Improving Child and Adolescent Health and the Transition to Adulthood
Highlighted Programs and Activities
NEW: Measurement of language development and predictors NICHD issued this opportunity to encourage community-engaged research that broadens the conceptualization of qualities of the environment that can support language development in children and that focuses on the development of novel measures of children’s language development. The overall goal is to build the number of strengths-focused, culturally and linguistically responsive, and generalizable tools to further our understanding of children’s language development and/or impairment. Learn more: PAR-24-243 and PAR-24-244.
Pediatric HIV/AIDS Cohort Study (PHACS) Led by NICHD and supported by other NIH institutes and centers, PHACS conducts multiple research projects to: understand how HIV and its treatment affect growth and development, sexual maturation, organ function, and socialization of pre-adolescents, adolescents, and young adults who acquired HIV perinatally; acquire more definitive information on the long-term safety of antiretroviral therapy (ART) when used during pregnancy and in newborns; ensure a mechanism is in place to estimate the upper bounds of risk for children who were exposed to ART during maternal treatment to prevent perinatal HIV transmission; continue the follow-up study of these populations. Learn more: RFA-HD-25-003.
Selected Recent Advances
Neuroinflammation, undetected infection, and sudden infant death syndrome (SIDS) (PMID: 38285456) SIDS is the sudden unexpected death of a baby younger than 1 year of age that doesn’t have a known cause, even after autopsy, examination of the death scene, and review of the clinical history. It is believed that several factors contribute to the risk of SIDS. Some evidence suggests that undiagnosed infection and brain inflammation play a role in at least some cases. Researchers analyzed blood, cerebrospinal fluid (CSF), and tissue samples from 71 infants who died of SIDS to look for evidence of neuro-inflammation and underlying infection. Of the 64 cases tested for evidence of neuro-inflammation measured by the presence of neopterin, 6 cases had elevated CSF levels. The researchers performed genetic sequencing analyses on the samples from those cases to look for evidence of infectious agents such as viruses or bacteria. In one of the cases, their analyses identified infection by the human parechovirus 3 (HPeV3) in the brain stem, which had been previously undetected. Because the brain stem coordinates autonomic functions such as breathing, the researchers speculated that infection in this region could have impaired autonomic functioning, contributing to the infant’s death.
Variations in antibiotic prescribing for North Carolina children on Medicaid (PMID: 38287204) Antibiotics are often prescribed to treat infections in children. However, inappropriate antibiotic use is also the primary cause of antimicrobial resistance, which in the long run makes infections more difficult to treat for everyone. In the United States, the highest rates of outpatient antibiotic use occur in the Appalachian regions. Researchers examined the rates and risk factors for inappropriate antibiotic prescription among children enrolled in Medicaid in North Carolina. The scientists found that compared to pediatricians, the risk of inappropriate antibiotic prescription was highest among other specialists and general practitioners, and lowest among nurse practitioners. Among all the study subjects, years, and counties, about 21% of antibiotic prescriptions were inappropriate in Appalachian counties, compared to 23% in counties located in other regions. Areas classified as rural had the highest rates of overall and inappropriate antibiotic prescribing. Non-Hispanic Black children were more likely to receive an inappropriate antibiotic than non-Hispanic White patients.
Free school meals associated with modest reduction in childhood obesity (PMID: 38495019) The Community Eligibility Provision (CEP) policy allows schools in low-income areas to provide free breakfast and lunch to all their students as opposed to requiring individual students to prove their eligibility. Using California public schools data for the 2013-19 period when CEP was adopted, researchers assessed whether this policy was associated with reductions in child obesity for children in grades 5, 7, and 9, after adjusting for other characteristics of the students and the schools. The researchers found that there was a small net decrease in obesity (a 2.4% relative reduction) after policy adoption for schools that participated in CEP, compared with similar eligible, nonparticipating schools.
The effects of temperature and air pollution on children’s respiratory health (PMID: 38622704) Exposure to fine particulate matter air pollution (PM2.5) can lead to various respiratory health conditions like upper and lower respiratory tract infections and chronic disorders like lung cancer. While ambient PM2.5 air pollution has decreased in urban areas over the years, rural areas in the intermountain area of the United States still experience elevated levels of PM2.5 due to residential wood fire for heat and wildfire smoke during summer and wildfire seasons. Researchers evaluated short-term or delayed fine particulate matter on three children’s respiratory health outcomes–asthma, lower respiratory tract infections, and upper respiratory tract infections–from 2017-2020 in rural western Montana. Incorporating data on temperature and season, researchers found that delayed short-term increases of PM2.5 increased the odds of asthma and was magnified by colder temperatures and winter months. Exposure to increases of 1 µg/m3 in PM2.5 increased the odds of upper respiratory tract infections and was magnified by warmer temperatures and spring and summer months. The findings in this study show the importance of addressing the impact air pollution and other environmental factors have on respiratory health.
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