1
|
Otterman G, Nurmatov UB, Akhlaq A, Korhonen L, Kemp AM, Naughton A, Chalumeau M, Jud A, Vollmer Sandholm MJ, Mora-Theuer E, Moultrie S, Lamela D, Tagiyeva-Milne N, Nelson J, Greenbaum J. Clinical care of childhood sexual abuse: a systematic review and critical appraisal of guidelines from European countries. Lancet Reg Health Eur 2024; 39:100868. [PMID: 38420107 PMCID: PMC10899013 DOI: 10.1016/j.lanepe.2024.100868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024]
Abstract
Background The clinical management of Child sexual abuse (CSA) demands specialised skills from healthcare professionals due to its sensitivity, legal implications, and serious physical health and mental health effects. Standardised, comprehensive clinical practice guidelines (CPGs) may be pivotal. In this systematic review, we examined existing CSA national CPGs (NCPGs) from European countries to assess their quality and reporting. Methods We systematically searched six international databases and multiple grey literature sources, reporting by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligible guidelines were CSA guidance from national health agencies or societies in 34 COST Action 19106 Network Countries (CANC), published between January 2012 and November 2022. Two independent researchers searched, screened, reviewed, and extracted data. NCPGs were compared for completeness with reference WHO 2017 and 2019 guidelines. We used the Appraisal of Guidelines for Research and Evaluation (AGREE II) to appraise quality and reporting. PROSPERO: CRD42022320747. Findings Of 2919 records identified by database searches, none met inclusion criteria. Of 4714 records identified by other methods, 24 NCPGs from 17 (50%) of CANC countries were included. In 17 (50%) of eligible countries, no NCPGs were found. Content varied significantly within and between countries. NCPGs lacked many components in state-of-the art clinical practice compared to WHO reference standards, particularly in safety and risk assessment, interactions with caregivers, and mental health interventions. Appraisal by AGREE II revealed shortcomings in NCPG development, regarding scientific rigour, stakeholder involvement, implementation and evaluation. Interpretation A notable number of European countries lack an NCPG; existing NCPGs often fall short. The healthcare response to CSA in Europe requires a coordinated approach to develop and implement high-quality CPGs. We advocate for a multidisciplinary team to develop a pan-European CSA guideline to ensure quality care for survivors. Funding Funding was provided by the International Centre for Missing and Exploited Children.
Collapse
Affiliation(s)
- Gabriel Otterman
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ulugbek B. Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Ather Akhlaq
- Institute of Business Management, Karachi, Pakistan
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Alison M. Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Aideen Naughton
- National Safeguarding Service, Public Health Wales, Cardiff, UK
| | - Martin Chalumeau
- Child Protection Unit - Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, France
| | - Andreas Jud
- Clinic for Child and Adolescent Psychiatry, Ulm University Clinics, Ulm, Germany
| | | | - Eva Mora-Theuer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Sarah Moultrie
- Pediatric Trauma Services, Benioff Children's Hospitals- Oakland, Oakland, CA, USA
| | - Diogo Lamela
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Porto, Portugal
| | - Nara Tagiyeva-Milne
- Department of Education, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Joanne Nelson
- Child and Adolescent Sexual Assault Treatment Service, Barnahus West, Saolta University Health Care Group, Galway, Ireland
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA
| | - the COST Action 19106 Research Team
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
- Institute of Business Management, Karachi, Pakistan
- National Safeguarding Service, Public Health Wales, Cardiff, UK
- Child Protection Unit - Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, France
- Clinic for Child and Adolescent Psychiatry, Ulm University Clinics, Ulm, Germany
- Department of Forensic Sciences, Oslo University, Oslo, Norway
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Pediatric Trauma Services, Benioff Children's Hospitals- Oakland, Oakland, CA, USA
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Porto, Portugal
- Department of Education, Liverpool School of Tropical Medicine, Liverpool, UK
- Child and Adolescent Sexual Assault Treatment Service, Barnahus West, Saolta University Health Care Group, Galway, Ireland
- International Centre for Missing and Exploited Children, Alexandria, VA, USA
| |
Collapse
|
2
|
de Visme S, Korevaar DA, Gras-Le Guen C, Flamant A, Bevacqua M, Stanzelova A, Trinh NTH, Ciobanu DA, Carvalho AA, Kyriakoglou I, Fuentes M, Refes Y, Briand-Huchet E, Sellier AL, Harrewijn I, Cohen JF, Chalumeau M. Inconsistency Between Pictures on Baby Diaper Packaging in Europe and Safe Infant Sleep Recommendations. J Pediatr 2024; 264:113763. [PMID: 37778411 DOI: 10.1016/j.jpeds.2023.113763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To describe the level of inconsistency between pictures on baby diaper packaging and safe infant sleep recommendations (SISRs) in Europe. STUDY DESIGN We attempted to identify all packaging of baby diapers sold in 11 European countries for infants weighing less than 5 kg through internet searches from July 2022 through February 2023. For each type of package, we extracted whether there was a picture depicting a baby, whether the baby was sleeping, and whether the picture of the sleeping baby was inconsistent with ≥1 of 3 SISRs: (i) nonsupine sleeping position, (ii) soft objects or loose bedding, or (iii) sharing a sleep surface with another person. Data were aggregated at the country level, and a random-effects meta-analysis of proportions was used to obtain summary estimates. The outcome was the summary estimate of the proportion of pictures that were inconsistent with SISRs. RESULTS We identified 631 baby diaper packaging types of which 49% (95% CI: 42-57; n = 311) displayed a picture of a sleeping baby. Among those 311 packages, 79% (95% CI 73-84) were inconsistent with ≥1 SISR, including a nonsupine sleeping position, 45% (95% CI 39-51), soft objects or loose bedding such as pillows or blankets, 51% (95% CI 46-57), and sharing a sleep surface with another person, 10% (95% CI 4-18). CONCLUSIONS Pictures on baby diaper packaging in Europe are often inconsistent with SISRs. The prevention of sudden unexpected death in infancy requires action from manufacturers and legislators to stop parents' exposure to misleading images that may lead to dangerous practices.
Collapse
Affiliation(s)
- Sophie de Visme
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; CHU de Nantes, INSERM, Department of General Pediatrics and Pediatric Emergencies, CIC1413, Nantes Université, Nantes, France
| | - Daniel A Korevaar
- Department of Pulmonary Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Christèle Gras-Le Guen
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; CHU de Nantes, INSERM, Department of General Pediatrics and Pediatric Emergencies, CIC1413, Nantes Université, Nantes, France; CHU de Nantes, Department of General Pediatrics and Pediatric Emergencies, Nantes Université, Nantes, France
| | - Alix Flamant
- Department of General Pediatrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Martina Bevacqua
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Anna Stanzelova
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Independent Researcher, Galway, Ireland
| | - Nhung T H Trinh
- Department of Pharmacy, PharmacoEpidemiology and Drug Safety Research Group, University of Oslo, Oslo, Norway
| | - Dalia-Alexandra Ciobanu
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Children's Hospital "Doctor Victor Gomoiu", Bucharest, Romania
| | - Ana Araújo Carvalho
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Centro Hospitalar e Universitário de Lisboa Central, Hospital Dona Estefânia, Paediatric Department, Lisboa, Portugal
| | - Ifigeneia Kyriakoglou
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Fuentes
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Pediatric Emergencies, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Yacine Refes
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France
| | - Elisabeth Briand-Huchet
- Naître et Vivre, National Association for the Support of Bereaved Parents and the Fight Against Sudden Unexpected Death in Infancy, Paris, France
| | | | - Inge Harrewijn
- Department of Neonatal Pediatrics and Intensive Care, Montpellier University Hospital, University of Montpellier, Montpellier, France.
| | - Jérémie F Cohen
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Martin Chalumeau
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| |
Collapse
|
3
|
Dupont C, Bocquet A, Brancato S, Chalumeau M, Darmaun D, de Luca A, Feillet F, Frelut ML, Guimber D, Lapillonne A, Linglart A, Peretti N, Roze JC, Siméoni U, Turck D, Chouraqui JP. Cow's milk-based infant formula supplements in breastfed infants and primary prevention of cow's milk allergy: A commentary of the Committee on Nutrition of the French Society of Pediatrics. Arch Pediatr 2023; 30:591-594. [PMID: 37709607 DOI: 10.1016/j.arcped.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/07/2023] [Indexed: 09/16/2023]
Abstract
The role of nutritional interventions for the primary prevention of cow's milk allergy (CMA) remains debated as well as the role of early introduction of allergenic foods, which is largely encouraged from the beginning of complementary feeding. Considering the introduction of cow's milk protein (CMP), current recommendations suggest avoidance of any cow's milk formula (CMF) supplements in breastfed infants in the maternity ward. By contrast, based on poor evidence, some authors support systematic supplements of CMP in breastfed children at risk of allergy from the first week of life. The Committee on Nutrition of the French Society of Pediatrics considers that such a proposal requires more clinical studies and mainly randomized and placebo-controlled clinical trials before becoming a recommendation.
Collapse
Affiliation(s)
- Christophe Dupont
- Paris Descartes University, Pediatric gastroenterology, Clinique Marcel Sembat, Ramsay Group, Boulogne Billancourt, France.
| | - Alain Bocquet
- French association of ambulatory paediatrics, France
| | - Sandra Brancato
- Institut de Recherche pour le Développement, Brignon, France
| | - Martin Chalumeau
- Paris Descartes University, APHP Necker-Enfants Malades hospital, Paris, France
| | | | - Arnaud de Luca
- Tours University and Inserm UMR 1069, 37000 Tours, France
| | | | | | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, University of Lille, INSERM U995, 59037 Lille, France
| | - Alexandre Lapillonne
- Paris Descartes University, APHP Necker-Enfants Malades hospital, Paris, France; CNRC, Baylor College of Medicine, Houston, TX, USA
| | - Agnès Linglart
- Paris-Sud, University, CHU de Bicêtre, 94270 Le Kremlin-Bicêtre, France
| | - Noel Peretti
- Pediatric Nutrition, University Pediatric Hospital of Lyon and INSERM U1060, CarMeN laboratory; Claude Bernard Lyon-1 University, F-69008 France
| | - Jean-Christophe Roze
- Neonatology and pediatric intensive care unit, Univesity hospital of Nantes and UMR 1280 INRA, Nantes University. France
| | - Umberto Siméoni
- Division of Pediatrics and DOHaD Lab, Woman, Mother and Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), 21 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, University of Lille, INSERM U995, 59037 Lille, France
| | - Jean-Pierre Chouraqui
- Paediatric Division of Nutrition and Gastro-enterology, Pediatric Department, Grenoble-Alpes University Hospital (CHUGA), Grenoble, France
| |
Collapse
|
4
|
Malorey D, Lorton F, Chalumeau M, Bourgoin P, Boussicault G, Chantreuil J, Gaillot T, Roué JM, Martinot A, Assathiany R, Saulnier JP, Caillon J, Grain A, Gras-Le Guen C, Launay E. Distribution, Consequences, and Determinants of Time to Antibiotics in Children With Community-Onset Severe Bacterial Infection: A Secondary Analysis of a Prospective Population-Based Study. Pediatr Crit Care Med 2023; 24:e441-e451. [PMID: 37260312 DOI: 10.1097/pcc.0000000000003306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To describe the distribution, consequences and potential determinants of time to antibiotics administration in children with community-onset severe bacterial infections (COSBIs). DESIGN Secondary analysis of the available data from a prospective population-based study from 2009 to 2014. SETTING An administrative area in western France accounting for 13% of the national pediatric population. PATIENTS All children from 1 month to 16 years old admitted to a PICU or who died before admission and had a COSBI. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The time to antibiotics was divided into patient interval (from first signs of COSBI to the first medical consultation) and medical interval (from the first consultation to appropriate antibiotics administration). The association between the medical interval and child outcome was studied by a multinomial logistic regression model and the potential determinants of the patient and medical intervals were by a Cox proportional-hazards model. Of the 227 children included (median age 2.1 yr), 22 died (9.7%), and 21 (9.3%) had severe sequelae at PICU discharge. Median patient and medical intervals were 7.0 hours (interquartile range [IQR], 2.0-16.5 hr) and 3.3 hours (IQR, 1.1-12.2 hr), respectively. The last quartile of medical interval was not associated with death (adjusted odds ratio [aOR], 3.7; 95% CI, 0.8-17.5) or survival with severe sequelae (aOR, 1.3; 95% CI, 0.4-4.0) versus survival without severe sequelae. Patient interval was shorter in younger children (adjusted hazard ratio [aHR], 0.95; 95% CI, 0.92-0.99), and medical interval was reduced when the first consultation was conducted in a hospital (aHR, 1.5; 95% CI, 1.1-2.0) versus outpatient medicine. CONCLUSIONS For children with COSBI, we found no significant association between medical interval and mortality or severe sequelae. An initial hospital referral could help reduce the time to antibiotics in COSBIs.
Collapse
Affiliation(s)
- David Malorey
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Paris Descartes University, Paris, France
| | - Fleur Lorton
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Paris Descartes University, Paris, France
- Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
- Department of Pediatric and Neonatal Critical Care, Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Department of Pediatric Critical Care, CHU d'Angers, Angers, France
- Department of Pediatric Critical Care, Hôpital Clocheville, CHU de Tours, Tours, France
- Department of Pediatric Critical Care, Hôpital Sud, CHU de Rennes, Rennes, France
- Department of Pediatric and Neonatal Critical Care, Hôpital Morvan, CHU de Brest, Brest, France
- University Lille, ULR 2694-METRICS: Evaluation des technologies de Santé et des pratiques médicales, CHU Lille, Lille, France
- Association pour la Recherche et l'Enseignement en Pédiatrie Générale (AREPEGE); Association Française de Pédiatrie Ambulatoire (AFPA), Cabinet de Pédiatrie, Issy-les-Moulineaux, France
- Department of Pediatric and Neonatal Critical Care, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
- Department of Microbiology, Hôtel Dieu, CHU de Nantes, Nantes, France
- Pediatric Haematology and Oncology Department, University Hospital of Nantes, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Paris Descartes University, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Pierre Bourgoin
- Department of Pediatric and Neonatal Critical Care, Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| | | | - Julie Chantreuil
- Department of Pediatric Critical Care, Hôpital Clocheville, CHU de Tours, Tours, France
| | - Théophile Gaillot
- Department of Pediatric Critical Care, Hôpital Sud, CHU de Rennes, Rennes, France
| | - Jean-Michel Roué
- Department of Pediatric and Neonatal Critical Care, Hôpital Morvan, CHU de Brest, Brest, France
| | - Alain Martinot
- University Lille, ULR 2694-METRICS: Evaluation des technologies de Santé et des pratiques médicales, CHU Lille, Lille, France
| | - Rémy Assathiany
- Association pour la Recherche et l'Enseignement en Pédiatrie Générale (AREPEGE); Association Française de Pédiatrie Ambulatoire (AFPA), Cabinet de Pédiatrie, Issy-les-Moulineaux, France
| | - Jean-Pascal Saulnier
- Department of Pediatric and Neonatal Critical Care, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
| | - Jocelyne Caillon
- Department of Microbiology, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Audrey Grain
- Pediatric Haematology and Oncology Department, University Hospital of Nantes, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | - Christèle Gras-Le Guen
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Paris Descartes University, Paris, France
- Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
- Department of Pediatric and Neonatal Critical Care, Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Department of Pediatric Critical Care, CHU d'Angers, Angers, France
- Department of Pediatric Critical Care, Hôpital Clocheville, CHU de Tours, Tours, France
- Department of Pediatric Critical Care, Hôpital Sud, CHU de Rennes, Rennes, France
- Department of Pediatric and Neonatal Critical Care, Hôpital Morvan, CHU de Brest, Brest, France
- University Lille, ULR 2694-METRICS: Evaluation des technologies de Santé et des pratiques médicales, CHU Lille, Lille, France
- Association pour la Recherche et l'Enseignement en Pédiatrie Générale (AREPEGE); Association Française de Pédiatrie Ambulatoire (AFPA), Cabinet de Pédiatrie, Issy-les-Moulineaux, France
- Department of Pediatric and Neonatal Critical Care, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
- Department of Microbiology, Hôtel Dieu, CHU de Nantes, Nantes, France
- Pediatric Haematology and Oncology Department, University Hospital of Nantes, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | - Elise Launay
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Paris Descartes University, Paris, France
- Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
- Department of Pediatric and Neonatal Critical Care, Femme Enfant Adolescent, CHU de Nantes, Nantes, France
- Department of Pediatric Critical Care, CHU d'Angers, Angers, France
- Department of Pediatric Critical Care, Hôpital Clocheville, CHU de Tours, Tours, France
- Department of Pediatric Critical Care, Hôpital Sud, CHU de Rennes, Rennes, France
- Department of Pediatric and Neonatal Critical Care, Hôpital Morvan, CHU de Brest, Brest, France
- University Lille, ULR 2694-METRICS: Evaluation des technologies de Santé et des pratiques médicales, CHU Lille, Lille, France
- Association pour la Recherche et l'Enseignement en Pédiatrie Générale (AREPEGE); Association Française de Pédiatrie Ambulatoire (AFPA), Cabinet de Pédiatrie, Issy-les-Moulineaux, France
- Department of Pediatric and Neonatal Critical Care, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
- Department of Microbiology, Hôtel Dieu, CHU de Nantes, Nantes, France
- Pediatric Haematology and Oncology Department, University Hospital of Nantes, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| |
Collapse
|
5
|
Otterman G, Nurmatov U, Akhlaq A, Naughton A, Kemp AM, Korhonen L, Jud A, Vollmer Sandholm MJ, Mora-Theuer E, Moultrie S, Chalumeau M, Karst WA, Greenbaum J. Appraisal of published guidelines in European countries addressing the clinical care of childhood sexual abuse: protocol for a systematic review. BMJ Open 2023; 13:e064008. [PMID: 37068895 PMCID: PMC10111900 DOI: 10.1136/bmjopen-2022-064008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION Childhood sexual abuse (CSA) is a global public health problem with potentially severe health and mental health consequences. Healthcare professionals (HCPs) should be familiar with risk factors and potential indicators of CSA, and able to provide appropriate medical management. The WHO issued global guidelines for the clinical care of children with CSA, based on rigorous review of the evidence base. The current systematic review identifies existing CSA guidelines issued by government agencies and academic societies in the European Region and assesses their quality and clarity to illuminate strengths and identify opportunities for improvement. METHODS AND ANALYSIS This 10-database systematic review will be conducted according to the Centre for Reviews and Dissemination guidelines and will be reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Guidance for HCPs regarding CSA, written by a national governmental agency or academic society of HCPs within 34 COST Action 19106 Network Countries (CANC) and published in peer-reviewed or grey literature between January 2012 and November 2022, is eligible for inclusion. Two independent researchers will search the international literature, screen, review and extract data. Included guidelines will be assessed for completeness and clarity, compared with the WHO 2017/2019 guidelines on CSA, and evaluated for consistency between the CANC guidelines. The Appraisal of Guidelines for Research and Evaluation II tool and Grading of Recommendations Assessment, Development and Evaluation methodology will be used to evaluate CANC guidelines. Descriptive statistics will summarise content similarities and differences between the WHO guidelines and national guidelines; data will be summarised using counts, frequencies, proportions and per cent agreement between country-specific guidelines and the WHO 2017/2019 guidelines. ETHICS AND DISSEMINATION There are no individuals or protected health information involved and no safety issues identified. Results will be published in a peer-reviewed medical journal. PROSPERO REGISTRATION NUMBER CRD42022320747.
