Mustafa Gülderen

Background. Influenza remains a major cause of morbidity and mortality in children worldwide, yet vaccination coverage is still suboptimal in many countries. We aimed to understand parental awareness, attitudes, and determinants of vaccine uptake to guide effective strategies for increasing coverage and protecting vulnerable pediatric populations. Method. A cross-sectional study was conducted between October 2023 and May 2024 in 38 hospitals across 23 provinces in Türkiye. Data were collected from 5002 families through face-to-face interviews, with 4404 valid responses analyzed. Results. The overall influenza vaccination rate among children was 4.4% (n=195/4404). Vaccination coverage was slightly higher in high-risk groups compared to non-high-risk groups (5.2% vs. 3.5%, p=0.003). Factors positively associated with vaccination uptake included the presence of chronic illness in the child (15.1% in vaccinated vs. 4.7% in unvaccinated, p

This study aimed to evaluate the demographic, clinical, laboratory, microbiological, and radiological characteristics of pediatric brucellosis patients with and without osteoarticular involvement, and to identify associated risk factors and outcomes. A retrospective analysis was conducted on 101 children diagnosed with brucellosis between 2008 and 2022. Data were extracted from patient files and electronic records. Patients were grouped based on the presence or absence of osteoarticular involvement. Of the 101 patients, 52 (51.5%) had osteoarticular involvement. Myalgia (P = .027), low back pain (P < .001), and higher serum standard tube agglutination titers (P = .004) were significantly more common in this group, while abdominal pain was more frequent in patients without joint involvement (P = .007). The time from symptom onset to hospital admission was significantly longer in the osteoarticular group (P = .033). Magnetic resonance imaging confirmed sacroiliitis and hip involvement in 69.2% of relevant cases. In tropical and endemic regions where brucellosis remains a significant public health problem, children presenting with myalgia, back pain, high standard tube agglutination titers, and prolonged symptom duration should be carefully evaluated for osteoarticular brucellosis. Early identification is essential for preventing complications and optimizing treatment.

Objective: Influenza is a contagious viral respiratory tract infection that causes severe illness, particularly in high-risk populations such as young children and individuals with pre-existing health conditions. The study aims to identify clinical characteristics and key risk factors associ ated with respiratory support and mortality in children with influenza infection. Materials and Methods: This retrospective, multicenter study was conducted across 33 hos pitals from 19 cities in Türkiye. Data from pediatric inpatients aged <18 years diagnosed with influenza between October 2023 and May 2024 were analyzed. Results: Among 1032 hospitalized children infected with influenza, 394 (38.2%) required res piratory support. The respiratory support group was significantly younger, with a mean age of 3.40 ± 4.37 years, compared to 4.96 ± 4.36 years in the non-respiratory support group (P < .001). The frequency of any underlying disease was significantly higher in the respiratory sup port group (P < .001). Notably, conditions such as neurometabolic disorders (20.3% vs. 9.6%) and pulmonary diseases (7.1% vs. 2.8%) were more common in this group. Influenza A infection and viral coinfections, particularly with respiratory syncytial virus, increased the likelihood of mechanical ventilation and mortality. The mortality proportion of all patients with influenza infection was 1.3% and the influenza vaccine coverage was only 1.1%. Conclusion: These findings highlight the urgent need to incorporate influenza vaccination into the national immunization program, especially for high-risk pediatric populations.

Background: Postexposure prophylaxis (PEP) is critical in preventing HIV acquisition after risky exposures, particularly in pediatric sexual assault victims. Despite its importance, adherence and follow-up remain significant challenges. Objectives: This study evaluates PEP and follow-up adherence and efficacy among pediatric sexual assault victims treated at a tertiary care hospital in Turkey. Methods: A retrospective analysis was conducted on 119 pediatric patients 1 month to 18 years of age, treated between September 2017 and September 2022. Data were collected on demographics, PEP initiation and completion, follow-up rates and serologic testing for HIV. PEP compliance, follow-up adherence and outcomes were analyzed. Results: PEP was initiated in 97% of the eligible 119 patients, with 70% completing the regimen. Compliance showed no significant differences by sex or age. Follow-up adherence decreased progressively, from 55% at the first month to 30% by the sixth month. Nausea and vomiting occurred in one case, indicating a low incidence of side effects. None of the patients seroconverted to HIV. Conclusion: A structured care system involving multidisciplinary collaboration, pioneered by pediatric infectious diseases, can lead to high PEP initiation and completion rates in children. Single-pill PEP regimens may enhance adherence. However, the decline in follow-up rates underscores the need for improved follow-up mechanisms and future interventions.

Aim: The use of broad-spectrum antibiotics, changes in patient profile, prolonged life expectancy, increased use of medical devices and technologies such as catheters, intravenous fluids, gastrostomy and tracheostomy have led to changes in the number and types of microorganisms isolated from infections and cultures. There are no data on infections seen in pediatric palliative care. The aim of this study was to determine the frequency of infections and the pathogens produced in culture, to identify the sites of growth and to review what should be done. Materials and Methods: This was planned as a cross-sectional, retrospective study between 11/18/2018 and 09/01/2023. Sociodemographic data, reason for hospitalization, number of hospitalizations, primary diagnoses, comorbid conditions, medical devices and technology used, time and place of culture, number of cultures, microorganisms grown and factors associated with culture growth were examined. Statistical analysis was performed with the SPSS 18.0 program. p

Background: Tuberculosis (TB) infection is transmitted by sharing the same airway with people with active TB. Children are often not considered the source of TB bacilli, and index case investigation is carried out after diagnosis. Here, we describe the impact of the presence of a household index case on childhood TB disease.Methods: The data of patients aged between 1 month and 18 years who were diagnosed with TB were collected. We compared patients according to whether they had an index case in the household or not.Results: A total of 202 TB patients were enrolled, of whom 62 (30.7%) had a household index case. There was no significant difference in having a household index case between TB patients under the age of five (23.3%) and older children (33.8%) (p = .140). Pulmonary TB was present in 61.4% of the cases, and extrapulmonary TB was present in 38.6% of the cases. The rate of patients who had a household index case was significantly higher in pulmonary TB (46.8%) compared to extrapulmonary TB (5.1%) (p < .001). Pulmonary TB patients with a history of household contact were more likely to have diagnostic radiological findings (93.1%) compared to those without (75.8%) (p = .009). However, pulmonary TB patients without household contact history had a higher rate of diagnostic microbiological findings (59.1%) and constitutional symptoms (63.6%) (p = .019 and p = .013, respectively).Conclusion: Household contact research is an important epidemiological tool. However, considering the contact rates in the household, new and more comprehensive public health programs are required to prevent the spread of childhood tuberculosis.