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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was undertaken to determine the extent of measles underreporting among preschool-age children. In two community surveys conducted in inner-city Los Angeles during 1990 and 1991, respondents were asked whether preschool-age children in their households had ever been ill with measles. Information about measles episodes was obtained and medical records were reviewed, when available. A probable measles case was defined as having 3 or more days of rash with fever of 38.3 degrees centigrade or greater, and either cough, coryza, or conjunctivitis. To determine the proportion of cases reported, probable measles cases identified were matched with measles cases reported to the Los Angeles County Department of Health Services. Of the 947 children ages 6 weeks through 59 months included in the surveys, 35 children had experienced an illness episode which met the probable measles case definition. Ten (29 percent) of the 35 probable measles cases were reported to the health department. Hospitals reported 9 (69 percent) of 13 probable measles cases evaluated while private physicians' offices reported 0 (0 percent) of 12 evaluated (Fisher's exact test, P < 0.001), although 5 children were seen by private physicians before rash onset. Reporting was more complete for cases occurring during 1990 and 1991 (33 percent) than from 1987 through 1989 (18 percent). The hospitalization rate for preschool-age children with probable measles cases in the catchment area was estimated to be 8 percent (95 percent confidence interval = 0 to 18 percent). Although measles is a serious communicable disease which is almost completely preventable, cases of it among preschool-age children in this high incidence area were substantially underreported,especially by private physicians. Due to reporting bias, reported measles cases were representative of more severe cases than all the cases that occurred.
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PMID:Measles reporting completeness during a community-wide epidemic in inner-city Los Angeles. 763 Sep 92

The relationship of vitamin A deficiency and child survival has been documented in a number of studies but not in others, yet the relationship of vitamin A with child morbidity remains controversial. We prospectively examined the relationship of dietary vitamin A intake and the incidences of diarrhea and respiratory infection among 28,753 Sudanese children between the ages of 6 mo and 6 y. Total dietary vitamin A intake was strongly and inversely associated with the risk of diarrhea (multivariate risk in top relative to bottom quintile = 0.58, 95% confidence interval = 0.47-0.72); we also observed a strong inverse association with the risk of having cough and fever (0.60, 0.45-0.81). On the other hand, we noted a significantly positive association of dietary vitamin A intake and incidence of cough alone (1.69, 1.52-1.88), a sign that may be assocsated with a healthy respiratory epithelium. Vitamin A intake was also negatively associated with the risk of measles. These prospective data emphasize the importance of adequate dietary vitamin A intake to protect the health of children in developing countries.
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PMID:Dietary vitamin A intake and the incidence of diarrhea and respiratory infection among Sudanese children. 773 81

An 18-year-old male who was admitted to hospital due to fever, skin rashes, cough, and malaise showed laboratory examination findings of leukopenia, thrombocytopenia, mild liver dysfunction, and hypoxia. Bone marrow aspiration revealed 2% histiocytes with hemophagocytosis. Chest X-ray showed bilateral diffuse interstitial pneumonia. The titer of anti-measles virus antibody was < 1:4, and that at convalescence stage was 1:64. He was diagnosed as having hemophagocytic syndrome and acute respiratory failure due to measles, and was treated with methylprednisolone pulse therapy. He promptly recovered from thrombocytopenia and acute respiratory distress. Steroid pulse therapy may be effective in these conditions due to measles.
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PMID:Virus-associated hemophagocytic syndrome due to measles accompanied by acute respiratory failure. 778 29