Collapse
Affiliation(s)
- Gabriel Otterman
- Barnafrid Centre, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ulugbek Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Ather Akhlaq
- Department of Health and Hospital Management, Institute of Business Management, Karachi, Pakistan
| | - Aideen Naughton
- National Safeguarding Service, Public Health Wales (NHS), Cardiff, UK
| | - Alison Mary Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Laura Korhonen
- Barnafrid Centre, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Andreas Jud
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
| | | | - Eva Mora-Theuer
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Sarah Moultrie
- Pediatric Trauma, UCSF Benioff Children's Hospital, Oakland, California, USA
| | - Martin Chalumeau
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospitals, Paris, France
| | - Wouter A Karst
- Forensic Medicine, GGD Branbant Zuidoost, Eindhoven, Netherlands
| | - Jordan Greenbaum
- International Centre for Missing & Exploited Children, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Blangis F, Malorey D, Gras-Le Guen C, Vabres N, Picherot G, Ricaud P, Chalumeau M, Launay E. Suboptimal care was frequent in severe child physical abuse cases and was mainly related to delayed diagnoses and ineffective secondary prevention. Acta Paediatr 2023; 112:876-882. [PMID: 36780249 DOI: 10.1111/apa.16708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/13/2022] [Accepted: 02/10/2023] [Indexed: 02/14/2023]
Abstract
AIM Our aim was to assess suboptimal care before a diagnosis of severe child physical abuse in western France. METHODS A confidential inquiry was carried out, based on children under 6 years of age who were hospitalised in the Nantes regional university hospital from 2016 to 2018. Two researchers retrospectively reviewed the medical records of all the children who were reported to the authorities for suspected severe child physical abuse. Two experts determined the optimality of care and identified the main categories of suboptimal care. RESULTS The median age of the 94 children included in the study was 8 months. A fifth of them had intra-cranial injuries and a quarter had fractures. One child died and a third had severe sequelae at hospital discharge. Included children frequently (37%) received suboptimal care before the diagnosis of severe CPA and this fell into two categories: delayed diagnosis was experienced by 17% and ineffective secondary prevention by 22%. CONCLUSION Suboptimal care for severe child physical abuse was frequent and fell into two categories: delayed diagnosis and ineffective secondary prevention. These results can help us to design corrective actions.
Collapse
Affiliation(s)
- Flora Blangis
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, Université Paris Cité, INSERM, Paris, France.,Inserm CIC 1413, Nantes University Hospital, Nantes, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - David Malorey
- Inserm CIC 1413, Nantes University Hospital, Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Christèle Gras-Le Guen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, Université Paris Cité, INSERM, Paris, France.,Inserm CIC 1413, Nantes University Hospital, Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Nathalie Vabres
- Unité d'Accueil des Enfants en Danger, Nantes University Hospital, Nantes, France
| | - Georges Picherot
- Department of Pediatrics, Nantes University Hospital, Nantes, France
| | - Patricia Ricaud
- Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, Université Paris Cité, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Elise Launay
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, Université Paris Cité, INSERM, Paris, France.,Inserm CIC 1413, Nantes University Hospital, Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| |
Collapse
|
7
|
Jacques M, Lorton F, Dufourg MN, Bois C, Launay E, Siméon T, Raude J, Guen CGL, Lévy-Brühl D, Charles MA, Chalumeau M, Scherdel P. Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort. Eur J Pediatr 2023; 182:1019-1028. [PMID: 36542162 PMCID: PMC9768772 DOI: 10.1007/s00431-022-04733-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as ≥ 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7-48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03-1.34] and 1.28 [1.06-1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36-2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41-2.34] and 1.23 [1.04-1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child's first two months (1.19 [1.03-1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52-3.26] vs. a pediatrician). CONCLUSIONS Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic, parental, and healthcare service characteristics. These findings may help in designing targeted corrective actions. WHAT IS KNOWN • Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries. • The partial understanding of the determinants of incomplete vaccination precludes the design of effective targeted corrective actions. WHAT IS NEW • High prevalence of incomplete vaccination at age two years in France. • Incomplete vaccination was independently associated with several socio-demographic, parental, and healthcare service characteristics.
Collapse
Affiliation(s)
- Marianne Jacques
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
| | - Fleur Lorton
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Marie-Noëlle Dufourg
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Corinne Bois
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Elise Launay
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Thierry Siméon
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Jocelyn Raude
- grid.414412.60000 0001 1943 5037EHESP-School of Public Health, Rennes, France
| | - Christèle Gras-Le Guen
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Daniel Lévy-Brühl
- grid.493975.50000 0004 5948 8741Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Marie-Aline Charles
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Martin Chalumeau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.508487.60000 0004 7885 7602Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants malades hospital, Université Paris Cité, Paris, France
| | - Pauline Scherdel
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
| |
Collapse
|
8
|
Bocquet A, Brancato S, Turck D, Chalumeau M, Darmaun D, De Luca A, Feillet F, Frelut ML, Guimber D, Lapillonne A, Linglart A, Peretti N, Rozé JC, Simeoni U, Briend A, Dupont C, Chouraqui JP. "Baby-led weaning" - Progress in infant feeding or risky trend? Arch Pediatr 2022; 29:516-525. [PMID: 36109286 DOI: 10.1016/j.arcped.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/12/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022]
Abstract
Baby-led weaning (BLW), proposed as a new form of complementary feeding, has emerged as a real trend phenomenon in the media. Infants are seated at the family table from the age of 6 months, facing the foods they grab and bring to their mouth: they decide which foods they want to eat and what amount. The consumption of mashed foods and the use of a spoon are totally discouraged. BLW is increasingly used in nurseries and centers of young children. A bibliographic search carried out between 2000 and 2021 found 423 articles, of which 38 were selected. The clinical studies selected are 11 cross-sectional observational studies and two randomized controlled studies. BLW promotes breastfeeding, the early introduction of morsels, the respect of the child's appetite, the use of unprocessed foods, and the choice of "homemade" and friendliness. These benefits can nonetheless be reached with usual complementary feeding (SCF), according to current recommendations. Other benefits are claimed without scientific evidence such as easier achievement of dietary complementary feeding and an optimal growth with prevention of excess weight gain. BLW has some obvious downsides. The infant may not get enough energy, iron, zinc, vitamins, and other nutrients, or too much protein, saturated fat, salt, or sugar. The risk of choking, which must be distinguished from the physiological gagging reflex, has not been ruled out by scientific studies. Currently, the Nutrition Committee of the French Pediatric Society considers that the data published to date in terms of benefits and risks of BLW do not lend themselves to advice for this practice in preference over SCF carried out according to current recommendations.
Collapse
Affiliation(s)
- A Bocquet
- Université de Franche-Comté, 25000 Besançon, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France.
| | - S Brancato
- Cabinet de pédiatrie, 4, rue du puits Descarsses, 30190 Brignon, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France
| | - D Turck
- Université de Lille, INFINITE-Inserm U1286, 59000 Lille, France
| | - M Chalumeau
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker - Enfants malades, AP HP, France; Centre of Research in Epidemiology and Statistics (CRESS), Obstetrical, Perinatal and Pediatric Epidemiology Research Team, INSERM; Université de Paris, Paris, France
| | - D Darmaun
- Inra UMR1280, Université Nantes-Atlantique, 44300 Nantes, France
| | - A De Luca
- Université de Tours, 37000 Tours, France
| | - F Feillet
- Université de Lorraine, 54000 Nancy, France
| | - M-L Frelut
- Cabinet de pédiatrie, 16, rue Septfonds, 81000 Albi, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France
| | - D Guimber
- Université de Lille, 59000 Lille, France
| | - A Lapillonne
- Université de Paris,EA7328,AP-HP, hôpital Necker-Enfants-Malades, 75015 Paris, France
| | - A Linglart
- AP-HP, Université Paris Saclay, endocrinologie et diabète de l'enfant, Hôpital Bicêtre, le Kremlin Bicêtre, France
| | - N Peretti
- Université de Lyon, Hospices Civils de Lyon, CaRMEN, 69000 Lyon, France
| | - J-C Rozé
- Inra UMR1280, Université Nantes-Atlantique, 44300 Nantes, France
| | - U Simeoni
- Université of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - A Briend
- Institut de Recherche Pour le Développement, 13002 Marseille, France
| | - C Dupont
- Université de Paris 75015 Paris, France; Clinique Marcel-Sembat, 92100 Boulogne-Billancourt, France
| | - J-P Chouraqui
- Gastro-entérologie et nutrition pédiatriques DMCP, CHUV, rue du Bugnon, 46, 1011 Lausanne, Switzerland
| | -
- Hôpital Necker - Enfants-Malades (NEM), 149, rue de Sèvres, 75015 Paris, France
| |
Collapse
|
9
|
Taine M, Heude B, Chalumeau M. Pharmacoepidemiology: A key complementary tool to evaluate the paediatric exposome. Paediatr Perinat Epidemiol 2022; 36:738-740. [PMID: 35821649 DOI: 10.1111/ppe.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/22/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Marion Taine
- Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université Paris Cité, Paris, France
| | - Barbara Heude
- Early life Research on later Health, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université Paris Cité, Paris, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université Paris Cité, Paris, France.,Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades Hospital, AP-HP, Université Paris Cité, Paris, France
| |
Collapse
|
10
|
Ouldali N, Bagheri H, Salvo F, Antona D, Pariente A, Leblanc C, Tebacher M, Micallef J, Levy C, Cohen R, Javouhey E, Bader-Meunier B, Ovaert C, Renolleau S, Hentgen V, Kone-Paut I, Deschamps N, De Pontual L, Iriart X, Guen CGL, Angoulvant F, Belot A, Donzeau A, Aridi LE, Lety S, Leboucher B, Baur A, Jeusset L, Selegny M, Fedorczuk C, Lajus M, Bensaid P, Laoudi Y, Pons C, Robert AC, Beaucourt C, De Pontual L, Richard M, Goisque E, Iriart X, Brissaud O, Segretin P, Molimard J, Orecel MC, Benoit G, Bongiovanni L, Guerder M, Pouyau R, De Guillebon De Resnes JM, Mezgueldi E, Cour-Andlauer F, Horvat C, Poinsot P, Frachette C, Ouziel A, Gillet Y, Barrey C, Brouard J, Villedieu F, Ro V, Elanga N, Gajdos V, Basmaci R, Mutar H, Rouget S, Nattes E, Hau I, Biscardi S, Jurdi HE, Jung C, Semama D, Huet F, Zoccarato AM, Sarakbi M, Mortamet G, Bost-Bru C, Bassil J, Vinit C, Hentgen V, Leroux P, Bertrand V, Parrod C, Craiu I, Kone-Paut I, Durand P, Tissiere P, Claude C, Morelle G, Guiddir T, Borocco C, Delion F, Guillot C, Leteurtre S, Dubos F, Jouancastay M, Martinot A, Voeusler V, Languepin J, Garrec N, Demersay AC, Morand A, Bosdure E, Vanel N, Ughetto F, Michel F, Caujolle M, Blonde R, Nguyen J, Vignaud O, Masserot-Lureau C, Gouraud F, Araujo C, Ingrao T, Naji S, Sehaba M, Roche C, Carbasse A, Milesi C, Mazeghrane M, Haupt S, Schweitzer C, Romefort B, Launay E, Guen CGL, Ali A, Blot N, Tran A, Rancurel A, Afanetti M, Odorico S, Talmud D, Chosidow A, Romain AS, Grimprel E, Pouletty M, Gaschignard J, Corseri O, Faye A, Gaschignard J, Melki I, Ducrocq C, Benzoïd C, Lokmer J, Dauger S, Chomton M, Deho A, Lebourgeois F, Renolleau S, Lesage F, Moulin F, Dupic L, Pinhas Y, Debray A, Chalumeau M, Abadie V, Frange P, Cohen JF, Allali S, Curtis W, Belhadjer Z, Auriau J, Méot M, Houyel L, Bonnet D, Delacourt C, Meunier BB, Quartier P, Shaim Y, Baril L, Crommelynck S, Jacquot B, Blanc P, Maledon N, Robert B, Loeile C, Cazau C, Loron G, Gaga S, Vittot C, Nabhani LE, Buisson F, Prudent M, Flodrops H, Mokraoui F, Escoda S, Deschamps N, Bonnemains L, Mahi SL, Mertes C, Terzic J, Helms J, Idier C, Chenichene S, Ursulescu NM, Beaujour G, Hakim A, Miquel A, Rey A, Wiedermann A, Charbonneau A, Veauvy-Juven A, Ferry A, Mandelcwajg A, Rousseau A, Prenant A, Bourneuf AL, Filleron A, Robine A, Félix A, Parizel A, Labarre A, Cantais A, Ros B, Coulon B, Biot B, Dalichoux B, Fournier B, Cagnard B, Vanel B, Brossier D, Ménager B, Ozanne B, Marie-Jeanne C, Bergerot C, Chavy C, Guidon C, Fabre C, Galeotti C, Baker C, Ballot-Schmit C, Belleau C, Charasse C, Favel C, Toumi C, Ferrandiz C, Couturier C, Pouchoux C, Chomton-Cailliez M, Kevorkian-Verguet C, Brunet C, Manteau C, Mougey C, Santy C, Fitament C, Petriat C, Rebelle C, Charron C, Dartus M, Toulorge D, Guillou-Debuisson C, Bartebin D, Klein V, Broustal E, Desselas E, Marteau E, Bouvrot E, Delacroix E, Coinde E, Elnabhani L, Amouyal E, Chaillou E, Gabilly-Bernard E, Ruiz E, Thibault E, Robin E, Darrieux E, Blondel E, Socchi F, Cazassus F, Bajolle F, Lacin F, Madhi F, Zekre F, Guerin F, Boussicault G, Ginies H, Magloire G, Arnold G, Coulognon I, Sicard-Cras I, Kahn JE, Bordet J, Fausser JL, Baleine JF, Brice J, Gendras J, Pekin K, Norbert K, Karsenty C, Savary L, Martinat L, Lesniewski L, Charbonnier L, Alexandre L, Percheron L, Vincenti M, Selegny M, Lanzini M, Grisval M, Mercy M, Lampin ME, Desgranges M, Duperril M, Orcel MC, Audier M, Favier M, Carpentier M, Balcean M, Bonnet M, Jouret M, Delattre M, Levy M, Valensi M, Shum M, Dumortier M, Gelin M, Nemmouchi M, Williaume M, Sebaha M, Genetay-Stanescu N, Giroux N, Crassard N, Derridj N, Lachaume N, Werner O, Guilluy O, Richer O, Tirel O, Pauvert A, Casha P, Perez N, Gras P, Leger PL, Pinchou M, Mornand P, Largo P, Ibanez RC, Roulland C, Albarazi SH, Bichali S, Faton S, Schott A, Walser S, Guillaume S, Vincent S, Galene-Gromez S, Kozisek S, Maugard T, Blanc T, Navarro T, Lauvray T, Kovacs T, Launay V, Despert V, Lhostis V, Gall V, Micaelli X, Benadjaoud Y, Matoussi Z, Géniaux H, Facile A, Pietri T, Palassin P, Pinel S, Chouchana L, Callot D, Boulay C. Correction to “Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study”. Lancet Reg Health Eur 2022. [PMID: 35967266 PMCID: PMC9364716 DOI: 10.1016/j.lanepe.2022.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
11
|
Lãzãrescu AM, Benichi S, Blauwblomme T, Beccaria K, Bourgeois M, Roux CJ, Vergnaud E, Montmayeur J, Meyer P, Cohen JF, Chalumeau M, Blangis F, Orliaguet G. Abusive Head Trauma in Infants During the COVID-19 Pandemic in the Paris Metropolitan Area. JAMA Netw Open 2022; 5:e2226182. [PMID: 36040743 PMCID: PMC9428740 DOI: 10.1001/jamanetworkopen.2022.26182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE The COVID-19 pandemic and the containment and mitigation measures taken were feared to be associated with increased child abuse. OBJECTIVE To investigate the trend of abusive head trauma (AHT) incidence and severity in infants during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS In a time-series analysis of a longitudinal, population-based, cohort study, all consecutive cases of AHT in infants younger than 12 months old referred between January 2017 and December 2021 to Necker Hospital for Sick Children, the single regional pediatric neurosurgery center for the Paris metropolitan area, were included. AHT was defined as 1 or more subdural hemorrhage and a positive multidisciplinary evaluation after a social, clinical, biological, and radiological workup. Data were analyzed from January to March 2022. MAIN OUTCOMES AND MEASURES The primary outcome was the monthly incidence of AHT, which was analyzed using Poisson regression modeling. Secondary outcomes included mortality and severe morbidity and were studied with logistic and linear regressions. The monthly incidence of neurosurgical interventions for hydrocephalus was used as a control series. RESULTS Among the 99 included infants with AHT (median [IQR] age, 4 [3-6] months; 64 boys [65%]), 86 of 99 (87%) had bridging vein thrombosis, 74 of 99 (75%) had retinal hemorrhages, 23 of 72 (32%) had fractures, 26 of 99 (26%) had status epilepticus, 20 of 99 (20%) had skin injuries, 53 of 99 (54%) underwent neurosurgical interventions, and 13 of 99 (13%) died. Compared with the prepandemic period (2017-2019), AHT incidence was stable in 2020 (adjusted incidence rate ratio, 1.02; 95% CI, 0.59-1.77) and then significantly increased in 2021 (adjusted incidence rate ratio, 1.92; 95% CI, 1.23-2.99). The severity of AHT worsened in 2021 in terms of mortality (odds ratio 9.39; 95% CI, 1.88-47.00). Other secondary outcomes and the control series were not significantly modified. CONCLUSIONS AND RELEVANCE In this cohort study, a marked increase in AHT incidence and severity occurred during the COVID-19 pandemic in the Paris metropolitan area. These results suggest the need for clinical awareness and preventive actions.
