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Introduction and Aim: In Malaysia, pertussis in children beyond infancy is underreported. This study aimed to determine the prevalence of Bordetella pertussis and the prevalence of pertussis-susceptible children aged ≥4 years who presented with acute respiratory infections., Methods: This single-center, cross-sectional study conducted at the Paediatric Emergency Department from 1 October 2022, to 31 January 2023, included children aged 4 years and older with ARTIs symptoms and excluded those who were COVID-19 positive. B. pertussis was detected via quantitative Polymerase Chain Reaction on nasopharyngeal swabs and pertussis toxin (PT) IgG enzyme-linked immunosorbent assay., Results: Children ( n  = 298) with a median (Interquartile range, [IQR]) age of 6.0 (5.0, 8.0) years old were recruited, and 98% were vaccinated adequately. Two cases of B. pertussis ( n  = 2/298, 0.67%) were detected. Both children were also co-infected with Bordetella spp . The majority of the patients ( n  = 246/296, 83.1%) had low protective antibodies against pertussis (anti-PT IgG <5 IU/ml), and children 5 years and older were more likely to have lower anti-PT Ig G levels of <5 IU/ml (odds ratio 2.02 [95% CI 1.04,3.90]) compared to children 4 years old., Conclusion: The prevalence of pertussis was low. However, there is significant waning immunity. Booster doses of pertussis vaccine should be given to all school-aged children.

Study Objectives: The effect of recombinant human growth hormone (rhGH) on sleep-disordered breathing (SDB) in Malaysian children with Prader-Willi syndrome (PWS) is under-investigated. We determined (1) the short- and long-term effects of rhGH and (2) factors associated with worsening SDB in children with PWS receiving rhGH., Methods: This retrospective study included children with PWS (with and without rhGH) who had undergone at least 1 polysomnography. Outcomes measured were the presence of SDB before and after starting rhGH and the progress of SDB with and without rhGH. Serial insulin-like growth factor 1 (IGF-1) measurements were recorded., Results: One-hundred and thirteen polysomnograms were analyzed. The majority (92.3%) of initial polysomnograms showed SDB, with a median (interquartile range) apnea-hypopnea index of 5.0 (2.6, 16.3) events/h. The age for receiving rhGH was a median (IQR) of 1.9 (0.7, 3.4) years. One-third (36.8%) had worsening SDB after initiating rhGH, which was associated with higher IGF-1 levels post-rhGH ( P = .007). After a median of 5 years of rhGH, 73.6% maintained or reduced their positive airway pressure settings. Without rhGH, 80% had increased their positive airway pressure settings. Worsening SDB while on rhGH was associated with higher body mass index, lower rhGH dose, higher IGF-1 levels, and non-15q deletion., Conclusions: The majority of Malaysian children with PWS had SDB. At initiation of rhGH, one-third of patients had worsening SDB, associated with increased IGF-1 levels. Stabilization of SDB was more frequently seen in those receiving long-term rhGH. Worsening SDB while on rhGH was associated with a higher body mass index, receiving a lower dose of rhGH, higher IGF-1 levels, and non-15q deletion., Citation: Tan YT, Azanan MS, Hng SY, et al. Long-term effect of growth hormone on sleep-disordered breathing in Malaysian children with Prader-Willi syndrome: a retrospective study. J Clin Sleep Med . 2024;20(8):1291-1299., (© 2024 American Academy of Sleep Medicine.)

Background and Objectives: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life., Methods and Study Design: This prospective cohort study included healthy motherinfant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months., Results: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01)., Conclusions: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.