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The high prevalence of RHD is a major public health problem in Yemen. Urgent screening surveys and an RHD prophylactic programme of appropriate management of group A β-haemolytic streptococcal pharyngotonsilitis are required.

Abstractobjectives To estimate the prevalence of Group A beta-haemolytic streptococcus (GAS) and non-GAS infections among children with acute pharyngotonsillitis in Aden, Yemen, to evaluate the value of a rapid diagnostic test and the McIsaac score for patient management in this setting and to determine the occurrence of emm genotypes among a subset of GAS isolated from children with acute pharyngotonsillitis and a history of acute rheumatic fever (ARF) or rheumatic heart disease (RHD).methods Group A beta-haemolytic streptococcus infections in school-aged children with acute pharyngotonsillitis in Aden, Yemen, were diagnosed by a rapid GAS antigen detection test (RADT) and/or GAS culture from a throat swab. The RADT value and the McIsaac screening score for patient management were evaluated. The emm genotype of a subset of GAS isolates was determined.results Group A beta-haemolytic streptococcus pharyngotonsillitis was diagnosed in 287/691 (41.5%; 95% CI 37.8-45.3) children. Group B, Group C and Group G beta-haemolytic streptococci were isolated from 4.3% children. The RADT had a sensitivity of 238/258 (92.2%) and specificity of 404/423 (95.5%) against GAS culture. A McIsaac score of ≥4 had a sensitivity of 93% and a specificity of 82% for confirmed GAS infection. The emm genotypes in 21 GAS isolates from children with pharyngitis and a history of ARF and confirmed RHD were emm87 (11), emm12 (6), emm28 (3) and emm5 (1).conclusion This study demonstrates a very high prevalence of GAS infections in Yemeni children and the value of the RADT and the McIsaac score in this setting. More extensive emm genotyping is necessary to understand the local epidemiology of circulating strains.

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Background Neonatal anthropometry is the single most portable, universally applicable cheap, and non-invasive technique that deals with a variety of human body measurements. The anthropometric data for newborns, infants and children reflect their general health, nutritional status, and future survival by tracking trends in growth and development over time. Patients and methods The present study was conducted on 1000 Yemeni singleton live full-term newborns (37–42 weeks gestation), 488 males and 512 females during first 24 h of delivery at Al-Sadaqa Teaching Hospital, Aden, Yemen during the years 2002–2003. Results The data analysis of seven anthropometric values for 1000 Yemeni term newborns of both sexes revealed the mean birth weight and SD was 3113.04 g (±519.52), crown-heel length, head, chest, mid-arm, abdominal and calf circumferences were 48.91 (1.62), 33.78 (1.13), 32.09 (1.48), 10.09 (1.02), 30.10 (1.92), and 10.94 (1.04) respectively. The Ponderal Index was calculated with mean value of 2.65 (0.40). This study showed significant sex differences in all the anthropometric measurements principally in the birth weight (3187.66 versus 3039.04) and crown-heel length CHL (49.28 versus 48.53). ( P < .001). The best cut-off point to determine LBW was calf circumference (8.5 cm), which showed the most significant correlation with birth weight (r = 0.5) followed by chest (r = 0.44) and mid-arm circumference (r = 0.41). Conclusions This study of normal reference values will provide basic step for future standardization of Yemen anthropometric parameters to be used for accurate assessment, development and maturity of newborn births that would lead to identify newborns at risk and help in better management.

Background Globally 3.8 million of children under 6 month of age are severely wasted. In Yemen, around 20% of children under six months were affected by malnutrition during the armed conflict in the last 7 years. Supplementary suckling may reestablish exclusive breastfeeding in infant less than 6 months of age with Severe Acute Malnutrition (SAM). This study aimed to determine the outcomes of employing supplementary suckling technique in treatment of uncomplicated SAM infants in a conflict-affected community. Methods A prospective hospital-based study was carried out between January to April 19th, 2020 among randomly selected infants less than 6 months of age with SAM following breastfeeding failure. Infants’ anthropometric indices were daily measured and recorded. Supplementary sulking technique was used in management with high or low protein milk-based formula supplement. Outcome was recorded as cured, died, defaulter or in nonrecovery state. Results In this study 108 infants were enrolled with a median (IQR) age of 4 (2.5-5) years and a male: female ratio of 1.4:1. After treatment, 80.6% recovered to cure, 12% defaulters, 6% died, and 2% did not respond to treatment Thirty-four infants (38.8%) gained weight with significantly increased median weight and median weight-for-age z score. The median (IQR) duration of treatment was 9 (7.5–14) days. The means of age and weight-for-length z score were correlated (r= -0.22, p = 0.025). Duration of treatment was a predictor of outcome (OR = 1.71, 95% CI = 0.05–0.62, p < 0.001). Conclusion Supplementary suckling technique for feeding infant with SAM aged less than 6 months had a positive impact on anthropometric indices with high cure rate. The younger the infant and the longer the duration of treatment, the better the outcome. Trial registration: Not Applicable

Background Globally 3.8 million of children under 6 month of age are severely wasted. In Yemen, around 20% of children under 6 months were affected by malnutrition during the armed conflict in the last 7 years. Supplementary suckling may reestablish exclusive breastfeeding in infant less than 6 months of age with Severe Acute Malnutrition (SAM). This study aimed to determine the outcomes of employing supplementary suckling technique in treatment of uncomplicated SAM infants in a conflict-affected community. Methods A prospective hospital-based study was carried out between January to April 19th, 2020 among randomly selected infants less than 6 months of age with SAM following breastfeeding failure. Infants’ anthropometric indices were daily measured and recorded. Supplementary sulking technique was used in management with high or low protein milk-based formula supplement. Outcome was recorded as cured, died, defaulter or in nonrecovery state. Results In this study 108 infants were enrolled with a median (IQR) age of 4 (2.5-5) years and a male: female ratio of 1.4:1. After treatment, 80.6% recovered to cure, 12% defaulters, 6% died, and 2% did not respond to treatment Thirty-four infants (38.8%) gained weight with significantly increased median weight and median weight-for-age z score. The median (IQR) duration of treatment was 9 (7.5-14) days. The means of age and weight-for-length z score were correlated (r = − 0.22, p = 0.025). Duration of treatment was a predictor of outcome (OR = 1.71, 95% CI = 0.05-0.62, p < 0.001). Conclusion Supplementary suckling technique for feeding infant with SAM aged less than 6 months had a positive impact on anthropometric indices with high cure rate. The younger the infant and the longer the duration of treatment, the better the outcome.