Scielo RSS <![CDATA[South African Journal of Child Health]]> vol. 12 num. 2 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>Jellyfish envenomation: A chilling toxidrome of seizures and cyanosis - a case report</b>]]> Jellyfish envenomation is a common incident in coastal areas all over the world. While the majority of reported cases are self-limiting with few lasting complications, a few deadly species can cause life-threatening and debilitating illnesses with a prolonged recovery time. Chrysaora spp. have been known to cause a diverse spectrum of manifestations. We report the case of a 7-year-old boy with jellyfish envenomation presenting with cyanosis, seizures, and hypertension not previously described in association with the Chrysaora spp. <![CDATA[<b>The role of kidney injury molecule-1, interleukin-18 and glutathione-S-transferase-</b><b>π</b><b> in paediatric HIV-associated nephropathy</b>]]> BACKGROUND. HIV-associated nephropathy (HIVAN) in sub-Saharan Africa remains a significant cause of morbidity and mortality in children. Early detection of kidney injury is essential for injury-specific interventions that may avert permanent kidney damage and delay progression of kidney injury. Kidney biopsy is presently the gold standard for diagnosis of related kidney disease; however, it is pervasive with attendant complications, and may not be representative owing to sampling error. Serum creatinine is an insensitive and non-specific marker for the diagnosis of various kidney diseases, particularly in HIV-infected patients, who usually have varying degrees of muscle wasting. Therefore, a non-invasive approach using additional biomarkers for early detection of HIV-related kidney diseases, particularly HIV-associated nephropathy (HIVAN), is urgently needed. OBJECTIVE. To determine the urinary concentrations of kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18) and glutathione-S-transferase-π (GST-π) in children with idiopathic focal segmental glomerulosclerosis (FSGS) and HIVAN. Methods. The study group comprised 34 children: 13 with HIVAN and 21 with idiopathic FSGS. The control groups were 19 HIV-positive and 16 HIV-negative children with no kidney disease. Urine samples collected from these 69 children were stored at -80°C. Urinary concentrations of KIM-1, IL-18 and GST-π were quantified using Bio-Plex assay. RESULTS. A significant increase in urinary KIM-1 levels was observed in the HIVAN group compared with the HIV-positive (p=0.0039) and HIV-negative (p=0.0438) control groups. There was no significant increase in KIM-1 levels on comparison of the idiopathic FSGS group with the control groups (HIV-positive and HIV-negative children) (p=0.0737 and p=0.1757, respectively). No statistically significant differences were noted in urinary IL-18 and GST-π levels across all study groups. CONCLUSION. Urinary KIM-1 levels are significantly elevated in children with HIVAN and may be a useful biomarker to detect kidney disease in HIV-1-infected children. <![CDATA[<b>Monitoring well-baby visits in primary healthcare facilities in a middle-income country</b>]]> BACKGROUND. Globally, child health services are a priority, but are most acutely felt in underdeveloped and developing countries. Most of the children who live in such countries die from a disease or combination of diseases that could easily have been prevented through immunisations, or treated at a primary healthcare level. Undernutrition contributes to over a third of these deaths. Preventive measures are important to proactively prevent such disease and mortality burdens. Well-baby visits are for babies who come to the clinic for preventive and promotive health, and who are not sick. One of the goals in the National Core Standards is to reduce waiting time in health establishments. However, it is imperative that all necessary assessments are conducted during a well-baby visit. The Road to Health booklet (RtHB) contains the baby's health record, and is issued to all caregivers, usually on discharge post-delivery. It also contains lists of appropriate assessments that should be performed during each well-baby visit according to age, including immunisations and health promotion messages for caregivers. In South Africa, infant morbidity and mortality rates are decreasing very slowly, requiring effective use of the RtHB to address important applied and research problems. OBJECTIVE. To investigate how 'well babies' were monitored in primary healthcare facilities. METHODS. A descriptive quantitative cross-sectional survey design was used for retrospective review of 300 babies' RtHBs, using a checklist developed directly from the assessment page of this booklet. The clinical microsystem model was used to guide the study. Data were analysed using SPSS version 22.0. RESULTS. Babies were shown to have been immunised in 100% of records, while discussion of side-effects and the management thereof were only recorded in 9.7% (n=20) charts. Records indicated that 98.7% (n=296) of babies were weighed, but only 71% (n=213) of weights were 'plotted' and 56.3% (n=169) classified according to the integrated management of childhood illnesses norms. CONCLUSION. Based on the findings, this research was able to make a contribution to the body of knowledge about baby monitoring practices in primary healthcare settings. <![CDATA[<b>Pulmonary hydatidosis: Still unrecognised in endemic regions - a 10-year review</b>]]> BACKGROUND. Echinococcus disease in still endemic in many low-middle-income countries, with 1 million people infected at any one time. Surgery, the mainstay of its treatment, is costly. OBJECTIVES. To describe the presentation, clinical features and outcomes of children referred with pulmonary hydatid disease at Inkosi Albert Luthuli Central Hospital in Durban, South Africa. METHODS. A 10-year review of children with pulmonary hydatid disease at Inkosi Albert Luthuli Hospital was carried out. The data collected were demographic, clinical, laboratory and radiological. Cases were mapped geographically to analyse for clustering of cases. Spearman's correlation was used to assess for correlations between laboratory markers. RESULTS. A total of 24 subjects, 75% of whom were male, were included. The mean (standard deviation) age at diagnosis was 8.9 (3.4) years. The mean delay in diagnosis was 5.8 (5.7) months. Of the subjects, 15 (71.4%) were from the Eastern Cape and 9 from KwaZulu-Natal provinces. Seventy-nine percent of the patients had been exposed to dogs, while 8% reported exposure to either sheep or cattle. There was right-sided preponderance, with 11 right- and 7 left-sided cysts; 6 patients had bilateral cysts, and 4 associated extrapulmonary cysts. Indirect haemagglutination assay was positive in 70%, and blood eosinophilia was present in 45% of the subjects, with no correlation between the two markers (p=0.22). Surgery was the only modality of treatment in 18 (75%) subjects, while 5 had had prior medical therapy for disseminated disease. The mean intensive care stay postoperatively was 2 (2) days with no mortality. CONCLUSION. Despite exposure to known risk factors and living in endemic regions, there is often a significant delay in diagnosis of pulmonary hydatid disease at Inkosi Albert Luthuli Hospital.