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  1. Article ; Online: What's new in childhood tuberculosis.

    Finlayson, Heather / Lishman, Juanita / Palmer, Megan

    Current opinion in pediatrics

    2023  Volume 35, Issue 2, Page(s) 166–175

    Abstract: Purpose of review: The current review identifies recent advances in the prevention, diagnosis, and treatment of childhood tuberculosis (TB) with a focus on the WHO's updated TB management guidelines released in 2022.: Recent findings: The COVID-19 ... ...

    Abstract Purpose of review: The current review identifies recent advances in the prevention, diagnosis, and treatment of childhood tuberculosis (TB) with a focus on the WHO's updated TB management guidelines released in 2022.
    Recent findings: The COVID-19 pandemic negatively affected global TB control due to the diversion of healthcare resources and decreased patient care-seeking behaviour. Despite this, key advances in childhood TB management have continued. The WHO now recommends shorter rifamycin-based regimens for TB preventive treatment as well as shorter regimens for the treatment of both drug-susceptible and drug-resistant TB. The Xpert Ultra assay is now recommended as the initial diagnostic test for TB in children with presumed TB and can also be used on stool samples. Point-of-care urinary lipoarabinomannan assays are promising as 'rule-in' tests for children with presumed TB living with HIV. Treatment decision algorithms can be used to diagnose TB in symptomatic children in settings with and without access to chest X-rays; bacteriological confirmation should always be attempted.
    Summary: Recent guideline updates are a key milestone in the management of childhood TB, and the paediatric TB community should now prioritize their efficient implementation in high TB burden countries while generating evidence to close current evidence gaps.
    MeSH term(s) Child ; Humans ; Pandemics ; COVID-19/diagnosis ; COVID-19/epidemiology ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology
    Language English
    Publishing date 2023-02-07
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1049374-8
    ISSN 1531-698X ; 1040-8703
    ISSN (online) 1531-698X
    ISSN 1040-8703
    DOI 10.1097/MOP.0000000000001226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Moving forward with dolutegravir in children weighing less than 20 kg.

    Rabie, Helena / Lishman, Juanita / Frigati, Lisa Jane

    The lancet. HIV

    2022  Volume 9, Issue 5, Page(s) e301–e302

    MeSH term(s) Child ; HIV Infections/drug therapy ; Heterocyclic Compounds, 3-Ring/therapeutic use ; Humans ; Oxazines ; Piperazines ; Pyridones
    Chemical Substances Heterocyclic Compounds, 3-Ring ; Oxazines ; Piperazines ; Pyridones ; dolutegravir (DKO1W9H7M1)
    Language English
    Publishing date 2022-04-18
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ISSN 2352-3018
    ISSN (online) 2352-3018
    DOI 10.1016/S2352-3018(22)00062-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Infants 21-90 days presenting with a possible serious bacterial infection - are evaluation algorithms from high income countries applicable in the South African public health sector?

    Lishman, Juanita / Smit, Liezl / Redfern, Andrew

    African journal of emergency medicine : Revue africaine de la medecine d'urgence

    2020  Volume 11, Issue 1, Page(s) 158–164

    Abstract: Background: Young infants with a possible serious bacterial infection (SBI) are a very common presentation to emergency centres (ECs). It is often difficult to distinguish clinically between self-limiting viral infections and an SBI. Available ... ...

    Abstract Background: Young infants with a possible serious bacterial infection (SBI) are a very common presentation to emergency centres (ECs). It is often difficult to distinguish clinically between self-limiting viral infections and an SBI. Available evaluation algorithms to assist clinicians are mostly from high-income countries. Data to inform clinical practice in low- and middle-income countries are lacking.
    Objectives: To determine the period prevalence of SBI and invasive bacterial infection (IBI) and describe current practice in the assessment and management of young infants aged 21-90 days presenting with a possible SBI to a Paediatric Emergency centre (PEC) in Cape Town, South Africa.
    Methods: A retrospective cross-sectional review of infants 21-90 days old presenting to the Tygerberg Hospital PED between 1 January 2016 and 31 May 2016.
    Results: A total of 248 infants 21-90 days were included in the study. Sixty-two patients (25%, 95% CI 20-30) had an SBI and 13 (5.2%, 95% CI 3-8) had an IBI. One hundred and sixty-five infants had a possible SBI based on WHO IMCI criteria. The sensitivity of the WHO IMCI criteria in detecting SBI was 82.3% (95% CI 70.5-90.8) and the specificity 38.7% (95% CI 31.7-46.1). More than half (51.2%) of the infants received antibiotics within the 48 h prior to presentation, of which 33.5% included intramuscular injection of Ceftriaxone. Only 20 (8.0%) patients in this age group were discharged home after initial evaluation. A significant relationship was noted between fever and the risk of SBI (p-value 0.010) and IBI (p-value 0.009). There also appeared to be a significant relationship between nutritional status and IBI (p-value 0.013).
    Conclusion: Period prevalence of SBI and IBI was higher compared to that published in the literature. Validated evaluation algorithms to stratify risk of SBI are needed to assist clinicians in diagnosing and managing infants appropriately in low- and middle-income settings.
    Language English
    Publishing date 2020-10-19
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2211-4203
    ISSN (online) 2211-4203
    DOI 10.1016/j.afjem.2020.09.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Short-term outcomes of South African children with multisystem inflammatory syndrome in children: a prospective cohort study.

