WCVs from birth to 11 months (incidence rate ratio (IRR): 0.85; 95% CI: 0.77–0.93) and 12 to 23 months (IRR: 0.80; 95% CI: 0.69–0.93). Rural status was not significantly associated with decreased WCVs from 24 to 35 months (IRR: 0.81; 95% CI: 0.63–1.03). Rural compared to urban status was associated with a 34% lower odds of WCV adherence from 12 to 23 months (odds ratio (OR): 0.66; 95% CI: 0.44–0.99). Furthermore, rural compared to urban status was associated with decreased immunization encounters from birth to 11 months (IRR: 0.60; 95% CI: 0.52–0.69), 12 to 23 months (IRR: 0.61; 95% CI: 0.50–0.71), and 24 to 35 months (IRR: 0.55; 95% CI: 0.40–0.76). Conclusions: Rurality was associated with decreased WCVs and immunization encounters among children with a history of NOWS residing in SC. Policy interventions, including telehealth services and expanded Medicaid access, could improve WCV and immunization rates among these children. Full article

Several studies suggest a relationship between phthalates (PAEs) and allergic diseases in children. Therefore, we speculated that PAE exposure may be an important environmental factor causing allergic diseases. The present study employed meta-analysis and network toxicology to analyze the interactions and assess potential pathogenic pathways between prenatal and postnatal PAE exposure and childhood allergic diseases. This study found that prenatal PAEs exposure was positively associated with childhood wheezing and eczema (OR = 1.03, 1.05), and postnatal PAEs exposure was positively associated with childhood wheezing, eczema, and rhinitis (OR = 1.10, 1.05, 1.06). PAE exposure from dust may elicit distinct effects compared to direct exposure to PAEs. Furthermore, a large number of overlapping genes between disease targets and PAEs were identified. Enrichment analysis highlighted the association of PAE-targeted genes with biological pathways integral to allergic diseases. Molecular docking results indicated a strong link between the PAEs and the core proteins, such as SRC, AKT1, and HSP90AA1. These proteins are critically involved in the regulation of immune–inflammatory processes underlying allergic diseases. This discovery not only enhances our understanding of the relationship between environmental pollutants and child health but also provides a robust reference for experimental studies on the induction of childhood diseases by early-life exposure to environmental pollutants. Full article

Background/Objectives: In the Republic of Serbia, measles vaccination was first introduced in 1971, while combined vaccination (measles, mumps, rubella) was made mandatory in 1996 as part of the national vaccination program. Reported prevalence values for 2023 were <0.75 cases per 100K population for measles, 0.09 cases per 100K for mumps, and no cases of rubella. Methods: This cross-sectional study was performed in May, 2024 as part of the project “Herd Immunity to Vaccine-Preventable and Other Relevant Infections in the Belgradian Population.” It focused on assessing herd immunity to measles, mumps and rubella (MMR) among residents insofar as these remain a public concern despite the availability of vaccines. A total of 2533 subjects were distributed across nine age groups, covering those aged 1–70⁺ years and various professional groups residing in Belgrade. Participants were stratified by age and activity. Upon obtaining individual information by online questionnaire and receiving a signed statement of informed consent, blood samples were obtained for IgG antibody testing (ELISA) to determine MMR serological status. The results were compared to national and international immunization standards to evaluate herd immunity levels. Results: Our results indicate varying levels of immunity for each virus, with specific demographic groups showing different immunity levels. Total measles seroprevalence during this study was 74.7%, with significant variation across all age groups. While high seropositivity was observed in both children (90.7%) and elder age groups (98.4%), middle-aged individuals in the age group 30–49 years showed significantly lower IgG levels. Between 2021 and 2023, there were no registered cases of rubella detected in Serbia, which indicates a high level of immunity. This was confirmed here with consistently high IgG levels across all age groups, with an average seropositivity of 94.8%. Average mumps seropositivity across all age groups was 85.1%. The lowest value was in the young child (1–5 years) age group (76.1%); the highest was in the elderly group (92.6%). Conclusions: The current findings suggest that the Belgradian population has strong overall immunity to MMR, yet with some concerns regarding measles immunity in middle-aged adults, suggesting a potential need for catch-up vaccinations. While rubella status indicates strong herd immunity and minimal risk of outbreaks, mumps immunity in some groups (children, middle-aged adults) is below the protective threshold. While it is still sufficient to prevent widespread transmission, it should be closely observed. To our knowledge, this study is the first of its kind to provide data about MMR seroprevalence in Belgrade. Findings indicate the need for constant surveillance and revaccination of vulnerable/seronegative groups. Full article