Collapse
Affiliation(s)
- Alina-Marilena Lãzãrescu
- Department of Pediatric Anesthesia and Intensive Care, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Sandro Benichi
- Department of Pediatric Neurosurgery, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Kévin Beccaria
- Department of Pediatric Neurosurgery, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Marie Bourgeois
- Department of Pediatric Neurosurgery, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Charles-Joris Roux
- Department of Pediatric Radiology, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Estelle Vergnaud
- Department of Pediatric Anesthesia and Intensive Care, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Juliette Montmayeur
- Department of Pediatric Anesthesia and Intensive Care, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Philippe Meyer
- Department of Pediatric Anesthesia and Intensive Care, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Jérémie F. Cohen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Institut National de la Santé et de la Recherche Medicale, Paris, France
- Child Protection Unit, Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Institut National de la Santé et de la Recherche Medicale, Paris, France
- Child Protection Unit, Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Flora Blangis
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Institut National de la Santé et de la Recherche Medicale, Paris, France
- Child Protection Unit, Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Gilles Orliaguet
- Department of Pediatric Anesthesia and Intensive Care, Assistance Publique–Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
- Unit EA7323 Evaluation of Therapeutics and Pharmacology in Perinatality and Pediatrics, Université Paris Cité, Paris, France
| |
Collapse
|
12
|
Yang S, Trinh NTH, Chalumeau M, Kaguelidou F, Ruemmele FM, Milic D, Lemaitre M, Cohen JF, Taine M. Pediatric Prescriptions of Proton Pump Inhibitors in France (2009-2019): A Time-Series Analysis of Trends and Practice Guidelines Impact. J Pediatr 2022; 245:158-164.e4. [PMID: 35120983 DOI: 10.1016/j.jpeds.2022.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/28/2021] [Accepted: 01/25/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To describe the ambulatory proton pump inhibitor (PPI) prescription in French children, its trends, and the impact of French (2014) and international (2018) clinical guidelines. STUDY DESIGN We described PPI prescription rates based on national dispensation data in French children (IQVIA's Xponent database, 2009-2019). Using a segmented linear regression, we assessed the impact of clinical guidelines on PPI prescription rates. Analyses were performed for the overall pediatric population and by age subgroups (infants <2 years old, children 2-11 years old, adolescents 12-17 years old). RESULTS During the study period, 8 060 288 pediatric PPI prescriptions were filled, with a mean PPI prescription rate of 52.5 per 1000 inhabitants per year. Between 2009 and 2019, the PPI prescription rate increased by 41% in the overall pediatric population (+110% in infants). The PPI prescription rate showed seasonal patterns with peaks in winter. After the release of French guidelines, significant decreases in trends of prescription rates occurred overall (change in trend -0.28, 95% CI -0.34;-0.23) and across all age groups. In infants, this change in trend was not sufficient to reverse the PPI prescription rate that was still increasing over time. In children, the PPI prescription rate slightly decreased and in adolescents, it was stable. After the release of international guidelines, a significant decrease in trend occurred in adolescents only (change in trend -0.26, 95% CI -0.47; -0.04). CONCLUSIONS The pediatric PPI prescription rate in France was high, displayed a major increase over the last decade, mainly among infants, and was modestly affected by clinical guidelines.
Collapse
Affiliation(s)
- Shuai Yang
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France
| | - Nhung T H Trinh
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; IQVIA, La Défense, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France.
| | - Florentia Kaguelidou
- Department of Pediatric Pharmacology and Pharmacogenetics, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France; Inserm, Clinical Investigation Center, Paris, France
| | - Frank M Ruemmele
- Pediatric Gastroenterology Hepatology and Nutrition, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France; Institut Imagine, Inserm U 1163, Paris, France
| | | | | | - Jérémie F Cohen
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marion Taine
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France
| |
Collapse
|
13
|
Lorton F, Chalumeau M, Martinot A, Assathiany R, Roué JM, Bourgoin P, Chantreuil J, Boussicault G, Gaillot T, Saulnier JP, Caillon J, Gras-Le Guen C, Launay E. Prevalence, Characteristics, and Determinants of Suboptimal Care in the Initial Management of Community-Onset Severe Bacterial Infections in Children. JAMA Netw Open 2022; 5:e2216778. [PMID: 35696162 PMCID: PMC9194668 DOI: 10.1001/jamanetworkopen.2022.16778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Assessment of the quality of initial care is necessary to target priority actions that can reduce the still high morbidity and mortality due to community-onset severe bacterial infections (COSBIs) among children. OBJECTIVE To study the prevalence, characteristics, and determinants of suboptimal care in the initial management of COSBIs. DESIGN, SETTING, AND PARTICIPANTS This prospective, population-based, cohort study and confidential enquiry was conducted between August 2009 and January 2014 in western France, a region accounting for 15% of the French pediatric population (1 968 474 children aged 1 month to 16 years) and including 6 pediatric intensive care units (PICUs) and 35 emergency departments. Participants included all children aged 1 month to 16 years who died before PICU admission or were admitted to a PICU with a COSBI (ie, bacterial sepsis, including meningitis, purpura fulminans, and pulmonary, osteoarticular, intra-abdominal, cardiac, and soft-tissue severe infections). Data were analyzed from March to June 2020. EXPOSURES Suboptimal care determined according to evaluation of 8 types of care: (1) the delay in seeking care by family, (2) the physician's evaluation of severity, (3) the patient's referral at the first consultation with signs of severity, (4) the timing and (5) dosage of antibiotic treatment, (6) the timing and (7) volume of fluid bolus administration, and (8) the clinical reassessment after fluid bolus. MAIN OUTCOMES AND MEASURES Two experts assessed the quality of care before death or PICU admission as optimal, possibly suboptimal, or certainly suboptimal. The consequences and determinants of certainly suboptimal care were identified with multinomial logistic regression and generalized linear mixed models. RESULTS Of the 259 children included (median [IQR] age, 24 [6-66] months; 143 boys [55.2%]), 27 (10.4%) died, and 25 (9.6%) had severe sequelae at PICU discharge. The quality of care was certainly suboptimal in 89 cases (34.4%). Suboptimal care was more frequent in children with sequelae (adjusted odds ratio [aOR], 5.61; 95% CI, 1.19-26.36) and less frequent in children who died (aOR, 0.16; 95% CI, 0.04-0.65) vs those surviving without sequelae. Factors independently associated with suboptimal care were age younger than 5 years (aOR, 3.15; 95% CI, 1.25-7.90), diagnosis of sepsis with no source (aOR, 5.77; 95% CI, 1.64-20.30) or meningitis (aOR, 3.39; 95% CI, 1.15-9.96) vs other severe infections, and care by a primary care physician (aOR, 3.22; 95% CI, 1.17-8.88) vs a pediatric hospital service. CONCLUSIONS AND RELEVANCE This study found that suboptimal care is frequent in the initial management of COSBI and is associated with severe sequelae. The paradoxical association with reduced risk of death may be explained by an insufficient adjustment on bacterial or host intrinsic factors. Management could be optimized by improving the quality of primary care, especially for young children.
Collapse
Affiliation(s)
- Fleur Lorton
- Centre of Clinical Research Femme Enfant Adolescent, Hôpital Femme Enfant Adolescent, Inserm 1413, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Alain Martinot
- Univ Lille, ULR 2694-METRICS, Evaluation des technologies de Santé et des pratiques médicales, CHU Lille, Lille, France
| | - Rémy Assathiany
- Association pour la Recherche et l’Enseignement en Pédiatrie Générale, Association Française de Pédiatrie Ambulatoire, Cabinet de Pédiatrie, Issy-les-Moulineaux, France
| | - Jean-Michel Roué
- Department of Pediatric and Neonatal Critical Care, Brest University Hospital, Brest, France
| | - Pierre Bourgoin
- Department of Pediatric and Neonatal Critical Care, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| | - Julie Chantreuil
- Department of Pediatric and Neonatal Critical Care, Hôpital Clocheville, CHU de Tours, Tours, France
| | | | - Théophile Gaillot
- Department of Pediatric Critical Care, Hôpital Sud, CHU de Rennes, Rennes, France
| | - Jean-Pascal Saulnier
- Department of Pediatric and Neonatal Critical Care, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
| | - Jocelyne Caillon
- Department of Microbiology, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Christèle Gras-Le Guen
- Centre of Clinical Research Femme Enfant Adolescent, Hôpital Femme Enfant Adolescent, Inserm 1413, CHU de Nantes, Nantes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| | - Elise Launay
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and Statistics, Université Paris Cité, Paris, France
- Department of Pediatrics and Pediatric Emergency, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| |
Collapse
|
14
|
Trinh NT, de Visme S, Cohen JF, Bruckner T, Lelong N, Adnot P, Rozé JC, Blondel B, Goffinet F, Rey G, Ancel PY, Zeitlin J, Chalumeau M. Recent historic increase of infant mortality in France: A time-series analysis, 2001 to 2019. Lancet Reg Health Eur 2022; 16:100339. [PMID: 35252944 PMCID: PMC8891691 DOI: 10.1016/j.lanepe.2022.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The infant mortality rate (IMR) serves as a key indicator of population health. Methods We used data from the French National Institute of Statistics and Economic Studies on births and deaths during the first year of life from 2001 to 2019 to calculate IMR aggregated by month. We ran joinpoint regressions to identify inflection points and assess the linear trend of each segment. Exploratory analyses were performed for overall IMR, as well as by age at death subgroups (early neonatal [D0-D6], late neonatal [D7-27], and post-neonatal [D28-364]), and by sex. We performed sensitivity analyses by excluding deaths at D0 and using other time-series modeling strategies. Results Over the 19-year study period, 53,077 infant deaths occurred, for an average IMR of 3·63/1000 (4·00 in male, 3·25 in female); 24·4% of these deaths occurred during the first day of life and 47·8% during the early neonatal period. Joinpoint analysis identified two inflection points in 2005 and 2012. The IMR decreased sharply from 2001 to 2005 (slope: -0·0167 deaths/1000 live births/month; 95%CI: -0·0219 to -0·0116) and then decreased slowly between 2005 and 2012 (slope: -0·0041; 95%CI: -0·0065 to -0·0016). From 2012 onwards, a significant increase in IMR was observed (slope: 0·0033; 95%CI: 0·0011 to 0·0056). Subgroup analyses indicated that these trends were driven notably by an increase in the early neonatal period. Sensitivity analyses provided consistent results. Interpretation The recent historic increase in IMR since 2012 in France should prompt urgent in-depth investigation to understand the causes and prepare corrective actions. Funding No financial relationships with any organizations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work.
Collapse
|
15
|
Taine M, Offredo L, Weill A, Dray-Spira R, Zureik M, Chalumeau M. Pediatric Outpatient Prescriptions in Countries With Advanced Economies in the 21st Century: A Systematic Review. JAMA Netw Open 2022; 5:e225964. [PMID: 35467734 PMCID: PMC9039774 DOI: 10.1001/jamanetworkopen.2022.5964] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE An international comparison of pediatric outpatient prescriptions (POPs) is pivotal to investigate inadequate practices at the national scale and guide corrective actions. OBJECTIVE To compare annual POP prevalence among Organisation for Economic Co-operation and Development (OECD) member countries. EVIDENCE REVIEW Two independent reviewers systematically searched PubMed, Embase, and institutes of public health or drug agency websites for studies published since 2000 and reporting POP prevalence (expressed as number of patients aged <20 years with ≥1 POP per 1000 pediatric patients per year) in OECD member countries or large geographic areas within them. Risk of bias was assessed for exhaustiveness and representativeness. Prevalence ratios (PRs) were used to compare the highest and lowest POP prevalence among countries overall, by levels of Anatomical Therapeutic Chemical (ATC) classification for the overall pediatric population, and by age group (ie, ages <5-6 vs ≥5-6 years), stratifying on prescription-only drug (POD) status. FINDINGS Among 11 studies performed on 3 regional and 8 national medicoadministrative databases in 11 countries, 35 552 550 pediatric patients were included. The overall risk of bias was low (10 studies were representative [90.9%], and the prevalence denominator included nonusers of health care for 9 studies [81.8%]). Prevalence of 1 or more POP per year ranged from 480 to 857 pediatric patients per 1000 in Sweden and France, respectively (PR, 1.8 [95% CI, 1.8-1.8]). Overall, among 8 studies reporting ATC level 1 drugs, Denmark had the lowest POP prevalence (eg, systemic hormonal preparations: 9 pediatric patients per 1000 per year) and France the highest (eg, systemic hormonal preparation: 216 pediatric patients per 1000 per year). Among 8 studies reporting ATC level 2 drugs for PODs, the PR between France and Denmark was 108.2 (95% CI, 108.2-108.2) for systemic corticosteroids and 2.1 (95% CI, 2.1-2.1) for drugs for obstructive airway disease. The PR for antibiotics was 3.4 (95% CI, 3.4-3.4) between New Zealand and Sweden. For pediatric patients aged 5 to 6 years or older, the PR for sex hormones was 2.1 (95% CI, 2.1-2.1) between Denmark and France. Among 7 studies reporting ATC level 5 drugs, the prevalence of the 10 most prevalent PODs was less than 100 pediatric patients per 1000 per year in Scandinavian countries and the Netherlands and less than 300 pediatric patients per 1000 per year in France and New Zealand. CONCLUSIONS AND RELEVANCE This study found large between-country variations in POPs, which may suggest substantial inappropriate prescriptions. The findings may suggest guidance for educational campaigns and regulatory decisions in some OECD member countries.
