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Poor diet quality (diet diversity and animal‐source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school‐age children compared to children <5 years of age, especially in low/middle‐income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school‐age children is needed. A 36‐month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school‐age children (5–8 years at baseline) in these households; the present study analysed findings in the cohort of school‐age children seen at all five study visits (n = 341). Diet quality improved more in the full package school‐age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z‐scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi‐sectoral community development intervention was associated with improvements in diet and growth of school‐age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school‐age children can be favourably influenced by community‐level interventions, even indirectly. Key messages: Relatively less is known about the factors that influence diet quality and growth in school‐age children compared to younger children, especially in low‐ and middle‐income countries.Better diet quality and growth were found among school‐age children whose families participated in an impact study multi‐sectoral intervention compared to children in control families or those whose families only received nutrition training.Diet and growth of school‐age children can be favourably influenced by community‐level interventions. [ABSTRACT FROM AUTHOR]

Background: Little is known about bullying experienced by internationally adopted teens residing in Europe. Objectives: Within the framework of an international research effort involving several European countries, the main goal of this study was to explore the experiences of bullying victimization suffered by adopted adolescents, as well as its impact on their psychological adjustment. Methods: The sample consisted of 199 adolescents born in Eastern European countries and adopted in France (n = 50), Italy (n = 59), Norway (n = 25) and Spain (n = 65). Results: More than half of the adopted adolescents had been exposed to some form of peer victimization in the previous 2 months, with verbal harassment and social exclusion being the most common forms of victimization. Differences between receiving countries were not statistically significant, suggesting a common pattern for Eastern European adopted adolescents living in Western Europe. More frequent experiences of peer victimization were associated with more psychological difficulties among the adopted adolescents. Conclusions: Findings highlight that adopted adolescents might have considerable difficulties in social integration with peers; these experiences of peer victimization might play an important role hindering their psychosocial adjustment. The socioemotional development of adopted people is not only linked to their pre‐adoptive experiences; factors in their daily lives (i.e., peer relationships) may also be associated with their psychological adjustment later in life. Interventions are needed to promote the real inclusion of these groups of children in their social and educational contexts. [ABSTRACT FROM AUTHOR]

Background: Children, especially disadvantaged children in poor countries, were expected to be among the "biggest victims" of the Covid pandemic. Economic burdens, decreased nutritious foods, reduced medical care, school closures, and ill‐health or death of family members were predicted to increase child undernutrition and developmental delays, and diminish home child‐rearing quality. Methods: A planned nutrition intervention could not be implemented due to Covid restrictions. However, three surveys (pre‐Covid [December 2019], July 2021, and September 2021) in 280 Nepali households (309 parent‐dyads, 368 children, 6–66 months old) collected demographics, child anthropometry and development (Ages and Stages Questionnaire‐3 [ASQ‐3]), and home child‐rearing quality (caregiver engagement, learning resources, adult supervision [UNICEF's Multiple Indicator Cluster Survey]). Mixed‐effect regression models adjusted for household (wealth, maternal education) and child factors (age, gender) and survey round. Results: Height, mid‐upper‐arm circumference, and head circumference measurements improved over time. The total ASQ‐3 score did not change: Communication scores increased while fine motor and personal‐social scores declined. Girls' growth and development worsened more than boys. Caregiver engagement (especially mothers') generally declined, but learning resource availability increased. More children were left unsupervised at Round 2 than Round 1 or 3. Conclusions: In this sample, some aspects of child growth, development, and home child‐rearing quality improved while others declined. Better understanding of these changes in child well‐being and the family environment during the pandemic could provide insight on how to protect children during future crises. [ABSTRACT FROM AUTHOR]

Maternal depression has been associated with adverse child growth and development; less is known about its relation to children's diet. In a cross‐sectional study embedded at endline of a longitudinal community development intervention, mothers of 629 children (age 23–66 months) in rural Nepal responded to household and children's diet questionnaires and were screened for depression. Child anthropometry and development (Ages and Stages Questionnaire) were assessed. Regression models examined children's diet, growth and development, adjusting for household, child and maternal characteristics. The prevalence of maternal depression was 21%. Maternal depression was associated with 11% lower likelihood that the child consumed one additional food group [Poisson regression, adjusted relative risk (aRR) 0.89, 95% confidence intervals (95% CI 0.81, 0.99), p = 0.024] and 13% lower likelihood that the child consumed one additional animal source food (ASF) [aRR 0.87, (95% CI 0.76, 1.01), p = 0.061] compared with children of nondepressed mothers. However, maternal depression was not associated with either child anthropometry or development: these outcomes were strongly associated with better home child‐rearing quality. Stunting also related to child age and intervention group; child development related to mother's education and household wealth. This study suggests a correlation between maternal depression and child dietary diversity. This association could be due to unmeasured confounders, and therefore, further research is warranted. Understanding the relationship of depression to child outcomes—and the role of other potentially compensatory household factors—could help address some of the earliest, modifiable influences in a child's life and contribute to innovative approaches to improve child well‐being. [ABSTRACT FROM AUTHOR]

