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This study aims at comparatively identifying the constitutional provisions for right to education, their implementation and impact on education in India and Nepal. This is an analytical descriptive study based on document analysis. By the mid of 2011, 81% constitutions of the world guaranteed or aspired to protect the right to primary education. Nepal and India both have clear constitutional provisions for right to free and compulsory basic education but are unable to fulfil the international and national educational commi tments and goals. India and Nepal fall in 2nd and 48th rank respectively based on population in the world in 2018. However, educational indicators indicate that both the countries could not ensure the educational access to all the children. In the year 2014-15, 22.131 million children were either not enrolled or did not complete primary education in India. This number was 270 958 in Nepal in the same year. Results show that there is a wide gap between the educational policies and their actual implementation in India and Nepal.

This study examined the impact of iPad integration on student motivation, engagement, and learning skills in a mathematics program. Subjects included 143 students aged 8 to 14 years old and 63 parents in an Indian-based school in Dubai where the national curriculum required the use of tablets be integrated into school subjects starting at grade three. All subjects responded to questions about how iPads could support learning math and the kind of challenges students faced. Classes were technology-driven using individualized learning groups and a variety of computer apps. Around 80 percent of the students indicated they understood new concepts better, were able to solve difficult math problems, and expected themselves to score better on their tests. It was found that providing instant access to a wide array of applications, resources, hands-on activities, and instant feedback can engage students and help them remain on task, especially those with special educational needs.

This ethnographic case study presents findings of an 18-month research study focusing on the ways in which families residing in an urban slum were using mobile phones and how this use supported literacy practices. Data collection included participant observations and interviews with 42 participants including parents, children and community members. Results of the data analysis indicated that in this urban slum, most participants owned a mobile phone which provided multiple entry points to learning. The phones ushered in new ways of brokering knowledge where children acted as 'experts' and enabled parents to perform everyday tasks while parents mediated as cultural brokers and fostered religious and cultural practices and knowledge of the mother tongue. The implications of the study point to the evolving nature of literacy practices, the versatility of the device, the uneven landscape of smartphone use and the limitations posed by the schooling contexts.

Background: Increasingly researchers are recognising the importance of including the perspectives of children and young people in research and in the development of interventions and innovations, in order to understand children's lives on their own terms. Purpose: This article reflects on the potential risks posed to children and young people in research and the role of gatekeepers in granting access and, in direct field activities, especially where the research could be deemed as 'sensitive'. Research Design: Using a combined descriptive and autoethnographic research design, questionnaires and reflections were gathered from the field experiences of researchers in four countries (India, Jamaica, Uganda and the UK) conducting research on children's experiences of violence victimisation as part of a gender-based violence prevention project. Data was collected retrospectively and analysed thematically with the aid of QSR NVivo. Results: Based on the five themes that emerged: accessing schools; approach to access; accessing participants; lessons learnt; and advice for other researchers, the overall findings indicate that researching sensitive topics with children and young people is necessarily problematic in order to safeguard them. This is especially the case in contexts where discrimination and stigma relating to certain topics may be a significant barrier to children's participation. Conclusion: Research planning requires attention to gatekeeper power, safeguarding children and young people, and understanding how processes and attitudes concerning the status and rights of children at national and institutional levels might influence the research process.

This study was conducted to explore the experiences of educators with mealtime behaviours of children with a diagnosis of Autism Spectrum Disorders (ASD) in schools, and to explore the strategies undertaken in schools to improve nutrition among these children. In-depth interviews were conducted with 13 educators of various special schools across Mumbai. They described their experiences with 3-11 year-old children with a diagnosis of ASD. Four themes emerged from this study: reasons for disruptive mealtime behaviours, using mealtimes as opportunities for indirect learning, strategies used to avoid disruptive mealtime behaviours, and school policies regarding food and nutrition. The presence of sensory stressors, changes in break-time schedules, and inability to communicate hunger were identified as main reasons for disruptive mealtime behaviours in the classroom. Strategies to tackle these behaviours were discussed. Most educators reported that their school followed a strict 'no junk-food' policy. The perspective of educators is important to understand the mealtime behaviours of children with ASD in school settings. The initiatives taken at the school-level are valuable as they provide a different approach and diverse strategies that may work to improve the food intake and nutrition of children with ASD.

Background: Stunting, indicating chronic malnutrition in children, remains a pressing concern globally, especially in low- and middle-income countries. India, despite substantial efforts, continues to grapple with high rates of stunting, impacting child development and health outcomes. Understanding the multifaceted factors contributing to stunting is crucial for targeted interventions and policy formulation. Methods: This descriptive cross-sectional study was conducted in Balipatana, Khordha district, Odisha, India among 400 children. A survey employing structured questionnaires and WHO Anthropometric guidelines for data collection was used. Statistical analyses including Chi-square tests and logistic regression models were used to uncover significant associations. Results: The study revealed a stunting prevalence of 28% among children under five, with 7% severe and 21% moderate stunting. Regression analysis revealed key risk factors included low birth weight (1.5-2.5 kg), parental illiteracy, lower household income (Rs. 1000-15000), inadequate toilet facilities, and specific drinking water sources. Conclusion: The findings align with global concerns about stunting, emphasizing the complex interplay of socioeconomic and environmental factors. Interventions targeting parental education, household economic status, and improving sanitation and drinking water facilities are imperative. By addressing these factors, focused efforts can be made to reduce childhood stunting, ensuring a healthier future for the nation's children. [ABSTRACT FROM AUTHOR]

Rash and fever are some of the most common chief complaints present in paediatric dermatology emergencies. The spectrum of differential diagnosis is broad, including many different infectious and some non-infectious agents. A systematic approach involving detailed history taking, careful clinical examination along with particular attention to epidemiological features are the most important factors to make a diagnosis. This article reviews the morphological patterns of various causes of fever with rash in children, including infectious as well as non-infectious causes, with special emphasis on the Indian scenario. We intend to highlight the clinical characteristics of each cause, which will not only help make a clinical diagnosis but also distinguish benign versus life-threatening causes of skin rash in febrile paediatric patients and provide early medical intervention. [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) is a common childhood physical disability, which often leads to secondary conditions and affects the quality of life (QOL) of the children suffering from it. This study measures the QOL of children with CP using Children with Cerebral Palsy Quality of Life Questionnaire (CP-QOL) and the factors affecting it. Methods: This cross-sectional study covering 140 purposively chosen caregivers of children with CP aged 4–12 years was conducted in Assam, India, 2023. Subscale scores of CP-QOL were computed to determine the overall QOL score. Cronbach's α assessed the subscales' reliability and interval consistency. Bivariate analysis was conducted to present the socio-demographic variation in QOL, and logistic regression revealed the determinants. Regression model diagnostics were performed, which included the Omnibus test, the Hosmer–Lemeshow test, a classification table showing the model's sensitivity, specificity, and overall accuracy, and a ROC curve displaying the model's overall accuracy in predicting the outcome variable. Results: The overall QOL score was 44.94 ± 16.28. QOL scores varied significantly with children's age, Gross Motor Function Classification System (GMFCS) levels, special school enrolment, mother's education, family structure, and the behaviour of relatives and neighbours. Nearly three-fourths of the caregivers perceived a poor QOL of their children with CP. Children's CP type, GMFCS level, associated conditions, and religion were significantly associated with their QOL. Conclusion: The QOL of children with CP are significantly lower, the primary factor being the GMFCS level. Efforts to educate caregivers and customized policies and programs will help improve CP children's QOL.