Collapse
Affiliation(s)
- Marion Taine
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medecines and Health Products, French National Health Insurance, Saint Denis, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université de Paris, National Institute of Health and Medical Research, F-75004, Paris, France
| | - Lucile Offredo
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medecines and Health Products, French National Health Insurance, Saint Denis, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université de Paris, National Institute of Health and Medical Research, F-75004, Paris, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medecines and Health Products, French National Health Insurance, Saint Denis, France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medecines and Health Products, French National Health Insurance, Saint Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medecines and Health Products, French National Health Insurance, Saint Denis, France
- Versailles Saint-Quentin-en-Yvelines University, Versailles, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université de Paris, National Institute of Health and Medical Research, F-75004, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| |
Collapse
|
16
|
Blangis F, Allali S, Cohen JF, Vabres N, Adamsbaum C, Rey-Salmon C, Werner A, Refes Y, Adnot P, Gras-Le Guen C, Launay E, Chalumeau M. Variations in Guidelines for Diagnosis of Child Physical Abuse in High-Income Countries: A Systematic Review. JAMA Netw Open 2021; 4:e2129068. [PMID: 34787659 PMCID: PMC8600386 DOI: 10.1001/jamanetworkopen.2021.29068] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/04/2021] [Indexed: 01/08/2023] Open
Abstract
Importance The highly variable practices observed regarding the early detection and diagnostic workup of suspected child physical abuse contribute to suboptimal care and could be partially related to discrepancies in clinical guidelines. Objective To systematically evaluate the completeness, clarity, and consistency of guidelines for child physical abuse in high-income countries. Evidence Review For this systematic review, national or regional guidelines that were disseminated from 2010 to 2020 related to the early detection and diagnostic workup of child physical abuse in infants aged 2 years or younger by academic societies or health agencies in high-income countries were retrieved. The definitions of sentinel injuries and the recommended diagnostic workup (imaging and laboratory tests) for child physical abuse were compared. Data were analyzed from July 2020 to February 2021. Findings Within the 20 included guidelines issued in 15 countries, 168 of 408 expected statements (41%) were missing and 10 statements (4%) were unclear. Among 16 guidelines characterizing sentinel injuries, all of them included skin injuries, such as bruises, hematoma, or burns, but only 8 guidelines (50%) included intraoral injuries and fractures. All 20 guidelines agreed on the indication for radiological skeletal survey, head computed tomography, and head magnetic resonance imaging but differed for those of bone scintigraphy, follow-up skeletal survey, spinal magnetic resonance imaging, cranial ultrasonography, chest computed tomography, and abdominal ultrasonography and computed tomography. Additionally, 16 guidelines agreed on exploring primary hemostasis and coagulation but not on the tests to perform, and 8 guidelines (50%) mentioned the need to investigate bone metabolism. Conclusions and Relevance These findings suggest that guidelines for the diagnosis of child physical abuse in infants were often clear but lacked completeness and were discrepant on major issues. These results may help identify priorities for well-designed original diagnostic accuracy studies, systematic reviews, or an international consensus process to produce clear and standardized guidelines to optimize practices and infant outcomes.
Collapse
Affiliation(s)
- Flora Blangis
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
- Inserm CIC 1413, Nantes University Hospital, F-44000, Nantes, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015, Paris, France
| | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015, Paris, France
| | - Jérémie F. Cohen
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015, Paris, France
| | - Nathalie Vabres
- Unité d’Accueil des Enfants en Danger, Nantes University Hospital, F-44000, Nantes, France
| | - Catherine Adamsbaum
- Department of Pediatric Radiology, AP-HP, Bicêtre Hospital, F-94270, Le Kremlin Bicêtre, France
| | - Caroline Rey-Salmon
- Pediatrics and Forensic Unit, AP-HP, Hôtel-Dieu Hospital, F-75004, Paris, France
| | - Andreas Werner
- AFPA, Association Française de Pédiatrie Ambulatoire, F-30400, Villeneuve les Avignons, France
| | - Yacine Refes
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
| | - Pauline Adnot
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015, Paris, France
| | - Christèle Gras-Le Guen
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
- Inserm CIC 1413, Nantes University Hospital, F-44000, Nantes, France
- Department of Pediatric Emergency Care, Nantes University Hospital, F-44000, Nantes, France
| | - Elise Launay
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
- Inserm CIC 1413, Nantes University Hospital, F-44000, Nantes, France
- Department of Pediatric Emergency Care, Nantes University Hospital, F-44000, Nantes, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Centre of Research in Epidemiology and Statistics, Université de Paris, INSERM, F-75004, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015, Paris, France
| | | |
Collapse
|
17
|
Bergerat M, Heude B, Taine M, Nguyen The Tich S, Werner A, Frandji B, Blauwblomme T, Sumanaru D, Charles MA, Chalumeau M, Scherdel P. Head circumference from birth to five years in France: New national reference charts and comparison to WHO standards. Lancet Reg Health Eur 2021; 5:100114. [PMID: 34557823 PMCID: PMC8454714 DOI: 10.1016/j.lanepe.2021.100114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The monitoring of head circumference (HC) is essential to early detect any conditions affecting its growth in early childhood. A positive secular trend and regional specificities in HC suggested the need to provide updated national HC reference growth charts. Methods We extracted all growth data collected from 42 primary-care physicians from across the French metropolitan territory who used the same electronic medical-records software. We selected HC measurements up to age five years for all children who were born after 1990 with birth weight > 2500 g. We derived new HC growth charts by using Generalized Additive Models for Location, Scale and Shape, then externally validated them until 30 months of age by comparison with the national population-based Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort and compared them to previous French and WHO growth charts. Findings With 973,869 HC measurements from 157,762 children, new calibrated HC growth charts from birth to age five years were generated. The new HC growth charts showed good external fit by comparison with the ELFE birth cohort. As compared with the new HC growth charts, the previous French and WHO growth charts mean HC z-scores were, respectively, -0.4 and -0.6 SD for girls and -0.2 and -0.6 SD for boys. Interpretation We produced and validated national calibrated HC growth charts by using a novel big-data approach applied to data routinely collected in clinical practice. Comparison with previous French and WHO growth charts confirmed a positive secular trend since the 1960s and regional specificities. Funding The French Ministry of Health; Laboratoires Guigoz—General Pediatrics section of the French Society of Pediatrics—Paediatric Epidemiological Research Group; the French Association of Ambulatory Pediatrics; and educational grant from the Regional Health Agency of Ile-de-France.
Collapse
Affiliation(s)
- Manon Bergerat
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Corresponding author at: Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, 16 avenue Paul Vaillant Couturier, Villejuif, F-94807, France
| | - Marion Taine
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
| | - Sylvie Nguyen The Tich
- Department of Pediatric Neurology, University Hospital Salengro, F-59037 Lille, France
- Société Française de Neurologie Pédiatrique, France
| | - Andreas Werner
- Association Française de Pédiatrie Ambulatoire, Commission Recherche, Pediatric office, Villeneuve-lès-Avignon, France
| | | | - Thomas Blauwblomme
- Université de Paris, Institut Imagine, INSERM U1163, F-75015 Paris, France
- Department of Pediatric Neurosurgery, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Dorin Sumanaru
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Institut national d'études démographiques (INED), INSERM, Joint Unit Elfe, Paris, France
| | - Martin Chalumeau
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Sick Children Hospital, Université de Paris, F-75015 Paris, France
| | - Pauline Scherdel
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004 Paris, France
| |
Collapse
|
18
|
Taine M, Offredo L, Dray-Spira R, Weill A, Chalumeau M, Zureik M. Paediatric outpatient prescriptions in France between 2010 and 2019: A nationwide population-based study: Paediatric outpatient prescriptions in France, 2010 to 2019. Lancet Reg Health Eur 2021; 7:100129. [PMID: 34557839 PMCID: PMC8454786 DOI: 10.1016/j.lanepe.2021.100129] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Paediatric outpatient prescription (POP) monitoring is pivotal to identify inadequate prescriptions and optimize drug use. We aimed at describing recent trends in POPs in France. Methods All reimbursed dispensations of outpatient prescribed drugs (excluding vaccines) were prospectively collected for the paediatric population (<18 years old) in the French national health database in 2010-2011 and 2018-2019 (mean 117,356,938/year). POP prevalence (proportion of children receiving ≥1 drug prescriptions/year) was calculated by age groups and compared by prevalence rate ratios (PRRs). Given the large sample size, 95% confidence intervals of POP prevalences and PRRs did not differ from estimates. Findings Among the 14,510,023 children resident in France in 2018-2019, mean POP prevalence was 857‰ children. Most prescribed therapeutic classes were analgesics (643‰), antibiotics (405‰), nasal corticosteroids (328‰), nonsteroidal anti-inflammatory drugs (NSAIDs) (244‰), antihistamines (246‰) and systemic corticosteroids (210‰). POPs decreased with age from 976‰ for infants to 782‰ for adolescents. Children <6 years old were notably more exposed to inhaled corticosteroids (PRR=3.06), non-penicillin beta-lactam antibacterial agents (PRR=3.05) and systemic corticosteroids (PRR=2.11) than older ones. The POP prevalence was slightly higher (PRR=1.04) during 2018-2019 than 2010-2011, with marked increases for anti-emetics (PRR=1.84), vitamin D (PRR=1.49), proton pump inhibitors (PRR=1.42), systemic contraceptives (PRR=1.24) and nasal corticosteroids (PRR=1.21) and decreases for propulsive/prokinetic agents (PRR=0.09), NSAIDs (PRR=0.73) and systemic antibiotics (PRR=0.88). Interpretation POP remained highly prevalent in France throughout the 2010s, especially for children <6 years old, with only a few improvements for selected therapeutic classes. These findings should prompt clinical guidance campaigns and/or regulatory policies. Funding Internal funding.
Collapse
Affiliation(s)
- Marion Taine
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université de Paris, F-75004 Paris, France.,EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France
| | - Lucile Offredo
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université de Paris, F-75004 Paris, France.,EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France
| | - Rosemary Dray-Spira
- EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France
| | - Alain Weill
- EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and StatisticS, U1153 Inserm, Université de Paris, F-75004 Paris, France.,Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades Hospital, AP-HP, Université de Paris, Paris, France
| | - Mahmoud Zureik
- EPI-PHARE (French National Agency for Medicines and Health Products Safety -ANSM- and French National Health Insurance -CNAM-), Saint-Denis, France.,Université Paris-Saclay, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Sud, Inserm, Anti-infective evasion and pharmacoepidemiology, CESP, 78180, Montigny-le-Bretonneux, France
| |
Collapse
|
19
|
Trinh NTH, Cohen R, Lemaitre M, Chahwakilian P, Coulthard G, Bruckner TA, Milic D, Levy C, Chalumeau M, Cohen JF. Community antibiotic prescribing for children in France from 2015 to 2017: a cross-sectional national study. J Antimicrob Chemother 2021; 75:2344-2352. [PMID: 32449915 DOI: 10.1093/jac/dkaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To assess recent community antibiotic prescribing for French children and identify areas of potential improvement. METHODS We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA's EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. For respiratory tract infections (RTIs), we described broad-spectrum antibiotic use and duration of treatment. We used Poisson regression to identify factors associated with antibiotic prescribing. RESULTS GPs prescribed more antibiotics than paediatricians [prescription rate 26.1 (95% CI 25.9-26.3) versus 21.6 (95% CI 21.0-22.2) per 100 visits, respectively; P < 0.0001]. RTIs accounted for more than 80% of antibiotic prescriptions, with presumed viral RTIs being responsible for 40.8% and 23.6% of all antibiotic prescriptions by GPs and paediatricians, respectively. For RTIs, antibiotic prescription rates per 100 visits were: otitis, 68.1 and 79.8; pharyngitis, 67.3 and 53.3; sinusitis, 67.9 and 77.3; pneumonia, 80.0 and 99.2; bronchitis, 65.2 and 47.3; common cold, 21.7 and 11.6; bronchiolitis 31.6 and 20.1; and other presumed viral RTIs, 24.1 and 11.0, for GPs and paediatricians, respectively. For RTIs, GPs prescribed more broad-spectrum antibiotics [49.8% (95% CI 49.3-50.3) versus 35.6% (95% CI 34.1-37.1), P < 0.0001] and antibiotic courses of similar duration (P = 0.21). After adjustment for diagnosis, antibiotic prescription rates were not associated with season and patient age, but were significantly higher among GPs aged ≥50 years. CONCLUSIONS Future antibiotic stewardship campaigns should target presumed viral RTIs, broad-spectrum antibiotic use and GPs aged ≥50 years.
Collapse
Affiliation(s)
- Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,IQVIA, La Défense, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | | | | | | | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Martin Chalumeau
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker - Enfants malades, Université de Paris, Paris, France
| | - Jérémie F Cohen
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker - Enfants malades, Université de Paris, Paris, France
| |
Collapse
|
20
|
Trinh NTH, Chalumeau M, Bruckner TA, Levy C, Bessou A, Milic D, Cohen R, Lemaitre M, Cohen JF. Monitoring outpatient antibiotic utilization using reimbursement and retail sales data: a population-based comparison in France, 2012-17. J Antimicrob Chemother 2021; 76:2446-2452. [PMID: 34120188 DOI: 10.1093/jac/dkab185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/26/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To assess whether a retail sales database could be used to monitor antibiotic utilization in the outpatient setting at the national level. METHODS We extracted 2012-17 outpatient antibiotic extrapolated retail sales (IQVIA's Xponent) and reimbursement data from the National Health Insurance (SNDS) in metropolitan France. We compared estimates of antibiotic use and consumption [number of antibiotic drug deliveries (DrID) and defined daily doses (DID) per 1000 inhabitants per day]. We relied on relative differences, Pearson's r statistics and time series using autoregressive integrated moving average (ARIMA) modelling to study: (i) differences in point estimates, (ii) correlation, and (iii) consistency in time trends between Xponent and SNDS. The analysis was conducted overall and in subgroups (age groups, therapeutic classes, major antimicrobial agents and regions). RESULTS We analysed approximately 377 million antibiotic drug deliveries, comprising nearly 3.4 billion DDDs. Overall, Xponent slightly overestimated SNDS point estimates with yearly relative differences of +3.5% for DrID and +3.3% for DID. Peaks in relative differences were observed for July and August months. Relative differences were <5% in most subgroups, except for fosfomycin and three French regions. Overall and across most subgroups, the correlation between Xponent and SNDS monthly aggregated estimates was almost perfect (r ≥ 0.992 for all subgroups, except for one region). ARIMA modelling showed high consistency between Xponent's and SDNS's DrID time series, but detected timepoints where the series significantly diverged. CONCLUSIONS IQVIA's Xponent and SNDS data were highly consistent. Xponent database seems suitable for monitoring outpatient antibiotic utilization in France.
Collapse
Affiliation(s)
- Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,IQVIA, La Défense, France
| | - Martin Chalumeau
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants malades, Université de Paris, Paris, France
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | | | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | | | - Jérémie F Cohen
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants malades, Université de Paris, Paris, France
| |
Collapse
|
21
|
Lelong N, Tararbit K, Le Page‐Geniller L, Cohen J, Kout S, Foix‐L'Hélias L, Boileau P, Chalumeau M, Goffinet F, Khoshnood B. Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population-based cohort (EPICARD) study of two post-operative predictive scores. Health Sci Rep 2021; 4:e300. [PMID: 34027127 PMCID: PMC8133834 DOI: 10.1002/hsr2.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Whereas no global severity score exists for congenital heart defects (CHD), risk (Risk Adjusted Cardiac Heart Surgery-1: RACHS-1) and/or complexity (Aristotle Basic Complexity: ABC) scores have been developed for those who undergo surgery. Population-based studies for assessing the predictive ability of these scores are lacking. OBJECTIVE To assess the predictive ability of RACHS-1 and ABC scores for the risk of infant mortality using population-based cohort (EPICARD) data for newborns with structural CHD. METHODS The study population comprised 443 newborns who underwent curative surgery. We assessed the predictive ability of each score alone and in conjunction with an a priori selected set of predictors of infant mortality. Statistical analysis included logistic regression models for which we computed model calibration, discrimination (ROC), and a rarely used but clinically meaningful measure of variance explained (Tjur's coefficient of discrimination). RESULTS The risk of mortality increased with increasing RACHS-1 and the ABC scores and models based on both scores had adequate calibration. Model discrimination was higher for the RACHS-1-based model (ROC 0.68, 95% CI, 0.58-0.79) than the ABC-based one (ROC 0.59, 95% CI, 0.49-0.69), P = 0.03. Neither score had the good predictive ability when this was assessed using Tjur's coefficient. CONCLUSIONS Even if the RACHS-1 score had better predictive ability, both scores had low predictive ability using a variance-explained measure. Because of this limitation and the fact that neither score can be used for newborns with CHD who do not undergo surgery, it is important to develop new predictive models that comprise all newborns with structural CHD.
