Africa Knowledge Hub for Children

Peer-reviewed articleEurope PMC28 Aug 2025

Growth impairment in Japanese children with inflammatory bowel disease: A multicenter prospective cohort study.

Objectives To investigate the prevalence and characteristics of growth impairment (GI) in children with inflammatory bowel disease (IBD). Methods In this prospective observational study, 402 children with ulcerative colitis (UC, n = 257) and Crohn's disease (CD, n = 145) were enrolled from the Japanese Pediatric IBD Registry (2012-2020). GI was defined by Paris classification criteria. Longitudinal outcomes were assessed in children with ≥2 years of follow-up (n = 307). Results At diagnosis, the GI prevalence was comparable between children with UC and CD (6.2% vs. 8.3%, p = 0.54). However, children with UC diagnosed at 0-4 years demonstrated significantly higher GI rates (35.3%) than older children (p < 0.001). All children with CD experiencing GI had small intestinal lesions. Among those with GI at diagnosis, fewer children with UC (9%) recovered growth at a 2-year follow-up than those with CD (50%). Among children with normal growth at baseline, new-onset GI occurred in 23% of UC and 16% of CD cases. Of these, 31% recovered within 2 years, while persistent GI was observed in 16% of UC and 11% of CD cases. Prolonged corticosteroid use at 1 year was more frequent in UC (31% vs. 19%, p = 0.02) and was significantly associated with persistent GI. Conclusions Distinct growth patterns exist in Japanese children with IBD. Children with UC diagnosed at 0-4 years are particularly vulnerable and may benefit from early, steroid-sparing treatment. The association between small intestinal lesions and GI in CD emphasizes the importance of small bowel evaluation. Age-specific, patient-centered growth monitoring is crucial to optimize long-term outcomes.

Shimizu H, Nambu R, Tachibana N et al.

Survival

Peer-reviewed articleEurope PMC28 Aug 2026

Perinatal HPA axis regulation and offspring neuropsychiatric development: mechanisms, developmental trajectories, and clinical implications.

Maternal hypothalamic-pituitary-adrenal (HPA) axis regulation forms part of the maternal-placental-foetal system through which prenatal environments may influence offspring developmental trajectories. During pregnancy, cortisol supports placental function and foetal maturation; however, its developmental significance depends on exposure timing, magnitude, and duration, placental glucocorticoid regulation, and foetal susceptibility. This narrative review synthesises evidence regarding maternal psychological distress, endogenous glucocorticoid regulation, placental glucocorticoid pathways, antenatal synthetic glucocorticoid exposure, and offspring neuropsychiatric development. Human studies indicate that maternal psychological distress and HPA-axis-related measures represent related but distinct dimensions of prenatal exposure. Associations have been reported between depressive and anxiety symptoms, maternal cortisol profiles, placental HSD11B2/11β-HSD2-related measures, and offspring glucocorticoid regulation. However, findings vary according to exposure definition, gestational timing, biological matrix, placental sampling, foetal sex, and covariate adjustment. Most evidence remains observational and does not establish a continuous causal pathway from maternal psychological distress through placental glucocorticoid dysregulation to later neurodevelopmental outcomes. Across foetal life, infancy, and childhood, studies have examined associations with stress-system regulation, cognitive and language development, emotional and behavioural functioning, and psychiatric vulnerability. Mechanistic research implicates epigenetic, immune-inflammatory, neurotrophic, cellular, and microbial pathways, although their mediating roles in humans remain incompletely established. Antenatal corticosteroids provide substantial neonatal benefits when clinically indicated for threatened preterm birth; current uncertainty mainly concerns potential long-term effects of repeated or additional exposure. Psychosocial and dietary interventions may improve maternal wellbeing and selected physiological outcomes, but whether these effects are mediated through cortisol regulation remains unclear. Future research should integrate repeated endocrine phenotyping, placental functional assessment, early-life developmental phenotyping, causal-inference approaches, multi-omics strategies, and longitudinal developmental follow-up to distinguish causal mechanisms from adaptation, confounding, and correlated biomarkers.

Guo Y, Liu J, Peng Y et al.

SurvivalDevelopmentProtectionRead at source

Peer-reviewed articleEurope PMC1 Jul 2025

Assessment of knowledge, attitude, and awareness regarding age estimation using forensic odontology among Karnataka Labour Department Officials: A cross-sectional survey.