Aim: In the context of global changes in the epidemiology of internationally adopted children (IACs), the prevalence of infectious diseases and nutritional impairment has not been recently reviewed. Moreover, in France, these characteristics of the children according to their continents of origin and preadoption special needs (SN) status have been incompletely explored. Methods: Demographic, infectious data and anthropometric of all the newly arrived IACs seen in a specialised clinic for international adoptees in Paris, France, between 2013 and 2016 were retrospectively reviewed. Results: Three hundred and fifty IACs [mean age: 3.4 years (±2.7), 204 male] from 39 countries were included; 55% had SN. Ninety‐nine patients had at least one infection, 42% being classified as 'serious' (chronic viral infection, tuberculosis or malaria). Chronic viral infection was diagnosed in 26 (7%) patients (HIV: 16 cases, HBV: 5, HCV: 4) and affected especially Asian children (P <.001). The prevalence of stunting, underweight, wasting and microcephaly was, respectively, 25%, 22%, 15% and 8%. Stunting was more frequent in children from Eastern Europe (P =.02), while SN children were more often microcephalic or underweight (respectively P =.03 and.02). Conclusion: The prevalence of serious infections and nutritional impairment remains high in IACs and requires early detection and careful follow‐up. [ABSTRACT FROM AUTHOR]

Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p =.04) or dairy products (aOR 0.95, p =.05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality. [ABSTRACT FROM AUTHOR]

Leptospirosis is an important zoonotic disease in Nepal; however, there is a lack of information on sources of leptospirosis infection for people and associated risk factors. We implemented a case–control study nested within a cross‐sectional survey to investigate zoonotic risks of human leptospirosis among adult, febrile patients seeking treatment in healthcare centres in Kaski District, Nepal, from April to October 2013. The study population was 239 febrile patients; the data consisted of paired blood samples; questionnaires on clinical symptoms; occupational, environmental and animal exposures; and a blood sample from animals in the household. In total, 63 cattle, 92 buffalo, 181 goats, 20 dogs and 14 rodents from 119 households were blood sampled. Serology was performed on the samples using the microscopic agglutination test (MAT) for a panel of 20 serovars with a starting dilution of 1:50. Clinical leptospirosis was defined as a titre of 1:400 or stronger, or a 4‐fold or greater rise between acute and convalescent titres, or evidence of seroconversion for one or more serovars represented by a titre of <1:50 in the acute sample and a titre of ≥1:100 in the convalescent sample. The prevalence of clinical leptospirosis was 5.4% (95% CI 2.6%–8.3%). The most common symptoms among recruited participants were loss of appetite and lethargy followed by chills, profuse sweating and backache. No individual clinical symptom nor combination of any two symptoms was significantly associated with clinical leptospirosis. However, owning goats (OR 1.3, CI 95% 1.05–1.66), working in rice fields (OR 1.3, CI 95% 1.11–1.72) and male gender (OR 4, CI 95% 1.12–17.26) significantly increased the risk of clinical leptospirosis in humans. Findings suggest that leptospirosis should be considered in the clinical differential diagnosis among febrile adult patients in Nepal, especially for men, goat owners and/or those who work in rice fields. [ABSTRACT FROM AUTHOR]

Adults with psoriasis have a greater risk of developing metabolic syndrome ( MetS) and cardiovascular disease ( CVD), but few studies have investigated the prevalence of MetS and other risk factors for CVD in children with psoriasis. In an assessor-blinded study, 20 children ages 9-17 years with a current or previously documented history of psoriasis involving 5% or more of their body surface area or psoriatic arthritis were compared with a cohort of age- and sex-matched controls with benign nevi, warts, or acne. MetS, our primary endpoint, was defined by the presence of abnormal values in at least three of the following measures: triglycerides, high-density lipoprotein cholesterol ( HDL-C), fasting blood glucose ( FBG), waist circumference, and blood pressure. Secondary endpoints included high-sensitivity C-reactive protein (hs- CRP), total cholesterol ( TC), and low-density lipoprotein cholesterol ( LDL-C). Thirty percent (6/20) of children with psoriasis met the criteria for MetS, compared with 5% (1/20) of the control group (p < 0.05). Subjects with psoriasis had higher mean FBG (91.1 mg/dL) than the control group (82.9 mg/dL) (p = 0.01). There were no statistically significant differences in the other four components of MetS, BMI, BMI percentile, hs- CRP, TC, or LDL-C. The results of this trial demonstrate that children with psoriasis have higher rates of MetS than age- and sex-matched controls. It may therefore be important to evaluate children with psoriasis for components of MetS to prevent future CVD morbidity and mortality. [ABSTRACT FROM AUTHOR]

