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Ozturk Ertem I, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Bilik B, Srinivasan R, Balta H, Gulumser O, Gan G, Calvocoressi L, Johnson B, Shabanova V, Forsyth BWC. Validation of the International Guide for Monitoring Child Development demonstrates good sensitivity and specificity in four diverse countries. Acta Paediatr 2019; 108:1074-1086. [PMID: 30472813 PMCID: PMC6520130 DOI: 10.1111/apa.14661] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022]
Abstract
AIM It is of critical importance to have internationally constructed tools to address early childhood development. The aim of this second phase of a two-phase study was to examine the sensitivity and specificity of the Guide for Monitoring Child Development (GMCD) in identifying developmental delay in four diverse countries. METHODS The first phase of this 2011-2015 back-to-back study included 4949 children up to 42 months of age from primary healthcare centres in Argentina, India, South Africa and Turkey. Distribution curves were generated to show the ages when the children attained GMCD milestones and those that could be used across sexes and countries were placed in age ranges corresponding to the 85th and 97th percentile point estimates. Phase two examined a separately recruited sample of children in those countries to determine sensitivity and specificity of the GMCD. RESULTS The validation phase of the 85 milestones in the GMCD identified delayed development in 30% of the 1731 children in the four countries. The sensitivity and specificity ranged from 0.71-0.94 and 0.69-0.82, respectively, for the total sample and the different age groups. CONCLUSION The GMCD standardised in four diverse countries has appropriate accuracy for identification of children with developmental delay.
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Affiliation(s)
- Ilgi Ozturk Ertem
- Developmental-Behavioural Paediatrics Division, Department of Paediatrics, Ankara University School of Medicine, Ankara, Turkey
| | | | | | - Yanina Sguassero
- Centro Rosarino De Estudios Perinatales (Perinatal Study Centre of Rosario), Rosario, Argentina
| | - Burcu Bilik
- Developmental-Behavioural Paediatrics Division, Department of Paediatrics, Ankara University School of Medicine, Ankara, Turkey
| | | | - Hakan Balta
- Developmental-Behavioural Paediatrics Division, Department of Paediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Ozlem Gulumser
- Developmental-Behavioural Paediatrics Division, Department of Paediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Geliang Gan
- Yale Centre for Analytic Science, Yale University School of Public Health, New Haven, CT, USA
| | - Lisa Calvocoressi
- Yale Centre for Analytic Science, Yale University School of Public Health, New Haven, CT, USA
| | - Benjamin Johnson
- Yale Centre for Analytic Science, Yale University School of Public Health, New Haven, CT, USA
| | - Veronika Shabanova
- Department of Paediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Brian W C Forsyth
- Department of Paediatrics, Yale University School of Medicine, New Haven, CT, USA
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Ertem IO, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Balta H, Gulumser O, Bilik B, Srinivasan R, Johnson B, Gan G, Calvocoressi L, Shabanova V, Forsyth BWC. Similarities and differences in child development from birth to age 3 years by sex and across four countries: a cross-sectional, observational study. Lancet Glob Health 2018; 6:e279-e291. [PMID: 29433666 DOI: 10.1016/s2214-109x(18)30003-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Knowledge about typical development is of fundamental importance for understanding and promoting child health and development. We aimed to ascertain when healthy children in four culturally and linguistically different countries attain developmental milestones and to identify similarities and differences across sexes and countries. METHODS In this cross-sectional, observational study, we recruited children aged 0-42 months and their caregivers between March 3, 2011, and May 18, 2015, at 22 health clinics in Argentina, India, South Africa, and Turkey. We obtained a healthy subsample, which excluded children with a low birthweight, perinatal complications, chronic illness, undernutrition, or anaemia, and children with missing health data. Using the Guide for Monitoring Child Development, caregivers described their child's development in seven domains: expressive and receptive language, gross and fine motor, play, relating, and self-help. Clinicians examining the children also completed a checklist about the child's health status. We used logit and probit regression models based on the lowest deviance information criterion to generate Bayesian point estimates and 95% credible intervals for the 50th percentile ages of attainment of 106 milestones. We assessed the significance of differences between sexes and countries using predefined criteria and regions of practical equivalence. FINDINGS Of 10 246 children recruited, 4949 children (48·3%) were included in the healthy subsample. For the 106 milestones assessed, the median age of attainment was equivalent for 102 (96%) milestones across sexes and 81 (76%) milestones across the four countries. Across countries, median ages of attainment were equivalent for all play milestones, 20 (77%) of 26 expressive language milestones, ten (67%) of 15 receptive language milestones, nine (82%) of 11 fine motor milestones, 14 (88%) of 16 gross motor milestones, and eight (73%) of 11 relating milestones. However, across the four countries the median age of attainment was equivalent for only two (22%) of nine milestones in the self-help domain. INTERPRETATION The ages of attainment of developmental milestones in healthy children, and the similarities and differences across sexes and country samples might aid the development of international tools to guide policy, service delivery, and intervention research, particularly in low-income and middle-income countries. FUNDING Eunice Kennedy Shriver National Institute of Child Health and Human Development.
