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Playwork is a recognised profession in the United Kingdom (UK) and is currently a growing area of interest internationally. However, debates about the nature and purpose of playwork have raged in the playwork field since the profession was invented in the early adventure playgrounds. This study is the first to capture data about what the now international playwork workforce understands to be the purpose of playwork. The International Playwork Census (IPC) was an online survey which asked participants from 19 different countries about their knowledge and experience of playwork. This paper reports on one question from the IPC: what is the purpose of playwork? A thematic analysis was undertaken from 193 responses on what was considered "the purpose of playwork" and three themes emerged: Facilitate and Provide for children's play; Support and Advocate. This paper describes how these three themes reflect both the historical change in understandings of the purpose of playwork and how different understandings of playwork are developed through the experience of practitioners working in range of different contexts.

The aim of this study was to compare bibliometric indicators of scientific productivity in physical activity (PA) in children and adolescents with Autism spectrum disorder (ASD) and Down syndrome (DS) in the PubMed database. A bibliometric study was conducted for the last 5 years (2017 to 2021). The data collected for each article were: year of publication, language of publication, country, journal name, and type of paper. The results showed that there was higher scientific productivity in the population with DS (20 studies) relative to their counterparts with ASD (31 studies). The language of publication in both cases was English. There were 10 countries that published on PA in ASD and 14 countries that published on DS. Overall, the greatest interest in publishing on PA in children and adolescents with ASD was in North America (6 studies), followed by Asia (5 studies) and Europe (4 studies). In the DS population it was in Europe (13 studies), North America (9 studies) and South America (4 studies). Nineteen journals were identified that published in the ASD population and 29 journals in DS. Six experimental studies were identified in ASD and 7 in DS. There was a higher scientific productivity with original studies. There was a positive trend of increasing scientific productivity over the years in both populations. We suggest the need to promote research on PA in both populations, regardless of the type of study, as it is an indicator of overall health status.

Purpose: Human adenoviruses (HAdVs) have always been suggested as one of the main causes of gastroenteritis in children. However, no comprehensive report on the global epidemiology of these viruses in pediatric gastroenteritis is available. Methods: A systematic search was conducted to obtain published papers from 2003 to 2023 in three main databases PubMed, Scopus, and Web of Science. Results: The estimated global pooled prevalence of HAdV infection in children with gastroenteritis was 10% (95% CI: 9-11%), with a growing trend after 2010. The highest prevalence was observed in Africa (20%, 95% CI: 14–26%). The prevalence was higher in inpatients (11%; 95% CI: 8-13%) and patients aged 5 years old and younger (9%; 95% CI: 7-10%). However, no significant difference was observed between male and female patients (P = 0.63). The most prevalent species was found to be the species F (57%; 95% CI: 41-72%). The most common HAdVs observed in children with gastroenteritis were types 40/41, 38, and 2. Analysis of case-control studies showed an association between HAdV and gastroenteritis in children (OR: 2.28, 95% CI; 1.51–3.44). Conclusion: This study provided valuable insights into the importance of HAdVs in children with gastroenteritis, especially in hospitalized and younger children. The results can be used in future preventive measurements and the development of effective vaccines. [ABSTRACT FROM AUTHOR]

One in five child deaths under age 5 are a result of severe wasting. Malnutrition at early ages is linked to lifelong consequences, such as reduced cognitive skills, reduced earnings in adulthood and chronic health conditions. Countries worldwide have committed to addressing child undernutrition, and ending hunger is foundational to the Millennium Development Goals. In this paper, we study the intergenerational effect of providing free tuition in secondary school on future children’s nutrition. We combined a novel longitudinal dataset that captures educational policies for 40 African countries from 1990 to 2019 with the Demographic and Health Survey (DHS). We identified three countries that introduced free secondary education several years after implementing free primary education. Exploiting this variation in timing we estimate the additional impact of providing free secondary education over free primary education. Using a difference-in-difference approach, we find that introducing free secondary education significantly reduced wasting. Cohorts exposed to free secondary had an 18% relative decrease in wasting. The impact on cohorts exposed only to free primary was smaller and not statistically significant. Expanding free secondary education has long-term, intergenerational benefits and is an effective path to reducing malnutrition. Results are robust to different specifications. [ABSTRACT FROM AUTHOR]