Background: There is paucity of reliable epidemiological data regarding the burden of food allergy in most developing countries, including India. Objective: To provide current estimates of the prevalence and distribution of food allergy among urban and rural school children aged 6–14 years in Delhi and the National Capital Region (NCR) of Khekra in India. Methods: A cross-sectional study was conducted from January 2022 to February 2023 to enroll school children, 6–14 years, from select urban and rural schools in Delhi and NCR. A questionnaire consisting of questions focused on household environment, early life factors, and pediatric food allergy characteristics was administered by a trained medical researcher to collect parent-proxy data. Univariate statistics were used to describe frequencies, percentages, and 95% confidence intervals for survey items. Results: The estimated prevalence of parent-reported food allergy was 0.8% (95% CI: 0.4–1.5; urban: 0.4%, 95% CI: 0.1–1.1; rural: 1.7%, 95% CI: 0.7–3.5). Fruits such as mango (0.3%, 95% CI: 0.1–0.9), strawberry (0.1%, 95% CI: 0.0–0.7), orange (0.1%, 95% CI: 0.0–0.7), and custard apple (0.1%, 95% CI: 0.0–0.7) were reported only by urban children, while rural children reported yogurt (0.6%, 95% CI: 0.1–1.8) and wheat (0.3%, 95% CI: 0.0–1.3). Both groups reported brinjal (also known as eggplant) and banana, 0.1% (95% CI: 0.0–0.7) of urban and 0.3% (95% CI: 0.0–1.3) of rural, respectively. Overall, commonly reported clinical symptoms were diarrhea and/or vomiting (100%, 95% CI: 76.2–100), abdominal pain (88.9%, 95% CI: 58.6–98.8), and rash/itchy skin (66.7%, 95% CI: 34.8–89.6). Among children with parent reported food allergy, 66.7% (95% CI: 34.8–89.6) of food allergies were physician diagnosed, of which 33.3% were diagnosed via history alone (95% CI:7.7–71.4) while 66.7% (95% CI: 28.6–92.3) were confirmed via skin prick test and/or blood test. Conclusion: The overall prevalence of food allergy is very low in Delhi and Khekra, India. Future work should focus on elucidating the complex interplay of early-life, environmental, genetic, and lifestyle factors to understand the reasons for India's low food allergy burden and improve epidemiological clues to prevention for the nations with higher disease burden.

Timely screening and surveillance of children for developmental delay and social–emotional learning difficulties are essential in Low- and Middle-Income Countries like India. Screening measures like the Parents’ Evaluation of Developmental Status (PEDS) and Strength and Difficulties Questionnaire (SDQ) are considered suitable for India due to their low cost, easy accessibility, and no training requirement for administration. However, India lacks validated screening measures, and the PEDS and SDQ have yet to be validated for children in India. The study aimed to translate the PEDS and SDQ from English to Hindi and psychometrically evaluate the same measures on children aged 4–8 years in India. The original PEDS and SDQ forms and their translations were pilot tested on 55 participants and evaluated using data from 407 children with typical development (TD) and 59 children with developmental disability (DD). Parents and teachers reported no meaningful discrepancy between the original and translated (Hindi) questionnaires. Internal consistency for the PEDS was acceptable, but unacceptable for most subscales on the SDQ, for both TD and DD samples. Test–retest reliability was poor for the PEDS but adequate for the SDQ. Results from known-group validity testing showed that the PEDS scores could be used to distinguish between the TD and DD samples. The results from this study provide further support for the use of the PEDS and SDQ in developing countries like India.

Timely screening and surveillance of children for developmental delay and social–emotional learning difficulties are essential in Low- and Middle-Income Countries like India. Screening measures like the Parents' Evaluation of Developmental Status (PEDS) and Strength and Difficulties Questionnaire (SDQ) are considered suitable for India due to their low cost, easy accessibility, and no training requirement for administration. However, India lacks validated screening measures, and the PEDS and SDQ have yet to be validated for children in India. The study aimed to translate the PEDS and SDQ from English to Hindi and psychometrically evaluate the same measures on children aged 4–8 years in India. The original PEDS and SDQ forms and their translations were pilot tested on 55 participants and evaluated using data from 407 children with typical development (TD) and 59 children with developmental disability (DD). Parents and teachers reported no meaningful discrepancy between the original and translated (Hindi) questionnaires. Internal consistency for the PEDS was acceptable, but unacceptable for most subscales on the SDQ, for both TD and DD samples. Test–retest reliability was poor for the PEDS but adequate for the SDQ. Results from known-group validity testing showed that the PEDS scores could be used to distinguish between the TD and DD samples. The results from this study provide further support for the use of the PEDS and SDQ in developing countries like India. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to understand the experiences of primary caretakers (PCTs) with a child diagnosed with celiac disease (CeD). There is paucity of research in understanding the experiences of PCTs of children with CeD in India. Methods: Purposive sampling was used to select PCTs of CeD-affected children from a tertiary hospital in New Delhi. Ten PCTs took part in the investigation. To gather the data, semi-structured interviews were held with participants. Hindi was used to administer the interviews. Results: The current study focused on the difficulties and worries PCTs experience in managing CeD. The main themes and sub-themes that emerged from the data were diagnosis of CeD (misdiagnosis of CeD, late diagnosis of CeD, feelings at the time of diagnosis, help from a doctor/nutritionist at the time of diagnosis); characteristics of CeD (CeD as a new disease, CeD as an allergy); attitude towards wheat (wheat as a poison, ignorance regarding negative effect of wheat); influence of significant others (making fun of the child, queries from others are a source of worry, non-acceptance of celiac disease by others and pressure to give gluten to the child); issues in following gluten-free diet (GFD) (fear of cross-contamination, distrust on GFD available outside home, GFD is expensive, making GFD is difficult, joint family, non-adherence to GFD, making non-GFD along with GFD); effect of CeD (financial effect of CeD, effect on physical and mental health of the child and PCT, effect on social life, change in family dynamics, eating restrictions); management of CeD (GFD for the whole family to manage CeD, family support to manage CeD, adhering to GFD, early diagnosis); and concerns (future marital concern for the child, cure of CeD, proper physical growth). Conclusion: The current study gave an understanding of how PCTs dealt with a child's CeD. The difficulties and worries of caretakers should be taken into consideration and appropriate recommendations made to lessen the strain of managing the child's CeD and the daily obstacles associated with it. [ABSTRACT FROM AUTHOR]

Background: Lead is toxic to children and effects the cognitive development. The primary objective was to assess the association of blood lead level (BLL) with cognitive performance and general intelligence, of urban school going children aged 6–16 years from ten cities of India. Secondary objective was to assess the association of anaemia with cognitive performance and general intelligence. Method: In this cross-sectional multicentric study, general intelligence was assessed by colored progressive matrices (CPM)/standard progressive matrices (SPM) test, visual-spatial ability through coding, attention and concentration ability through digit span and working memory through arithmetic tests. Blood samples of participants were collected to assess lead levels. Socioeconomic status and anthropometric measures were also collected. Results: From April 2019–February 2020, 2247 participants with equal gender distribution were enrolled from 60 schools. The median (IQR) BLL was 8.8 (4.8, 16.4) μg/dl. We found that BLL was significantly associated with attention and concentration ability and 1 μg/dl increase in BLL decreases the performance by odds of 1.02 (95 % CI 1.01–1.03). Anaemia is found to be associated with ‘borderline or dull normal’ performance for general intelligence [Adjusted Odds Ratio (AOR) = 1.93 (95 % CI 1.53–2.45)], visual-spatial [AOR = 1.35 (95 % CI 1.03–1.76)], attention and concentration [AOR = 1.30 (95 % CI 1.02–1.66)], working memory [AOR = 1.69 (95 % CI 1.34–2.12)] abilities. Conclusion: Since increasing BLL decreases cognitive performance and anaemia decreased both cognitive performance and intelligence, attempts must be made to keep BLL as low as possible and prevent exposure in school going children.

