“…In a study of 145 children with CZS followed at a referral centre in Pernambuco [ 29 ], 49% had been hospitalised by age 24 months, with an average stay of 4 days and very similar discharge diagnoses as reported here. A smaller study from Rio de Janeiro reported gastrointestinal tract-related admissions as the main reason for hospitalisations, but with respiratory and nervous system problems as the next most important; this study also examined the nursing care required for the 41 hospitalisations studied, finding that 8% required intensive and 54% semi-intensive care (i.e., clinically unstable) [ 30 ]. The high risk of infections may partly reflect increased risk of broncho-aspirations in this population, where a high proportion may have persistent dysphagia, as well as infections associated with invasive devices.…”