Background Globally, the respiratory syncytial virus (RSV) is the most common etiologic agent of acute respiratory illnesses in children. However, its burden has not been well addressed in developing countries. We aimed to estimate the molecular epidemiology of RSV in children less than 18 years of age with acute respiratory infections in Africa by conducting a systematic review and meta-analysis. Methods We systematically searched PubMed, Scopus, CINAHL, and Global Index Medicus databases to identify studies published from January 1, 2002, to April 27, 2022, following the PRISMA 2020 guideline. We assessed the study quality using the Joanna Brigg's Institute (JBI) critical appraisal checklists. We conducted a qualitative synthesis by describing the characteristics of included studies and performed the quantitative synthesis with random effects model using STATA-14. We checked for heterogeneity with Q statistics, quantified by I2, and determined the prediction interval. We performed subgroup analyses to explain the sources of heterogeneity and assessed publication biases by funnel plots augmented with Egger's test. Results Eighty-eight studies with 105 139 participants were included in the review. The overall pooled prevalence of RSV in children <18 years of age was 23% (95% confidence interval (CI) = 20, 25%). Considerable heterogeneity was present across the included studies. The adjusted prediction interval was found to be 19%-27%. Heterogeneities were explained by subgroups analyses. The highest prevalence of RSV was found among inpatients, 28% (95% CI = 25, 31%) compared with inpatients/outpatients and outpatients, with statistically significant differences (P < 0.01). The RSV estimate was also highest among those with acute lower respiratory tract illnesses (ALRTIs), 28% (95% CI = 25, 31%) compared with acute upper respiratory tract illnesses (AURTIs) and both acute upper/lower respiratory manifestations, with statistically different prevalence (P < 0.01). RSV infection estimates in each sub-region of Africa were statistically different (P < 0.01). There were no statistically significant differences in RSV infections by designs, specimen types, and specimen conditions, despite them contributing to heterogeneity. Conclusions We found a high prevalence of RSV in pediatric populations with acute respiratory tract illnesses in Africa, highlighting that the prevention and control of RSV infections in children deserve more attention. [ABSTRACT FROM AUTHOR]

Background: Non-traumatic coma is a common acute childhood presentation to healthcare facilities in Africa and is associated with high morbidity and mortality. Historically, the majority of cases were attributed to cerebral malaria (CM). With the recent drastic reduction in malaria incidence, non-malarial coma is becoming a larger proportion of cases and determining the aetiology is diagnostically challenging, particularly in resource-limited settings. The purpose of this study will be to evaluate the aetiology and prognosis of non-traumatic coma in African children. Methods: With no date restrictions, systematic searches of MEDLINE, Embase, and Scopus will identify prospective and retrospective studies (including randomised controlled trials, cluster randomised trials, cohort studies, cross-sectional, and case-control studies) recruiting children (1 month–16 years) with non-traumatic coma (defined by Blantyre Coma Score ≤ 2 or comparable alternative) from any African country. Disease-specific studies will be included if coma is associated and reported. The primary outcome is to determine the aetiology (infectious and non-infectious) of non-traumatic coma in African children, with pooled prevalence estimates of causes (e.g., malaria). Secondary outcomes are to determine overall estimates of morbidity and mortality of all-cause non-traumatic coma and disease-specific states of non-traumatic coma, where available. Random effects meta-analysis will summarise aetiology data and in-hospital and post-discharge mortality. Heterogeneity will be quantified with τ2, I2, and Cochran's Q test. Discussion: This systematic review will provide a summary of the best available evidence on the aetiology and outcome of non-traumatic coma in African children. Systematic review registration: PROSPERO CRD42020141937 [ABSTRACT FROM AUTHOR]

• Morbidity and mortality in children due to COVID-19 remained low • Adolescents had higher reported cases than younger children • Reported cases were lower in pediatric population than adult population • Testing protocols vary between countries; reflects bias in reported cases Few data on the COVID-19 epidemiological characteristics among the pediatric population in Africa exists. This paper examines the age and sex distribution of the morbidity and mortality rate in children with COVID-19 and compares it to the adult population in 15 Sub-Saharan African countries. A merge line listing dataset shared by countries within the Regional Office for Africa was analyzed. Patients diagnosed within 1 March and 1 September 2020 with a confirmed positive RT-PCR test for SARS-CoV-2 were analyzed. Children's data were stratified into three age groups: 0-4 years, 5-11 years, and 12-17 years, while adults were combined. The cumulative incidence of cases, its medians, and 95% confidence intervals were calculated. 9% of the total confirmed cases and 2.4% of the reported deaths were pediatric cases. The 12-17 age group in all 15 countries showed the highest cumulative incidence proportion in children. Adults had a higher case incidence per 100,000 people than children. The cases and deaths within the children's population were smaller than the adult population. These differences may reflect biases in COVID-19 testing protocols and reporting implemented by countries, highlighting the need for more extensive investigation and focus on the effects of COVID-19 in children. [ABSTRACT FROM AUTHOR]