Context Child labour remains a significant concern in India, with numerous children engaged in hazardous occupations, often lacking valid age documentation. Forensic odontology, a specialised discipline within dentistry, can play a pivotal role in age estimation and individual identification in such cases. However, its integration into child labour enforcement mechanisms is limited. Aim To assess the knowledge, attitude, and awareness of Karnataka State Labour Department officials regarding the role of forensic odontology in age estimation related to child labour cases. Methods A cross-sectional survey was conducted among 80 officials from the Karnataka State Labour Department, each with a minimum of 5 years of experience. A structured questionnaire comprising 20 items assessed knowledge, attitude, and awareness regarding forensic odontology and its relevance to child labour cases. Multivariate data analysis was performed using The Unscrambler X software from CAMO Analytics. Results While a majority of officials had heard of forensic odontology, their primary source of information was media rather than formal training. Most participants acknowledged the significance of forensic odontology in age estimation and expressed interest in undergoing formal training. However, limited access to resources and lack of training were cited as major barriers to its implementation. Conclusion The study reveals a significant knowledge and training gap among Labour Department officials regarding forensic odontology. Incorporating structured training programs and promoting interdisciplinary collaboration could enhance the effective application of forensic odontology in child labour cases.

Satelur KP, Annegowda VM, Priya YBG et al.

ProtectionINRead at source

Peer-reviewed articleEurope PMC1 Mar 2026

Trends in net survival for 1,834,894 patients with cancer from 16 population-based cancer registries in Japan, 2000-14 (CONCORD-3).

Background In 2018, CONCORD-3 updated long-term surveillance of cancer survival trends worldwide. In this monograph, we conducted further analyses and examined trends in net survival using the Japanese data during 2000-14. Methods Sixteen population-based cancer registries in Japan contributed data to CONCORD-3 with anonymized individual records on 2 237 861 patients diagnosed with one of 15 adult cancers (15-99 years), and brain tumors and hematological malignancies in children (0-14 years). Five-year net survival was estimated with the Pohar Perme estimator and age-standardized with International Cancer Survival Standard weights. We estimated survival for three calendar periods, by age group, sex, anatomic site or morphology, and by stage at diagnosis. Results Five-year net survival improved between 2000-04 and 2010-14 for several cancers, including brain tumors (27.9%-46.3%), ovarian cancer (35.5%-46.3%), stomach cancer (50.5%-60.3%), lymphoid malignancies (47.5%-57.3%), myeloid malignancies (24.8%-33.3%), and esophageal cancer (27.7%-36.0%). Breast cancer, childhood lymphoma, and prostate cancer showed consistently high or improving survival (85.9%-93.0%). In contrast, survival for melanoma remained unchanged. Net survival was low for pancreatic cancer (6.9%-8.3%). Among selected countries, survival was higher in Japan for esophageal (36.0%), liver (30.1%), and lung cancers (32.9%). Survival for melanoma, hematologic malignancies, and childhood cancers was lower in Japan than in Western countries. Conclusions Net survival in Japan improved substantially for several cancers, but survival for pancreatic cancer remained low. International collaboration is crucial to accelerate the development of effective cancer control strategies.

Sugiyama H, Di Carlo V, Matz M et al.

JPRead at source

Peer-reviewed articleEurope PMC24 Oct 2025

Girls and Women in Mines: an Invisible Path of Forced Labour in Italy.

This study aims to shed light on the largely understudied history of girls and women working in Italian mines during the 19th and 20th centuries. Giovanni Loriga authored an outstanding paper on Pneumoconiosis in 1930 at the Johannesburg Conference. By examining his sources from earlier surveys, travel records, and congressional proceedings, the research uncovers data on women and girls in slate (Liguria), asbestos (Piedmont), zinc-lead (Sardinia and Lombardy), and sulfur mines (Sicily), along with their working conditions. The research findings reveal that girls and women were integral to the mining industry throughout Italy, despite being underrepresented and relegated to specific tasks. Ultimately, the paper explores the development of protective Italian legislation, its inadequate enforcement, and suspension during World War I. The paper concludes by highlighting the ongoing global issue of girls' labour in mines, drawing a parallel between the historical situation in Italy and the contemporary reality denounced by organizations like the ILO and UNICEF.

