We evaluated 113 pediatric patients with chronic hepatitis C from 2009 to 2019 at a Brazilian tertiary center. Seventy patients received pegylated-interferon treatment. The sustained virologic response was 61.4%, and 92.8% reported side effects. Currently, we are following 39 patients with chronic hepatitis C, 24 of whom are eligible for treatment with direct-acting antivirals according to Brazilian recommendations.Background Abdominal tuberculosis (TB) in children is poorly described and often poses a diagnostic challenge. We evaluated abdominal involvement in children presenting with bacteriologically confirmed TB. Methods We undertook a retrospective study at Tygerberg Hospital, Cape Town, from January 1, 2014, through December 31, 2018, of all children ( less then 13 years) diagnosed with bacteriologically confirmed TB, in whom abdominal involvement was found. https://www.selleckchem.com/products/Y-27632.html Demographic and clinical data were collected through folder review, laboratory records and imaging reports. Results Of 966 children with bacteriologically confirmed TB, 111 (11.5%) had abdominal involvement; 16 (14.4%) were excluded from further analysis because of lack of clinical data. The median age of the remaining 95 children was 43 months (interquartile range 20-94); 26 (27%) were HIV positive. The main gastrointestinal symptoms/signs were weight loss (84.2%), abdominal distention (54.7%), hepatomegaly (60.0%) and abdominal pain (26.3%). The main pathological types were intra-abdominal lymph nodes (68.4%), solid organ involvement (54.7%), peritoneal type (23.2%) and intestinal type (10.5%). Splenic abscesses and solid organ involvement on ultrasonography were more common in HIV-positive children (P less then 0.001 and P = 0.008, respectively). Liver abscesses were associated with age less than 5 years (P = 0.03), while abdominal lymphadenopathy on ultrasonography was more common in children older than 5 years (P = 0.038). Abdominal specimens were collected in an attempt to identify Mycobacterium tuberculosis in 15 of 95 (15.8%) patients and were positive in 13 of 15 (86.7%). Conclusions Over 10% of children with confirmed TB had abdominal involvement. Abdominal TB should be considered in any pediatric TB case with abdominal symptoms, and ultrasonography should be the radiologic study of choice.We examined the dynamics of coronavirus 2019 (Covid-19) transmission within families. Our investigation demonstrated significantly lower rates of Covid-19 positivity in children compared with adults residing in the same household. Children of 5-17 years of age were 61% and children of 0-4 years of age were 47% less likely to have positive polymerase chain reaction results compared with adults residing in the same household.Context Syndromic surveillance consists of the systematic collection and use of near real-time data about health-related events for situational awareness and public health action. As syndromic surveillance programs continue to adopt new technologies and expand, it is valuable to evaluate these syndromic surveillance systems and practices to ensure that they meet public health needs. Objective This assessment's aim is to provide recent information about syndromic surveillance systems and practice characteristics among a group of state and local health departments. Design/setting Information was obtained between November 2017 and June 2018 through a telephone survey using an Office of Management and Budget-approved standardized data collection tool. Participants were syndromic surveillance staff from each of 31 state and local health departments participating in the National Syndromic Surveillance Program funded by the Centers for Disease Control and Prevention. Questions included jurisdictional experience, daton Overall, syndromic surveillance was relevantly integrated into the public health surveillance infrastructure. The near real-time nature of the data and its flexibility to monitor different types of health-related issues make it especially useful for public health practitioners. Despite these advances, syndromic surveillance capacity, locally and nationally, must continue to evolve and progress should be monitored to ensure that syndromic surveillance systems and data are optimally able to meet jurisdictional needs.Context and setting Kansas City, Missouri, experiences substantial racial/ethnic health disparities, particularly associated with that city's high level of residential segregation. Among the risk factors for poor health are substandard housing, particularly common in African American neighborhoods, which lead to asthma and therefore to school absences. A 2018 ballot initiative in Kansas City, Missouri, would allow health inspectors to investigate complaints of poor or hazardous conditions in rental housing. Objectives Because the Kansas City, Missouri Health Department cannot legally advocate directly for voter support of public health policies, department staff used outside consultants to demonstrate the potential positive impact of environmental initiatives. Design The Win-Win model provides a standardized, unbiased economic analysis of interventions to help public health officials make informed policy and program decisions and engage in cross-sectoral collaboration. Results The Win-Win model found that if an asthma home remediation program were provided for almost 7000 low-income children in Kansas City, it would result in 55 000 fewer days of missed school annually among other promising outcomes. The model also showed a $1.67 return-on-investment to local and state government for each dollar spent and a 3-year breakeven point. The results from the Win-Win model were integrated into Kansas City's Community Health Improvement Plan and made available on the Win-Win Project Web site. The proposed law to promote rental inspections passed with 57% of the vote. Conclusions The model results allowed for an informed, unbiased point of evidence that the health department could present to community groups and elected officials leading up to the vote on the health inspection initiative.Context Despite attention to federal and state governments' response to the US opioid crisis, few studies have systematically examined local governments' role in tackling this problem. Objectives To determine what opioid policy and programmatic activities local governments are implementing, which activities are more challenging and require a greater latent ability to implement, and what community, environmental, and institutional factors shape such ability. Design A cross-sectional survey and multistage sampling procedure. Setting/participants Of all 358 county governments in 5 purposively selected states (Colorado, North Carolina, Ohio, Pennsylvania, and Washington) surveyed, 171 counties (response rate = 47.8%) with complete data on self-reported policy and programmatic activities and predictor variables were eligible for analysis. Main outcome measures Nineteen opioid policy and programmatic activities were analyzed individually and combined into a latent implementation ability index using empirical Bayes means estimates.