Abstract There is an increasing burden of noncommunicable diseases (NCDs) in India which may be related to changing dietary patterns. We aimed to assess dietary patterns in children since they have time to change unhealthy patterns before NCDs develop. Participants were 665 children, 9–12 years old, born with low birth weight and 77 similarly aged normal birth weight controls. We collected data on sociodemography, anthropometry, body composition, and markers of risk for NCDs: grip strength, long jump, hemoglobin A1c (HbA1c). A food frequency questionnaire was used to collect dietary data from which dietary patterns were derived using principal component analysis (PCA). Fourteen food groups were included in the PCA analysis, resulting in three components: ‘fruits and vegetables’, ‘protein’, and ‘sugar and fat’. Higher socioeconomic status and maternal education were associated with lower adherence to the fruit and vegetable pattern and higher adherence to the protein and sugar and fat patterns. Adherence to the fruits and vegetables pattern was associated with lower height‐for‐age, whereas the fat and sugar pattern was associated with higher indicators of body fat. In linear regression analyses adjusted for age, sex, religion, socioeconomic status, maternal education, and season of data collection, adherence to the ‘fruits and vegetables’ pattern was associated with lower grip strength, shorter long jump, and lower HbA1c. Adherence to the other patterns was not associated with NCD risk factors. Higher consumption of fruits and vegetables, achievable even by poorer families in the cohort, may lower HbA1c, a risk factor for diabetes.

There is an increasing burden of noncommunicable diseases (NCDs) in India which may be related to changing dietary patterns. We aimed to assess dietary patterns in children since they have time to change unhealthy patterns before NCDs develop. Participants were 665 children, 9–12 years old, born with low birth weight and 77 similarly aged normal birth weight controls. We collected data on sociodemography, anthropometry, body composition, and markers of risk for NCDs: grip strength, long jump, hemoglobin A1c (HbA1c). A food frequency questionnaire was used to collect dietary data from which dietary patterns were derived using principal component analysis (PCA). Fourteen food groups were included in the PCA analysis, resulting in three components: 'fruits and vegetables', 'protein', and 'sugar and fat'. Higher socioeconomic status and maternal education were associated with lower adherence to the fruit and vegetable pattern and higher adherence to the protein and sugar and fat patterns. Adherence to the fruits and vegetables pattern was associated with lower height‐for‐age, whereas the fat and sugar pattern was associated with higher indicators of body fat. In linear regression analyses adjusted for age, sex, religion, socioeconomic status, maternal education, and season of data collection, adherence to the 'fruits and vegetables' pattern was associated with lower grip strength, shorter long jump, and lower HbA1c. Adherence to the other patterns was not associated with NCD risk factors. Higher consumption of fruits and vegetables, achievable even by poorer families in the cohort, may lower HbA1c, a risk factor for diabetes. [ABSTRACT FROM AUTHOR]

Background: Fever with rash is common among children and is seen by both dermatologists and pediatricians. The various causes of fever with rash in children include viral infections, bacterial infections, rickettsial species, collagen vascular diseases, and drug hypersensitivity rash. Viral exanthems are by far the most common cause of fever with rash in children. Common viral etiologies are measles, rubella, varicella, adenovirus, herpes simplex virus (HSV) 1 and 2, human herpes virus 6, human herpes virus 7, Epstein-Barr virus, coxsackie, dengue, chikungunya, influenza A and B, and hepatitis B. Aims: The study aimed to study the magnitude of various viral causes of fever with rash in children and to study the various morphological patterns of rash. Materials and Methods: This was a hospital-based observational study which included 90 children presenting to the dermatology and pediatrics outpatient department with fever and rash. Immunoglobulin M antibody testing for measles, rubella, varicella, HSV, chikungunya virus, dengue virus, and hepatitis B virus was done. Reverse transcription-polymerase chain reaction for COVID-19 virus was done when suspected. Results: The most common etiology of fever with rash was viral (51.1%). Out of all viruses isolated, measles was the most common (15.55%), followed by Chikungunya (14.44%). Maculopapular rash was the most common morphology of rash (40%) found in patients. Among the patients having maculopapular rash, measles was the most common virus isolated. Conclusion: Viral exanthems should be considered a strong differential in all children presenting with fever and rash. [ABSTRACT FROM AUTHOR]

Introduction: Gender stereotyping in television advertising is a universal phenomenon and has the potential to influence children's perceptions of gender roles. Despite India's enormous child population, gender representation in television advertising is hardly researched. Methods: This study was conducted using a content analysis methodology to examine gender stereotypes in children's television advertising in India. A total of 189 unique advertisements were selected from six prime cartoon channels, namely Nickelodeon, Disney Channel, Hungama, Cartoon Network, Discovery Kids, and Pogo TV. A stratified constructed sample of 319 central figures from 102 hours of TV viewing was collected over two consecutive weeks in November 2018 during children's prime-time viewings. Results: This study examines gender role cues in children's television advertising using McArthur and Resko's coding method. The sample was subsequently analyzed using chi-square statistics, and the findings were contextualized and compared with those from other Asian nations. The results indicated that men significantly dominate (voice-over, product authority, autonomous roles, fact-based arguments, other products, end comments, pleasure, and practical rewards), whereas females are stereotyped (dependent roles, product users, portrayal of domestic products in domestic settings, opinion-based arguments, and self-enhancement rewards). Discussion: However, the results reveal a reduction in certain stereotypical aspects, such as a significant increase in women performing voice-overs and portraying characters with product authority and autonomy, while men exhibit increased involvement with domestic products and rewards such as selfenhancement, practical, and pleasure rewards. The theoretical (social learning and role congruity theory) and practical implications for advertisers and marketers are discussed based on these findings. [ABSTRACT FROM AUTHOR]

This article presents findings from a community-based cross-sectional study conducted in Attappadi, Kerala, India, aimed at assessing the prevalence of the triple burden of malnutrition among indigenous children aged 0–19 years. Historically, the indigenous population in Attappadi has faced significant developmental challenges, including high rates of malnutrition, infant mortality, and neonatal mortality. This study revealed alarming rates of undernutrition among children aged 0–59 months, with 40.9% experiencing stunting, 27.4% wasting, and 48.3% being underweight. Adolescent girls also suffered from undernutrition, with 21% classified as underweight and 43.3% experiencing stunting. Surprisingly, overweight or obesity was identified as a nutritional problem, affecting 1.4% of children aged 0–59 months, 4.2% of children aged 5–9 years, and 10.5% of adolescent girls. Additionally, a distressing proportion of young children aged 12–59 months (91.2%) were anaemic, with 50% diagnosed specifically with iron deficiency anaemia (IDA). Nearly all adolescent girls (96.6%) were reportedly suffering from anaemia. Deficiencies in vitamin B12, vitamin D, folate, and vitamin-A were prevalent among 35%, 20%, 16%, and 12% of children aged 12–59 months, respectively. The study underscores the urgent need for comprehensive interventions to address this triple burden of malnutrition. Recommendations include promoting culturally appropriate local food-based solutions, establishing participatory and community-led systems for health and nutrition information dissemination, and strengthening the nutrition surveillance system through village-level health and nutrition workers. By adopting a holistic approach, these interventions can help improve the nutritional status and well-being of the indigenous tribal children in Attappadi. [ABSTRACT FROM AUTHOR]