Salerno S

ProtectionITRead at source

Peer-reviewed articleEurope PMC17 Jun 2026

Effect of systemic counselling on anxiety and childbirth self-efficacy among first-time mothers: a randomised controlled trial protocol in prenatal healthcare centres of Babol, Iran.

Introduction Pregnancy and childbirth are transformative experiences that can provoke anxiety, potentially reducing women's confidence and satisfaction with the process. Systemic counselling, which considers family and interpersonal dynamics, may alleviate anxiety, enhance self-efficacy and improve satisfaction with childbirth. Addressing these psychological and relational factors is crucial for maternal and neonatal well-being. Methods and analysis This parallel-group randomised controlled trial will involve 72 primiparous pregnant women in Babol, Iran. Eligible participants will be randomly assigned to either the intervention or control group using permuted block randomisation with a block size of four. The intervention group will receive six structured 90-minute sessions, including one in-person and five online group sessions (6-10 participants per session) delivered via WhatsApp. The sessions follow a Bowen systemic counselling approach targeting family and social dynamics. The primary outcomes are anxiety reduction, enhanced childbirth self-efficacy and improved satisfaction with childbirth. The target sample size is 72 participants (36 per group). Participant enrolment began in November 2025 and is currently ongoing. Data will be analysed using both the full analysis set (FAS) and per-protocol set (PPS). The trial is currently ongoing and is expected to be completed by July 2026. Ethics and dissemination The study was approved by the Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1404.070). The sponsor is Babol University of Medical Sciences. No external funding was received. Results will be disseminated through peer-reviewed journals and scientific conferences. Trial registration IRCT20100510003902N7.

Movaddt A, Mohsenzadeh-Ledari F, Omidvar S et al.

SurvivalDevelopmentExperimentalIRRead at source

Peer-reviewed articleEurope PMC11 Sept 2026

A verbal and social autopsy study to improve estimates of mortality determinants in Pakistan: study design and methods.

Background Reducing newborn, child, adolescent, and maternal mortality is a global priority, yet Pakistan continues to bear a high burden of preventable deaths. Routine civil registration does not capture causes or social determinants for most of these deaths. The verbal and social autopsy (VASA) methodology fills this gap by combining symptom-based identification of the cause of death with structured assessment of social and care-seeking factors. Here we describe the methodological framework of a national VASA study conducted using the Pakistan National Nutrition Survey 2018 sampling frame, designed to estimate cause-specific mortality and social determinants of stillbirths and neonatal, post-neonatal, adolescent, and maternal deaths. Methods We used the sampling frame of the Pakistan National Nutrition Survey 2018 and employed VASA techniques to identify biological causes and social determinants of stillbirths, neonatal, child, adolescent, and maternal deaths. By utilising adapted VASA tools and rigorous analytical methods, we sought to bridge the gap between health systems and mortality data by examining deaths that occurred in and outside of healthcare facilities. Our aim was to provide insights into preventable deaths to guide public health interventions and policymaking, such as integrating VASA into the national survey and building the capacity of community-level healthcare workers to conduct VASA. Conclusions This study provides a vital contribution to improving health outcomes and reducing mortality in low- and middle-income countries by integrating sociocultural and systemic factors into mortality analysis. Keywords verbal and social autopsy, cause of death, VASA methodology, Pakistan.

Chauhadry IA, Soofi SB, Habib MA et al.

SurvivalPKRead at source

Peer-reviewed articleEurope PMC1 Jan 2026

Use of transcutaneous bilirubinometers in preterm infants in Japan.