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Affiliation(s)
- Ilgi Ozturk Ertem
- Department of Paediatrics, Division of Developmental and Behavioural Paediatrics, School of Medicine, Ankara University, Ankara, Turkey.
| | | | - Mphelekedzeni C Mulaudzi
- Department of Paediatrics and Child Health, Kalafong Hospital, University of Pretoria, Pretoria, South Africa
| | | | - Hakan Balta
- Department of Paediatrics, Division of Developmental and Behavioural Paediatrics, School of Medicine, Ankara University, Ankara, Turkey
| | - Ozlem Gulumser
- Department of Paediatrics, Division of Developmental and Behavioural Paediatrics, School of Medicine, Ankara University, Ankara, Turkey
| | - Burcu Bilik
- Department of Paediatrics, Division of Developmental and Behavioural Paediatrics, School of Medicine, Ankara University, Ankara, Turkey
| | | | - Benjamin Johnson
- Yale Center for Analytical Science, School of Public Health, Yale University, New Haven, CT, USA
| | - Geliang Gan
- Yale Center for Analytical Science, School of Public Health, Yale University, New Haven, CT, USA
| | - Lisa Calvocoressi
- Yale Center for Analytical Science, School of Public Health, Yale University, New Haven, CT, USA
| | - Veronika Shabanova
- Department of Pediatrics, School of Medicine, Yale University, New Haven, CT, USA
| | - Brian W C Forsyth
- Department of Pediatrics, School of Medicine, Yale University, New Haven, CT, USA
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Ceyhan M, Yildirim I, Ecevit C, Aydogan A, Ornek A, Salman N, Somer A, Hatipoğlu N, Camcioglu Y, Alhan E, Celik U, Hacimustafaoglu M, Celebi S, Inan D, Kurt N, Oner A, Gulumser O, Gunes A, Coskun Y. Inappropriate antimicrobial use in Turkish pediatric hospitals: A multicenter point prevalence survey. Int J Infect Dis 2010; 14:e55-61. [DOI: 10.1016/j.ijid.2009.03.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 02/16/2009] [Accepted: 03/07/2009] [Indexed: 10/20/2022] Open
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Ceyhan M, Yildirim I, Balmer P, Borrow R, Dikici B, Turgut M, Kurt N, Aydogan A, Ecevit C, Anlar Y, Gulumser O, Tanir G, Salman N, Gurler N, Hatipoglu N, Hacimustafaoglu M, Celebi S, Coskun Y, Alhan E, Celik U, Camcioglu Y, Secmeer G, Gur D, Gray S. A prospective study of etiology of childhood acute bacterial meningitis, Turkey. Emerg Infect Dis 2008; 14:1089-96. [PMID: 18598630 PMCID: PMC2600347 DOI: 10.3201/eid1407.070938] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Vaccines to prevent bacterial meningitis in this region must provide reliable protection against serogroup W-135. Determination of the etiology of bacterial meningitis and estimating cost of disease are important in guiding vaccination policies. To determine the incidence and etiology of meningitis in Turkey, cerebrospinal fluid (CSF) samples were obtained prospectively from children (1 month–17 years of age) with a clinical diagnosis of acute bacterial meningitis. Multiplex PCR was used to detect DNA evidence of Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis. In total, 408 CSF samples were collected, and bacterial etiology was determined in 243 cases; N. meningitidis was detected in 56.5%, S. pneumoniae in 22.5%, and Hib in 20.5% of the PCR-positive samples. Among N. meningitidis–positive CSF samples, 42.7%, 31.1%, 2.2%, and 0.7% belonged to serogroups W-135, B, Y, and A, respectively. This study highlights the emergence of serogroup W-135 disease in Turkey and concludes that vaccines to prevent meningococcal disease in this region must provide reliable protection against this serogroup.
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