    Lishman, Juanita / Abraham, Deepthi Raju / Fourie, Barend / Yunis, Nurea Abdulbari / Redfern, Andrew / van der Zalm, Marieke M / Rabie, Helena

    Archives of disease in childhood

    2023  Volume 108, Issue 10, Page(s) 792–798

    Abstract: Background: Despite the life-threatening presentation of multisystem inflammatory syndrome in children (MIS-C), the overall prognosis is favourable in centres with access to appropriate supportive care. In this study, we investigate the short-term ... ...

    Abstract Background: Despite the life-threatening presentation of multisystem inflammatory syndrome in children (MIS-C), the overall prognosis is favourable in centres with access to appropriate supportive care. In this study, we investigate the short-term outcomes in children with MIS-C in Cape Town, South Africa.
    Methods: This prospective observational cohort study included children <13 years who fulfilled the WHO case definition of MIS-C and were admitted to Tygerberg Hospital in Cape Town, South Africa between 1 June 2020 and 31 October 2021. Clinical features were recorded at baseline and at follow-up at the 6-week cardiology and 3-month rheumatology-immunology clinics, respectively.
    Findings: Fifty-three children with a median age of 7.4 years (IQR 4.2-9.9) were included. There was a slight male predominance (30/53; 56.6%) and the majority was of mixed ancestry (28/53; 52.83%) or black African ancestry (24/53; 45.3%). Fourteen children (14/53; 26.4%) had comorbid disease. The median length of hospital stay was 8 days (IQR 6-10). All children had an echocardiogram performed at baseline of which 39 were abnormal (39/53; 73.6%). All children were discharged alive. The median days from discharge to cardiology follow-up was 39 days (IQR 33.5-41.5) and for rheumatology-immunology clinic was 70.5 days (IQR 59.5-85.0). Eleven children (11/41; 26.8%) had a persistently abnormal echocardiogram at cardiology follow-up. Systemic inflammation and organ dysfunction resolved in most.
    Interpretation: Although the short-term outcomes of MIS-C in our cohort were generally good, the cardiac morbidity needs further characterisation and follow-up.
    MeSH term(s) Child ; Humans ; Male ; Child, Preschool ; Female ; Prospective Studies ; South Africa/epidemiology ; Pneumonia, Viral ; COVID-19
    Language English
    Publishing date 2023-05-26
    Publishing country England
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 524-1
    ISSN 1468-2044 ; 0003-9888 ; 1359-2998
    ISSN (online) 1468-2044
    ISSN 0003-9888 ; 1359-2998
    DOI 10.1136/archdischild-2022-325287
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Transient acetylcholine receptor-related myasthenia gravis, post multisystem inflammatory syndrome in children (MIS-C) temporally associated with COVID-19 infection.

    Essajee, Farida / Lishman, Juanita / Solomons, Regan / Abraham, Deepthi Raju / Goussard, Pierre / Van Toorn, Ronald

    BMJ case reports

    2021  Volume 14, Issue 8

    Abstract: We report on a unique case of a 7-year-old girl with new onset ocular myasthenia gravis shortly after recovery from multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection. The diagnosis of myasthenia gravis ... ...