Collapse
Affiliation(s)
- Nathalie Lelong
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
| | - Karim Tararbit
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
| | | | - Jérémie Cohen
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
- Department of General Pediatrics and Pediatric Infectious DiseasesAP‐HP, Hôpital Necker ‐ Enfants malades, Université de ParisParisFrance
| | - Souad Kout
- Department of NeonatologyCHI André GrégoireMontreuilFrance
| | - Laurence Foix‐L'Hélias
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
- Department of Neonatology, Hôpital Armand Trousseau, Assistance Publique‐Hôpitaux de ParisMedecine Sorbonne UniversityParisFrance
| | - Pascal Boileau
- Department of NeonatologyCHI Poissy Saint‐Germain‐en‐LayePoissyFrance
| | - Martin Chalumeau
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
- Department of General Pediatrics and Pediatric Infectious DiseasesAP‐HP, Hôpital Necker ‐ Enfants malades, Université de ParisParisFrance
| | - François Goffinet
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
- Port‐Royal Maternity UnitCochin University Hospital, Assistance Publique Hôpitaux de ParisParisFrance
| | - Babak Khoshnood
- INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research TeamUniversité de Paris, CRESSParisFrance
| |
Collapse
|
22
|
Dubois C, Smeesters PR, Refes Y, Levy C, Bidet P, Cohen R, Chalumeau M, Toubiana J, Cohen JF. Diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis: systematic review and meta-analysis. Clin Microbiol Infect 2021; 27:1736-1745. [PMID: 33964409 DOI: 10.1016/j.cmi.2021.04.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Acute pharyngitis is one of the most common conditions in outpatient settings and an important source of inappropriate antibiotic prescribing. Rapid antigen detection tests (RADTs) offer diagnosis of group A streptococcus at the point of care but have limited sensitivity. Rapid nucleic acid tests (RNATs) are now available; a systematic review of their accuracy is lacking. OBJECTIVES To evaluate the accuracy of RNATs in patients with pharyngitis; to explore test-level and study-level factors that could explain variability in accuracy; and to compare the accuracy of RNATs with that of RADTs. DATA SOURCES MEDLINE, Embase, Web of Science (1990-2020). STUDY ELIGIBILITY CRITERIA Cross-sectional studies and randomized trials. PARTICIPANTS Patients with pharyngitis. INDEX TEST/S AND REFERENCE STANDARDS RNAT commercial kits compared with throat culture. METHODS We assessed risk of bias and applicability using QUADAS-2. We performed meta-analysis of sensitivity and specificity using the bivariate random-effects model. Variability was explored by subgroup analyses and meta-regression. RESULTS We included 38 studies (46 test evaluations; 17 411 test results). RNATs were most often performed in a laboratory. The overall methodological quality of primary studies was uncertain because of incomplete reporting. RNATs had a summary sensitivity of 97.5% (95% CI 96.2%-98.3%) and a summary specificity of 95.1% (95% CI 93.6%-96.3%). There was low variability in estimates across studies. Variability in sensitivity and specificity was partially explained by test type (p < 0.05 for both). Sensitivity analyses limited to studies with low risk of bias showed robust accuracy estimates. RNATs were more sensitive than RADTs (13 studies; 96.8% versus 82.3%, p 0.004); there was no difference in specificity (p 0.92). CONCLUSIONS The high diagnostic accuracy of RNATs may allow their use as stand-alone tests to diagnose group A streptococcus pharyngitis. Based on direct comparisons, RNATs have greater sensitivity than RADTs and equal specificity. Further studies should evaluate RNATs in point-of-care settings.
Collapse
Affiliation(s)
- Constance Dubois
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, Paris, France
| | - Pierre R Smeesters
- Academic Children Hospital Queen Fabiola, Université libre de Bruxelles, Department of Paediatrics, Brussels, Belgium; Molecular Bacteriology Laboratory, Université libre de Bruxelles, Brussels, Belgium
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, ACTIV, Créteil, France
| | - Philippe Bidet
- Robert Debré Hospital, APHP, Université de Paris, Department of Microbiology, Paris, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, ACTIV, Créteil, France
| | - Martin Chalumeau
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, Paris, France; Necker-Enfants malades Hospital, APHP, Université de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Paris, France
| | - Julie Toubiana
- Necker-Enfants malades Hospital, APHP, Université de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Paris, France; Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Jérémie F Cohen
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, Paris, France; Necker-Enfants malades Hospital, APHP, Université de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Paris, France.
| |
Collapse
|
23
|
Blangis F, Taylor M, Adamsbaum C, Devillers A, Gras-Le Guen C, Launay E, Bossuyt PM, Cohen JF, Chalumeau M. Add-on bone scintigraphy after negative radiological skeletal survey for the diagnosis of skeletal injury in children suspected of physical abuse: a systematic review and meta-analysis. Arch Dis Child 2021; 106:361-366. [PMID: 32998873 DOI: 10.1136/archdischild-2020-319065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/11/2020] [Accepted: 08/27/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To systematically assess the extent to which bone scintigraphy (BS) could improve the detection rate of skeletal injury in children suspected of physical abuse with an initial negative radiological skeletal survey (RSS). STUDY DESIGN We searched MEDLINE and Web of Science for series of ≥20 children suspected of physical abuse who underwent RSS and add-on BS. We assessed the risk of bias and the heterogeneity and performed random-effects meta-analyses. RESULTS After screening 1140 unique search results, we reviewed 51 full-text articles, and included 7 studies (783 children, mostly ≤3 years old). All studies were of either high or unclear risk of bias. Substantial heterogeneity was observed in meta-analyses. The summary detection rate of skeletal injury with RSS alone was 52% (95% CI 37 to 68). The summary absolute increase in detection rate with add-on BS was 10 percentage points (95% CI 6 to 15); the summary relative detection rate was 1.19 (95% CI 1.13 to 1.25); the summary number of children with a negative RSS who needed to undergo a BS to detect one additional child with skeletal injury (number needed to test) was 3 (95% CI 2 to 7). CONCLUSIONS From the available evidence, add-on BS in young children suspected of physical abuse with a negative RSS might allow for a clinically significant improvement of the detection rate of children with skeletal injury, for a limited number of BS procedures required. The quality of the reviewed evidence was low, pointing to the need for high-quality studies in this field.
Collapse
Affiliation(s)
- Flora Blangis
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, F-75004 Paris, France .,Inserm CIC 1413, Nantes University Hospital, F-44000 Nantes, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015 Paris, France
| | - Melissa Taylor
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015 Paris, France
| | - Catherine Adamsbaum
- Department of Pediatric Radiology, AP-HP, Bicêtre hospital, F-94270 Le Kremlin Bicêtre, France
| | - Anne Devillers
- Department of Nuclear Medicine, Centre Eugène Marquis, F-35000 Rennes, France
| | - Christèle Gras-Le Guen
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, F-75004 Paris, France.,Inserm CIC 1413, Nantes University Hospital, F-44000 Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, F-44000 Nantes, France
| | - Elise Launay
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, F-75004 Paris, France.,Inserm CIC 1413, Nantes University Hospital, F-44000 Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, F-44000 Nantes, France
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, The Netherlands
| | - Jérémie F Cohen
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015 Paris, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, F-75015 Paris, France
| |
Collapse
|
24
|
Cohen JF, Korevaar DA, Matczak S, Chalumeau M, Allali S, Toubiana J. COVID-19-Related Fatalities and Intensive-Care-Unit Admissions by Age Groups in Europe: A Meta-Analysis. Front Med (Lausanne) 2021; 7:560685. [PMID: 33521004 PMCID: PMC7840596 DOI: 10.3389/fmed.2020.560685] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives: Precise international estimates of the age breakdown of COVID-19–related deaths and intensive-care-unit (ICU) admissions are lacking. We evaluated the distribution of COVID-19–related fatalities and ICU admissions by age groups in Europe. Materials and methods: On April 6, 2020, we systematically reviewed official COVID-19–related data from 32 European countries. We included countries that provided data regarding more than 10 COVID-19–related deaths stratified by age according to pre-specified age groups (i.e., <40, 40–69, ≥70 years). We used random-effects meta-analysis to summarize the data. Results: Thirteen European countries were included in the review, for a total of 31,864 COVID-19–related deaths (range: 27–14,381 per country). In the main meta-analysis (including data from Germany, Hungary, Italy, The Netherlands, Portugal, Spain, Switzerland; 21,522 COVID-19–related fatalities), the summary proportions of individuals <40, 40–69, and ≥70 years old among all COVID-19–related deaths were 0.1% (0.0–0.2; I2 28.6%), 13.0% (10.8–15.4; I2 91.5%), and 86.6% (84.2–88.9; I2 91.5%), respectively. ICU data were available for four countries (France, Greece, Spain, Sweden). The summary proportions of individuals around <40–50, around 40–69, and around ≥60–70 years old among all COVID-19–related ICU admissions were 5.4% (3.4–7.8; I2 89.0%), 52.6% (41.8–63.3; I2 98.1%), and 41.8% (32.0–51.9; I2 99%), respectively. Conclusions: People under 40 years old represent a small fraction of most severe COVID-19 cases in Europe. These results may help health authorities respond to public concerns and guide future physical distancing and mitigation strategies. Specific measures to protect older people should be considered.
Collapse
Affiliation(s)
- Jérémie F Cohen
- Université de Paris, Centre of Research in Epidemiology and Statistics-CRESS, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Soraya Matczak
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Martin Chalumeau
- Université de Paris, Centre of Research in Epidemiology and Statistics-CRESS, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Julie Toubiana
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| |
Collapse
|
25
|
Dudognon D, Levy C, Chalumeau M, Biscardi S, Dommergues MA, Dubos F, Levieux K, Aurel M, Minodier P, Zenkhri F, Mezgueldi E, Craiu I, Morin L, Béchet S, Varon E, Cohen R, Cohen JF. Diagnostic Accuracy of Routinely Available Biomarkers to Predict Bacteremia in Children With Community-Acquired Pneumonia: A Secondary Analysis of the GPIP/ACTIV Pneumonia Study in France, 2009-2018. Front Pediatr 2021; 9:684628. [PMID: 34746044 PMCID: PMC8567958 DOI: 10.3389/fped.2021.684628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objective(s): Blood cultures (BC), when performed in children seen in the emergency department with community-acquired pneumonia (CAP), are most of the time sterile. We described the diagnostic accuracy of white blood cells (WBC), absolute neutrophils count (ANC), C-reactive protein (CRP), and procalcitonin (PCT) to predict blood culture (BC) result in childhood CAP. Study Design: Secondary analysis of a prospective study carried out in eight pediatric emergency departments (France, 2009-2018), including children (≤15 years) with CAP. Analyses involved univariate comparisons and ROC curves. Results: We included 13,752 children with CAP. BC was positive in 137 (3.6%) of the 3,829 children (mean age 3.7 years) in whom it was performed, mostly with Streptococcus pneumoniae (n = 107). In children with bacteremia, ANC, CRP and PCT levels were higher (median 12,256 vs. 9,251/mm3, 223 vs. 72 mg/L and 8.6 vs. 1.0 ng/mL, respectively; p ≤ 0.002), but WBC levels were not. The area under the ROC curve of PCT (0.73 [95%CI 0.64-0.82]) was significantly higher (p ≤ 0.01) than that of WBC (0.51 [0.43-0.60]) and of ANC (0.55 [0.46-0.64]), but not than that of CRP (0.66 [0.56-0.76]; p = 0.21). CRP and PCT thresholds that provided a sensitivity of at least 90% were 30 mg/L and 0.25 ng/mL, respectively, for a specificity of 25.4 and 23.4%, respectively. CRP and PCT thresholds that provided a specificity of at least 90% were 300 mg/L and 20 ng/mL, respectively, for a sensitivity of 31.3 and 28.9%, respectively. Conclusions: PCT and CRP are the best routinely available predictive biomarkers of bacteremia in childhood CAP.
Collapse
Affiliation(s)
- Danaé Dudognon
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Paris Est University, IMRB-GRC GEMINI, Créteil, France
| | - Martin Chalumeau
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France.,Epidemiology and Statistics Research Centre - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université de Paris, Paris, France
| | - Sandra Biscardi
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Marie-Aliette Dommergues
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Department of General Pediatrics, Centre Hospitalier de Versailles-Le Chesnay, Versailles, France
| | - François Dubos
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Unit and Infectious Diseases, Univ. Lille, CHU Lille, Lille, France
| | - Karine Levieux
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Department of Pediatrics, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Marie Aurel
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Department of General Pediatrics, AP-HP, Hôpital Robert Debré, Université de Paris, Paris, France
| | - Philippe Minodier
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, Centre Hospitalier Universitaire Nord, Marseille, France
| | - Ferielle Zenkhri
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, AP-HP, Hôpital Le Kremlin-Bicêtre, Université Paris Sud, Bicêtre, France
| | - Ellia Mezgueldi
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Lyon, France
| | - Irina Craiu
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, AP-HP, Hôpital Le Kremlin-Bicêtre, Université Paris Sud, Bicêtre, France
| | - Laurence Morin
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Pediatric Emergency Department, AP-HP, Hôpital Robert Debré, Université de Paris, Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Créteil, France
| | - Emmanuelle Varon
- Centre National de Référence des Pneumocoques, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Paris Est University, IMRB-GRC GEMINI, Créteil, France.,Service des Petits Nourrissons, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France.,Epidemiology and Statistics Research Centre - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université de Paris, Paris, France
| | | |
Collapse
|
26
|
Toubiana J, Levy C, Allali S, Jung C, Leruez-Ville M, Varon E, Bajolle F, Ouldali N, Chareyre J, Béchet S, Elbez A, Casanova JL, Chalumeau M, Cohen R, Cohen JF. Association between SARS-CoV-2 infection and Kawasaki-like multisystem inflammatory syndrome: a retrospective matched case-control study, Paris, France, April to May 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 33272357 PMCID: PMC7716402 DOI: 10.2807/1560-7917.es.2020.25.48.2001813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and Kawasaki disease (KD)-like multisystem inflammatory syndrome in a retrospective case–control study in France. RT-PCR and serological tests revealed SARS-CoV-2 infection in 17/23 cases vs 11/102 controls (matched odds ratio: 26.4; 95% confidence interval: 6.0–116.9), indicating strong association between SARS-CoV-2 infection and KD-like illness. Clinicians should keep a high level of suspicion for KD-like illness during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Julie Toubiana
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Corinne Levy
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.,AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
| | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Camille Jung
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Marianne Leruez-Ville
- Virology laboratory, Necker-Enfants Malades University Hospital, AP-HP, EA 7328, Université de Paris, Paris, France
| | - Emmanuelle Varon
- Laboratoire de Microbiologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Fanny Bajolle
- M3C-Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France
| | - Naim Ouldali
- Unité d'épidémiologie clinique, AP-HP, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France.,GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Judith Chareyre
- Pediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France
| | - Stephane Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Annie Elbez
- AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, Howard Hughes Medical Institute, New York, United States.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Imagine Institute, Pediatric Hematology and Immunology Unit, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Martin Chalumeau
- Université de Paris, Centre of Research in Epidemiology and Statistics - CRESS, INSERM, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Robert Cohen
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Unité Court Séjour, Petits nourrissons, Service de Néonatalogie, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Jérémie F Cohen
- Université de Paris, Centre of Research in Epidemiology and Statistics - CRESS, INSERM, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| |
Collapse
|
27
|
Abstract
BACKGROUND Sore throat is a common condition caused by viruses or bacteria, and is a leading cause of antibiotic prescription in primary care. The most common bacterial species is group A streptococcus ('strep throat'). Between 50% to 70% of pharyngitis cases are treated with antibiotics, despite the majority of cases being viral in origin. One strategy to reduce antibiotics is to use rapid tests for group A streptococcus to guide antibiotic prescriptions. Rapid tests can be used alone or in combination with a clinical scoring system. OBJECTIVES To assess the efficacy and safety of strategies based on rapid tests to guide antibiotic prescriptions for sore throat in primary care settings. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Web of Science, and LILACS, as well as the trial registries ClinicalTrials.gov and the WHO ICTRP on 5 June 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing rapid tests with management based on clinical grounds to guide the prescription of antibiotics for people with a sore throat in ambulatory care settings. We included trials that randomised individuals, as well as cluster-RCTs in which individual practitioners (or practices) or emergency departments were randomised. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data on the primary outcomes (number of participants provided with an antibiotic prescription; number of participants with an antibiotic dispensed) and secondary outcomes (duration of sore throat symptoms; duration of other symptoms; quality of life measures; number of participants with a complication attributed to the index infection; number of participants in need of re-consultation by the end of follow-up; number of participants in need of hospital admission by the end of follow-up; number of satisfied participants; number of participants with an adverse event attributed to the rapid test). We assessed the risk of bias of all included trials and used GRADE to assess the certainty of the evidence. We performed meta-analyses and sensitivity analyses when feasible. MAIN RESULTS We included five trials (2891 children and adult participants in total; 2545 participants after adjusting for clustering). Management in the intervention group was as follows: in three trials rapid tests were used in combination with a clinical scoring system; in one trial, some physicians were asked to use rapid tests alone, while others were asked to use rapid tests in combination with a clinical scoring system; in one trial, rapid tests were used alone. Based on data from five trials (2545 participants), a large reduction in prescribed antibiotics was found in the rapid test group (481/1197) versus management based on clinical grounds (865/1348), for a summary risk difference (RD) of -25%, 95% confidence interval (CI) -31% to -18%; I2 = 62%; moderate-certainty evidence. Estimates of effect on antibiotic prescription rates were stable in various sensitivity analyses. Based on data from two trials (900 people) originating from the same overarching study, the evidence suggests that rapid tests may not reduce dispensed antibiotic treatments: rapid test group (156/445) versus management based on clinical grounds (197/455); summary RD -7%, 95% CI -17% to 2%; I2 = 53%; low-certainty evidence. Four trials (2075 participants) reported data on the number of participants with a complication attributed to the index infection; the summary odds ratio (OR) was 0.85, 95% CI 0.03 to 26.65; P = 0.93; I2 = 62%; very low-certainty evidence, which means that people in the rapid testing group were less likely to develop complications of the index infection, but the evidence is very uncertain. Two trials (1161 participants) reported on the number of participants in need of re-consultation by the end of follow-up; the summary OR was 1.12, 95% CI 0.57 to 2.21; P = 0.74; I2 = 59%; low-certainty evidence, which means that participants in the rapid testing group were more likely to be in need of re-consultation by the end of the study follow-up, but the evidence is uncertain. Lack of data impeded assessment of other secondary outcomes (including safety outcomes) and of sources of heterogeneity. AUTHORS' CONCLUSIONS: Rapid testing to guide antibiotic treatment for sore throat in primary care probably reduces antibiotic prescription rates by 25% (absolute risk difference), but may have little or no impact on antibiotic dispensing. More studies are needed to assess the efficacy and safety of rapid test-guided antibiotic prescribing, notably to evaluate patient-centred outcomes and variability across subgroups (e.g. adults versus children).
