Leprosy in children and adolescents under 15 years old in an urban centre in Brazil

This original study describes the intra-urban distribution of cases of leprosy in residents under 15 years old in Salvador, Bahia, Brazil; the study also identifies the environment in which Mycobacterium leprae is being transmitted. The cases were distributed by operational classification, clinical forms, type of contact and the addresses were geo-referenced by neighborhood. Between 2007 and 2011, were reported 145 cases of leprosy in target population living in Salvador, corresponding to detection rates of 6.21, 6.14, 5.58, 5.41 and 6.88/100,000 inhabitants, respectively. The spatial distribution of the disease was focal. Of the 157 neighborhoods of Salvador, 44 (28.6%) notified cases of leprosy and in 22 (50%) of these were detected more than 10 cases per 100,000 inhabitants. The infectious forms were found in 40% of cases. Over 90% of cases had been living in Salvador for more than five years. Overall, 52.6% reported having had contact with another infected individual inside the household and 25% in their social circle. In Salvador, M. leprae transmission is established. The situation is a major concern, since transmission is intense at an early age, indicating that this endemic disease is expanding and contacts extend beyond individual households.

Distinguishing predisposing factors for enamel hypoplasia and molar-incisor hypomineralization in children in Ile-Ife, Nigeria

Aim: To determine if the prevalence of enamel hypoplasia, molar-incisor hypomineralisation (MIH) and deciduous molar hypomineralisation (DMH) is associated with the socioeconomic status of the child and to determine the prevalence of enamel hypoplasia and MIH/DMH comorbidity in the study population. Methods: Information was collected on the sex and socioeconomic status of the 1,169 study participants’ resident in Ile-Ife, Nigeria, recruited through a household survey. The children were clinically examined to assess for the presence of enamel hypoplasia, MIH and DMH. Associations between sex, socioeconomic status and the prevalence of enamel hypoplasia, MIH and DMH were determined. The proportion of children with enamel hypoplasia and MIH/DMH co-morbidity was also determined. Results: Among the 1,169 study participants, 47(4.0%) had MIH, 15 (1.3%) had DMH and 161 (13.8%) had enamel hypoplasia. One (0.09%) study participant had MIH/DMH co-morbidity, 12 (1.0%) had DMH/enamel hypoplasia co-morbidity, and 9 (0.8%) had MIH/hypoplasia co-morbidity. There was no significant association between the socioeconomic status and presence of enamel hypoplasia (p=0.22), MIH (p=0.78) or DMH (p=1.00). Conclusions: The socioeconomic status cannot be used as a distinguishing factor for enamel hypoplasia, MIH and DMH. The possibility of co-existence of enamel hypoplasia and MIH/DMH makes it imperative to find ways to distinguish between the lesions.

Evaluation of Neurodevelopment and Factors Affecting it in Children With Acyanotic Congenital Cardiac Disease

Background: The rate of congenital heart disease is 0.8% in all live births. The majority of this, however, is acyanotic congenital heart disease. The survival rate of children with cardiac disease has increased with the developments provided in recent years and their lifetime is extended. Objectives: This study aims to evaluate neurodevelopment of children with uncomplicated acyanotic congenital heart disease in preschool period and determine the factors affecting their neurodevelopmental process. Patients and Methods: 132 children with acyanotic congenital heart disease aged 6 - 72 months were involved in the study. Mental development and intelligence levels of patients under 2 years old were assessed by using Bayley Development Scale-III, and Stanford Binet Intelligence test was employed for patients over 2 years old. Denver Developmental Screening Test II was applied to all patients for their personal-social, fine motor, gross motor and language development. Results: The average age of patients (67 girls, 65 boys) included in the study was 35.2 ± 19.6 months. It was determined that there were subnormal mental level in 13 (10%) patients and at least one specific developmental disorder in 33 (25%) patients. Bayley Mental Development Scale score of patients who had received incubator care in perinatal period was found significantly low (88 ± 4.2) compared to those with no incubator care (93.17 ± 8.5) (P = 0.028). Low educational level of father was established to be linked with low mental development scores at the age of 2 and following that age (P < 0.05). Iron deficiency anemia was discovered to be related to low psychometric test scores at every age (P < 0.05). Conclusions: Neurodevelopmental problems in children with acyanotic congenital heart disease were found higher compared to those in society. Mental development and intelligence levels of patients were determined to be closely associated with receiving incubator care, father’s educational level and iron deficiency anemia.