Background: Eosinophilic esophagitis is a chronic immune-mediated disease with increasing prevalence. In pediatric populations, it often coexists with IgE-mediated food sensitization. This dual diagnosis presents unique therapeutic challenges, including on the one hand both temporary and lifelong dietary restrictions, and on the other hand, therapeutic interventions with a potential impact on quality of life (QoL). Objectives: This study prospectively evaluated the prevalence of IgE-mediated food sensitization and allergy in children with EoE attending a tertiary center in Flanders, Belgium. Additionally, it prospectively documented dietary habits and restrictions in these children, with or without concomitant IgE-mediated food allergies, and assessed the impact of dietary management on quality of life compared to pharmacological treatment. Methods: We consecutively followed 30 children with biopsy-confirmed pediatric EoE (PedEoE) attending a tertiary referral center for at least 12 months. Patient demographics, allergy testing, dietary history, and treatment modalities were recorded. Symptom score and PedEoE QoL were assessed using validated Pediatric Eosinophilic Esophagitis Symptom Score (PEESS 2.0) and Pediatric Quality of Life Inventory (PedsQL 3.0) questionnaires. Statistical analysis was performed using the Mann–Whitney U test and Kruskal–Wallis test with Dunn’s test as a post hoc test. Results: Among 30 children with EoE (60% male, median age 8 years), 60 PedEoE QoL (PedsQL) and 39 symptom (PEESS) questionnaires were collected at one or more time points over a median follow-up of 14.5 months. IgE sensitization to common dietary triggers was observed in multiple patients, with varying clinical reactivity. Symptom scores tended to be higher in children without histological remission, though differences were not statistically significant (median PEESS 23.75 vs. 17.50, p = 0.1934). Grouped by degree of dietary restriction, QoL scores showed significant differences (child p = 0.0102; parent p = 0.0203), with children in the 1–2 food elimination group reporting better QoL compared to the 0 food elimination and >6 food elimination groups. No clear statistically significant differences were observed between the 1–2 food elimination group and the 3–4 or 5–6 food elimination groups. Conclusions: IgE sensitization is prevalent among pediatric EoE patients and has significant clinical implications for disease management. Treatment choice can influence not only disease control but also the QoL of both patients and their families. Full article

Vector-borne diseases (VBDs) significantly impact global child health, with mosquito-transmitted infections like malaria and arboviruses accounting for a substantial portion of this burden. However, other arthropod-borne diseases—transmitted by vectors such as ticks, fleas, sand flies, lice, and triatomine bugs—also pose serious health risks to children worldwide. This review specifically excludes mosquito-borne diseases to concentrate on these less-discussed yet clinically important pediatric VBDs. We examine their clinical manifestations, diagnostic challenges, and treatment options, highlighting the unique vulnerabilities of children, including immature immune systems, behavioral factors, and communication barriers that can delay diagnosis. Additionally, we explore how environmental and anthropogenic factors, such as climate change and urbanization, are expanding the geographic range of these vectors, leading to the emergence of diseases like Lyme disease and leishmaniasis in new regions. By focusing on non-mosquito VBDs, this review aims to raise awareness and inform healthcare providers and public health practitioners about the comprehensive landscape of pediatric vector-borne diseases. Full article

Bacillus Calmette–Guérin (BCG)-related immune reconstitution inflammatory syndrome (IRIS) is a recognised complication following antiretroviral therapy (ART) initiation in HIV-infected infants. We report the case of a 19-month-old child with undiagnosed perinatally acquired HIV due to maternal nondisclosure. The child developed ipsilateral axillary lymphadenitis at the BCG vaccination site shortly after starting ART. The clinical features and temporal association with ART supported a diagnosis of BCG-IRIS. The child was successfully managed with conservative pharmacological treatment alone—rifampicin, isoniazid, and macrolide therapy—without surgical incision or corticosteroids. Progressive improvement of the lesion was observed, and complete clinical resolution occurred over the following months, alongside immune recovery. This case underscores the importance of recognising BCG-IRIS, even in settings where HIV diagnosis may be delayed, and supports the feasibility of conservative management in paediatric patients, potentially avoiding surgical intervention in settings of localised disease. Full article