Human type A rotavirus (RV-A) is world-recognized as the major pathogen causing viral gastroenteritis in children under 5 years of age. The literature indicates a substantial increase in the diversity of rotavirus strains across continents, especially in Africa, which can pose significant challenges including an increase of disease burden and a reduction of vaccines' effectiveness. However, few studies have mapped the variety of circulating virus strains in different regions, which may hamper decisions on epidemiological surveillance and preventive public health measures. Thus, our aim was to compile the most updated available evidence on the genetic profile of RV-A among children in Africa and determine the prevalence of different genotypes according to the geographical regions by means of a broad systematic review. Systematic searches were performed in PubMed, Scopus, Web of Science, and Scielo without language, time limits, or geographical restrictions within the African continent. We selected full-text peer-reviewed articles assessing the genetic profile (i.e., genotyping) of RV-A in children up to 5 years old in Africa. Overall, 682 records were retrieved, resulting in 75 studies included for evidence synthesis. These studies were published between 1999 and 2022, were conducted in 28 countries from the five African regions, and 48% of the studies were carried out for 24 months or more. Most studies (n = 55; 73.3%) evaluated RV-A cases before the introduction of the vaccines, while around 20% of studies (n = 13) presented data after the vaccine approval in each country. Only seven (9.3%) studies compared evidence from both periods (pre- and post-vaccine introduction). Genotyping methods to assess RV-A varied between RT-PCR, nested or multiplex RT-PCR, testing only the most common P and G-types. We observed G1 and P[8] to be the most prevalent strains in Africa, with values around 31% and 43%, respectively. Yet if all the genotypes with the following highest prevalence were added ((G1 + G2, G3, G9) and (P[8] + P[6], P[4])), these figures would represent 80% and 99% of the total prevalence. The combination G1P[8] was the most reported in the studies (around 22%). This review study demonstrated an increased strain diversity in the past two decades, which could represent a challenge to the efficacy of the current vaccine. [ABSTRACT FROM AUTHOR]

Violence against children—which includes maltreatment (including physical, sexual, psychological and emotional violence, and neglect), bullying (including cyberbullying), youth violence (including physical assault with or without weapons), intimate partner violence (including exposure to domestic violence and direct involvement in teen dating violence), and sexual violence—continues to present itself as a significant public health crisis in Sub-Saharan Africa (SSA) leading to numerous short- and long-term deleterious outcomes. As such, the prevention of violence against children in SSA is a critical public health priority. In this systematic literature review, we identified 45 articles that reported on results from 22 programs that seek to reduce violence against children in SSA. Results suggested that programs that focus on (1) economic strengthening, (2) teachers schools, (3) entire families, (4) caregivers only, and (5) children only are generally effective in reducing violence against children by promoting focused action on the mechanisms of change (e.g., parenting skills, enhanced parent–child relationships, resistance skills for children). To date, no research in SSA has examined the impact of policy interventions on childhood victimization or community-level interventions to change norms and values that support violence against children. Future research is needed to examine the impacts of comprehensive efforts to prevent violence against children in SSA as well as factors that predict uptake and sustainability of such prevention efforts in SSA. [ABSTRACT FROM AUTHOR]

Introduction: Child marriage remains a prevalent issue in low- and middle-income countries (LMIC) despite global declines. Girls are disproportionately affected, facing health risks, limited education, and restricted decision-making power. We aim to provide insights for child marriage prevalence across LMIC from 1990 to 2020, with a focus on sexual violence and early sexual intercourse for public health policy interventions. Methods: This study used World Bank datasets to assess progress in addressing child marriage in LMIC countries. Statistical analyses, including trend analysis and compound annual growth rate (CAGR), were conducted to evaluate indicators of first marriage, sexual violence, and sexual intercourse. Countries with sufficient data were categorized based on prevalence rates and trends, and detailed analysis focused on significant indicators. Results: While significant reductions were observed in the prevalence of child marriage before the age of 15 and 18 and early sexual intercourse in most countries, few countries show increasing trends, and others could not demonstrate statistical trends due to data limitations, such as scarcity of data for boys. Overall, many countries showed a decline in sexual violence and early sexual intercourse before the age of 15, but some exhibited increasing trends. For instance, Zambia and Senegal showed a decreasing trend of sexual violence, while Nigeria exhibited an increasing trend. Notably, Uganda, Cameroon, and Sierra Leone for women, and Namibia, Zambia, and Kenya for men, experienced substantial decline in early sexual intercourse. Conclusion: There is a decline in child marriage, sexual violence, and early sexual intercourse in most countries independent from the income group. Only a few countries show slight increasing trends. The improvements confirm that policies that address education, employment, and deep-rooted gender inequality at the societal level seem to be effective and help reach the SDG. However, better data are needed to enhance the understanding of the development of child marriage in these countries to improve the effectiveness of policy intervention. Therefore, we recommend that policymakers not only include existing evidence that continues progress but also increase and improve the monitoring of relevant indicators. Plain Language Summary: Child marriage remains a prevalent issue despite global declines, particularly affecting girls who suffer from health risks, lower education, and restricted decision-making power. However, little is known about boys in this context. This study aims to examine We aim to provide insights for child marriage prevalence across LMIC from 1990 to 2020, with a focus on sexual violence and early sexual intercourse for public health policy interventions. To achieve this, we assessed progress in addressing child marriage in LMIC countries using World Bank datasets. Through statistical analyses, including trend analysis and linear regression, we evaluated various indicators. Countries with sufficient data were categorized based on prevalence and trends. The results revealed significant reductions in all indicators, few countries show increasing trends, and others could not demonstrate statistical trends due to data limitations, such as scarcity of data for boys. The Central African Republic experienced an increase in child marriage prevalence. Overall, many countries showed a decline in sexual violence and intercourse before the age of 15, but some exhibited increasing trends. For instance, Zambia and Senegal showed a decreasing trend of sexual violence, while Nigeria exhibits an increasing trend. Notably, Uganda, Cameroon, and Sierra Leone experienced substantial declines in early sexual intercourse for women, and Namibia, Zambia, and Kenya for men. There is a decline in child marriage, sexual violence, and early sexual intercourse in most countries independent of the income group. Only a few countries show slight increasing trends. The improvements confirm that policies that address education, employment, and deep-rooted gender inequality at societal level seem to be effective and help reach the SDG. However, better data are needed to enhance the understanding of the development of child marriage in these countries to improve the effectiveness of policy intervention. Therefore, we recommend that policymakers not only include existing evidence that continues progress but also increase and improve the monitoring of relevant indicators. [ABSTRACT FROM AUTHOR]