Backgrounds: The Universal Immunization Program of India is one of the most cost-effective interventions in public health. Missing or delaying vaccination may elicit an uncertain immune response in the body, making the population susceptible to vaccine-preventable diseases. The objectives of this study were to determine the coverage of newborn immunization for birth doses under the National Immunization Schedule and its epidemiological determinants in the rural areas of the Dehradun district, Uttarakhand. Materials and Methods: A community-based cross-sectional study was conducted for a period of one year with a sample size of 570. World Health Organization (WHO) 30 Cluster sampling technique was used with 19 children in each cluster. The data on determinants were collected using a semi-structured, pre-designed schedule through a house-to-house survey. Multivariate analysis was conducted to identify factors associated with immunization coverage, taking the significance level as P < 0.05. Results: The coverage of the Bacillus Calmette-Guérin vaccine, oral polio vaccine zero dose and hepatitis B birth dose were 100%, 91.9%, and 58.8%, respectively in the study area with an overall prevalence of incomplete coverage of newborn immunization as 42.5%. The most cited reason for children being unimmunized with birth doses was the unavailability of vaccines at the birthplace center (29.6%). Conclusions: The prevalence of incomplete coverage of newborn immunization was quite high, which was undermining the holistic approach of the National Immunization Program. Vaccine availability and accessibility at the birthplace with capacity building and training of the healthcare workers may be considered to ensure coverage of birth doses. [ABSTRACT FROM AUTHOR]

Childhood injuries are a major public health challenge in India and globally. This systematic review was conducted to understand the burden and spectrum of childhood injuries, with a focus on unintentional injuries, among children 5-14 years of age and to suggest approaches to prevention that can be adopted in the Indian context. This systematic review was conducted with the standard approach and use of keywords. A total of 33 studies which were found to be relevant were analyzed. Road traffic accidents (RTAs) contribute to nearly 85% of all unintentional injuries and related deaths and 90% of disability-adjusted life years (DALYs) lost in developing countries. Poor traffic regulation, heavy traffic load, and poor skill of identifying the dangerous road crossing sites make the children's age group vulnerable and prone to RTA. Children with poor skill of identification and response to dangerous road crossing sites, along with heavy unregulated traffic were found to be the major reasons for such accidents and make this age group more vulnerable. Public health-based prevention approaches need to be based upon legislation, regulation, and enforcement, as well as environmental modification, education and skill development, emergency medical care using levels of prevention, and principles of targeted prevention to effectively address child health challenges. Addressing child injuries should be a key component of all endeavors aimed at enhancing child mortality and morbidity rates, as well as the overall welfare of children, both at the national and global levels. It is imperative to prioritize policies focused on preventing unintentional injuries across all age groups, with particular attention to children. [ABSTRACT FROM AUTHOR]

Background: Non-genetic factors like microbial dysbiosis may be contributing to the increasing incidence/progression of type 1 diabetes mellitus (T1DM). Objectives: To analyse the gut microbiota profile in Indian children with T1DM and its effect on glycaemic control. Methodology: Faecal samples of 29 children with T1DM were collected and faecal microbial DNA was extracted and subjected to 16S rRNA (ribosomal RNA) sequencing and further analysis. Results: The dominant phyla in children with T1DM were Firmicutes and Bacteroidetes. Butyrate-producing bacteria Blautia and Ruminococcus showed a significant negative correlation with the glycosylated haemoglobin (HbA1C) levels (p < 0.05). Coprococcus and Propionibacterium were important negative predictors of glycaemic control (p < 0.05). Conclusion: Our study suggests that Indian children with T1DM have a distinct gut microbiome taxonomic composition and that short-chain fatty acid-producing bacteria like Ruminococcus and Blautia (butyrate-producing) may play an important role in the glycaemic control of subjects with T1DM. [ABSTRACT FROM AUTHOR]

Abstract Childhood stunting is recognized as significant public health concern in India. It is a form of malnutrition with impaired linear growth and creates a range of adversaries among children, including under-5 mortality, morbidity, and physical and cognitive growth. The purpose of the present study was to recognize the various leading determinants causing childhood stunting from both individual and contextual level in Indian context. Data were obtained from the India’s Demography and Health Survey (DHS) conducted in 2019–2021. A total of 1, 46,521 children aged 0–59 months were included in this present study. The study applied a multilevel mixed-effect logistic regression model in which individual factors nested within community based contextual-level factors estimating the likelihood of childhood stunting phenomena among Indian children. The variance explained in full model accounted for about 35.8% of the odds of stunting across the communities. The present study elucidates that the recognized factors from individual level characteristics have really increased the odds of childhood stunting: gender of child, multiple births, low birth weight, low BMI among mothers, less educational attainment by mothers, maternal anemic status, breast feeding duration longer than usual,

Abstract Background Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five. Study design Cross-sectional study. Methods The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed. Results Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79–0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69–0.99) are less likely to seek treatment. Conclusion The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.

Background: Childhood obesity is a grave public health concern in the 21st century. It is becoming a widespread problem in low and middle-income countries, particularly in urban areas. Childhood obesity is a precursor to metabolic syndrome, poor physical health, mental disorders, respiratory problems, and glucose intolerance, which can all continue into adulthood. Developing countries like India face a unique problem of a ‘double burden’, where undernutrition and obesity co-exist. Objectives: The study aimed to determine the prevalence of overweight/ obesity among school-going children and to identify the modifiable risk factors associated with it. Methodology: An epidemiological cross-sectional study was conducted in a private school located in the Western suburbs of Mumbai. The study included all students from the 1st to 10th standard of the secondary section, who were willing to participate. Before the study, necessary permissions were obtained from the school authorities and parental consent was taken. The study was conducted over 4 days in October 2023. Data was collected through interviews using a pre-structured questionnaire. The collected data will be analyzed using SPSS for descriptive and inferential statistics. Results: Among 521 participants, the Prevalence of Overweight is 14.77% and Obesity is 6.71% in our study. Statistical significance was found between BMI and Smartphone usage, BMI and Occupation of Mother. Conclusion: Dietary factors have always been associated with overweight & obesity however our study reveals that other factors also play a pivotal role in development of obesity which is an important risk factor for Non- Communicable Diseases further in adulthood.

This study examines malnutrition's triple burden, including anaemia, overweight, and stunting, among children aged 6–59 months. Using data from the National Family Health Survey-5 (2019–2021), the study identifies risk factors and assesses their contribution at different levels to existing malnutrition burden. A random intercept multilevel logistic regression model and spatial analysis are employed to identify child, maternal, and household level risk factors for stunting, overweight, and anaemia. The study finds that 34% of children were stunted, 4% were overweight, and 66% were anaemic. Stunting and anaemia prevalence were higher in central and eastern regions, while overweight was more prevalent in the north-eastern and northern regions. At the macro-level, the coexistence of stunting, overweight, and anaemia circumstantiates the triple burden of childhood malnutrition with substantial spatial variation (Moran's I: stunting-0.53, overweight-0.41, and anaemia-0.53). Multilevel analysis reveals that child, maternal, and household variables play a substantial role in determining malnutrition burden in India. The nutritional health is significantly influenced by a wide range of determinants, necessitating multilevel treatments targeting households to address this diverse group of coexisting factors. Given the intra-country spatial heterogeneity, the treatment also needs to be tailor-made for various disaggregated levels. [ABSTRACT FROM AUTHOR]