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Aims: Survey the health of young children residing in Russian orphanages. Methods: Retrospective chart review of all 193 ‘healthy’ young children (105M:88F, age range 2–72 months) residing in orphanages in Murmansk, Russia. Results: Mothers of these institutionalized children had complex histories including chronic health problems (38%), use of tobacco (41%), alcohol (39%) and illicit drugs (7%). Frequent diagnoses of the children included rickets (21%), foetal alcohol syndrome (10%), anemia (6%), developmental delay (11% mild, 25% moderate, 28% severe), behavioural problems (60%) and ‘perinatal encephalopathy’ (46% <1 year of age). At orphanage entry, growth delays were common (underweight 34%, short stature 25%, microcephaly 34%). During orphanage residence, height z scores further decreased (p = 0.01), but head circumference improved (p < 0.0001, paired t-tests). Head circumferences increased significantly in 62% of microcephalic children. Smaller children (z score >−2) at entry exhibited more rapid growth (z score/month) for weight (+0.24 vs. −0.12, p = 0.04), height (+0.81 vs. −0.65, p = 0.0001), and head circumference (+1.02 vs. −0.10, p = 0.0004). Growth correlated with child developmental status. Conclusions: Young institutionalized children in Murmansk have complex medical status, social histories and frequent growth and developmental delays. Anthropometric measurements—particularly head circumference—improved during orphanage residence in children who entered with more severe growth delays. [ABSTRACT FROM AUTHOR]

Background: Alcohol use in Russia is among the highest in the world. Over 600,000 children reside in institutional care in Russia, most of them in baby homes and orphanages. The actual prevalence of fetal alcohol spectrum disorders (FASD) among these children is unknown. Therefore, we performed a systematic survey of phenotypic features associated with prenatal alcohol exposure among institutionalized Russian children and related these findings to their growth, development, medical, and social histories. Methods: Phenotypic screening was conducted of all 234 baby home residents in the Murmansk region of Russia (mean age 21+12.6 months). Phenotypic expression scores were devised based on facial dysmorphology and other readily observable physical findings. Growth measurements from birth, time of placement in the baby home, and at present were analyzed. In addition, the charts of 64% of the children were randomly selected for retrospective review. Information collected included maternal, medical, developmental, and social histories. Results: Thirteen percent of children had facial phenotype scores highly compatible with prenatal alcohol exposure and 45% had intermediate facial phenotype scores. These scores correlated with maternal gravidity and age. At least 40% of mothers in whom history was available ingested alcohol during pregnancy; some also used illicit drugs and tobacco. Z scores for growth measurements corresponded to phenotypic score, as did the degree of developmental delay. Children with no or mild delay had significantly lower phenotypic scores than those with moderate or severe delay ( p=0.04); more than 70% of children with high phenotypic scores were moderately or severely delayed. Conclusions: More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers. [ABSTRACT FROM AUTHOR]

ABSTRACT Background. Helicobacter pylori (H. pylori ) infection has been linked to gastritis, diarrhea, peptic ulcers, failure-to-thrive, anemia, as well as predisposition to gastric malignancies. Because many internationally adopted children have diarrhea, failure-to-thrive, and anemia on arrival to the US, we determined the prevalence of HP antibodies among these children. Methods. Serum samples from 226 unselected children from 18 countries who were evaluated in the International Adoption Clinic at New England Medical Center were tested for antibodies to H. pylori . The results of serologic screening were analyzed in relation to age at adoption, site of residence prior to adoption, weight and height, and the presence or absence of anemia, diarrhea, or intestinal parasites. Results. 31% of internationally adopted children had antibodies to H. pylori . The presence of H. pylori -antibodies was associated with residence in an orphanage (vs. foster care) prior to adoption, older age at adoption, and coinfection with intestinal parasites. No direct effects on height or weight were identified; no associations with diarrhea or anemia were found. Conclusions. Internationally adopted children have a high incidence of exposure to H. pylori , as diagnosed serologically. Residence in an orphanage (compared with foster care), older age at adoption, and coinfection with intestinal parasites were more common among children seropositive for anti-H. pylori antibodies. [ABSTRACT FROM AUTHOR]

Examines the affectation of Wegener's granulomatosis (WG) in the respiratory tracts and kidneys. Use of photomicrograph in lesional skin biopsy; Signs and symptoms of the disease; Incidence of WG in pediatric age group.