Post-exposure prophylaxis and follow-up in children and young persons presenting with sexual assault.

Introduction: Paediatric sexual assault (SA) victims should be assessed for post-exposure prophylaxis (PEP) to mitigate the risk of sexually transmitted infections (STIs). We describe the clinical characteristics of children and young persons (CYPs) presenting with SA at KK Women's and Children's Hospital in Singapore, viral PEP (human immunodeficiency virus [HIV] and hepatitis B virus [HBV]) prescribing practices, and STI evaluation at follow-up.

Method: Medical records of CYPs ≤16 years who presented with SA between January 2022 and August 2023 were reviewed, including assault and assailant characteristics, baseline and follow-up STI screening, PEP prescription, adherence and follow-up attendance.

Fever of Unknown Origin in Children: A 14-Year, Single Institution Retrospective Review.

Aim: To glean additional knowledge on children with fever of unknown origin (FUO).

Methods: Children <18 years old referred to Infectious Disease Service for FUO in a tertiary paediatric hospital were analysed retrospectively from December 2004 to January 2019. Clinical profile, interventions and outcomes were reviewed.

Respiratory syncytial virus hospitalisation by chronological month of age and by birth month in infants.

Understanding the distribution of respiratory syncytial virus (RSV) disease burden by more granular age bands in infants is necessary for optimising infant RSV immunisation strategies. Using a Bayesian model, we synthesised published data from a systematic literature review and unpublished data shared by international collaborators for estimating the distribution of infant RSV hospitalisations by month of age. Based on local RSV seasonality data, we further developed and validated a web-based prediction tool for estimating infant RSV hospitalisation distribution by birth month.

Expert consensus on the burden of respiratory syncytial virus disease and the utility of nirsevimab for disease prevention and protection of infants.

Background: Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide. In Singapore, RSV substantially contributes to the morbidity and mortality of children aged < 5 years, particularly during their first year of life, with hospitalization rates peaking during epidemic outbreaks. This expert consensus paper aims to provide an overview of the RSV disease burden, unmet needs, and the urgency for RSV prevention in all infants.

Long-term sequelae post-hospitalization for respiratory syncytial virus vs. Omicron SARS-CoV-2 or influenza in adults and children: a retrospective cohort study.

Objectives: Risk of long-term sequelae after COVID-19 hospitalization is well documented in adults and children; however, less is known about long-term sequelae after hospitalization for other respiratory viral infections (RVIs), such as respiratory syncytial virus (RSV). We sought to compare long-term sequelae after RSV hospitalization, contrasted against Omicron COVID-19 and influenza, in children and adults.

Methods: This retrospective population-based cohort study in Singapore included all hospitalizations for RSV/influenza from 1 January 2017 to 3 September 2023, and all COVID-19 hospitalizations after Omicron emergence (1 January 2022-3 September 2023).

Long-term Sequelae Following Dengue Infection vs SARS-CoV-2 Infection in a Pediatric Population: A Retrospective Cohort Study.

Background: Long-term postacute sequelae following SARS-CoV-2 infection in children have been extensively documented. However, while persistence of chronic symptoms following pediatric dengue infection has been documented in small prospective cohorts, population-based studies are limited. We evaluated the risk of multisystemic complications following dengue infection in contrast to that after SARS-CoV-2 infection in a multiethnic pediatric Asian population.

Severity of respiratory syncytial virus versus SARS-CoV-2 Omicron and influenza infection amongst hospitalized Singaporean adults: a national cohort study.

Background: More data is required to contextualise respiratory-syncytial-virus (RSV) disease burden, versus other vaccine-preventable respiratory-viral-infections (RVIs) in older adults. We aimed to compare severity of RSV in hospitalized adults versus influenza/boosted COVID-19.

Methods: Retrospective population-based cohort study, including all adult RSV hospitalizations (2021-2023) in Singapore.

Invasive Pneumococcal Disease and Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines in Singapore Children Over 24 Years.

Background: Data on burden of invasive pneumococcal disease (IPD) are lacking from Southeast Asia. With the introduction of higher-valency pneumococcal conjugate vaccines (PCVs), we aim to assess the impact of PCV introduction into Singapore's National Childhood Immunisation Schedule (NCIS) on IPD burden and serotype replacement.

Methods: Using IPD surveillance data from a single center, we compared the incidence of IPD in children aged <17 years before and after introduction of the PCV into the NCIS (2000-2009, period 1; 2010-2023, period 2).