Congenital anomalies are distressing events for future parents/parents when a foetal anomaly is detected during pregnancy or when the infant is born with a disability or a congenital disorder. Maternal health services in India do not provide information on these disorders as part of routine activities. The objective is to understand women's knowledge and attitude on causes, prevention, rights; attituted towards disability; and knowledge on medical care, rehabilitation, and welfare services in Pune district, India, with the goal of identifying the contents of birth defects education resources. The study used a qualitative descriptive design. Six focus group discussions were conducted with 24 women from Pune district. Qualitative content analysis was used to identify emergent themes. Three themes emerged. Firstly, women's knowledge on congenital anomalies was limited. These conditions were discussed generally with other adverse pregnancy experiences, and with reference to children with disabilities. Secondly, pregnancy termination for conditions considered untreatable was majorly advocated by most women. Directive counselling for pregnancy termination by doctors was common. Thirdly, stigmatizing attitudes were responsible for children with disabilities being considered a burden, for maternal blaming, and for the stigma and isolation of families. Knowledge on rehabilitation was limited. The study identified that participants. Three target groups and contents for birth defects education were identified. Women's resources should include knowledge on preconception and antenatal opportunities for reducing risks, available medical care, and legal rights. Parents' resources should provide information on treatment, rehabilitation, legal provisions, and rights of disabled children. Resources for the general community should additionally include disability sensitization messages to ensure the inclusion of children with congenital disabilities. [ABSTRACT FROM AUTHOR]

Childhood stunting is recognized as significant public health concern in India. It is a form of malnutrition with impaired linear growth and creates a range of adversaries among children, including under-5 mortality, morbidity, and physical and cognitive growth. The purpose of the present study was to recognize the various leading determinants causing childhood stunting from both individual and contextual level in Indian context. Data were obtained from the India's Demography and Health Survey (DHS) conducted in 2019–2021. A total of 1, 46,521 children aged 0–59 months were included in this present study. The study applied a multilevel mixed-effect logistic regression model in which individual factors nested within community based contextual-level factors estimating the likelihood of childhood stunting phenomena among Indian children. The variance explained in full model accounted for about 35.8% of the odds of stunting across the communities. The present study elucidates that the recognized factors from individual level characteristics have really increased the odds of childhood stunting: gender of child, multiple births, low birth weight, low BMI among mothers, less educational attainment by mothers, maternal anemic status, breast feeding duration longer than usual, < 4 antenatal care (ANC) visits during gestation period. Similarly, contextual-level factors like rural places of residence, western Indian children, and communities with high poverty rates, lower literacy rates, improper sanitation, and unsafe drinking water were also found to have a significant positive association with childhood stunting. The study finally concludes that cross level interaction between individual and contextual-level factors are identified as significant determinants of linear growth retardation among child in India. In order to reduce this type of malnutrition among the child one should more concentrate on both individual and contextual-level factors as a notable reasons. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five. Study design: Cross-sectional study. Methods: The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed. Results: Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79–0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69–0.99) are less likely to seek treatment. Conclusion: The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost. [ABSTRACT FROM AUTHOR]

Due to the limited availability of suitable measures, screening children for developmental delays and social–emotional learning has long been a challenge in India. This scoping review examined the use of the Parents’ Evaluation of Developmental Status (PEDS), PEDS: Developmental Milestones (PEDS:DM), and the Strength and Difficulties Questionnaire (SDQ) with children (

Background: Fever with rash is common among children and is seen by both dermatologists and pediatricians. The various causes of fever with rash in children include viral infections, bacterial infections, rickettsial species, collagen vascular diseases, and drug hypersensitivity rash. Viral exanthems are by far the most common cause of fever with rash in children. Common viral etiologies are measles, rubella, varicella, adenovirus, herpes simplex virus (HSV) 1 and 2, human herpes virus 6, human herpes virus 7, Epstein–Barr virus, coxsackie, dengue, chikungunya, influenza A and B, and hepatitis B. Aims: The study aimed to study the magnitude of various viral causes of fever with rash in children and to study the various morphological patterns of rash. Materials and Methods: This was a hospital-based observational study which included 90 children presenting to the dermatology and pediatrics outpatient department with fever and rash. Immunoglobulin M antibody testing for measles, rubella, varicella, HSV, chikungunya virus, dengue virus, and hepatitis B virus was done. Reverse transcription-polymerase chain reaction for COVID-19 virus was done when suspected. Results: The most common etiology of fever with rash was viral (51.1%). Out of all viruses isolated, measles was the most common (15.55%), followed by Chikungunya (14.44%). Maculopapular rash was the most common morphology of rash (40%) found in patients. Among the patients having maculopapular rash, measles was the most common virus isolated. Conclusion: Viral exanthems should be considered a strong differential in all children presenting with fever and rash.

Background: Non-genetic factors like microbial dysbiosis may be contributing to the increasing incidence/progression of type 1 diabetes mellitus (T1DM). Objectives: To analyse the gut microbiota profile in Indian children with T1DM and its effect on glycaemic control. Methodology: Faecal samples of 29 children with T1DM were collected and faecal microbial DNA was extracted and subjected to 16S rRNA (ribosomal RNA) sequencing and further analysis. Results: The dominant phyla in children with T1DM were Firmicutes and Bacteroidetes. Butyrate-producing bacteria Blautia and Ruminococcus showed a significant negative correlation with the glycosylated haemoglobin (HbA1C) levels (p < 0.05). Coprococcus and Propionibacterium were important negative predictors of glycaemic control (p < 0.05). Conclusion: Our study suggests that Indian children with T1DM have a distinct gut microbiome taxonomic composition and that short-chain fatty acid-producing bacteria like Ruminococcus and Blautia (butyrate-producing) may play an important role in the glycaemic control of subjects with T1DM.

Childhood injuries are a major public health challenge in India and globally. This systematic review was conducted to understand the burden and spectrum of childhood injuries, with a focus on unintentional injuries, among children 5–14 years of age and to suggest approaches to prevention that can be adopted in the Indian context. This systematic review was conducted with the standard approach and use of keywords. A total of 33 studies which were found to be relevant were analyzed. Road traffic accidents (RTAs) contribute to nearly 85% of all unintentional injuries and related deaths and 90% of disability-adjusted life years (DALYs) lost in developing countries. Poor traffic regulation, heavy traffic load, and poor skill of identifying the dangerous road crossing sites make the children's age group vulnerable and prone to RTA. Children with poor skill of identification and response to dangerous road crossing sites, along with heavy unregulated traffic were found to be the major reasons for such accidents and make this age group more vulnerable. Public health-based prevention approaches need to be based upon legislation, regulation, and enforcement, as well as environmental modification, education and skill development, emergency medical care using levels of prevention, and principles of targeted prevention to effectively address child health challenges. Addressing child injuries should be a key component of all endeavors aimed at enhancing child mortality and morbidity rates, as well as the overall welfare of children, both at the national and global levels. It is imperative to prioritize policies focused on preventing unintentional injuries across all age groups, with particular attention to children.