    Abstract We report on a unique case of a 7-year-old girl with new onset ocular myasthenia gravis shortly after recovery from multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection. The diagnosis of myasthenia gravis was based on suggestive symptoms of fatigable bilateral orbital ptosis, diplopia, positive ocular cold compression test and serum acetylcholine receptor antibody positivity, as well as a favourable treatment response to pyridostigmine. The addition of corticosteroids and methotrexate resulted in complete resolution of the ocular signs.
    MeSH term(s) COVID-19 ; Child ; Female ; Humans ; Myasthenia Gravis/complications ; Myasthenia Gravis/diagnosis ; Myasthenia Gravis/drug therapy ; Receptors, Cholinergic ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome
    Chemical Substances Receptors, Cholinergic
    Language English
    Publishing date 2021-08-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-244102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical Presentation and Outcome of Acute Respiratory Illnesses in South African Children During the COVID-19 Pandemic.

    Redfern, Andrew / van der Zalm, Marieke M / Lishman, Juanita / Goussard, Pierre / Smit, Liezl / Dagan, Ron / Barday, Mikhail / Mare, Minette / Claassen, Mathilda / Van Zyl, Gert / Rabie, Helena / Verhagen, Lilly M

    The Pediatric infectious disease journal

    2023  Volume 42, Issue 8, Page(s) 672–678

    Abstract: Background: Data from low- and middle-income countries (LMICs) show higher morbidity and mortality in children with acute respiratory illness (ARI) from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, whether SARS-CoV-2 infection ... ...

    Abstract Background: Data from low- and middle-income countries (LMICs) show higher morbidity and mortality in children with acute respiratory illness (ARI) from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, whether SARS-CoV-2 infection is distinct from other causes of ARI in this regard is unclear. We describe clinical characteristics and outcomes of South African children with SARS-CoV-2 and non-SARS-CoV-2 ARIs.
    Methods: We performed a cross-sectional study including 0-13 years old children admitted to Tygerberg Hospital between May and December 2020 with an ARI. Routine clinical data were collected by the attending clinicians. All children underwent SARS-CoV-2 polymerase chain reaction testing. For severity of disease, the need for respiratory support and duration of support was considered. Multivariable logistic regression models were built to determine the factors associated with SARS-CoV-2 infection and severity.
    Results: Data for 176 children were available, 38 (22%) children were SARS-CoV-2 polymerase chain reaction positive and 138 (78%) were negative. SARS-CoV-2 positive children were more likely to be female (OR: 2.68, 95% CI: 1.18-6.07), had lower weight-for-age Z score (OR: 0.76, 95% CI: 0.63-0.93), presented more frequently with fever (OR: 3.56, 95% CI: 1.54-8.24) and less often with cough (OR: 0.27, 95% CI: 0.11-0.66). SARS-CoV-2 infection was associated with significantly longer duration of oxygen treatment (median 8 vs. 3 days; OR: 1.1, 95% CI: 1.01-1.20). Overall, 66% of children had viral coinfection, with no significant difference between the groups. In total, 18% of SARS-CoV-2 positive children were readmitted within 3 months for a respiratory reason, compared with 15% SARS-CoV-2 negative children ( P = 0.64).
    Conclusions: Our data show that ARIs from SARS-CoV-2 cannot be easily differentiated, but were associated with a higher morbidity compared with ARIs from other causes. Overall outcomes were good. The long-term implications of severe SARS-CoV-2 pneumonia in young children in low- and middle-income countries require further study.
    MeSH term(s) Child ; Humans ; Female ; Child, Preschool ; Infant, Newborn ; Infant ; Adolescent ; Male ; COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; Cross-Sectional Studies ; South Africa/epidemiology
    Language English
    Publishing date 2023-07-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000003951
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The Impact of SARS-CoV-2 Variants on the Clinical Phenotype and Severity of Multisystem Inflammatory Syndrome in Children in South Africa.

    Abraham, Deepthi Raju / Butters, Claire / Abdulbari Yunis, Nurea / Lishman, Juanita / Scott, Christiaan / van der Zalm, Marieke M / Zühlke, Liesl / Rabie, Helena / Webb, Kate

    The Pediatric infectious disease journal

    2022  Volume 41, Issue 12, Page(s) e510–e512

    Abstract: The effects of SARS-CoV-2 variants on disease phenotype and severity of multisystem inflammatory syndrome in children (MIS-C) are unknown. We compared the clinical phenotype of MIS-C in 129 South African children across four distinct (Ancestral type, ... ...