Background: Single low-dose primaquine (SLDPQ) effectively blocks the transmission of Plasmodium falciparum malaria, but anxiety remains regarding its haemolytic potential in patients with glucose-6-phopshate dehydrogenase (G6PD) deficiency. We, therefore, examined the independent effects of several factors on haemoglobin (Hb) dynamics in falciparum-infected children with a particular interest in SLDPQ and G6PD status. Methods: This randomised, double-blind, placebo-controlled, safety trial was conducted in Congolese and Ugandan children aged 6 months–11 years with acute uncomplicated P. falciparum and day (D) 0 Hbs ≥ 6 g/dL who were treated with age-dosed SLDPQ/placebo and weight-dosed artemether lumefantrine (AL) or dihydroartemisinin piperaquine (DHAPP). Genotyping defined G6PD (G6PD c.202T allele), haemoglobin S (HbS), and α-thalassaemia status. Multivariable linear and logistic regression assessed factor independence for continuous Hb parameters and Hb recovery (D42 Hb > D0 Hb), respectively. Results: One thousand one hundred thirty-seven children, whose median age was 5 years, were randomised to receive: AL + SLDPQ (n = 286), AL + placebo (286), DHAPP + SLDPQ (283), and DHAPP + placebo (282). By G6PD status, 284 were G6PD deficient (239 hemizygous males, 45 homozygous females), 119 were heterozygous females, 418 and 299 were normal males and females, respectively, and 17 were of unknown status. The mean D0 Hb was 10.6 (SD 1.6) g/dL and was lower in younger children with longer illnesses, lower mid-upper arm circumferences, splenomegaly, and α-thalassaemia trait, who were either G6PDd or heterozygous females. The initial fractional fall in Hb was greater in younger children with higher D0 Hbs and D0 parasitaemias and longer illnesses but less in sickle cell trait. Older G6PDd children with lower starting Hbs and greater factional falls were more likely to achieve Hb recovery, whilst lower D42 Hb concentrations were associated with younger G6PD normal children with lower fractional falls, sickle cell disease, α-thalassaemia silent carrier and trait, and late treatment failures. Ten blood transfusions were given in the first week (5 SLDPQ, 5 placebo). Conclusions: In these falciparum-infected African children, posttreatment Hb changes were unaffected by SLDPQ, and G6PDd patients had favourable posttreatment Hb changes and a higher probability of Hb recovery. These reassuring findings support SLDPQ deployment without G6PD screening in Africa. Trial registration: The trial is registered at ISRCTN 11594437. [ABSTRACT FROM AUTHOR]

The WHO Model List of Essential Medicines for Children (EMLc) has not been systematically revised in the last few years. We conducted a survey addressed to healthcare professionals prescribing, preparing, or administering medicines to children and a narrative review to identify problematic paediatric formulations or missing medicines in all therapeutic fields to inform the review of the EMLc in 2023. A total of 285 physicians (63%), 28 nurses (6%) and 142 pharmacists (31%), mostly working in the hospital setting, reported at least one problematic medicine. 290 medicines were reported as missing (completely or the child-appropriate formulation). The top three most mentioned were ciprofloxacin together with phenobarbital and omeprazole. 387 medicines were reported as problematic (34% were oral liquid formulations, 34% tablets, 18% parenteral preparations. Mostly of the products were antibacterials (27%), cardiovascular medicines (11%) and antivirals (11%). The obtained responses show the perspective of healthcare workers working around the world, particularly in the European region (25%), in the African region (24%), and in the Region of the Americas (19%), with limited representation from Northern Africa and the Middle East. Our results need to be analysed with the outputs of other ongoing works before specific products can enter the WHO-hosted Global Accelerator for Paediatric formulations network prioritisation process. Efforts to develop appropriate formulations for children should be accelerated so that the uncertainties associated with off-label drug preparation and use are minimised, and therapeutic benefits are optimised. [ABSTRACT FROM AUTHOR]