Background/Objective: With strong evidence of physical inactivity's link to chronic disease and economic burden – particularly with childhood active living behaviors tracking into adulthood – it is imperative to promote physical activity among children and adolescents in India. Objectives: To evaluate active living patterns among Indian children and adolescents. Methods: The India Report Card (IRC) team, which consists of experts in India and Canada, systematically collected and appraised evidence on 11 indicators of active living, including 5 behavioral (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior), 2 individual-level (Physical Fitness, Yoga) and 4 sources of influence (Family and Peers, School, Community and Built Environment, Government). Peer-reviewed articles were appraised based on national representativeness, sample size, and data quality. Grey literature was appraised based on comprehensiveness, validity of the sources, and representativeness. All indicators were assessed against parameters provided by the Active Healthy Kids Global Alliance. Results: Active Transportation and Government Strategies were ranked highest with a B- and C+ grade, respectively. Overall Physical Activity and Schools were assigned a C grade, while Sedentary Behavior and Community and Built Environment were given D grades. Yoga was the lowest ranking indicator with a D- grade. Organized Sport Participation, Active Play, Family and Peers, and Physical Fitness were all graded incomplete. Conclusions: Active Transportation, Government Strategies, and Overall Physical Activity have improved since the 2018 IRC, a positive trend that needs to be translated to other indicators. However, Sedentary Behavior has consistently worsened, with grades C, C-, and D-, in 2016, 2018, and 2022, respectively. Evidence generated by the 2022 IRC suggests opportunities for improvement not only in India, but also the 56 other countries taking part in Global Matrix 4.0.

Context: In India, pneumonia deaths in the past decade show a decreasing trend in the child mortality rate from 74.6 to 45.4. However, NFHS-5 records an increase in prevalence to 2.8% from 2.7% in NFHS-4. The childhood pneumonia control strategies focus on strengthening the health system, skill-building health workers, counseling, and creating awareness about promoting healthy behaviors regarding the management of sick children. Aims: The study attempts to understand "caregivers" care-seeking behavior and the management of childhood pneumonia. Setting and Design: The study was conducted in the Akkalkuwa block of Nandurbar district, Maharashtra, India. We used episodic interviews, asking caregivers to recollect specific events linked to the need for treatment. Methods and Material: A total of 11 in-depth interviews of mothers were conducted whose under-five children had pneumonia in the past year. These interviews used vignettes from real pneumonia cases to discuss community priorities for health care and actions taken to improve child's health. In addition, the qualitative data from the in-depth interviews were thematically analyzed. Result: Cough, breathlessness, and disturbance in the routine schedule of the child were the major symptoms to identify pneumonia (vavlya) among children. Branding on the stomach, oil massage, and jadi-buti were commonly observed phenomena to seek help. Low priority, the influence of traditional healers and herbal medicines, and the inaccessibility of quality healthcare services were the main factors that led to the child's treatment. Conclusion: Culturally appropriate activities are to be imparted on recognition of symptoms and appropriate care seeking, and community health workers need capacity building. [ABSTRACT FROM AUTHOR]

Introduction and Aims : Dilated cardiomyopathy (DCM) is an important cause of heart failure (HF) among children. Research on pediatric DCM remains surprisingly scarce. The primary objective of the study was to evaluate the clinical profile and outcomes of pediatric DCM and the secondary objective was to study the predictors of outcome. Methods and Results : We enrolled all patients with cardiomyopathy who presented to us between 1990 and 2020 and were younger than 18 years. During the 30-year study period, we identified 233 cases of pediatric cardiomyopathy. One hundred and nineteen (51%) cases had DCM. This retrospective cohort was analyzed to study their outcome and the possible predictors of outcome. Nearly, 8% presented in the neonatal period, and 37% in infancy. The most common mode of presentation was dyspnea on exertion (71%). Ninety-three patients presented in heart failure (78%). The median left ventricular dimension z-score in diastole was 4.3 (range 2.5--9.06). The median left ventricle (LV) ejection fraction was 31%. Seventy-two percent of this cohort were on angiotensin-converting-enzyme inhibitors, 40% on aldosterone antagonists, and 47% on beta-blockers. One-third had syndromic, metabolic, genetic, or any secondary cause identified. Twenty-seven patients satisfied the three-tiered clinical classification for the diagnosis of probable acute myocarditis. Over a mean follow-up of 3.29 years, 27% were lost to follow-up. Among the remaining patients who were on follow-up (n = 86), 39 (45%) died, 31 (36%) recovered, and 16 (18%) had persistent LV dysfunction. Heart Failure was the most common cause of death. Eight patients in this cohort (4.2%) had thromboembolic phenomena. Nine had sustained ventricular arrhythmias and six had atrial/junctional arrhythmias. Among the various risk factors studied, only infantile onset had a significant relationship with death or ventricular arrhythmias (P value-- 0.05). The 5-year survival rate of DCM patients was 59%. Conclusion : A reasonably good percentage of our population showed recovery of the left ventricular function (36%). Only infantile onset had a significant relationship with death or ventricular arrhythmias. The outcome in our DCM cohort is similar to other population cohorts. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand the parental stress, psychological distress, and parenting practices of parents of pre-schoolers during the COVID-19 pandemic. Methods and Materials: An online cross-sectional survey was conducted with the parents of preschool children aged 3–6 years. Researchers used the Parental Stress Scale, Self-Reporting Questionnaire, and Parent Practice Interview to collect data from parents in the Southern Indian city of Bengaluru. Results: A total of 60 responses were obtained from the online survey. Moderate to a high level of parental stress and mild to moderate levels of psychological distress were found among the parents. Around 21 (35%) of parents were found in need of mental health consultation. The study found no group differences in parental stress and psychological distress among various socio-demographic variables. The study found a significant association between parental stress and the parenting practices of participants. Higher mean scores were observed on mothers in setting clear expectations of pre-schoolers. Conclusion: Parenting young pre-schoolers is a difficult task. COVID-19 pandemic has made the parenting process challenging for parents. Parents must engage the children at home, and helping them cope with the new environment is a tightrope walk. Such uncertainties are supposed cause distress and lead to poor parenting parents among the parents, especially with pre-schoolers who are more demanding. There is a need to address parents' concerns and train them to deal with the situations effectively. [ABSTRACT FROM AUTHOR]

Background and Aims: The outbreak of Tomato flu in India has affected the children making the parents tremble in worry and pain. The outbreak of this disease first occurred in India affecting young children below 5 years of age, thereby causing a threat to the country, neighboring countries, and the rest of the world—although no death is yet recorded. The aim of this research is to discuss the issues, challenges, and possible solutions associated with 2022 Tomato flu outbreaks in India. Results: Tomato flu is caused by Coxsackievirus A16 as confirmed in the United Kingdom. The health authorities are currently monitoring the spread of the virus and trying to understand it to develop strategies to contain it. But they are left with some challenges relating to the health system, surveillance, and adherence to preventive protocols among others. Conclusion: To prevent the spread of Tomato flu to other neighboring countries like China, Bangladesh, Pakistan, Sri Lanka, Myanmar, Afghanistan, Bhutan, Nepal, and the Maldives, the Indian Government must provide adequate public health control measures to contain the disease in children. Various recommendations have been given below. [ABSTRACT FROM AUTHOR]

Due to the limited availability of suitable measures, screening children for developmental delays and social–emotional learning has long been a challenge in India. This scoping review examined the use of the Parents' Evaluation of Developmental Status (PEDS), PEDS: Developmental Milestones (PEDS:DM), and the Strength and Difficulties Questionnaire (SDQ) with children (<13 years old) in India. The scoping review was conducted following the Joanna Briggs Institute Protocol to identify primary research studies that examined the use of the PEDS, PEDS:DM, and SDQ in India between 1990 and 2020. A total of seven studies for the PEDS and eight studies for the SDQ were identified for inclusion in the review. There were no studies using the PEDS:DM. Two empirical studies used the PEDS, while seven empirical studies used the SDQ. This review represents the first step in understanding the use of screening tools with children in India. [ABSTRACT FROM AUTHOR]