Collapse
Affiliation(s)
- Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker, Paris, France
- Université de Paris, CRESS, INSERM, Paris, France
| | - Jean-Yves Pauchard
- Département Médico-Chirurgical de Pédiatrie, Hôpital de l'Enfance de Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Nils Hjelm
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Inserm UMR1153, Paris Descartes University, Paris, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France
| | - Martin Chalumeau
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker, Paris, France
- Université de Paris, CRESS, INSERM, Paris, France
| |
Collapse
|
28
|
Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, Debray A, Basmaci R, Salvador E, Biscardi S, Frange P, Chalumeau M, Casanova JL, Cohen JF, Allali S. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ 2020; 369:m2094. [PMID: 32493739 PMCID: PMC7500538 DOI: 10.1136/bmj.m2094] [Citation(s) in RCA: 646] [Impact Index Per Article: 161.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN Prospective observational study. SETTING General paediatric department of a university hospital in Paris, France. PARTICIPANTS 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. MAIN OUTCOME MEASURES The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. RESULTS 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. CONCLUSIONS The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.
Collapse
Affiliation(s)
- Julie Toubiana
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Clément Poirault
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| | - Alice Corsia
- Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France
| | - Fanny Bajolle
- M3C-Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Jacques Fourgeaud
- Virology Laboratory, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France
| | - François Angoulvant
- Pediatric Emergency Department, Necker-Enfants Malades University Hospital, AP-HP; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université de Paris, Paris, France
| | - Agathe Debray
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| | - Romain Basmaci
- Pediatric and Emergency Unit, Louis Mourier Hospital, Université de Paris, Paris, France
| | - Elodie Salvador
- Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France
| | - Sandra Biscardi
- Pediatric Emergency Unit, Hôpital Intercommunal, Créteil, France
| | - Pierre Frange
- Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, AP-HP; EHU 7328 PACT, Imagine Institute, Université de Paris, Paris, France
| | - Martin Chalumeau
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, INSERM, Université de Paris, Paris, France
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Imagine Institute, Pediatric Hematology and Immunology Unit, Necker-Enfants Malades Hospital, AP-HP, Université de Paris, Paris, France
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller Unversity, Howard Hughes Medical Institute, New York, NY, USA
| | - Jérémie F Cohen
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, INSERM, Université de Paris, Paris, France
| | - Slimane Allali
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| |
Collapse
|
29
|
Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, Debray A, Basmaci R, Salvador E, Biscardi S, Frange P, Chalumeau M, Casanova JL, Cohen JF, Allali S. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ 2020; 369:m2094. [PMID: 32493739 DOI: 10.1101/2020.05.10.20097394] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN Prospective observational study. SETTING General paediatric department of a university hospital in Paris, France. PARTICIPANTS 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. MAIN OUTCOME MEASURES The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. RESULTS 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. CONCLUSIONS The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.
Collapse
Affiliation(s)
- Julie Toubiana
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Clément Poirault
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| | - Alice Corsia
- Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France
| | - Fanny Bajolle
- M3C-Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Jacques Fourgeaud
- Virology Laboratory, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France
| | - François Angoulvant
- Pediatric Emergency Department, Necker-Enfants Malades University Hospital, AP-HP; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université de Paris, Paris, France
| | - Agathe Debray
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| | - Romain Basmaci
- Pediatric and Emergency Unit, Louis Mourier Hospital, Université de Paris, Paris, France
| | - Elodie Salvador
- Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France
| | - Sandra Biscardi
- Pediatric Emergency Unit, Hôpital Intercommunal, Créteil, France
| | - Pierre Frange
- Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, AP-HP; EHU 7328 PACT, Imagine Institute, Université de Paris, Paris, France
| | - Martin Chalumeau
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, INSERM, Université de Paris, Paris, France
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Imagine Institute, Pediatric Hematology and Immunology Unit, Necker-Enfants Malades Hospital, AP-HP, Université de Paris, Paris, France
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller Unversity, Howard Hughes Medical Institute, New York, NY, USA
| | - Jérémie F Cohen
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, INSERM, Université de Paris, Paris, France
| | - Slimane Allali
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France
| |
Collapse
|
30
|
Blangis F, Poullaouec C, Launay E, Vabres N, Sadones F, Eugène T, Cohen JF, Chalumeau M, Gras-Le Guen C. Bone Scintigraphy After a Negative Radiological Skeletal Survey Improves the Detection Rate of Inflicted Skeletal Injury in Children. Front Pediatr 2020; 8:498. [PMID: 33102400 PMCID: PMC7545028 DOI: 10.3389/fped.2020.00498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/15/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Timely diagnosis of child physical abuse is of paramount importance. The added value of bone scintigraphy (BS) after a negative radiological skeletal survey (RSS) in children with suspected physical abuse has never been evaluated. Objective: The objective of this study was to assess the extent to which BS could improve the detection rate of skeletal injury in children with suspected physical abuse with an initial negative RSS. Methods: We used discharge codes to retrospectively identify children evaluated for suspected physical abuse in a university hospital (Nantes, France). We included all consecutive children younger than 3 years old who underwent both RSS and BS, with an interval of ≤96 h between tests, from 2013 to 2019. BS and RSS results were interpreted independently during the study period. We specifically analyzed BS results for children with a negative RSS to assess the value of BS as an add-on test. Results: Among the 268 children ≤3 years old with suspected physical abuse who underwent RSS, 140 (52%) also underwent BS within 96 h and were included in the analysis. The median age was 6 months old (interquartile range: 3-8). The detection rate of ≥1 skeletal injury with RSS alone was 49% (n = 69/140, 95% CI: 41-58%) vs. 58% (n = 81/140, 50-66%) with RSS followed by add-on BS, for an absolute increase in the detection rate of 9% points (95% CI: 4-14%). The number of children with a negative RSS who would need to undergo BS to detect one additional child with ≥1 skeletal injury was 6 (95% CI: 4-11). Conclusion: In young children with suspected physical abuse with a negative RSS, add-on BS would allow for a clinically significant improvement in the detection rate of skeletal injuries for a limited number of BS procedures required. Prospective multicenter studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Flora Blangis
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, Paris, France.,INSERM CIC 1413, Nantes University Hospital, Nantes, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, Paris, France
| | - Cyrielle Poullaouec
- Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Elise Launay
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, Paris, France.,INSERM CIC 1413, Nantes University Hospital, Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Nathalie Vabres
- Unité d'Accueil des Enfants en Danger, Nantes University Hospital, Nantes, France
| | - Flavie Sadones
- Department of Radiology, Nantes University Hospital, Nantes, France
| | - Thomas Eugène
- Department of Nuclear Medicine, Nantes University Hospital, Nantes, France
| | - Jérémie F Cohen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, Paris, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, Paris, France
| | - Christèle Gras-Le Guen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Epidemiology and Statistics Research Center, Université de Paris, INSERM, Paris, France.,INSERM CIC 1413, Nantes University Hospital, Nantes, France.,Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| |
Collapse
|
31
|
Chalumeau M, Scherdel P, Heude B. Response to Letter to the Editor: "Algorithms to Define Abnormal Growth in Children: External Validation and Head-to-Head Comparison". J Clin Endocrinol Metab 2019; 104:3417-3418. [PMID: 30896762 DOI: 10.1210/jc.2019-00564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/15/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Epidemiology and Biostatistics Sorbonne Paris Cité Center, Paris Descartes University, Paris, France
- Department of General Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Pauline Scherdel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Epidemiology and Biostatistics Sorbonne Paris Cité Center, Paris Descartes University, Paris, France
| | - Barbara Heude
- Early Origins of the Child's Health and Development Team, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Epidemiology and Biostatistics Sorbonne Paris Cité Center, Paris Descartes University, Villejuif, France
| |
Collapse
|
32
|
Sacri A, Lauzon–Guillain B, Dufourg M, Bois C, Charles M, Chalumeau M. Iron-fortified formula use in young children and association with socioeconomic factors in the French nationwide ELFE cohort. Acta Paediatr 2019; 108:1285-1294. [PMID: 30536768 DOI: 10.1111/apa.14682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/14/2018] [Accepted: 12/04/2018] [Indexed: 01/01/2023]
Abstract
AIM To study the rate of iron-fortified infant formula (IFF) use in young children in France and its association with socioeconomic factors. METHODS The ELFE national birth cohort included, in 2011, 18 329 living births in 349 hospitals randomly selected. The present analyses were restricted to children with follow-up at age two years. Milk consumption was evaluated by parental telephone interview, and its association with socioeconomic factors was studied. RESULTS The 12 341 analysed children had a mean age of 26 months; 50% were girls. Rate of IFF use before two years old and at two years old was 65% and 43%, respectively. At age two years, use of IFF was lower with young age of the mother (adjusted OR [aOR] = 0.4, 95% CI: 0.3-0.5), low educational level (aOR = 0.7, 95% CI: 0.6-0.9), high parity (aOR = 0.3, 95% CI 0.2-0.4), and mother smoking (aOR = 0.8, 95% CI: 0.7-0.9) as well as low household income (aOR = 0.5, 95% CI: 0.4-0.7), and parents' unemployment (aOR = 0.7, 95% CI: 0.5-0.9). CONCLUSION In this national population-based study, the rate of implementation of the ID prevention strategy was much lower at two years old than before two years old, and significantly lower in disadvantaged populations.
Collapse
Affiliation(s)
- Anne‐Sylvia Sacri
- Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité Obstetrical Perinatal and Pediatric Epidemiology Research team (EPOPé), Labex GR–Ex Inserm, UMR1153 Paris France
- Department of General Pediatrics and Pediatric Infectious Diseases Necker–Enfants malades Hospital AP‐HP Paris France
- Paris Descartes University Paris France
- Paris Diderot University Sorbonne Paris Cité Paris France
| | - Blandine Lauzon–Guillain
- Paris Descartes University Paris France
- INSERM, UMR 1153 Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité Early Life Research on Later Health team (EAROH) Paris France
- INRA, U 1125 CRESS Early Life Research on Later Health team (EAROH) Paris France
| | | | - Corinne Bois
- Unité mixte Inserm–Ined–EFS ELFE, Ined Paris France
- Service Départemental de PMI Conseil Départemental des Hauts–de–Seine Nanterre France
| | - Marie‐Aline Charles
- Paris Descartes University Paris France
- INSERM, UMR 1153 Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité Early Life Research on Later Health team (EAROH) Paris France
- Unité mixte Inserm–Ined–EFS ELFE, Ined Paris France
| | - Martin Chalumeau
- Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité Obstetrical Perinatal and Pediatric Epidemiology Research team (EPOPé), Labex GR–Ex Inserm, UMR1153 Paris France
- Department of General Pediatrics and Pediatric Infectious Diseases Necker–Enfants malades Hospital AP‐HP Paris France
- Paris Descartes University Paris France
| |
Collapse
|
33
|
Voiriot G, Philippot Q, Elabbadi A, Elbim C, Chalumeau M, Fartoukh M. Risks Related to the Use of Non-Steroidal Anti-Inflammatory Drugs in Community-Acquired Pneumonia in Adult and Pediatric Patients. J Clin Med 2019; 8:jcm8060786. [PMID: 31163625 PMCID: PMC6617416 DOI: 10.3390/jcm8060786] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate symptoms during community-acquired pneumonia (CAP), while neither clinical data nor guidelines encourage this use. Experimental data suggest that NSAIDs impair neutrophil intrinsic functions, their recruitment to the inflammatory site, and the resolution of inflammatory processes after acute pulmonary bacterial challenge. During CAP, numerous observational data collected in hospitalized children, hospitalized adults, and adults admitted to intensive care units (ICUs) support a strong association between pre-hospital NSAID exposure and a delayed hospital referral, a delayed administration of antibiotic therapy, and the occurrence of pleuropulmonary complications, even in the only study that has accounted for a protopathic bias. Other endpoints have been described including a longer duration of antibiotic therapy and a greater hospital length of stay. In all adult series, patients exposed to NSAIDs were younger and had fewer comorbidities. The mechanisms by which NSAID use would entail a complicated course in pneumonia still remain uncertain. The temporal hypothesis and the immunological hypothesis are the two main emerging hypotheses. Current data strongly support an association between NSAID intake during the outpatient treatment of CAP and a complicated course. This should encourage experts and scientific societies to strongly advise against the use of NSAIDs in the management of lower respiratory tract infections.
Collapse
Affiliation(s)
- Guillaume Voiriot
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
- Sorbonne Université, UFR Médecine, 75006 Paris, France.
- Faculté de Médecine, GRC CARMAS, Université Paris Est, 94000 Créteil, France.
| | - Quentin Philippot
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
| | - Alexandre Elabbadi
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
| | - Carole Elbim
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, Team "Immune System, Neuroinflammation and Neurodegenerative Diseases", Hôpital Saint-Antoine, 75012 Paris, France.
| | - Martin Chalumeau
- UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, 75014 Paris, France.
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, 75015 Paris, France.
| | - Muriel Fartoukh
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
- Sorbonne Université, UFR Médecine, 75006 Paris, France.
- Faculté de Médecine, GRC CARMAS, Université Paris Est, 94000 Créteil, France.
| |
Collapse
|
34
|
Fleury J, Scherdel P, Frampas E, Vabres N, Rey-Salmon C, Blot M, Launay E, Chalumeau M, Gras-Le Guen C. Evaluation of a Temporal Association between Vaccination and Subdural Hematoma in Infants. J Pediatr 2019; 209:134-138.e1. [PMID: 30910470 DOI: 10.1016/j.jpeds.2019.01.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/10/2019] [Accepted: 01/24/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate a temporal association between vaccination and subdural hematoma, the main feature of abusive head trauma. STUDY DESIGN From a prospective population-based survey carried out in 1 administrative district in France between January 2015 and April 2017, including all infants between 11 and 52 weeks old who underwent a first cerebral imaging (computerized tomography scan or magnetic resonance imaging), we conducted a nested case-control study. Vaccine exposure was compared between cases (infants with subdural hematoma) and 2-3 paired controls, without subdural hematoma or any other imaging findings compatible with abusive head trauma. Cases and controls were matched on chronological (±7 days) and gestational (≤33 vs >33 weeks) ages, respectively. Vaccination status was collected in the personal national pediatric health booklet. RESULTS Among the 228 prospectively surveyed infants, 28 had subdural hematoma including 22 with abusive head trauma. The mean chronological age at imaging was 5.3 months among the 28 cases and the 62 controls, who did not differ significantly in median time since last vaccination (1.4 vs 1.3 months, P = .62) or frequency of at least 1 vaccination since birth (86% vs 89%; matched-pairs OR 0.77, 95% CI 0.17-3.86) or within 7 days (0.94, 0.08-6.96), 14 days (0.70, 0.12-2.92), or 21 days (0.48, 0.08-1.98) before cerebral imaging. CONCLUSIONS We found no significant temporal association between vaccination and subdural hematoma diagnosis, which must continue to be considered a red flag for abusive head trauma and child abuse.