This study explores common factors associated with not meeting minimum dietary diversity (MDD) among 27,072 children aged 6–23 months in Eastern and Southern Africa using data from nine Demographic and Health Surveys from 2013 to 2016. MDD was defined as consumption of more than or equals to five of eight food groups including breast milk in the past 24 h. Equity gaps were calculated as the difference in MDD prevalence between the top and bottom wealth quintiles. Logistic regression was conducted to identify common factors for not meeting MDD at the household, maternal and child levels across two or more countries to inform regional policies to improve children's diets. Kenya had the highest MDD wealth equity gap (40.4 pts), and South Africa had the smallest (14.4 pts). Equity gaps for flesh foods or eggs (up to 39.8 pp) were larger than for grain or legumes (up to 20 pp). Common risk factors for not reaching MDD included younger child age (6–11 months) (n = 9 countries), no formal maternal occupation (n = 6), not receiving vitamin‐A supplementation (n = 3), younger maternal age (n = 3), lower maternal education (n = 3), no media (n = 3) or newspaper (n = 3) exposure, lower household wealth quintile (n = 3), use of nonefficient cooking fuel (n = 2), longer time to get to the water source (n = 2), not listening to the radio (n = 2) and higher birth order (n = 2). Priorities for improving MDD in the region include introducing diverse foods at a young age from 6 months with early nutrition counselling, promoting higher maternal education, increasing food purchasing power and ensuring the support of younger mothers. Key messages: Diets of children in Eastern and Southern Africa (ESA) lack diversity.A number of common risk factors predict dietary diversity across countries.Risk factors for low dietary diversity include wealth, education and media access.Wide equity gaps were apparent for most food groups in ESA.Interventions addressing affordability and access to diverse diets are needed. [ABSTRACT FROM AUTHOR]

Background: While rotavirus causes severe diarrheal disease in children aged <5 years, data on other viral causes in sub-Saharan Africa are limited. Methods: In the Vaccine Impact on Diarrhea in Africa study (2015–2018), we analyzed stool from children aged 0–59 months with moderate-to-severe diarrhea (MSD) and without diarrhea (controls) in Kenya, Mali, and The Gambia using quantitative polymerase chain reaction. We derived the attributable fraction (AFe) based on the association between MSD and the pathogen, accounting for other pathogens, site, and age. A pathogen was attributable if the AFe was ≥0.5. The severity of attributable MSD was defined by a modified Vesikari score (mVS). Monthly cases were plotted against temperature and rainfall to assess seasonality. Results: Among 4840 MSD cases, proportions attributed to rotavirus, adenovirus 40/41, astrovirus, and sapovirus were 12.6%, 2.7%, 2.9%, and 1.9%, respectively. Attributable rotavirus, adenovirus 40/41, and astrovirus MSD cases occurred at all sites, with mVS of 11, 10, and 7, respectively. MSD cases attributable to sapovirus occurred in Kenya, with mVS of 9. Astrovirus and adenovirus 40/41 peaked during the rainy season in The Gambia, while rotavirus peaked during the dry season in Mali and The Gambia. Conclusions: In sub-Saharan Africa, rotavirus was the most common cause of MSD; adenovirus 40/41, astrovirus, and sapovirus contributed to a lesser extent among children aged <5 years. Rotavirus- and adenovirus 40/41-attributable MSD were most severe. Seasonality varied by pathogen and location. Efforts to increase the coverage of rotavirus vaccines and to improve prevention and treatment for childhood diarrhea should continue. Among children <5 years, rotavirus, adenovirus 40/41, and astrovirus cause moderate to severe diarrhea (MSD) in Kenya, Mali, and The Gambia, and sapovirus causes MSD in Kenya. Rotavirus and adenovirus 40/41 MSD have the highest severity. [ABSTRACT FROM AUTHOR]