The function of the immune system is not only dependent on factors like genetics, age, the environment, and exposure to infectious agents and allergens but also on our microbiota and our diet. It has been known for centuries that food can influence health and vulnerability to infection. This is especially true for infants, young children, and the elderly. This review focuses on how nutrition can support immune function from gestation to school-aged children. Immune support begins during pregnancy by the mother’s diet and transfer of nutritional components as well as antibodies to her fetus. After birth, breastfeeding is of crucial importance for immune development as well as for the development of the intestinal microbiota of an infant. If breastfeeding is not possible, early-life formulas are an alternative. These can provide several of the functionalities of breastmilk, as well as the key nutrients a child needs. New foods are introduced during and after weaning, and after this period, children switch to consuming a normal diet. However, due to circumstances, children can be malnourished. This can range from severe protein/energy malnutrition to micronutrient deficiencies and obesity, all of which can affect the function of the immune system. This narrative review describes the immune challenges in early life, explores breastfeeding and early life nutrition, and provides mechanistic insight into the relative contribution of macronutrients, micronutrients and other immunomodulatory food components that can support immune function in early life. Full article

Breastfeeding is recognized as the gold standard in infant nutrition, providing necessary nutrients for optimal growth and development. Beyond its nutritional function, breastfeeding has numerous benefits for both mother and child. This literature review examines the effects of breastfeeding on the development of the nervous and immune systems, its influence on cognitive development, and the impact of stress on lactation. In addition, it explores the emotional effects of breastfeeding on mothers, the challenges associated with exclusive breastfeeding, and the process of weaning along with its implications for both mother and infant. It is indicated that stress significantly affects lactation regulation, with elevated cortisol levels potentially disrupting hormonal balance. Furthermore, the essential roles of oxytocin, sialic acid, and docosahexaenoic acid in infant brain development and cognitive functions are highlighted. Breastfeeding is associated with the regulation of the baby’s sleep through the effects of tryptophan, serotonin, and melatonin, which at the same time provide the baby with a sense of security with the mother. It is indicated that women who breastfeed are less likely to suffer from mental health problems and are at a lower risk of hypertension, diabetes, and cardiovascular disease. The weaning process is often a difficult time for mother and child; thus, it should be introduced gradually to minimize stress, anxiety, and potential mood disturbances in the mother. Full article

The first 1000 days of life starts from conception to a child’s second birthday. Research suggests that the period is critical for cognitive, physical, and emotional development. Investments in maternal and child healthcare during this period have a profound impact on long-term health, educational attainment, and economic productivity. This study examined the impact of such investments on child health outcomes in Kenya, using data from the 2015/2016 Kenya Integrated Household Budget Survey (KIHBS). Key areas of focus included maternal healthcare, early antenatal care, skilled delivery, exclusive breastfeeding, proper weaning practices, immunization, and the timely treatment of childhood illnesses. Using the Cox regression hazard model, the study revealed that twins faced a higher risk of mortality compared to single births, while firstborns were less likely to die before their fifth birthday; larger household sizes were associated with reduced child mortality, and children in female-headed households had a lower likelihood of dying, likely due to better adherence to proper health and nutritional practices. Maternal health conditions, the place of delivery, and assistance during childbirth significantly influenced survival, with government health facility deliveries yielding better outcomes than homebirths. This study emphasizes the importance of educating pregnant women and mothers on health risks and public health protocols during this critical period. Strengthening healthcare systems and promoting equitable access to essential services during the first 1000 days could improve child survival rates and enhance long-term economic productivity. Full article

In postmodern society, many protagonists promote a “distorted and unnatural” image of marriage and family, while others consider marriage and the family unit relics of the past. The contemporary world is characterized by different kinds of “turbulence” that affect individuals on both psychological and spiritual levels, as well as by extreme oscillations between a normal and a distorted image of the family and the image of God. In this context, all Catholics, especially Catholic families, are called to be “protagonists of the New Evangelization”. However, due to Catholic “mediocrity”, the family, which is the heart of the New Evangelization, can become less effective and limited in its evangelical mission. The individualism of our postmodern era, along with the prevalence of unstable and fluid relationships, impacts family bonds. Catholic families are not immune to the negative trends that affect families today. Many Catholic families face challenges and difficulties that can damage the relationship between parent and child. This article aims to explore how contemporary family dynamics within Catholic families influence the attachment between parent and child. Furthermore, it examines how children’s perceptions of parents relate to their perceptions of God. The intention is also to recognize the consequences of certain images of God on religious development. Does God become a “substitute attachment figure” when a parent is absent from the family? If so, how can religious education help individuals develop a more mature faith and relationship with God, moving beyond an infantile attachment? Full article