Characterising the asynchronous resurgence of common respiratory viruses following the COVID-19 pandemic.

The COVID-19 pandemic and relevant non-pharmaceutical interventions (NPIs) interrupted the circulation of common respiratory viruses. These viruses demonstrated an unprecedented asynchronous resurgence as NPIs were relaxed. We compiled a global dataset from a systematic review, online surveillance reports and unpublished data from Respiratory Virus Global Epidemiology Network, encompassing 92 sites.

Long-term multi-systemic complications after SARS-CoV-2 Omicron and Delta infection in children: a retrospective cohort study.

Objectives: Most studies on long-term sequelae of SARS-CoV-2 infection in children were conducted pre-Omicron and pre-dated vaccination rollout. We examined long-term risk of new-incident multi-systemic sequelae following SARS-CoV-2 Delta/Omicron infection in a multi-ethnic Asian paediatric population.

Methods: Retrospective cohort study of Singaporean children aged 1-17 years infected during Delta/Omicron BA.

Time to positivity of blood cultures in paediatric patients.

Aim: Continuous monitoring of blood culture (BC) systems allows rapid detection of microbial growth. We aimed to determine differences in time to positivity (TTP) in BACTEC BC between organisms and whether a 36-h period was sufficient to detect all relevant pathogenic bacteria for children admitted to a tertiary care paediatric hospital.

Methods: This was a retrospective audit of positive aerobic (AE) and anaerobic (AN) BC from paediatric inpatients with available TTP from 1 August 2016 to 2 January 2019.

Long COVID prevalence, risk factors and impact of vaccination in the paediatric population: A survey study in Singapore.

Introduction: Information on the quality of health of children and younger persons (CYPs) after SARS-COV-2 infection remains scarce, especially from Asia. In this study, we utilised an online survey to investigate Long COVID prevalence in CYPs in Singapore.

Method: The study was an anonymised online survey of physical and functional symptoms, made available from 14 October 2022 to 15 January 2023.

T cell hybrid immunity against SARS-CoV-2 in children: a longitudinal study.

Background: Hybrid immunity to SARS-CoV-2, resulting from both vaccination and natural infection, remains insufficiently understood in paediatric populations, despite increasing rates of breakthrough infections among vaccinated children.

Methods: We conducted a prospective longitudinal study to investigate the magnitude, specificity, and cytokine profile of antigen-specific T cell responses elicited by breakthrough SARS-CoV-2 infection in a cohort of mRNA-vaccinated children (n = 29) aged 5-11. This longitudinal analysis involved six distinct time points spanning a 16-month period post-vaccination, during which we analysed a total of 159 blood samples.

Estimation of trajectory of protective efficacy in infectious disease prevention trials using recurrent event times.

In studies of infectious disease prevention, the level of protective efficacy of medicinal products such as vaccines and prophylactic drugs tends to vary over time. Many products require administration of multiple doses at scheduled times, as opposed to one-off or continual intervention. Accurate information on the trajectory of the level of protective efficacy over time facilitates informed clinical recommendations and implementation strategies, for example, with respect to the timing of administration of the doses.

Remdesivir therapy for severe pediatric COVID-19 in Singapore: A single-center retrospective observational cohort study.

Background And Aims: There is a paucity of information on remdesivir (RDV) use in severe pediatric coronavirus disease 2019 (COVID-19). We aimed to explore the effectiveness of RDV as the cumulative proportion of pediatric COVID-19 patients deescalated from Day 5 of high dependency or intensive care unit (HD/ICU).

Methods: All children ≤18 years admitted to Singapore's largest pediatric hospital from January 1, 2020 to March 18, 2022 were reviewed retrospectively.

BNT162b2 vaccine induced variant-specific immunity, safety and risk of Omicron breakthrough infection in children aged 5 to 11 years: a cohort study.

There is little information on BNT162b2 vaccine-induced variant-specific immunogenicity, safety data and dynamics of breakthrough infections in pediatric populations. We addressed these questions using a prospective two dose BNT162b2 (10 mcg) vaccination cohort study of healthy children 5-11 years in Singapore. Follow up included blood samples at scheduled visits, daily vaccination symptom diary and confirmation of SARS-CoV-2 infection.

Paediatric actinomycosis: A 16-year, single-institution retrospective review of cases.

Aim: Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children.

Methods: A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020.