Background: Stunting affects >20% of children <5 years old worldwide and disproportionately impacts underserved communities. The Vaccine Impact on Diarrhea in Africa (VIDA) Study examined the association between an episode of moderate-to-severe diarrhea (MSD) and the risk of subsequent stunting in children <5 years living in 3 sub-Saharan African countries. Methods: In this prospective, matched, case-control study among children <5 years, data were collected over 36 months from 2 groups. "Children with MSD" visited a health center within 7 days of illness onset experiencing ≥3 loose stools/day plus sunken eyes, poor skin turgor, dysentery, intravenous rehydration, or hospitalization. "Children without MSD" were enrolled from the community within 14 days of the index MSD child; they were diarrhea-free during the previous 7 days and were matched to the index case by age, sex, and residence. Using generalized linear mixed-effects models, we estimated the effect of an MSD episode on odds of being stunted, defined as height-for-age z-scores <−2, at a follow-up visit 2–3 months post-enrollment. Results: The proportion of stunting at enrollment was similar when 4603 children with MSD and 5976 children without MSD were compared (21.8% vs 21.3%; P =.504). Among children not stunted at enrollment, those with MSD had 30% higher odds of being stunted at follow-up than children without MSD after controlling for age, sex, study site, and socioeconomic status (adjusted OR: 1.30; 95% CI: 1.05–1.62: P =.018). Conclusions: Children <5 years in sub-Saharan Africa without stunting experienced an increased likelihood of stunting during 2–3 months following an episode of MSD. Strategies for control of early childhood diarrhea should be integrated into programs intended to reduce childhood stunting. Stunting disproportionately impacts young children living in low-income countries. In the VIDA study among children <5 years old living in sub-Saharan Africa, an episode of moderate-to-severe diarrhea conferred a 30% higher odds of becoming stunted during 60 days of follow-up. [ABSTRACT FROM AUTHOR]

Background: Migration-flows pose the risk of poliovirus reintroduction from endemic countries to Greece. This study aims to evaluate serologic-immunity/vaccination against poliomyelitis in newly-arriving migrant children. Methods: Demographic-immunisation data and blood-serum were obtained from migrants 1-14years-old, referred to a hospital-clinic in Athens-Greece within three months from arrival. Immunity to polioviruses-1-3 was determined by serum-neutralizing-antibodies(WHO guidelines). Titers ≥ 1:8 were considered positive. Results: From 9/2010 to 9/2013, 274 children(150 refugees/124 immigrants), mean age 7.1years-old, were enrolled. Only 57(20.8%) of them presented with vaccination-records. Children originated mainly from Asia(n = 198), Eastern Europe(n = 28), Middle East(n = 24) and Africa(n = 24) with 160(58.4%) from polio-endemic-countries(Afghanistan-112(40.8%), Pakistan-24(8.8%) and India-24(8.8%)). Seropositivity against polio-1-2&3 was 84.3%, 86.1% and 74.5%, respectively. Immigrants, had higher seroprotective rates against polioviruses-1-2&3 than refugees(polio-1:p = 0.002;polio-2:p = 0.004,polio-3:p < 0.001). Seronegativity to 1PVs-2PVs and all three polio serotypes was found in 37(13.5%),12 (4.4%), and 30 children(10.9%) respectively. Increasing number of vaccine-doses, and younger-age, were positively-associated with seropositivity. Discussion: A remarkable fraction of newly-arrived migrant-children were seronegative to one or more polioviruses. [ABSTRACT FROM AUTHOR]

This article uses Kenya and Ghana as case studies to analyse the construction of children, information and communication technologies (ICT) and the internet in Africa. The article discusses the interaction of girl-child protection and media risk discourses and the implication for children, girls, and women in Africa. It highlights the positioning of children in relation to ICT and the internet in terms of gender, age, class, and other demographic factors. It further examines whether, how and which children are constructed as agents or victims, and the ways in which their agency/victimhood is discussed. The article finds dominant child protection and media risk discourses focusing on the risk posed by the internet for children, particularly girls, as the main drivers of the representation of the problem. It also offers a critique of the solutions proposed to addressing the problems presented by the internet for children for taking a homogenising as well as a legalistic and regulatory approach. The article concludes by problematizing these problem representations and solutions, as well as the silences and the ways in which the in problems can be approached differently. Prior State of Knowledge: A lot of research documents the realisation of children's rights provided by the UN Convention on the rights of the Child. However, there is a dearth of research on the digital rights of children particularly in Africa. Novel Contributions: Through analysis of policy and institutional perspectives relating to children, ICTs and the internet in Kenya and Ghana, this article offers a critical approach to the construction of children and ICTs in policy and practice. Practical Implications: The article counters dominant narratives that may affect children's ability to access and benefit from the internet. It advocates for policies and programs that seek to understand children's online experiences and support children to engage constructively with the internet. [ABSTRACT FROM AUTHOR]

Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to undernutrition in children under five years old in North Africa. We searched five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest, and CINAHL) for eligible observational studies published after 2006. STATA version 17 software was used to calculate the odds ratios between associated factors and indicators of undernutrition, with 95% confidence intervals. For each factor, the overall odds were pooled using a forest plot. Due to the significant heterogeneity among the studies (I2 > 50%), a random-effects model was used, and sensitivity analysis was conducted to examine the effect of outliers. Out of 1093 initially identified studies, 14 met the selection criteria. Our meta-analysis revealed that uneducated mothers were the most common factor associated with undernutrition in North African children. Children aged 0–23 months were significantly associated with stunting (odds ratios (OR) = 1.27; 95% CI: 1.18; 1.37) and wasting (OR = 1.68; 95% CI: 1.42; 1.99). Children living in rural areas were also at higher odds of being stunted (OR = 1.74; 95% CI: 1.64; 1.84) and underweight (OR = 1.59; 95% CI: 1.35; 1.88). These analyses also indicated that a lower wealth index, mothers' nutritional health, uneducated fathers, and low birth weight were other factors significantly associated with stunting. Addressing undernutrition in Northern Africa requires a multidisciplinary approach prioritising mothers and young children, especially families in underprivileged areas. [ABSTRACT FROM AUTHOR]

The African continent represents the part of the world where early childhood care and education (ECCE) preceding primary schooling is the least developed. It is therefore essential to propose an analysis of the prospects for the development of early childhood education in the coming years. This article deals in the first instance with the international infatuation for pre-primary education based on both scientific evidence and also international agendas. It then explores the possibilities of putting forward a coherent African response to global demands concerning early childhood education and promoting the inclusion of local cultural content in designing pre-primary educational structures. Finally, the article suggests some principles that might guide international cooperation activities affecting the early childhood sector. [ABSTRACT FROM AUTHOR]

Background: Promoting physical activity (PA) is a critical first step in preventing and lowering the prevalence of non-communicable chronic diseases across all age groups. The Global Observatory on Physical Activity (GoPA) of the World Health Organization (WHO) suggested country-specific guidelines for promoting PA across all age categories to achieve this. However, despite an increase in obesity, there is no information on their compliance for pre-secondary school children in sub-Saharan Africa (SSA). We mapped evidence in the literature and described the available evidence on implementing GoPA recommendations for presecondary school children in SSA. Methods: This scoping review included a search in PubMed, Google Scholar, Scopus, and Cochrane Library with the dates 2013–2020, using keywords and the terms (Physical activity OR exercise AND (GoPA recommendations OR Guidelines) AND ((presecondary school children) OR (primary school children) OR (basic school children) OR (children)). The most important data were tabulated. Results: Twenty-three studies were identified of which ten were eligible for data extraction. Of these ten studies, 2 (20%) were conducted in Nigeria, 4 (40%) in South Africa, 2 (20%) in Ghana and 1(10%) each in Kenya and Senegal were extracted. None of these nations has a national plan or strategy to promote PA and reduce sedentary behaviors (SB). Conclusion: A gap in the formulation of PA guidelines exists in SSA. Urgent action is needed for a national plan or strategy by individual country in SSA to reduce the burden of physical inactivity among school children in SSA. [ABSTRACT FROM AUTHOR]

This commentary examines 4 ethical issues in a case of clinicians considering conducting research on children in conflict zones: (1) whether any time or resources should be taken away from treating acute injuries in order to conduct research; (2) obtaining consent for children to participate in research, which is particularly challenging given that children can be separated from parents or guardians; (3) whether the research is feasible at the moment, since starting research that stands little chance of being completed is ethically questionable; and (4) maintaining neutrality, impartiality, and humanity. Research that puts participants and researchers at risk of additional harm must be considered carefully. Here, we propose that both research and clinical care might occur simultaneously when researchers engage humbly with involved communities as the research is being designed, conducted, and reported in order to understand and resolve ethical issues involved. [ABSTRACT FROM AUTHOR]

Research on migrant children and young people has often focused on the global North and less on South–South migration. This article discusses language and its effect on how young migrants access Ghanaian schools. Through interviews with 68 pupils, 21 parents and 40 teachers and principals from 30 schools across Accra, we found that children and young people from francophone countries were placed in lower than age‐appropriate grades due to their lower command of English. Our study highlights the complex linguistic barriers facing migrant youth in an anglocentric educational system. The article discusses the relevance of our results in other postcolonial multilingual nations in the global South. [ABSTRACT FROM AUTHOR]

