Hong Kim Tang

Background: Febrile seizures (FS) are a common neurological emergency in early childhood and frequently raise concerns among caregivers regarding the likelihood of recurrence. Accurate risk stratification is important for counseling and follow‐up, particularly in resource‐limited settings. We aimed to estimate the incidence and identify prognostic factors for FS recurrence, and to propose a simple approach for clinical risk stratification. Methods: In this prospective cohort study conducted at the Children's Hospital 2 (Ho Chi Minh City, Vietnam), we enrolled 631 children aged 1 month to 6 years with a first FS and followed them for recurrence over a median follow‐up of 1.9 years. A simple count‐based approach to risk stratification was derived from independent predictors identified by multivariable Cox regression. Results: During follow‐up, 174 children (27.6%) experienced recurrence, corresponding to an incidence of 173 per 1000 person‐years. The predictors included: age < 21 months at first FS (adjusted HR: 2.02; 95% CI: 1.45, 2.81), family history of FS (adjusted HR: 1.83; 95% CI: 1.34, 2.49), and multiple seizures within the same febrile illness (adjusted HR: 1.60; 95% CI: 1.17, 2.21). Two‐year recurrence risk ranged from 13.8% (0 predictors) to 63.1% (3 predictors). Model discrimination was modest, with a bootstrap‐corrected AUC of 0.67 (95% CI: 0.62–0.72). Conclusions: Our findings provide contemporary data on the incidence and risk factors of FS recurrence and support a simple, clinically applicable approach to risk stratification. This information may assist clinicians in counseling families and planning follow‐up, particularly in resource‐limited settings.

This study was to measure physical activity (PA) and sleep habits among junior high school students in HCMC and identify factors associated with World Health Organization (WHO) recommendations. We performed a cross-sectional study with 1,023 junior high school students were randomly selected. Participants wore wrist-worn accelerometers for seven consecutive days to objectively record PA and sleep using validated methods. Multivariate models were used to identify predictors of achieving WHO recommendations for PA (≥60 min/day moderate-to-vigorous physical activity-MVPA) and sleep (8–10 hours/night). Data completed on 948 students with 47.5% males and the mean age was 12.9 years. Only 35.1% and 42.8% met WHO PA and sleep recommendations, respectively. Boys engaged in significantly more MVPA than girls, while girls spent more time in light activity. Girls also showed better sleep quality—longer sleep duration, higher efficiency, and shorter latency—whereas older adolescents had shorter and less efficient sleep than younger peers. Across all groups, average sleep duration was below WHO recommendations. After adjusting for other factors, boys were significantly more likely than girls to achieve the PA guidelines. Overall, the findings indicate that gender, age, BMI, parental modeling, family encouragement, and supportive school environments are the strongest predictors of whether adolescents meet recommended PA levels. Girls, younger age, overweight/obesity, family sleeping reminders and quiet sleep environment were significant factors of adhering sleep recommendation. Our study revealed the multifactorial interaction of individual, family, and environmental factors in meeting WHO recommended levels for PA and sleep in adolescents. Multidisciplinary interventions are required to promote adolescent behaviors.

Objective: Febrile seizures (FS) are common and usually self‐limited, yet a subset of children develop epilepsy. Early risk stratification remains challenging, particularly in resource‐limited settings with limited access to long‐term neurologic follow‐up. We aimed to estimate the incidence and identify the most robust predictors of epilepsy following FS in children. Methods: In this prospective cohort study at Children's Hospital 2 (Ho Chi Minh City, Vietnam), 631 children aged 1 month to 6 years with first FS were enrolled (March 2023–March 2024) and followed through July 2025. Children with any history of seizures prior to the index FS were excluded. Epilepsy was defined per the International League Against Epilepsy (ILAE) 2014 criteria. Predictor selection used clinical reasoning and Bayesian Model Averaging (BMA), followed by multivariable Cox regression. Discrimination was evaluated using Harrell's C‐index and time‐dependent AUC; internal validation was performed with bootstrap resampling. Results: Over a median follow‐up of 2.0 years, 35 children (5.5%) developed epilepsy, corresponding to an incidence of 29 per 1000 person‐years. After BMA, four independent predictors were retained: neurodevelopmental delay (HR = 8.78), family history of epilepsy (HR = 2.66), focal seizures (HR = 3.23), and each additional FS recurrence (HR = 1.50). The predictor set showed strong discrimination (C‐index: 0.87; AUC at 24 months: 0.89 with 95% CI: 0.82, 0.95). Significance: This parsimonious set of clinical predictors may support early counseling and targeted follow‐up of children with FS, especially where pediatric neurology resources are limited. Model development and validation are ongoing. Plain Language Summary: We followed 631 children after their first febrile seizure to see who might later develop epilepsy. About 5.5% of children developed epilepsy within 2 years. Children with developmental delay, focal seizures, a family history of epilepsy, or repeated FS were at higher risk. Using these four simple factors may help doctors give families clearer advice and closer follow‐up, especially where access to pediatric neurologists is limited.