    Abstract The effects of SARS-CoV-2 variants on disease phenotype and severity of multisystem inflammatory syndrome in children (MIS-C) are unknown. We compared the clinical phenotype of MIS-C in 129 South African children across four distinct (Ancestral type, Beta, Delta, and Omicron) variant-driven waves and found that MIS-C remains a severe disease with a stable clinical presentation, regardless of variant.
    MeSH term(s) Humans ; SARS-CoV-2/genetics ; COVID-19 ; South Africa/epidemiology ; Systemic Inflammatory Response Syndrome/diagnosis ; Phenotype
    Language English
    Publishing date 2022-09-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000003691
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Acute Appendicitis in Multisystem Inflammatory Syndrome in Children With COVID-19.

    Lishman, Juanita / Kohler, Charles / de Vos, Corne / van der Zalm, Marieke M / Itana, Justina / Redfern, Andrew / Smit, Liezl / Rabie, Helena

    The Pediatric infectious disease journal

    2020  Volume 39, Issue 12, Page(s) e472–e473

    MeSH term(s) Africa, Southern/epidemiology ; Appendicitis/complications ; Appendicitis/diagnosis ; Appendicitis/epidemiology ; Appendicitis/surgery ; Biomarkers ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Polymerase Chain Reaction ; SARS-CoV-2/classification ; SARS-CoV-2/genetics ; Symptom Assessment ; Systemic Inflammatory Response Syndrome/complications ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/epidemiology ; Systemic Inflammatory Response Syndrome/therapy
    Chemical Substances Biomarkers
    Keywords covid19
    Language English
    Publishing date 2020-06-30
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000002900
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: SARS-CoV-2 in children and their accompanying caregivers: Implications for testing strategies in resource limited hospitals.

    Smit, Liezl / Redfern, Andrew / Murray, Sadia / Lishman, Juanita / van der Zalm, Marieke M / van Zyl, Gert / Verhagen, Lilly M / de Vos, Corné / Rabie, Helena / Dyk, Annemarie / Claassen, Mathilda / Taljaard, Jantjie / Aucamp, Marina / Dramowski, Angela

    African journal of emergency medicine : Revue africaine de la medecine d'urgence

    2022  Volume 12, Issue 3, Page(s) 177–182

    Abstract: Background: Identification of SARS-CoV-2 infected individuals is imperative to prevent hospital transmission, but symptom-based screening may fail to identify asymptomatic/mildly symptomatic infectious children and their caregivers.: Methods: A COVID- ...

    Abstract Background: Identification of SARS-CoV-2 infected individuals is imperative to prevent hospital transmission, but symptom-based screening may fail to identify asymptomatic/mildly symptomatic infectious children and their caregivers.
    Methods: A COVID-19 period prevalence study was conducted between 13 and 26 August 2020 at Tygerberg Hospital, testing all children and their accompanying asymptomatic caregivers after initial symptom screening. One nasopharyngeal swab was submitted for SARS-CoV-2 using real-time reverse-transcription polymerase chain reaction (rRT-PCR). An additional Respiratory Viral 16-multiplex rRT-PCR test was simultaneously done in children presenting with symptoms compatible with possible SARS-CoV-2 infection.
    Results: SARS-Co-V 2 RT-PCR tests from 196 children and 116 caregivers were included in the analysis. The SARS-CoV-2 period prevalence in children was 5.6% (11/196) versus 15.5% (18/116) in asymptomatic caregivers (
    Conclusion: Given the poor correlation between SARS-CoV-2 symptoms and RT-PCR test positivity, universal testing of children and their accompanying caregivers should be considered for emergency and inpatient paediatric admissions during high COVID-19 community transmission periods. Universal PPE and optimising ventilation is likely the most effective way to control transmission of respiratory viral infections, including SARS-CoV-2, where universal testing is not feasible. In these settings, repeated point prevalence studies may be useful to inform local testing and cohorting strategies.
    Language English
    Publishing date 2022-04-25
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2211-4203
    ISSN (online) 2211-4203
    DOI 10.1016/j.afjem.2022.04.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Acute Appendicitis in Multisystem Inflammatory Syndrome in Children With COVID-19

    Lishman, Juanita / Kohler, Charles / de Vos, Corne / van der Zalm, Marieke M / Itana, Justina / Redfern, Andrew / Smit, Liezl / Rabie, Helena

    Pediatr. infect. dis. j

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #760013
    Database COVID19

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