Background This study aimed to investigate the current use of transcutaneous bilirubinometers (TcBMs) in preterm infants in Japan, given their potential for noninvasive and prolonged jaundice monitoring. Methods A nationwide questionnaire survey was conducted across 229 facilities for preterm infants. Responses were stratified by facility level and analyzed using Fisher's exact test. Results Of the 229 facilities, 149 (65%) responded, with 76 (51%) using TcBMs in preterm infants. TcBM use increased with gestational age. TcBMs were more commonly used in Level II facilities than in Level III/IV facilities (63% vs. 40%, p = 0.0087). In late preterm infants, TcBMs tended to be used immediately after birth, whereas in extremely preterm infants, they were often introduced after the first postnatal week. Level II facilities showed a tendency to use TcBMs immediately after birth, even in infants of relatively low gestational age. JM-105 was the most used device, and the anterior chest was the primary measurement site. 55% of the facilities using TcBMs reported adopting Morioka's new treatment criteria for neonatal jaundice. While most facilities disinfected devices after each use, concerns remained regarding measurement accuracy and infection control. Conclusion TcBMs are used in approximately half of the facilities in Japan, with greater use in Level II centers. Broader dissemination of guidelines may encourage safer and more consistent practices.

Xu Y, Sato Y, Morioka I et al.

SurvivalJPRead at source

Peer-reviewed articleEurope PMC1 Sept 2026

Contribution of improved quality of early essential newborn care to neonatal mortality decline in Cambodia, 2010-2022: a retrospective observational study.

Introduction Between 2005 and 2010, reductions in newborn mortality fell behind those for maternal and under-five child mortality in Cambodia. To improve newborn outcomes, we developed and scaled-up early essential newborn care (EENC) nationally using a new clinical coaching and data-based quality improvement approach. This study aimed to determine EENC's contribution to Cambodia's observed neonatal mortality decline between 2010 and 2022. Methods Standard indicators in the EENC monitoring and evaluation framework were calculated from programme records, nationally representative population-based surveys and facility-based assessments using standardised methods. The Lives Saved Tool (LiST) was used to model newborn lives saved 2010-2022 using facility estimates of care quality. Results Newborn mortality declined from 27 to 8/1000 live births (70.4%) comparing 2010 and 2022. The average annual rate of newborn mortality decline accelerated by 33% after EENC introduction in 2012 compared with the previous 10 years, with greatest declines among high-risk groups (poorest, rural, uneducated and with low birth interval). Between 2010 and 2022, EENC was integrated into national and subnational policies, standards and implementation plans and introduced to 87.6% of birth facilities. The average birth practice score rose to 72.9% (95% CI 59.0% to 83.4%) in 2022, from 6% (95% CI 1.7% to 20.1%) in 2011. Significant improvements were seen in application of clean birth environments, immediate drying and stimulation, thermal protection (immediate and prolonged skin to skin contact), delayed cord clamping and clean cord care. LiST modelling estimated that EENC interventions averted 21 704 Cambodian newborn deaths (range 17 694-26 450) during 2010-2022 and were responsible for 75.3% (range 69.5%-80.5%) of the observed national mortality reduction. Conclusion A new approach to EENC programme implementation led to sustained country-wide improvements in evidence-based practices around birth. Improved care quality was associated with 69.5-80.5% of the observed neonatal mortality decline in Cambodia between 2010 and 2022.

Krang S, Rathavy T, Murray JCS et al.

SurvivalPractitionerKHRead at source

Peer-reviewed articleEurope PMC2 Aug 2026

Austere and Burnt Offerings: Countering the Material and Symbolic Othering Within School Meals in Aotearoa New Zealand with a Community Psychology Lens.

Globally, school meals have formed a social safety net for improving children's nutrition, health, and educational attainment. In Aotearoa New Zealand, government funded lunches for children attending schools in low-income neighbourhoods were introduced in 2020, amidst rising poverty levels and consequent household food insecurity. The aspirations encapsulated within the scheme's indigenous Māori name, 'Ka Ora, Ka Ako' ('to be well, healthy and safe; to be ready to learn') have lost focus since reforms to the lunches in 2024 prioritised cost savings, resulting in widely publicised quality issues. This present study draws from a critical multi-level investigation into the issue of hungry children in New Zealand schools, prior to the introduction of 'Ka Ora, Ka Ako'. Narrative analysis identified how food in schools has been conceptualised within the context of a settler colonial charity model and neoliberal austerity. Applying a critical community psychology lens highlights how burnt and meagre lunches offered to children from food insecure households are a concrete product of historically grounded, unequal relations between groups. A community psychology approach reimagines state-funded food in schools as a public good, arguing for equitable rights to nutrition, including recognition of Māori rights to food sovereignty.

Jackson KM

SurvivalDevelopmentProtectionNZRead at source

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