Previous studies on factors associated with physical activity among adolescents in Ho Chi Minh City have lacked a specific framework. This study aimed to assess factors associated with moderate and vigorous physical activity time among Ho Chi Minh City’s adolescents. We used the Health Belief Model to develop a more comprehensive survey. This cross sectional study, conducted from January to May 2023, analyzed data from 301 students. Variables were measured using a self-management questionnaire with three sections: socioeconomics, physical activity, and the Health Belief Model. This study found that adolescents spent an average of 54.7 minutes per day engaging in moderate to vigorous physical activity. This duration was independently associated with convenience (Coefficient = 5.49; p = 0.002), self-efficacy (Coefficient = 5.63; p<0.001), having an exercise companion (Coefficient = 16.98; p<0.001), and the perception that more than 60 minutes of daily activity is needed (Coefficient = 16.82; p<0.001). The Health Belief Model has the potential to explain the time spent in moderate to vigorous physical activity among adolescents in Ho Chi Minh City. Self-efficacy, convenience, companionship, and perceptions of appropriate physical activity duration should be considered when developing intervention programs.

Background: This study was conducted to assess the correlation between baseline waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), triceps skinfold thickness (TSFT) and subscapular skinfold thickness (SSFT) with body mass index (BMI) at follow-up and to identify the anthropometric parameters accounting for the highest proportion of the BMI variation among junior high school students in Ho Chi Minh City. Methods: This was a 5-y prospective cohort study; 761 students were followed annually. Data collected included height, weight, WC, TSFT and SSFT. Pearson correlation coefficients were calculated to investigate the correlations between baseline anthropometric parameters with BMI at follow-up. Multilevel mixed-effect models with linear regression analyses and Poisson regression were used to assess the relationship between all listed variables with BMI changes as well as the risk of being overweight/obesity. Results: BMI, WC, TSFT, SSFT, WHtR, the sum of four skinfold thicknesses and % body fat at baseline were all strongly correlated with BMI at follow-up (p<0.001). Among multiple linear regression models, the models with WC or WHtR accounted for the highest variation in BMI changes (approximately 74.5%) (p<0.001), while the model with WHR explained only 22.7% of the variation in BMI changes. Conclusion: WC is a simple anthropometric indicator, which can be easily used to assess adiposity and is significantly associated with BMI changes over time.

Background: The evidence on associations between sedentary behaviour (SB) and motor skills in 3‐ to 4‐year‐olds is unclear and mostly from high‐income countries.Objective: The objective of this study is to examine associations between (1) screen time (h/day) and total daily SB (h/day), and gross and fine motor skills, and (2) meeting the restraint, screen time and overall SB (restraint and screen time) guidelines and fine and gross motor skills.Methods: Cross‐sectional study of 1394 3‐ to 4‐year‐olds from the pilot phase of the SUNRISE International study. Time spent in SB was measured using the activPAL accelerometer, whereas screen time and restraint were measured using a parent questionnaire. Fine and gross motor skills were measured using parent‐reported Ages and Stages Questionnaire (ASQ‐3). Associations between SB and motor skills were determined using linear and logistic regression, adjusting for sex and socioeconomic status.Results: Every additional 1 h of screen time was associated with 0.50‐point reduction in gross motor skills scores (p = 0.008). More screen time was associated with decreased odds of being on track for fine and gross motor skill development (p < 0.001 and p = 0.017, respectively). Meeting the screen time (p = 0.009) and overall SB guidelines (p = 0.006) were favourably associated with fine motor skills scores. Meeting the screen time, restraint and overall SB guidelines were favourably associated with gross motor skills scores (p = 0.007, p < 0.001 and p < 0.001, respectively), higher odds of being on track for fine (p = 0.033, p = 0.015 and p < 0.001, respectively) and gross motor skills (p = 0.006, p < 0.001 and p < 0.001, respectively) development.Conclusion: The present study adds to the evidence on the importance of sedentary behaviour for the motor development of 3‐ to 4‐year‐olds. It is important that policy makers and health educators develop strategies that will encourage and promote adherence to sedentary behaviour guidelines among 3‐ and 4‐year‐olds.

Background: Insufficient physical activity, excessive screen time and short sleep duration among young children are global public health concerns; however, data on prevalence of meeting World Health Organisation 24‐h movement behaviour guidelines for 3–4‐year‐old children in low‐ and middle‐income countries (LMICs) are limited, and it is unknown whether urbanisation is related to young children's movement behaviours. The present study examined differences in prevalence of meeting 24‐h movement behaviour guidelines among 3–4‐year‐old children living in urban versus rural settings in LMICs.Methods: The SUNRISE Study recruited 429, 3–4‐year‐old child/parent dyads from 10 LMICs. Children wore activPAL accelerometers continuously for at least 48 h to assess their physical activity and sleep duration. Screen time and time spent restrained were assessed via parent questionnaire. Differences in prevalence of meeting guidelines between urban‐ and rural‐dwelling children were examined using chi‐square tests.Results: Physical activity guidelines were met by 17% of children (14% urban vs. 18% rural), sleep guidelines by 57% (61% urban vs. 54% rural), screen time guidelines by 50% (50% urban vs. 50% rural), restrained guidelines by 84% (81% urban vs. 86% rural) and all guidelines combined by 4% (4% urban vs.4% rural). We found no significant differences in meeting the guidelines between urban and rural areas.Conclusions: Only a small proportion of children in both rural and urban settings met the WHO 24‐h movement guidelines. Strategies to improve movement behaviours in LMICs should consider including both rural and urban settings.

Background: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. Objective: To identify how to improve surveillance of movement behaviours, from the perspective of experts. Methods: This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from ‘extremely’ to ‘not at all’ important. Consensus was defined as > 70% rating of ‘extremely’ or ‘very’ important. Results: We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research. Conclusions: This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.