Collapse
Affiliation(s)
- Juliette Fleury
- Unité d'accueil des enfants en danger, University Hospital of Nantes, Nantes, France; Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France
| | - Pauline Scherdel
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France; Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, Paris, France; Epidémiologie Clinique, Centre d'Investigation Clinique (CIC004), University Hospital of Nantes, Nantes, France
| | - Eric Frampas
- Department of Radiology, University Hospital of Nantes, Nantes, France
| | - Nathalie Vabres
- Unité d'accueil des enfants en danger, University Hospital of Nantes, Nantes, France; Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France
| | | | - Marie Blot
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France
| | - Elise Launay
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France; Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, Paris, France; Epidémiologie Clinique, Centre d'Investigation Clinique (CIC004), University Hospital of Nantes, Nantes, France
| | - Martin Chalumeau
- Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Paris Descartes University, Paris, France
| | - Christèle Gras-Le Guen
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France; Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal, and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, Paris, France; Epidémiologie Clinique, Centre d'Investigation Clinique (CIC004), University Hospital of Nantes, Nantes, France.
| |
Collapse
|
35
|
Allali S, Lionnet F, Mattioni S, Callebert J, Stankovic Stojanovic K, Bachmeyer C, Arlet JB, Brousse V, de Montalembert M, Chalumeau M, Grateau G, Maciel TT, Launay JM, Hermine O, Georgin-Lavialle S. Plasma histamine elevation in a large cohort of sickle cell disease patients. Br J Haematol 2019; 186:125-129. [PMID: 30924132 DOI: 10.1111/bjh.15900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/12/2019] [Indexed: 01/24/2023]
Abstract
The role of mast cells has been questioned in sickle cell disease (SCD). We performed a prospective study evaluating plasma histamine and tryptase levels in a cohort of paediatric and adult patients, in steady state (n = 132) and during vaso-occlusive crisis (VOC) (n = 121). Histamine level was elevated in 18% of patients in steady state and in 61% during VOC. Median histamine level was significantly higher during VOC than in steady state (24·1 [7·0-45·0] vs 9·6 [6·2-14·4] nmol/l, P < 0·0001). Tryptase level was slightly increased during VOC without reaching pathological values. These results suggest a role of mast cell activation in SCD pathophysiology.
Collapse
Affiliation(s)
- Slimane Allali
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France.,Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutical Implications, Paris Descartes - Sorbonne Paris Cite ́ University, Imagine Institute, Inserm U1163, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - François Lionnet
- Department of Internal Medicine, Tenon Hospital, AP-HP, Paris VI University, Paris, France
| | - Sarah Mattioni
- Department of Internal Medicine, Tenon Hospital, AP-HP, Paris VI University, Paris, France
| | - Jacques Callebert
- Department of Biochemistry and Molecular Biology, Inserm UMR942, Lariboisière Hospital, AP-HP, Paris Descartes University, Paris, France
| | | | - Claude Bachmeyer
- Department of Internal Medicine, Tenon Hospital, AP-HP, Paris VI University, Paris, France
| | - Jean-Benoit Arlet
- Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutical Implications, Paris Descartes - Sorbonne Paris Cite ́ University, Imagine Institute, Inserm U1163, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France.,Department of Internal Medicine, Georges-Pompidou European Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Valentine Brousse
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Mariane de Montalembert
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Martin Chalumeau
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker Hospital for Sick Children, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France.,Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Inserm UMR1153, Paris, France
| | - Gilles Grateau
- Department of Internal Medicine, Tenon Hospital, AP-HP, Paris VI University, Paris, France
| | - Thiago T Maciel
- Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutical Implications, Paris Descartes - Sorbonne Paris Cite ́ University, Imagine Institute, Inserm U1163, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Jean-Marie Launay
- Laboratory of Excellence GR-Ex, Paris, France.,Department of Biochemistry and Molecular Biology, Inserm UMR942, Lariboisière Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Olivier Hermine
- Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutical Implications, Paris Descartes - Sorbonne Paris Cite ́ University, Imagine Institute, Inserm U1163, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France.,Department of Haematology, Necker Hospital for Sick Children, AP-HP, Paris Descartes University, Paris, France.,Reference Center for Mastocytosis, Necker Hospital for Sick Children, AP-HP, Paris, France
| | | |
Collapse
|
36
|
Scherdel P, Matczak S, Léger J, Martinez-Vinson C, Goulet O, Brauner R, Nicklaus S, Resche-Rigon M, Chalumeau M, Heude B. Algorithms to Define Abnormal Growth in Children: External Validation and Head-To-Head Comparison. J Clin Endocrinol Metab 2019; 104:241-249. [PMID: 30137417 DOI: 10.1210/jc.2018-00723] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/15/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Growth monitoring of apparently healthy children aims at early detection of serious conditions by use of both clinical expertise and algorithms that define abnormal growth. The seven existing algorithms provide contradictory definitions of growth abnormality and have a low level of validation. OBJECTIVE An external validation study with head-to-head comparison of the seven algorithms combined with study of the impact of use of the World Health Organization (WHO) vs national growth charts on algorithm performance. DESIGN With a case-referent approach, we retrospectively applied all algorithms to growth data for children with Turner syndrome, GH deficiency, or celiac disease (n = 341) as well as apparently healthy children (n = 3406). Sensitivity, specificity, and theoretical reduction in time to diagnosis for each algorithm were calculated for each condition by using the WHO or national growth charts. RESULTS Among the two algorithms with high specificity (>98%), the Grote clinical decision rule had higher sensitivity than the Coventry consensus (4.6% to 54% vs 0% to 8.9%, P < 0.05) and offered better theoretical reduction in time to diagnosis (median: 0.0 to 0.9 years vs 0 years, P < 0.05). Sensitivity values were significantly higher with the WHO than national growth charts at the expense of specificity. CONCLUSION The Grote clinical decision rule had the best performance for early detection of the three studied diseases, but its limited potential for reducing time to diagnosis suggests the need for better-performing algorithms based on appropriate growth charts.
Collapse
Affiliation(s)
- Pauline Scherdel
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origins of the Child's Health and Development Team, Paris Descartes University, Villejuif, France
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Paris Descartes University, Paris, France
| | - Soraya Matczak
- Department of General Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Juliane Léger
- Department of Pediatric Endocrinology and Diabetology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, Reference Centre for Endocrine Growth and Development Diseases, Paris, France
| | - Christine Martinez-Vinson
- Department of Pediatric Gastroenterology and Nutrition, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Diderot University, Paris, France
| | - Olivier Goulet
- Department of Pediatric Gastroenterology-Hepatology and Nutrition, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Raja Brauner
- Unité d'Endocrinologie Pédiatrique, Fondation Ophtalmologique Adolphe de Rothschild, Paris Descartes University, Paris, France
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, AgroSupDijon Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, Université Bourgogne Franche-Comté, Dijon, France
| | - Matthieu Resche-Rigon
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Epidémiologie Clinique, Statistique, pour la Recherche en Santé, Service de Biostatistique et Information Médicale, Saint-Louis Hospital, Paris Diderot University, Paris, France
| | - Martin Chalumeau
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Paris Descartes University, Paris, France
- Department of General Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origins of the Child's Health and Development Team, Paris Descartes University, Villejuif, France
| |
Collapse
|
37
|
Allali S, Lionnet F, Mattioni S, Bachmeyer C, Arlet J, Brousse V, De Montalembert M, Chalumeau M, Grateau G, Hermine O, Launay J, Georgin Lavialle S. Augmentation des taux plasmatiques d’histamine chez les patients atteints de drépanocytose. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
38
|
Lorton F, Chalumeau M, Assathiany R, Martinot A, Bucchia M, Roué JM, Bourgoin P, Chantreuil J, Boussicault G, Gaillot T, Saulnier JP, Caillon J, Levy C, Cohen R, Gras-Le Guen C, Launay E. Vaccine-preventable severe morbidity and mortality caused by meningococcus and pneumococcus: A population-based study in France. Paediatr Perinat Epidemiol 2018; 32:442-447. [PMID: 30170336 DOI: 10.1111/ppe.12500] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In a context of suboptimal vaccination coverage and increasing vaccine hesitancy, we aimed to study morbidity and mortality in children related to missing or incomplete meningococcal C and pneumococcal conjugate vaccines. METHODS We conducted a prospective, observational, population-based study from 2009 to 2014 in a French administrative area that included all children from age 1 month to 16 years who died before admission or were admitted to an intensive care unit for a community-onset bacterial infection. Vaccine-preventable infection was defined as an infection with an identified serotype included in the national vaccine schedule at the time of infection and occurring in a non- or incompletely vaccinated child. Death and severe sequelae were studied at hospital discharge. Frequencies of vaccine-preventable morbidity and mortality caused by meningococcus and pneumococcus were calculated. RESULTS Among the 124 children with serotyped meningococcal (n = 75) or pneumococcal (n = 49) severe infections included (median age 26 months), 20 (16%) died and 12 (10%) had severe sequelae. Vaccine-preventable infections accounted for 18/124 infections (15%, 95% CI 9, 22), 5/20 deaths (25%, 95% CI 9, 49), and 3/12 severe sequelae cases (25%, 95% CI 0, 54). The vaccine schedule for meningococcal C and pneumococcal conjugate vaccinations was incomplete for 71/116 (61%) children targeted by at least one of these two vaccination programs. CONCLUSIONS Mortality and morbidity rates related to vaccine-preventable meningococcal or pneumococcal infection could be reduced by one quarter with better implementation of immunisation programs. Such information could help enhance the perception of vaccine benefits and fight vaccine hesitancy.
Collapse
Affiliation(s)
- Fleur Lorton
- Centre d'investigation clinique INSERM 1413, Femme Enfant Adolescent CHU de Nantes, Nantes, France.,Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France.,Services d'urgences pédiatriques et de pédiatrie générale, Hôpital Femme Enfant Adolescent, Nantes, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Necker hospital for Sick Children, Paris, France.,Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Rémy Assathiany
- Association pour le Recherche et l'Enseignement en Pédiatrie Générale (AREPEGE), Versailles, France.,Cabinet de Pédiatrie, Association Française de Pédiatrie Ambulatoire (AFPA), Issy-les-Moulineaux, France
| | | | - Marie Bucchia
- Services d'urgences pédiatriques et de pédiatrie générale, Hôpital Femme Enfant Adolescent, Nantes, France
| | - Jean-Michel Roué
- Service de réanimation pédiatrique et néonatale, Hôpital Morvan, CHU de Brest, Brest, France
| | - Pierre Bourgoin
- Service de réanimation pédiatrique et néonatale, Hôpital Femme Enfant Adolescent, CHU de Nantes, Nantes, France
| | - Julie Chantreuil
- Service de réanimation pédiatrique et néonatale, Hôpital Clocheville, CHU de Tours, Tours, France
| | | | - Théophile Gaillot
- Service de réanimation pédiatrique, Hôpital Sud, CHU de Rennes, Rennes, France
| | - Jean-Pascal Saulnier
- Service de réanimation pédiatrique et néonatale, Tour Jean Bernard, CHU de Poitiers, Poitiers, France
| | - Jocelyne Caillon
- Laboratoire de microbiologie, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France.,Centre Hospitalier Intercommunal de Créteil, Centre de Recherche Clinique, Créteil, France
| | - Christèle Gras-Le Guen
- Centre d'investigation clinique INSERM 1413, Femme Enfant Adolescent CHU de Nantes, Nantes, France.,Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France.,Services d'urgences pédiatriques et de pédiatrie générale, Hôpital Femme Enfant Adolescent, Nantes, France
| | - Elise Launay
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France.,Services d'urgences pédiatriques et de pédiatrie générale, Hôpital Femme Enfant Adolescent, Nantes, France
| |
Collapse
|
39
|
Abstract
BACKGROUND People affected with sickle cell disease (SCD) are at high risk of infection from Haemophilus influenzae type b (Hib). Before the implementation of Haemophilus influenzae type b conjugate vaccination in high-income countries, this was responsible for a high mortality rate in children under five years of age. In African countries, where coverage of this vaccination is still extremely low, Hib remains one of the most common causes of bacteraemias in children with SCD. The increased uptake of this conjugate vaccination may substantially improve the survival of children with SCD. This is an update of a previously published Cochrane Review. OBJECTIVES The primary objective was to determine whether Hib conjugate vaccines reduce mortality and morbidity in children and adults with SCD.The secondary objectives were to assess the following in children and adults with SCD: the immunogenicity of Hib conjugate vaccines; the safety of these vaccines; and any variation in effect according to type of vaccine, mode of administration (separately or in combination with other vaccines), number of doses, and age at first dose. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched trial registries (04 July 2018) and contacted relevant pharmaceutical companies to identify unpublished trials.Date of last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinoapthies Trials Register: 18 December 2017. SELECTION CRITERIA All randomised controlled trials (RCTs) and quasi-RCTs comparing Hib conjugate vaccines with placebo or no treatment, or comparing different types of Hib conjugate vaccines in people with SCD. DATA COLLECTION AND ANALYSIS No trials of Hib conjugate vaccines in people with SCD were found. MAIN RESULTS There is an absence of evidence from RCTs relating to the subject of this review. AUTHORS' CONCLUSIONS There has been a dramatic decrease in the incidence of invasive Hib infections observed in the post-vaccination era in people with SCD living in high-income countries. Therefore, despite the absence of evidence from RCTs, it is expected that Hib conjugate vaccines may be useful in children affected with SCD, especially in African countries where there is a high prevalence of the disease. The implementation of childhood immunisation schedules, including universal Hib conjugate vaccination, may substantially improve the survival of children with SCD living in low-income countries. We currently lack data to evaluate the potential effect of Hib vaccination among unvaccinated adults with SCD. Further research should assess the optimal Hib immunisation schedule in children and adults with SCD.
Collapse
Affiliation(s)
- Slimane Allali
- Department of General Pediatrics, Necker Hospital for Sick Children, 149 rue de Sevres, Paris, France, 75015
| | | | | | | | | |
Collapse
|
40
|
Scherdel P, Hjelm N, Salaün JF, Heude B, Chalumeau M. Survey highlights important discrepancies between definitions of paediatric abnormal growth taught to medical students in 23 European countries. Acta Paediatr 2018; 107:1218-1222. [PMID: 29421846 DOI: 10.1111/apa.14266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/13/2017] [Accepted: 02/02/2018] [Indexed: 11/29/2022]
Abstract
AIM This study compared the definitions of abnormal growth that are taught across Europe to explain previously reported variations in growth-monitoring practices. METHODS We developed two online surveys in 2016 to obtain the definitions of abnormal growth in European countries and approached the national chairs of the European Confederation of Primary Care Paediatricians in 18 countries and the International Federation of Medical Students' Associations in 33 countries. RESULTS We obtained definitions from 10 of 18 paediatricians and 18 of 33 students, covering 23 of the 33 European countries surveyed. Abnormal faltering growth was always defined, either by a single parameter (24%) or combined parameters (76%). Four static parameters were used: standardised height (100%), standardised weight (60%), standardised body mass index (12%) and distance to target height (20%). Two dynamic parameters were used: growth deflection (28%) and growth velocity (32%). The thresholds used to define abnormal faltering growth varied slightly in some cases and widely in others. Abnormal accelerated growth appeared in 52% of the definitions, with important variations in parameters and thresholds. CONCLUSION There were important between-country discrepancies in the definitions of paediatric abnormal growth that were taught in 23 European countries. Standardisation is vital.
Collapse
Affiliation(s)
- Pauline Scherdel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS); Paris Descartes University; Paris France
- Early Origins of the Child's Health and Development Team (ORCHAD); INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS); Paris Descartes University; Paris France
| | - Nils Hjelm
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS); Paris Descartes University; Paris France
| | - Jean-François Salaün
- Association Française de Pédiatrie Ambulatoire; Commission Recherche, Gradignan; Pediatric Office; St-Brieuc France
| | - Barbara Heude
- Early Origins of the Child's Health and Development Team (ORCHAD); INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS); Paris Descartes University; Paris France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS); Paris Descartes University; Paris France
- Department of General Pediatrics; Necker - Enfants Malades Hospital; AP-HP; Paris Descartes University; Paris France
| | | |
Collapse
|
41
|
Lorton F, Chalumeau M, Assathiany R, Martinot A, Bourgoin P, Caillon J, Levy C, Cohen R, Gras-le guen C, Launay E. Évolution épidémiologique des infections bactériennes sévères communautaires de l’enfant : l’exception française. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
42
|
Lorton F, Chalumeau M, Assathiany R, Martinot A, Bourgoin P, Caillon J, Gras-le-Guen C, Launay E. Infections bactériennes sévères communautaires de l’enfant : fréquence et conséquences des soins suboptimaux initiaux. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
43
|
Launay E, Neez E, Brasme JF, Cohen JF, Chalumeau M. Diagnosis delays: a threat for patients and researchers? J Pediatr 2018; 197:318-319. [PMID: 29551310 DOI: 10.1016/j.jpeds.2018.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Elise Launay
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale Hôpital Mère-Enfant CHU de Nantes Nantes, France
| | - Emilie Neez
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France
| | - Jean-François Brasme
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service d'oncologie et hématologie pédiatrique CHU d'Angers Angers, France
| | - Jérémie F Cohen
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale et maladies infectieuses Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris Paris Descartes University Paris, France
| | - Martin Chalumeau
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale et maladies infectieuses Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris Paris Descartes University Paris, France
| |
Collapse
|
44
|
Voiriot G, Chalumeau M, Messika J, Basille D, Philippe B, Ricard JD, Andrejak C, Jounieaux V, Sanchez O, Fartoukh M. [Risks associated with the use of non-steroidal anti-inflammatory drugs during pneumonia]. Rev Mal Respir 2018; 35:430-440. [PMID: 29754841 DOI: 10.1016/j.rmr.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/10/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen. STATE OF THE ART Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge. In hospitalized children and adults with CAP, observational data suggest a strong and independent association between the outpatient exposure to NSAIDs and the occurrence of pleuropulmonary complications (pleural empyema, excavation, and abscess). In the only study taking into account possible protopathic bias, the association still persists. Other markers of morbidity have been described, including delay in hospital management, prolonged antibiotic therapy, and higher transfer rate to an intensive care unit. PERSPECTIVES Data describing the role of self-medication and the biological mechanisms involved are needed. CONCLUSIONS Intake of NSAIDs during outpatient treatment of CAP is probably the second modifiable factor of morbidity after inadequate antibiotic therapy. In light of existing data in children and adults, health authorities should urgently reassess the risk-benefit ratio of NSAIDS in CAP.