The studies conducted a decade ago showed that the Ponseti method, suffers from many execution-related issues-particularly in low and middle-income countries including poverty, physical distance, lack of transportation etc. The society has undergone many changes, including improvements in literacy, connectivity (both transport and digital), etc., in the last decade. Therefore, this study is designed to identify the contemporary apprehensions, concerns, and challenges of parents seeking CTEV treatment for their child through the Ponseti Method in India. A descriptive cross-sectional study of 200 parents of the children undergoing treatment at a multi-specialty hospital is carried out using an interview guide. The semi-structured interviews were conducted telephonically and recorded. The statistical analysis shows that a male child is presented late than a female child. The physical distance is associated with child discomfort during the casting and bracing phase, with the travel method affecting the follow-up. The increase in travel time may result in increased casts due to a lack of regular follow-up. Parents' income level is also strongly associated with regularity of follow-up and child discomfort during treatment. The patients traveling long distances in public transport are the most vulnerable group regardless of gender. The children in such cases are more likely to experience discomfort during the casting and bracing phase with a lack of regular follow-up. Expert doctors and brace unavailability in the local area remain vital challenges for the parents. [ABSTRACT FROM AUTHOR]

With strong evidence of physical inactivity's link to chronic disease and economic burden – particularly with childhood active living behaviors tracking into adulthood – it is imperative to promote physical activity among children and adolescents in India. To evaluate active living patterns among Indian children and adolescents. The India Report Card (IRC) team, which consists of experts in India and Canada, systematically collected and appraised evidence on 11 indicators of active living, including 5 behavioral (Overall Physical Activity , Organized Sport Participation , Active Play , Active Transportation , Sedentary Behavior), 2 individual-level (Physical Fitness , Yoga) and 4 sources of influence (Family and Peers , School , Community and Built Environment , Government). Peer-reviewed articles were appraised based on national representativeness, sample size, and data quality. Grey literature was appraised based on comprehensiveness, validity of the sources, and representativeness. All indicators were assessed against parameters provided by the Active Healthy Kids Global Alliance. Active Transportation and Government Strategies were ranked highest with a B- and C+ grade, respectively. Overall Physical Activity and Schools were assigned a C grade, while Sedentary Behavior and Community and Built Environment were given D grades. Yoga was the lowest ranking indicator with a D- grade. Organized Sport Participation , Active Play , Family and Peers , and Physical Fitness were all graded incomplete. Active Transportation , Government Strategies , and Overall Physical Activity have improved since the 2018 IRC, a positive trend that needs to be translated to other indicators. However, Sedentary Behavior has consistently worsened, with grades C, C-, and D-, in 2016, 2018, and 2022, respectively. Evidence generated by the 2022 IRC suggests opportunities for improvement not only in India, but also the 56 other countries taking part in Global Matrix 4.0. [ABSTRACT FROM AUTHOR]

Low dietary diversity significantly interplays with children's growth failure. However, evidence of its crucial role in children's health remains inconclusive in developing countries such as India. This study attempts to find the association between dietary diversity and growth outcomes among children aged between 6 and 23 months in India using the fourth round of the National Family Health Survey (NFHS), 2015–2016. A total of 67,278 mother-child pairs of children between the ages of 6–23 months and mothers aged 15–49 years were included in this study. Pearson's chi-square significance test and multivariable logistic regression were used to determine the association between dietary diversity and child growth outcomes (stunted, wasted, and underweight). The study found that the prevalence of stunting and severe stunting among children aged between 6 and 23 months were 35.9% and 16.2%; 23.8% and 8.5% represented wasting, and severe wasting; and more than 32%, 10% were underweight and severely underweight respectively. This present study found that having an inadequate minimum dietary diversity (<4 food groups) significantly increases the risk of being stunted (adjusted odds ratio (AOR) = 1.29; 95% confidence interval (CI); 1.21–1.38), wasted (AOR = 1.29; 95% CI; 1.21–1.38), and underweight (AOR = 1.47; 95% CI; 1.39–1.56). Further, it was noted that children who did not intake dairy products, eggs, and other fruits and vegetables were more likely to be stunted, wasted, and underweight and more likely to be severely stunted, wasted, and underweight. Therefore, additional nutrition-specific interventions are urgently needed to strengthen and enhance existing feeding interventions aimed at improving infant and young child feeding (IYCF) practices, including complementary feeding practices among children aged between 6 and 23 months in India. The Government should focus such interventions more on states or regions where the prevalence of adequate minimum dietary diversity (MDD) and malnutrition is high. [ABSTRACT FROM AUTHOR]

The article advocates for an inclusive immunization schedule in India, emphasizing the need to extend the current program to cover individuals up to the age of 26. It highlights the potential benefits, including enhanced individual protection, reduced disease transmission and prevention of outbreaks and proposes a comprehensive vaccine schedule tailored to different age groups to address the unique healthcare challenges in India.

Abstract Background and Aims The outbreak of Tomato flu in India has affected the children making the parents tremble in worry and pain. The outbreak of this disease first occurred in India affecting young children below 5 years of age, thereby causing a threat to the country, neighboring countries, and the rest of the world—although no death is yet recorded. The aim of this research is to discuss the issues, challenges, and possible solutions associated with 2022 Tomato flu outbreaks in India. Results Tomato flu is caused by Coxsackievirus A16 as confirmed in the United Kingdom. The health authorities are currently monitoring the spread of the virus and trying to understand it to develop strategies to contain it. But they are left with some challenges relating to the health system, surveillance, and adherence to preventive protocols among others. Conclusion To prevent the spread of Tomato flu to other neighboring countries like China, Bangladesh, Pakistan, Sri Lanka, Myanmar, Afghanistan, Bhutan, Nepal, and the Maldives, the Indian Government must provide adequate public health control measures to contain the disease in children. Various recommendations have been given below.

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Background: Mental illness in parents impairs their parenting capability, which has a lifelong detrimental impact on their children's physical and psychological health. In the current Indian context, due to weak social security nets, family is the only plausible intervention to ensure adequate substitute child care. Therefore, this study explores various risk factors and barriers to providing substitute family care. Methods: We used a mixed-method approach to gather information from 94 substitute family caregivers. Quantitative screening data were collected from four hospitals using a clinical data mining tool and an interview guide to gather caregiver perspectives on economic, familial, and social risks and barriers associated with caring. We used thematic analysis to consolidate the qualitative findings. Results: Most of the substitute caregivers were females from low-income households. The study identified 11 sub-themes and 23 specific themes associated with risks and barriers to substitute care. These themes fell into four broad areas: economic, familial, school-related risks, and specific cultural and service access barriers. Focus on economic interventions is likely to result in strengthening the substitute family caregiver. Conclusion: The paradigmatic shift of treatment focus from the patient to the entire household would benefit the children just as it does the patient. [ABSTRACT FROM AUTHOR]

Background: Increasingly researchers are recognising the importance of including the perspectives of children and young people in research and in the development of interventions and innovations, in order to understand children's lives on their own terms. Purpose: This article reflects on the potential risks posed to children and young people in research and the role of gatekeepers in granting access and, in direct field activities, especially where the research could be deemed as 'sensitive'. Research Design: Using a combined descriptive and autoethnographic research design, questionnaires and reflections were gathered from the field experiences of researchers in four countries (India, Jamaica, Uganda and the UK) conducting research on children's experiences of violence victimisation as part of a gender-based violence prevention project. Data was collected retrospectively and analysed thematically with the aid of QSR NVivo. Results: Based on the five themes that emerged: accessing schools; approach to access; accessing participants; lessons learnt; and advice for other researchers, the overall findings indicate that researching sensitive topics with children and young people is necessarily problematic in order to safeguard them. This is especially the case in contexts where discrimination and stigma relating to certain topics may be a significant barrier to children's participation. Conclusion: Research planning requires attention to gatekeeper power, safeguarding children and young people, and understanding how processes and attitudes concerning the status and rights of children at national and institutional levels might influence the research process. [ABSTRACT FROM AUTHOR]