Immune response of infants vaccinated under Expanded Programme on Immunization (EPI) was evaluated for measles, poliomyelitis, and tuberculosis in Ifo/Otta area of Ogun State and Badagry area of Lagos State, Nigeria. In the prevaccination evaluation of measles antibody, 59 per cent were protected and 41 per cent were at risk in Ifo/Otta area, while 49 per cent were protected and 51 per cent were at risk in the Badagry area. After measles vaccination, 89 per cent of those evaluated seroconverted and 11 per cent did not in Ifo/Otta area, while in Badagry area, 86 per cent of those evaluated seroconverted and 14 per cent did not. For polio neutralizing antibody evaluated at post-immunization, 91 per cent seroconverted, while 9 per cent did not in Ifo/Otta area, while in Badagry area 66 per cent seroconverted and 34 per cent did not. Tuberculin test was used to evaluate the cellular response to BCG vaccination against tuberculosis. 64 per cent were found protected, while 18 per cent were at risk in both areas examined and 18 per cent dropped out. Using Gomez method to evaluate the nutritional status of the infants, 34 per cent were malnourished in Ifo/Otta area and are mostly immigrants. In Badagry area, 53 per cent were normal while 47 per cent were malnourished and most of the malnourished infants were plagued with diarrhoea, severe cough, high fever or malaria infection. Most of the malnourished in the two areas screened were between 9 and 18 months of age, which is the crucial period in the growing stage of the children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of immune response in infants with different nutritional status: vaccinated against tuberculosis, measles and poliomyelitis. 785 39

A prospective study was conducted on 75 consecutive cases of primary cavitary pulmonary tuberculosis in hospitalized children below 2 years to determine the spectrum of the disease. Diagnosis was based on clinical, radiological, tuberculin test and histopathological findings and not on isolation of tubercle bacilli. Peak age was 7-12 months. Ten mothers suffered from pulmonary fibrocavitary disease and 73% of cases were severely malnourished. Presenting symptoms were fever and cough, at times dyspnea and often followed measles. Unlike adults, hemoptysis was seldom encountered. Cavitary lesions were characterized by protean radiological manifestations and varied in size and appearance. They were more often multiple than solitary, bilateral or distributed in one or more lobes, usually in the right lung. Location within consolidation and other associated pulmonary pathology was frequent with miliary nodules in 45.3%. Widespread hematogenous infection was common with tuberculous meningitis in 28%. The accepted diagnostic features of tuberculosis, viz., hilar and mediastinal lymhadenopathy and positive tuberculin test were often absent. Mortality was 34.7% and in inverse proportion to age. The observations stress the difficulties in diagnosis [corrected].
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PMID:Cavitating pulmonary tuberculosis below age of 2 years. 787 42

The clinical features, chest radiographs and computed tomographic (CT) images were evaluated in 11 cases with serologically proved adult measles complicated with pneumonia (10 were previously healthy and one had sarcoidosis). Pneumonia appeared during the rash period in all cases. Respiratory symptoms were cough (9/11), dyspnea (3/11), and hypoxemia (10/11). Pneumonia manifestations were detected in only 4 cases by chest radiograph; on the other hand, they were seen in all cases by CT scan and consisted of ground-glass opacities (73%), nodular opacities (64%) and consolidation (27%). CT seems to be a useful method to detect measles pneumonia if it is suspected. Measles pneumonia in previously healthy patients had a good prognosis, as the hypoxemia disappeared within 6 days in all cases. The sarcoidosis patient showed prolonged pneumonic shadows and period of hypoxemia. Measles pneumonia occurring in a host with cellular immunodeficiency may have a severe clinical course.
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PMID:[Clinical features of measles pneumonia in adults: usefulness of computed tomography]. 825 23

Childhood epidemics were a commonly accepted part of life in the two decades around the turn of the century. Official health and education records portray, however, not an apathetic acceptance of epidemics but a public concern with their prevention and control. Education boards referred to outbreaks of measles, mumps, whooping-cough, scarlet fever and diphtheria in explaining poor attendance rates while school inspectors commented on the impact that epidemics had on schoolwork. District health officers closed and disinfected schools to prevent the spread of infection, and outside of schools nurses became actively engaged in the public health campaign to counteract epidemics, particularly in the remote rural districts. Both health and education records therefore portray the public concern and official actions in contending with childhood epidemics at the turn of the century in New Zealand.
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PMID:"Measles, mumps and mud": childhood epidemics at the turn of the century. 829 93