Collapse
Affiliation(s)
- G Voiriot
- Service de réanimation médico-chirurgicale, hôpital Tenon, hôpitaux universitaires de l'Est-Parisien, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
| | - M Chalumeau
- Service de pédiatrie générale et maladies infectieuses, hôpital universitaire Necker-Enfants-Malades, Assistance publique-hôpitaux de Paris, 75015 Paris, France; Faculté de médecine, université Paris-Descartes-Paris-V, 75006 Paris, France
| | - J Messika
- Service de réanimation médico-chirurgicale, hôpital Louis-Mourier, hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance publique-hôpitaux de Paris, 92700 Colombes, France
| | - D Basille
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France
| | - B Philippe
- Service de pneumologie, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - J-D Ricard
- Service de réanimation médico-chirurgicale, hôpital Louis-Mourier, hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance publique-hôpitaux de Paris, 92700 Colombes, France; Faculté de médecine, université Paris-Diderot-Paris-VII, 75013 Paris, France
| | - C Andrejak
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France; Faculté de médecine, université de Picardie-Jules-Verne, 80025 Amiens, France
| | - V Jounieaux
- Service de pneumologie et réanimation respiratoire, centre hospitalier universitaire Amiens-Picardie, 80080 Amiens, France; Faculté de médecine, université de Picardie-Jules-Verne, 80025 Amiens, France
| | - O Sanchez
- Faculté de médecine, université Paris-Descartes-Paris-V, 75006 Paris, France; Service de pneumologie, soins intensifs et endoscopies bronchiques, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, Assistance Publique-hôpitaux de Paris, 75015 Paris, France
| | - M Fartoukh
- Service de réanimation médico-chirurgicale, hôpital Tenon, hôpitaux universitaires de l'Est-Parisien, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Faculté de médecine, Sorbonne université Paris, 75013 Paris, France
| |
Collapse
|
45
|
Levieux K, Patural H, Harrewijn I, Briand Huchet E, de Visme S, Gallot G, Chalumeau M, Gras Le Guen C, Hanf M. The French prospective multisite registry on sudden unexpected infant death (OMIN): rationale and study protocol. BMJ Open 2018; 8:e020883. [PMID: 29666137 PMCID: PMC5905759 DOI: 10.1136/bmjopen-2017-020883] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Even after 'back-to-sleep' campaigns, sudden unexpected infant death (SUID) continues to be the leading cause of death for infants 1 month to 1 year old in developed countries, with devastating social, psychological and legal implications for families. To sustainably tackle this problem and decrease the number of SUIDs, a French SUID registry was initiated in 2015 to (1) inform prevention with standardised data, (2) understand the mechanisms leading to SUID and the contribution of the already known or newly suggested risk factors and (3) gather a multidisciplinary group of experts to coordinate and develop innovative and urgent research in the SUID area. METHODS AND ANALYSIS This observational multisite prospective observatory includes all cases of sudden unexpected deaths in children younger than 2 years occurring in the French territory covered by the 35 participating French referral centres. From these cases, various data concerning sociodemographic conditions, death scene, personal and family medical history, parental behaviours, sleep environment, clinical examinations, biological and imagery investigations and autopsy are systematically collected. These data will be complemented as of 2018 with a biobank of diverse biological samples (blood, hair, urine, faeces and cerebrospinal fluid), with other administrative health-related data (health claim reimbursements and hospital admissions) and socioenvironmental data. Insights from exploratory descriptive statistics and thematic analysis will be combined for the design of targeted strategies to effectively reduce preventable infant deaths. ETHICS AND DISSEMINATION The French sudden unexpected infant death registry (Observatoire National des Morts Inattendues du Nourrisson registry;OMIN) was approved in 2015 by the French Data Protection Authority in clinical research (Commission Nationale de l'Informatique et des Libertés: number 915273) and by an independent ethics committee (Groupe Nantais d'Ethique dans le Domaine de la Santé: number 2015-01-27). Results will be discussed with associations of families affected by SUID, caregivers, funders of the registry, medical societies and researchers and will be submitted to international peer-reviewed journals and presented at international conferences.
Collapse
Affiliation(s)
- Karine Levieux
- Pediatric Emergency Care Unit, Nantes University Hospital, Nantes, France
- Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Hugues Patural
- Pediatric Intensive Care Unit, Saint-Étienne University Hospital, Saint Etienne, France
| | - Inge Harrewijn
- Pediatric Intensive Care Unit, Montpellier University Hospital, Montpellier, France
| | | | | | - Géraldine Gallot
- Biological Resource Center (BRC), Nantes University Hospital, Nantes, France
| | - Martin Chalumeau
- Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Christèle Gras Le Guen
- Pediatric Emergency Care Unit, Nantes University Hospital, Nantes, France
- Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Matthieu Hanf
- Inserm CIC 1413, Nantes University Hospital, Nantes, France
- Inserm UMR 1181 B2PHI, Versailles Saint Quentin University, Villejuif, France
| | | |
Collapse
|
46
|
Levy C, Vie le Sage F, Varon E, Chalumeau M, Grimprel E, Cohen R. Pediatric Ambulatory and Hospital Networks for Surveillance and Clinical Epidemiology of Community-Acquired Infections. J Pediatr 2018; 194:269-270.e2. [PMID: 29637893 DOI: 10.1016/j.jpeds.2017.11.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Corinne Levy
- University Paris Est, IMRB- GRC GEMINI, Créteil, France; ACTIV, Pediatric Clinical and Therapeutical Association of the Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, France; GPIP, Pediatric Infectious Disease Group, France; AFPA, French Association of Ambulatory Pediatricians, Saint-Germain-en-Laye, France
| | - François Vie le Sage
- GPIP, Pediatric Infectious Disease Group, France; AFPA, French Association of Ambulatory Pediatricians, Saint-Germain-en-Laye, France
| | - Emmanuelle Varon
- National Reference Center for Pneumococci, Microbiology Laboratory, Assistance Publique-Hôpitaux de Paris, Hospital Georges-Pompidou, Paris, France
| | - Martin Chalumeau
- GPIP, Pediatric Infectious Disease Group, France; Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS-INSERM U1153), Paris Descartes University, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Emmanuel Grimprel
- GPIP, Pediatric Infectious Disease Group, France; Department of General Pediatrics, Hospital Trousseau, AP-HP, University Pierre et Marie Curie, Paris, France
| | - Robert Cohen
- University Paris Est, IMRB- GRC GEMINI, Créteil, France; ACTIV, Pediatric Clinical and Therapeutical Association of the Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, France; GPIP, Pediatric Infectious Disease Group, France; AFPA, French Association of Ambulatory Pediatricians, Saint-Germain-en-Laye, France; Unité Court Séjour, Petits Nourrissons, Neonatology Department, Centre Hospitalier Intercommunal de Créteil, France
| |
Collapse
|
47
|
Trinh NTH, Chahwakilian P, Bruckner TA, Sclison S, Levy C, Chalumeau M, Milic D, Cohen R, Cohen JF. Discrepancies in national time trends of outpatient antibiotic utilization using different measures: a population-based study in France. J Antimicrob Chemother 2018; 73:1395-1401. [DOI: 10.1093/jac/dky018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/03/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nhung T H Trinh
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
| | | | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France
- Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Department of General Paediatrics and Paediatric Infectious Disease, Necker—Enfants malades hospital, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France
| | | | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Unité Court Séjour, Petits Nourrissons, Service de Néonatalogie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Jérémie F Cohen
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Department of General Paediatrics and Paediatric Infectious Disease, Necker—Enfants malades hospital, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France
| |
Collapse
|
48
|
Alby-Laurent F, Lambe C, Ferroni A, Salvi N, Lebeaux D, Le Gouëz M, Castelle M, Moulin F, Nassif X, Lortholary O, Chalumeau M, Toubiana J. Salvage Strategy for Long-Term Central Venous Catheter-Associated Staphylococcus aureus Infections in Children. Front Pediatr 2018; 6:427. [PMID: 30740390 PMCID: PMC6355702 DOI: 10.3389/fped.2018.00427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/21/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Current international guidelines strongly recommend catheter removal in case of S. aureus central line-associated bloodstream infection (CLASBI), but a catheter salvage strategy may be considered in children given age-related specificities. No data is available regarding the outcome of this strategy in children. This study aims to evaluate catheter salvage strategy in children with S. aureus CLABSI, and to determine treatment failure rates and associated risk factors. Methods: We retrospectively analyzed data for all children <18 years having S. aureus CLABSI on a long-term central venous catheter in a tertiary hospital from 2010 to 2014. We defined catheter salvage strategy as a central venous catheter left in place ≥3 days after initiation of empiric treatment for suspected bacteremia, and catheter salvage strategy failure as the persistence or relapse of bacteremia with a S. aureus strain harboring the same antibiotic susceptibility pattern, or the occurrence or the worsening of local or systemic infectious complication between 72 h and 28 days after the first positive blood culture. Results: During the study period, 49 cases of S. aureus CLABSI on long-term central venous catheters were observed in 41 children (including 59% with long-term parenteral nutrition) and 6 (15%) isolates were resistant to methicillin. A catheter salvage strategy was chosen in 37/49 (76%) cases and failed in 12/37 (32%) cases. Initial presence of bloodstream co-infection, serum concentration of vancomycin under the targeted value and inadequate empiric treatment were significantly associated with catheter salvage therapy failure. Conclusions: The catheter salvage strategy of S. aureus CLABSI on a long-term central venous catheter was frequent in the studied hospital and failed only in one third of cases.
Collapse
Affiliation(s)
- Fanny Alby-Laurent
- Department of General Pediatrics and Infectious Diseases, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Cécile Lambe
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Agnès Ferroni
- Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Nadège Salvi
- Department of Pediatric Critical Care and Anesthesia, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - David Lebeaux
- Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Morgane Le Gouëz
- Department of General Pediatrics and Infectious Diseases, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Martin Castelle
- Pediatric Hematology-Immunology Unit, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Florence Moulin
- Department of Pediatric Intensive Care Unit, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Xavier Nassif
- Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Olivier Lortholary
- Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Martin Chalumeau
- Department of General Pediatrics and Infectious Diseases, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Julie Toubiana
- Department of General Pediatrics and Infectious Diseases, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
49
|
Bertille N, Purssell E, Hjelm N, Bilenko N, Chiappini E, de Bont EGPM, Kramer MS, Lepage P, Lava SAG, Mintegi S, Sullivan JE, Walsh A, Cohen JF, Chalumeau M. Symptomatic Management of Febrile Illnesses in Children: A Systematic Review and Meta-Analysis of Parents' Knowledge and Behaviors and Their Evolution Over Time. Front Pediatr 2018; 6:279. [PMID: 30345264 PMCID: PMC6183237 DOI: 10.3389/fped.2018.00279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/13/2018] [Indexed: 01/22/2023] Open
Abstract
Recommendations to guide parents' symptomatic management of febrile illnesses in children have been published in many countries. The lack of systematic appraisal of parents' knowledge and behaviors and their evolution over time precludes an analysis of their impact and identification of targets for future educational messages. We systematically searched for studies published between 1980 and 2016 that reported a quantitative evaluation of knowledge and behaviors of >50 parents for managing fever in children. We used MEDLINE and tracked related articles, citations and co-authors personal files. Study selection and data extraction were independently performed by two reviewers. For each item of knowledge and behaviors, we calculated mean frequencies during the first and last quinquennials of the studied period and assessed temporal trends with inverse-variance weighted linear regression of frequencies over years. We observed substantial methodological heterogeneity among the 62 included articles (64 primary studies, 36,791 participants, 30 countries) that met inclusion criteria. Statistically significant changes over time were found in the use of rectal (98 to 4%) and axillary temperature measurement (1-19%), encouraging fluid intake (19-62%), and use of acetylsalicylic acid (60 to 1%). No statistically significant change was observed for the accurate definition of fever (38-55%), or the use of acetaminophen (91-92%) or ibuprofen (20-43%). Parents' knowledge and behaviors have changed over time but continue to show poor concordance with recommendations. Our study identified future targets for educational messages, including basic ones such as the definition of fever.
Collapse
Affiliation(s)
- Nathalie Bertille
- Inserm U1153 Équipe de Recherche en Épidémiologie Obstétricale, Périnatale et Pédiatrique, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - Edward Purssell
- School of Health Sciences, City, University of London, London, United Kingdom
| | - Nils Hjelm
- Inserm U1153 Équipe de Recherche en Épidémiologie Obstétricale, Périnatale et Pédiatrique, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Natalya Bilenko
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Elena Chiappini
- Department of Health Science, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - Eefje G P M de Bont
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Michael S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Philippe Lepage
- Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Sebastiano A G Lava
- University Children's Hospital Bern-University of Bern, Bern, Switzerland.,Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Santiago Mintegi
- Pediatric Emergency Department, Cruces University Hospital, Bilbao, Spain.,Biocruces Health Research Institute, University of the Basque Country, Bilbao, Spain
| | - Janice E Sullivan
- Department of Pediatrics, University of Louisville, Louisville, KY, United States
| | - Anne Walsh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jérémie F Cohen
- Inserm U1153 Équipe de Recherche en Épidémiologie Obstétricale, Périnatale et Pédiatrique, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - Martin Chalumeau
- Inserm U1153 Équipe de Recherche en Épidémiologie Obstétricale, Périnatale et Pédiatrique, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| |
Collapse
|
50
|
Sacri AS, Ferreira D, Khoshnood B, Gouya L, Barros H, Chalumeau M. Stability of serum ferritin measured by immunoturbidimetric assay after storage at -80°C for several years. PLoS One 2017; 12:e0188332. [PMID: 29228047 PMCID: PMC5724861 DOI: 10.1371/journal.pone.0188332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/03/2017] [Indexed: 02/04/2023] Open
Abstract
Background Iron deficiency (ID) may impair long-term neurological development when it occurs in young infants. In cohort studies, it is sometimes necessary to evaluate ID with sera kept frozen for several years. To assess ID, learned societies recommend measuring serum ferritin (SF) level combined with C-reactive protein level. The long-term stability of C-reactive protein in frozen samples is well established but not ferritin. Methods We measured SF level (immunoturbidimetric assay; in micrograms per liter) immediately after collection from 53 young adults recruited and followed-up in Porto, Portugal, from 2011 to 2013 (SF1), and then, in 2016 in two aliquots kept frozen at– 80°C for 3 to 5 years: one without (SF2A) and one with (SF2B) intermediate thawing in 2014. We compared SF1 to SF2A then SF2B; statistical agreement was evaluated by the Bland and Altman method and the effect of intermediate thawing by regression modelling. Results Mean SF2A–SF1 and SF2B–SF1 differences were -2.1 (SD 7.0) and 48.9 (SD 66.9). Values for Bland and Altman 95% limits of agreement were higher for the comparison of SF2B and SF1 than SF2A and SF1: -82.2 to 179.9 and -15.8 to 11.8, respectively; the effect of thawing was highly significant (p <0.001). Conclusions Agreement between SF values before and after 3 to 5 years of constant freezing at -80°C was in a generally accepted range, which supports the hypothesis of ferritin’s stability at this temperature for a long period. In long-term storage by freezing, intermediate thawing induced a major increase in values.
Collapse
Affiliation(s)
- Anne-Sylvia Sacri
- INSERM UMR1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), équipe Épidémiologie Périnatale, Obstétricale et Pédiatrique (ÉPOPé); Labex GR-Ex; Université Paris Descartes; Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades hospital, AP-HP; Université Paris Descartes, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- * E-mail:
| | - Daniela Ferreira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Babak Khoshnood
- INSERM UMR1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), équipe Épidémiologie Périnatale, Obstétricale et Pédiatrique (ÉPOPé); Labex GR-Ex; Université Paris Descartes; Paris, France
| | - Laurent Gouya
- Centre de recherche sur l'inflammation, INSERM UMR 1149, Université Paris Diderot; ERL CNRS 8252, Faculté de Médecine site Bichat, Labex GR-Ex, Paris, France
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Martin Chalumeau
- INSERM UMR1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), équipe Épidémiologie Périnatale, Obstétricale et Pédiatrique (ÉPOPé); Labex GR-Ex; Université Paris Descartes; Paris, France
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades hospital, AP-HP; Université Paris Descartes, Paris, France
| |
Collapse
|