Anaemia control programmes in India are hampered by a lack of representative evidence on anaemia prevalence, burden and associated factors for adolescents. The aim of this study was to: (1) describe the national and subnational prevalence, severity and burden of anaemia among Indian adolescents; (2) examine factors associated with anaemia at national and regional levels. Data (n = 14,673 individuals aged 10–19 years) were from India's Comprehensive National Nutrition Survey (CNNS, 2016–2018). CNNS used a multistage, stratified, probability proportion to size cluster sampling design. Prevalence was estimated using globally comparable age‐ and sex‐specific cutoffs, using survey weights for biomarker sample collection. Burden analysis used prevalence estimates and projected population from 2011 Census data. Multivariable logistic regression models were used to analyse factors (diet, micronutrient deficiencies, haemoglobinopathies, sociodemographic factors, environment) associated with anaemia. Anaemia was present in 40% of girls and 18% of boys, equivalent to 72 million adolescents in 2018, and varied by region (girls 29%–46%; boys 11%–28%) and state (girls 7%–62%; boys 4%–32%). Iron deficiency (ferritin < 15 μg/L) was the strongest predictor of anaemia (odds ratio [OR]: 4.68, 95% confidence interval [CI]: [3.21,6.83]), followed by haemoglobinopathies (HbA2 > 3.5% or any HbS) (OR: 2.81, 95% CI: [1.66,4.74]), vitamin A deficiency (serum retinol <20 ng/ml) (OR: 1.86, 95% CI: [1.23,2.80]) and zinc deficiency (serum zinc < 70 μg/L) (OR: 1.32, 95% CI: [1.02,1.72]). Regional models show heterogeneity in the strength of association between factors and anaemia by region. Adolescent anaemia control programmes in India should continue to address iron deficiency, strengthen strategies to identify haemoglobinopathies and other micronutrient deficiencies, and further explore geographic variation in associated factors. Key messages: The Comprehensive National Nutrition Survey (CNNS) 2016–2018 is the only nationally representative survey to measure haemoglobin, haemoglobinopathies, biomarkers of micronutrient deficiencies, diet and social factors in Indian adolescents aged 10–19 years.Using CNNS data, we found that 28.5% of adolescents (girls: 39.6%, boys: 17.6%) were anaemic, with variation by region or state.Our prevalence estimates translate to 72 million adolescents being anaemic, with Uttar Pradesh having twice as many anaemic adolescents as any other state.Iron deficiency, haemoglobinopathies, vitamin A deficiency and zinc deficiency were associated with an increased risk of anaemia; these associations may vary subnationally. [ABSTRACT FROM AUTHOR]

This review was designed to assess the pooled prevalence of early childhood caries (ECC) in India. An electronic data search was done in PubMed/MEDLINE and Scopus databases in October 2020. Epidemiological surveys assessing the prevalence of ECC were included, and data on gender, geographic region, sampling strategy, feeding habits, and dmft values were extracted. The risk of bias was assessed, and a meta-analysis was performed for pooled prevalence and mean dmft values. The selection of articles, data extraction, and validity assessment were done independently by the two reviewers (ID and RV). A third reviewer (CJ) resolved any conflict between these two reviewers. A total of seventy-one studies were included for quantitative analysis. The pooled prevalence of ECC estimated from 71 studies with 69,330 participants is 46.9% (confidence interval [CI] 46.5–47.2). Males had a higher prevalence of ECC (47%, CI: 46.4–47.6,40 studies, 26,840 participants) than females (43.8%, CI: 43.2–44.2,40 studies, 24,389 participants). Region-wise analysis showed the highest number of studies (44) in southern India, with a sample size of 35,988 with a pooled prevalence of 44.6% (CI: 44–45.1). The pooled mean dmft (random effect) is 2.23 (1.97–2.48), with males having a higher proportion of 2.26 compared to 2.23 in females. The pooled prevalence of ECC was 46.9%, and the pooled mean was 2.23. The results from this study state that one in every two children in India is suffering from ECC, reflecting its public health relevance.

Introduction: To date, the focus on COVID-19 among children, especially in low- and middle-income countries, has been to address key issues including poor vaccination rates. However, the focus is changing with new variants and concerns regarding the development of hyperinflammatory syndromes. There have also been concerns with the overuse of antibiotics to treat patients with COVID-19, with the Indian Government developing guidelines, including those for children, to improve patient care. Consequently, a need to document the current management of children with COVID-19 in India and use the findings for future guidance. Materials and Methods: Pilot study assessing the management of children with COVID-19 among five hospitals in India using purposely developed case report forms, which had been piloted in Bangladesh. Results: Low numbers of children in hospital with COVID-19 (11.9% of in-patient beds). The majority were boys (58.3%) and between 11 and 18 years (55.5%). Reasons for admission were in line with previous studies and included respiratory distress/breathing difficulties. 69.4% of children with COVID-19 were prescribed antibiotics empirically, typically those on the Watch list, and administered parenterally, with only limited switching to oral therapy. A minority were prescribed antimalarials, antivirals and anti-parasitic medicines. There was appreciable prescribing of immune boosters and steroids. Conclusion: It was encouraging to see low hospitalisation rates. However, concerns with high empiric use of antibiotics and limited switching to oral formulations need to be addressed potentially, by instigating antimicrobial stewardship programmes. Similarly, other antimicrobials where these are not recommended.

Abstract Background Vaccination is considered as a powerful and cost-effective weapon against many communicable diseases. An increase in full vaccination among the most vulnerable populations in Bangladesh was observed in the last decade. This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination among children aged 12–23 months using the nationally representative data from the Bangladesh Demographic and Health Surveys (BDHS). Methods Data for this study have been drawn from the 2007 and 2017–18 BDHS, which covered 10,996 and 20,127 ever-married women aged 15–49 years in 2007 and 2017–18, respectively. Binary logistic regression analysis was performed to find the factors associated with children who did not receive full vaccination. Further, the concentration index was used to observe the socioeconomic inequality for the outcome variable. Results The proportion of children who did not get fully vaccinated decreased by more than 6 points (18.2 percent to 11.8 percent) between the years 2007 and 2017–18. In 2017–18, the odds of children who were not fully vaccinated were 58 percent and 53 percent less among mothers who had primary education in 2007 [adjusted odds ratio (AOR): 0.42; confidence interval (CI): 0.24–0.73] and 2017–18 [AOR: 0.47; CI: 0.23–0.94] respectively, compared to mothers with no education. The inequality for children who were not fully vaccinated had declined between two survey periods [concentration index (CCI) value of − 0.13 in 2007 and -0.08 in 2017–18]. The concentration of inequality in children with higher parity who did not receive full vaccination had increased from 5 percent in 2007 to 16.9 percent in 2017–18. There was a drastic increase in the socioeconomic inequality contributed by place of delivery from 2.9 percent (2007) to 60.5 percent (2017–18) among children who did not receive full vaccination. Conclusions The present study provide eminent evidence that non-coverage of full vaccination is more prevalent among children from poor households in Bangladesh, which is mainly associated with factors like mother’s education, father’s education and working status and household wealth index across the two rounds. These factors suggest multifaceted pro-poor interventions that will protect them from hardship and reduce their socioeconomic inequalities in coverage of full vaccination.