In 1991, in Ndola, Zambia, staff at urban health centers randomly allocated children with acute measles who did not require hospitalization to receive either a single oral dose of 200,000 IU of oil-soluble vitamin A (90 children) or a placebo (110 children). (A single oral administration of vitamin A at this dose is recommended by the World Health Organization [WHO]). This double-blind placebo-controlled clinical study aimed to determine whether or not a single oral dose of vitamin A would minimize measles-associated morbidity in children who do not require hospitalization. The cross-sectional analysis revealed that at week 4 the vitamin A group was more likely than the placebo group to have no symptoms of acute respiratory infection (ARI) (93% vs. 78%) and less likely to have pneumonia (0 vs. 12%) (p = 0.005). It did not find any significant association prior to week 4, however. None of the three longitudinal analyses found vitamin A to have a significant benefit on morbidity. These analyses considered the effect of treatment on the movement of individual patients between ARI health states. The odds ratio for pneumonia in children with measles-associated cough and for measles-associated cough or pneumonia in asymptomatic measles patients suggested that vitamin A minimized morbidity (0.73 and 0.52, respectively). Yet vitamin A failed to improve pneumonia (odds ratio = 1.23, in favor of placebo). These findings suggest that a single oral dose of 200,000 IU of oil-soluble vitamin A is not as effective at preventing measles complications as that indicated earlier for two 200,000 IU doses of water-miscible vitamin A. Thus, the WHO recommendations need to be reconsidered.
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PMID:Efficacy of a single oral dose of 200,000 IU of oil-soluble vitamin A in measles-associated morbidity. 861 Jun 56

Verbal autopsy uses a caretaker interview to determine the cause of death. We conducted a study of the major causes of child death in Namibia to determine the validity of this method. A questionnaire, including signs and symptoms of the diagnoses of interest was administered to the caretaker in 135 deaths of children < 5 years old who were identified from hospital records. The 243 diagnoses included malnutrition (77), diarrhoea (73), pneumonia (36), malaria (33), and measles (24). Sensitivity and specificity of various algorithms of reported signs and symptoms were compared to the medical diagnoses. An algorithm for malnutrition (very thin or swelling) had 73 per cent sensitivity and 76 per cent specificity. An algorithm for cerebral malaria (fever, loss of consciousness or convulsion) had 72 per cent sensitivity and 85 per cent specificity, while for all malaria deaths the same algorithm had low sensitivity (45 per cent) and high specificity (87 per cent). For diarrhoea, loose or liquid stools had high sensitivity (89 per cent), but low specificity (61 per cent). Cough with dyspnoea or tachypnoea had 72 per cent sensitivity and 64 per cent specificity. An algorithm for measles (age > or = 120 days, rash) had 71 per cent sensitivity and 85 per cent specificity. The study results suggest verbal autopsy data can be useful to ascertain the leading causes of death in childhood, but may have limitations for health impact evaluation.
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PMID:Validation study of a verbal autopsy method for causes of childhood mortality in Namibia. 900 66

In India, an estimated 80% of children are infected with tubercle bacillus by 10 years of age. Elimination of tuberculosis depends on finding all infectious patients and providing them with curative chemotherapy. Pulmonary tuberculosis--the most common form in children--is diagnosed when a child presents with fever, prolonged cough, weight loss, recurrent wheezing, or chest infection; the chest x-ray is suggestive of tuberculosis; and three or more of the following conditions exist: 1) Mantoux test result of 10 mm or more, 2) tuberculosis lymphadenitis by fine needle aspiration cytology, 3) grade III malnutrition, 4) no BCG vaccination, 5) positive family history of tuberculosis, and 6) recent history of pertussis or measles. Recommended, for children with pulmonary tuberculosis, is a regimen of isoniazid, rifampicin, and pyrazinamide daily for 2 months, followed by the first two drugs daily for an additional 4 months. The poor tuberculosis cure rates in most developing countries reflect patient non-compliance with treatment regimens.
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PMID:Current concept in the diagnosis and treatment of childhood pulmonary tuberculosis. 914 78


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