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Background Children are at higher risk of influenza virus infection, and it is difficult to diagnose. They are also responsible for the transmission of influenza because of their longer viral shedding compared to adults. In Malaysia, studies on influenza in children are scarce, and as a result, policy decisions cannot be formulated to control the infection. Hence, the objective of this study is to determine the prevalence and epidemiological characteristics of influenza among children with upper respiratory symptoms in the Sabah state of Malaysia. Methods A cross-sectional study with a simple random sampling was conducted among children with upper respiratory symptoms in Sabah from 1 March 2019 to 29 February 2020. Patients admitted to a pediatric ward of Sabah Women and Children’s Hospital who presented with a fever >38 °C and cough within 48 h of admission were enrolled in this study. A nasopharyngeal swab was taken, and influenza was diagnosed by lateral flow test. Clinical features of influenza-positive children were compared with children whose results were negative. Results A total of 323 nasopharyngeal samples were collected, and 66 (20.4%) of them were positive for influenza. Fifty-six (85%) were infected by influenza A whereas ten (15%) were by influenza B virus. Higher temperature (aOR 2.03, 95% CI 1.296–3.181), less activity (aOR 2.07, 95% CI 1.158–3.693), and seizure (aOR 4.2, 95% CI 1.614–10.978) on admission were significant risk factors associated with influenza in children. Meteorology parameters such as humidity and rainfall amount were statistically significant at 95% CI [1.133 (1.024–1.255)] and 95% CI [0.946 (0.907–0.986)]. Conclusion The prevalence of influenza was high among children with upper respiratory symptoms, and they were infected predominantly with the influenza A virus. Children presented with seizures, less activity, and fever were the significant risk factors for influenza. Influenza vaccination should be prioritized as preventive measures for children.

Introduction: Childhood undernutrition while being a preventable condition remains a major public health issue because it contributes to the mortality and morbidity of children globally. Intervention strategies to improve the nutritional status of children include therapeutic food, cash transfers, antibiotics and nutritional education. The objective is to review the effects of various nutritional interventions in addressing undernutrition in children. Methods: Comprehensive search of literature in electronic databases were conducted in PubMed, Science Direct, and Scopus containing the Medical Subject Headings (MeSH) and the title terms ‘Undernutrition’ OR ‘Malnutrition AND ‘Intervention’ OR ‘Management’ AND ‘Children’ OR ‘Childhood’ between January 2000 and August 2019. Of the 4358 studies that were identified, 17 studies matched the inclusion criteria and were reviewed. Results: Therapeutic food is an integral part of nutritional interventions in majority of the studies along with cash transfers and nutritional education. The most consistent outcome in most of the studies was improvement in the nutritional status which subsequently reduces the undernutrition in children. Conclusion: Therapeutic food, conditional cash transfer and nutritional education yielded the best outcome in alleviating undernutrition in developing countries.

Every year influenza epidemic causes about 3 – 5 million severe respiratory infections and 250,000 to 500,000 deaths worldwide. Among them about 28,000 – 111,500 (11 – 22%) children under 5 years old die because of influenza-related acute lower respiratory tract infections. This review aims to explore the burden, risk factors and seasonality related to influenza virus infection among children under 5 years old in tropical countries. From 1st to 31st December 2020 literature search was done on PubMed and ScienceDirect databases using ‘influenza’ and other keywords such as paediatric, children, neurology complication and breastfeeding for articles published in the English language. About 10% of hospitalization with respiratory infections in children <18 years old are related to influenza. It is reported that about 11% – 26% of febrile illnesses among outpatients and 6 –14% of hospitalized patients with pneumonia were due to influenza virus. Global paediatric mortality estimates that death caused by influenza is highest among 1 – 12 months old children which is about 2.8% of all deaths. In Malaysia, there are no seasonal variations of influenza and the prevalence is higher during the middle of the year. Risk factors include male, age <12 months old and presented with seizure. Breastfeeding and vaccination for pregnant mothers can be beneficial for infants up to 6 months old. Influenza among the paediatric group is a significant health burden even in healthy children and are likely to be underdiagnosed. Vaccination can also be focused on pregnant mothers and children less than 12 years old.