Background: Trauma is among the leading causes of morbidity and mortality among pediatric and adolescent populations worldwide, with over ninety percent of childhood injuries occurring in low-income and middle-income countries. Lack of region-specific data on pediatric injuries is among the major challenges limiting the ability of health systems to implement interventions to prevent injuries and improve outcomes. We aim to characterize the burden of pediatric health injuries, initial healthcare interventions and outcomes seen in thirteen diverse healthcare facilities in Tanzania. Methods: This was a prospective cohort study of children aged up to 18 years presenting to emergency units (EUs) of thirteen multi-level health facilities in Tanzania from 1st October 2019 to 30th September 2020. We describe injury patterns, mechanisms and early interventions performed at the emergency units of these health facilities. Results: Among 18,553 trauma patients seen in all thirteen-health facilities, 4368 (23.5%) were children, of whom 2894 (66.7%) were male. The overall median age was 8 years (Interquartile range 4–12 years). Fall 1592 (36.5%) and road traffic crash (RTC) 840 (19.2%) were the top mechanisms of injury. Most patients 3748 (85.8%) arrived at EU directly from the injury site, using motorized (two or three) wheeled vehicles 2401 (55%). At EU, 651 (14.9%) were triaged as an emergency category. Multiple superficial injuries (14.4%), fracture of forearm (11.7%) and open wounds (11.1%) were the top EU diagnoses, while 223 (5.2%) had intracranial injuries. Children aged 0–4 years had the highest proportion (16.3%) of burn injuries. Being referred and being triaged as an emergency category were associated with high likelihood of serious injuries with adjusted odds ratio (AOR) 4.18 (95%CI 3.07–5.68) and 2.11 (95%CI 1.75–2.56), respectively. 1095 (25.1%) of patients were admitted to inpatient care, 14 (0.3%) taken to operation theatre, and 25 (0.6%) died in the EU. Conclusions: In these multilevel health facilities in Tanzania, pediatric injuries accounted for nearly one-quarter of all injuries. Over half of injuries occurred at home. Fall from height was the leading mechanism of injury, followed by RTC. Most patients sustained fractures of extremities. Future studies of pediatric injuries should focus on evaluating various preventive strategies that can be instituted at home to reduce the incidence and associated impact of such injuries. [ABSTRACT FROM AUTHOR]

African immigrant children experience some of the poorest mental health outcomes in Canada, yet limited research has systematically mental health determinants among this growing demographic. Our participatory action research project (PAR) explored, from the perspectives of parents, the factors influencing the mental health of African immigrant children in Alberta, Canada. The project utilized an intersectionality theoretical lens to collect and analyze data from a sample of 81 African immigrant parents who participated in nine conversation cafés and five focus groups. This PAR approach provided an ideal structure to engage parents and generate knowledge on the factors influencing their children's mental health. Parents identified racial discrimination, limited mental health awareness, limited access to mental health supports, changing family dynamics, parental absenteeism, and unresolved pre-migration trauma as factors influencing their children's mental health. These factors were perceived as contributing to children's experiences of material deprivation, social problems, and emotional difficulties. Our findings suggest that interventions to overcome these factors and enhance the mental health of African immigrant children must target transformation of the family, community, and cultural systems within which their lives are embedded, as well as the policies and institutions that produce and reproduce child mental health vulnerabilities. Highlights: Racism was perceived as causing employment difficulties, material deprivation, low educational attainment, and emotional difficulties in children. Changing family dynamics (e.g., marital divorce) resulting from resettlement pressures were perceived as a source of mental stress. Unresolved pre-migration traumas were reported as a risk factor for mood swings, interpersonal difficulties, and illicit drug use. Utilization of mental health supports was curtailed by stigma and limited mental health awareness. [ABSTRACT FROM AUTHOR]

The Ebola virus is known as one of the deadliest pathogens to infect humans. Children represent a minority of Ebola Virus Disease cases globally. Yet, the different Ebola outbreaks in Africa had a wide impact on children's lives and children' rights. Review the published literature to date on Children's rights during Ebola outbreaks. Outcomes shall contribute to get a better understanding of the main limitations or violations of children's rights, identify potential gaps in the literature and support the promotion and protection of children's rights for current and future health crisis. A scoping review from PubMed, Medline, Cochrane Library and Web of Science was performed using PRISMA-ScR guidelines. Articles, reports and editorial, published on Ebola Outbreaks between 1976 and 2020 were retrieved. The UNCRC clusters of rights and treaty specific guidelines were used as a framework. Documents were found through a targeted search of websites from international or regional organisations involved in Ebola crises and children's protection. 48 articles and reports were reviewed. Few documents focused solely on children's rights. Several articles covered the topic of children and Ebola outbreaks. Most of the data are linked to basic health, education, discrimination of orphans and survivors. 31% of the reviewed articles underline the violence against the children (rape, abuse, Female genital mutilations), while 21% focus on the right to education. 23% cover the topic of orphans. Impact on mental health and SRH were amongst the other covered topics. A lack of data on children's rights and their violations during epidemics is observed. Regional and international collaboration is needed to document the situation of children in health emergencies. Health measures and strategies based on children's opinions and raising awareness of their crucial role in society is key. Child-centred guidelines should be developed based on these elements. [ABSTRACT FROM AUTHOR]