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0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and non-infections (5.8%), and non-AIDS-related infections (47%) and non-infections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 count and better weight-for-age z-score were protective against death. Conclusions Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and non-opportunistic infections as causes of death in our cohort.Objective To determine the association between age-disparate relationships and risk of Human Immunodeficiency Virus (HIV) infection among adolescent girls and young women (AGYW) aged 15-24 years. Design Systematic review and meta-analysis of published studies until January 5, 2020 in sub Saharan Africa (SSA). Methods We searched several electronic databases, grey literature, and hand searched reference list of included studies to identify eligible studies for data abstraction. We assessed the quality of included studies using Newcastle-Ottawa Scale for non-randomized studies. The DerSimonian-Laird random effects model was used to pool the overall results using risk ratios (RR), presented in a forest plot with 95% confidence interval (CI) and predictive interval (PI). Heterogeneity was assessed with Cochrane's Q-test and quantified with I-squared values. Publication bias was checked with funnel plots and Egger's test. Results We included 24 studies with an overall sample size of 33,390. Favipiravir Data show that age-disparate relationships were significantly associated with unprotected sexual intercourse (pooled RR, 1.57; 95% CI, 1.34-1.83; 95% PI, 1.22-2.02), and higher risk for HIV infection (pooled RR, 1.39; 95 CI, 1.21-1.60; 95% PI, 0.80-2.42). Studies included in pooling risk of unprotected sexual intercourse were largely homogeneous (I-squared value= 0.0, p = 0.79) while those for HIV infection were heterogeneous (I-squared value = 89.0%, p less then 0.01). We found no publication bias and no study influenced the meta-analytic results. Conclusions Age-disparate relationships among AGYW are associated with increased risk of unprotected sexual intercourse and HIV infection in SSA. HIV prevention interventions should target this sub-population. Exposure of infants to antiretroviral drugs for prevention of mother-to-child transmission can induce resistance to nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). Data from nine national surveys of pretreatment drug resistance in children newly diagnosed with HIV show high levels of resistance to NRTIs included in first-line antiretroviral treatment (ART) regimens (dual abacavir-lamivudine/emtricitabine resistance). Additional research is needed to determine the impact of NRTI resistance on treatment response and optimize infant ART.Assessment of vitamin and trace element status (VTE) is important in the clinical management of the sick child. In this position paper, we present the various assessment methods available to the clinical practitioner, and critically discuss pitfalls with interpretation of their results. There are 4 main approaches to assess the VTE body status of an individual patient including clinical examination, dietary assessment, and measurement of direct and indirect biomarkers of VTE in biological samples. Clinical signs of VTE deficiencies usually present only when body stores are substantially depleted and are often difficult to detect or differentiate from other nonnutrient-related causes. In isolation, dietary assessment of micronutrients can be inaccurate and imprecise, in disease and in individual patient assessment but may be useful to complement findings from other VTE assessment methods. Use of biomarkers is the most common approach to assess VTE status in routine practice but in the presence of systemic inflammatory response and in the absence of appropriate paediatric reference intervals, interpretation of biomarker results might be challenging and potentially mislead clinical practice. The use of a multimodal approach, including clinical examination, dietary assessment, and laboratory biomarkers is proposed as the optimal way to ascertain the VTE status of individual patients. In the presence of acute inflammatory conditions, VTE measurements in plasma should be replaced by biomarkers not affected by systemic inflammatory response or delayed until inflammatory state is resolved.Commissioned by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), we investigated how European physicians training in these fields are educated in nutrition. A survey on time spent in nutrition training, composition of multidisciplinary nutrition teams, and topics covered during training enrolled 50 participants. A median of 20% of training time was spent on nutrition training during fellowship. Fourteen (28%) had regular nutrition teaching. Thirty-four (68%) were part of a multidisciplinary nutrition team. Twelve (24%) used the ESPGHAN syllabus. Most frequent topics during nutrition training were diagnosis/investigation of failure to thrive, indications/contraindications for enteral feeds, and benefits/risks of enteral/parenteral nutrition. Twenty-seven (54%) had taken a formal nutrition course. Nutrition training in Europe varies and the ESPGHAN training syllabus is not yet implemented Europe-wide. ESPGHAN nutrition summer schools, and Web-based learning may provide appropriate training. We suggest that all patients necessitating nutritional care be treated by multidisciplinary nutrition teams.Nonthermal methods are more efficient at preserving various biological properties of human milk, as compared with holder pasteurization (HoP), which is the most common preservation method. This study was performed to assess the effects of nonthermal processing on bactericidal activity against Escherichia coli in human milk. Milk samples obtained from the Regional Human Milk Bank in Warsaw at Holy Family Hospital were processed by HoP, irradiated with ultraviolet-C (UV-C) for 5, 10, and 15 minutes (6720 J/L each minute), subjected to 2 variations of high-pressure processing (HPP) 450 MPa for 15 minutes and 200 MPa for 10 minutes + 400 MPa for 10 min, with a 10-minutes break. The samples were then evaluated by a bactericidal assay (raw untreated human milk was used as a control). The bactericidal capacity after HoP was preserved in 12.1% of samples, showing a significant reduction in bactericidal properties compared with in raw milk (P 0.05). Nonthermal methods of human milk treatment better preserve the bactericidal capacity compared with holder pasteurisation.