Background: Febrile seizure is the most common childhood neurological disorder, is an important health problem with potential short-and long-term complications, also leading to economic burden and increased parental anxiety about fevers and seizures occurring in their children. There are no routine recommendation to detect etiological causes of FS for neurological perspective, further knowledge about the etiological causes of FS in children will support preventive measures and follow-up strategies. The aim of this study is to evaluate the percentage of respiratory viruses in children with FS. Methods: This prospective multicenter study, entitled "Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study)" examined representative populations in eight different cities in Turkey between March 1, 2016 and April 1, 2017. Nasopharyngeal swabs were taken from all children at presentation. A respiratory multiplex array was performed to detect for influenza A and B; respiratory syncytial virus A and B; human parainfluenza virus 1-2-3 and 4; human coronavirus 229E and OC43; human rhinovirus; human enterovirus; human adenovirus; human bocavirus; human metapneumovirus. Results: During the study period, at least one virus was detected in 82.7% (144/174) of children with FS. The most frequently detected virus was adenovirus, followed by influenza A and influenza B. Detection of more than one virus was present in 58.3% of the children with FS, and the most common co-existence was the presence of adenovirus and influenza B. In children younger than 12 months, Coronavirus OC43 was the most common, while influenza A was most frequently observed in children older than 48 months (p < 0.05). Human bocavirus was common in children who experienced complex FS, while respiratory syncytial virus (RSV) A was more common in children who experienced simple FS. Influenza B virus was the most common virus identified in children who were experiencing their first incidence of FS (p < 0.05).Conclusions: This study indicates that respiratory viruses are important in the etiology of FS in children. The results show that antibiotics must be prescribed carefully in children with FS since the majority of cases are related to viral causes. Widespread use of the existing quadrivalent influenza vaccine might be useful for the prevention of FS related to the flu. Further vaccine candidates for potential respiratory pathogens, including RSV, might be helpful for the prevention of FS. ARTICLE HISTORY

Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15 years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5 years of age, and 29.5% were in children under 1 year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15 years of age in Turkey, 21.7 to 28 per 100,000 children under 1 year of age, 9.8-13.8 per 100,000 children under 5 years of age, 3.96-6.52 per 100,000 children between 5 and 10 years of age and 0.42 to 0.71 per 100,000 children between 10 and 15 years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p < 0.001) and neurological complications (p < 0.001) were significantly more common in previously healthy children, whereas hematological complications (p < 0.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6 days, and it was longer in children with underlying conditions (<0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p < 0.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15 years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-768 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children <1 year of age, and there are no prevention strategies for these children other ...

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Aim: To study the prevalence of nocturnal enuresis and the impact of associated familial factors in Turkish children with a different socioeconomic status. Methods: A specific questionnaire was distributed to 3,000 parents of primary school children (6–12 years old). Of these children, 1,500 attended primary schools in Umraniye, a suburban region of Istanbul (group 1), and the other 1,500 children visited schools in Suadiye, a well-developed part of Istanbul (group 2). The first part of the survey investigated the familial conditions of the children (financial status, family history of enuresis, and family size). The second part of the questionnaire surveyed the demographic and physical characteristics of the children. The last part was designed to investigate the opinions and beliefs of the parents about nocturnal enuresis and treatment modalities. The prevalence rates of nocturnal enuresis and associated familial factors of these children from two different regions of Istanbul were compared. Results: Of the 3,000 questionnaires distributed, 2,589 (86.3%) were returned and included in the final analysis. The mean age of group 1 and 2 children was 8.88 ± 1.4 and 8.9 ± 1.5 years, respectively (p > 0.05). The gender of the subjects was equally distributed (48.6% males and 51.4% females). Enuresis was present in 334 children (25.5%) of group 1 and in 205 children (16%) of group 2. Enuresis was significantly more common in group 1 (p < 0.01). The families consisted of 4.69 ± 1.4 and 4.1 ± 1.1 persons, respectively (p < 0.01). A yearly income of USD 7,000 was achieved in group 2 by 54%, in group 1 by only 0.7% (p < 0.01). Only 26 children of group 1 (7.8%) and 22 children of group 2 (10.8%) were noted to receive medical enuresis treatments, with no statistically significant difference between the groups (p > 0.01). The parents of the enuretic children from the suburban region of Istanbul were found to consider the condition a normal developmental entity. They believed that enuresis will resolve spontaneously and that no treatment is necessary. On the contrary, the parents of the enuretic children in the well-developed region of the city believed that enuresis is a psychological problem and that intensive psychological assistance is essential for the management. Conclusions: Our study indicates that the prevalence of nocturnal enuresis in Turkey is comparable to that reported in the literature. The parents consider that enuresis nocturna is not a fatal disorder, that the drugs used in the treatment may be harmful, and that no medical assistance is required. Trained health personnel and physicians should inform the parents about enuresis in order to prevent possible behavioral and self-esteem problems.

Background:Chronic disease of children can cause changes in the health-related quality of life (HrQoL) of the family members.Aims:To evaluate the HrQoL of healthy siblings of children with chronic disease.Study Design:Cross-sectional study.Methods:The study included healthy sibling of children with chronic disease (cerebral palsy, epilepsy, diabetes, celiac disease, hematologic/oncologic disease, or asthma) and healthy sibling of healthy children to evaluate the quality of life. We used the Pediatric Quality of Life Inventory questionnaire; the physical health and psychosocial health scores were calculated using the responses of the sibling and parent. The primary endpoint was the comparison of HrQoL scores of healthy siblings of children with chronic disease and that of healthy siblings of healthy children.Results:This study included a respective healthy sibling of 191 children with chronic disease and healthy sibling of 100 healthy children. The physical health, psychosocial health, and total health scores of healthy siblings of children with chronic disease were significantly lower than that of healthy siblings of healthy children (p<0.001). Among the healthy siblings of children with chronic disease, the lowest psychosocial health score was found in the siblings of children with cerebral palsy, hematologic/oncologic disease, and asthma (p<0.001). The global impact on the quality of life for healthy siblings of children with chronic disease was significantly higher in the self-report of the children than that of the parents (30.4% versus 15.1%, p<0.05).Conclusion:Most healthy siblings of children with chronic disease are physically and psychosocially affected and there is low parental awareness of this condition. This can increase the risk of emotional neglect and abuse of these children. Therefore, special support programs are needed for the families of children with chronic diseases.