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Indian Pediatr 2013;50: 894
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K Rajeshwari
Email:
[email protected]
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Reduction in hospitalization rates for pneumonia after vaccination
(N Engl J Med 2013; 369:155-63)
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The introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into
the U.S. childhood immunization schedule in 2000 has substantially
reduced the incidence of vaccine-serotype invasive pneumococcal disease
in young children and in unvaccinated older children and adults. By
2004, hospitalizations associated with pneumonia from any cause also
declined markedly among young children. Because of concerns about
increase in disease caused by nonvaccine serotypes, it was important to
determine whether the reduction in pneumonia-related hospitalizations
among young children had been sustained through 2009 and whether such
hospitalizations in older age groups had also declined. The annual rates
of hospitalization for pneumonia from any cause using the Nationwide
Inpatient Sample database were determined in the United States. Average
annual rates of pneumonia-related hospitalizations from 1997 through
1999 (before the introduction of PCV7) and from 2007 through 2009 (well
after its introduction) were used to estimate annual declines in
hospitalizations due to pneumonia. The annual rate of hospitalization
for pneumonia among children younger than 2 years of age declined by
551.1 per 100,000 children (95% confidence interval [CI], 445.1 to
657.1), which translates to 47,000 fewer hospitalizations annually than
expected on the basis of the rates before PCV7 was introduced. Overall,
an age-adjusted annual reduction of 54.8 per 100,000 or 168,000 fewer
hospitalizations for pneumonia annually was estimated. Substantial
reductions in hospitalizations for pneumonia among adults were also
observed.
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Ivermectin versus lindane for scabies (Ann Parasitol
2013; 59:37-41)
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The treatment of choice for scabies is still controversial. This study
aimed at comparing the efficacy of oral ivermectin vs. lindane
lotion 1% for the treatment of scabies. 440 patients with scabies were
randomized: the first group received a single dose of oral ivermectin
200 mcg/kg body weight, and the second group was treated with two
applications of topical lindane lotion 1%, with a 1-week interval.
Treatment was evaluated at intervals of 2 and 4 weeks, and if there was
treatment failure at the 2-week follow-up, treatment was repeated.
Single dose of oral ivermectin provided a cure rate of 63.6% at the
2-week follow-up, which increased to 81.8% at the 4-week follow-up after
repeating the treatment. Treatment with two applications of lindane
lotion 1%, with a 1-week interval between them, was effective in 45.4%
of patients at the 2-week follow-up, which increased to 63.6% at the
4-week follow-up after this treatment was repeated. Single dose
ivermectin was as effective as two applications of lindane lotion 1% at
the 2-week follow-up. After repeating the treatment, ivermectin was
superior to lindane lotion 1% at the 4-week follow up.
Comment Ivermectin is an effective drug for scabies.
Oral tablets are far easier to take than topical applications of lindane.
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Increasing fruit and vegetable consumption among
schoolchildren (Food Nutr Bull 2013; 34:75-94)
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To reverse the trend of rising child obesity rates in many middle-income
countries, recommendations include increasing fruit and vegetable
consumption. Schools can positively impact children’s eating behavior,
and multicomponent interventions that include the curriculum, school
food environments, and parental involvement are most effective. The aim
of this study was to find out how fruits and vegetables feature in the
dietary guidelines provided to schools, what specific schemes are
available for providing these foods, the extent to which nutrition
education is included in the curriculum, and how vegetables and fruits
are procured in primary schools. In 2008, a survey questionnaire
previously validated and revised was sent electronically to national
program managers and focal points for school feeding programs in 58
middle-income countries. The rationale was to obtain information
relevant to the entire country from these key informants. The survey
response rate was 46%. Few countries have any special fruit and
vegetable schemes; implementation constraints include cost and lack of
storage facilities. Although 11 of 18 countries have both nutrient-based
guidelines and school food guidelines for meals, fruits and vegetables
are often not adequately specified. In some countries, nutrition
education, special activities, school gardens, and parental
participation are used to promote fruits and vegetables.
Comments Specific schemes are needed in some countries, together with
school food guidelines that include fruits and vegetables. Fruits may be
provided as a midday meal in countries like India where cooking of food
for children at schools is emerging as a difficult option.
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