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Crohn Disease

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Giardiasis is one of the most common gastrointestinal parasitic diseases worldwide and it is caused by an enteric pathogen named Giardia spp. Giardiasis is the most commonly reported human parasite of gastroenteritis with frequent sporadic cases and community-wide outbreaks via water- and -in smaller proportion- foodborne pathways. Giardiasis encompasses a complex and diverse spectrum of symptom patterns ranging from asymptomatic carriage to acute and chronic health states. Prolonged chronic infections eau enhance extra-intestinal and post-infectious sequelae. Estimation of the population health status, also known as "disease burden", requires well-defined information on clinical outcomes of infection. Unfortunately, regarding the diverse symptomatology and limited knowledge on pathogenesis mechanisms, giardiasis burden is often difficult to estimate and report. Objectives: To accurately estimate the disease burden of giardiasis and explain satisfactory its clinical impact, it is therefore necessary to have information on the nature and frequency of these sequelae. To this end, we aim to be able to get a better understanding of the symptoms of Giardia infection in humans. The aim of this thesis will be to review the clinical impact of giardiasis worldwide using a systematic search approach. To this end we will proceed in a two-step approach as follows: 1.First we will review existing assessments of the disease burden of Giardia. This will give an overview of the current disease models (i.e., lists of giardiasis symptoms .2.Next we will perform a systematic review of clinical symptoms associated with Giardia infection in humans in order to identify the health states which are associated with the giardiasis burden and estimate the occurrence of potential sequelae (acute and chronic) of giardiasis. Methods: In order to address the identified gaps, we chose to perform systematic review of the literature according to PRISMA guidelines. We will focus on prospective studies (i.e., cohort studies, longitudinal studies and outbreak investigations) retrospective studies (i.e., case-control studies) and cross-sectional studies. Findings: To date, we have irrefutable evidence of variability in clinical outcomes associated with Giardia infection. Typically assumed as a re-emerging and neglected disease, giardiasis places a heavy burden in both developed and developing countries. It has been linked to persistent diarrhoea that may contribute to substantial weight loss, retardation of growth and development in infants, cognitive impairment and malabsorption. In addition, it has been confirmed that acute giardiasis is associated with significant post-infectious chronic sequelae in adults such as imitable bowel syndrome, chronic fatigue or functional dyspepsia. These persistent sequelae affect the quality of life by continuing to inflict on patients long lasting discomfort and pain.

Giardia --- Diagnosis --- Root Cause Analysis --- Review Literature as Topic

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En Belgique, les services de néonatalogie sont divisés d’une part en néonatalogie intensive (NIC), prenant en charge des bébés nécessitant un haut degré de surveillance avec des appareils de réanimation et une technologie de pointe, et d’autre part en néonatalogie non intensive (n*) destinée aux bébés plus stables ou après une période de soins intensifs. Les services de maternité sont les principaux lieux de naissance et de vie qui offrent aux parents un cadre sécurisant pendant le court séjour de la maman et du nouveau-né. Les soins complémentaires, tels que les soins de développement sont de plus en plus présents dans ces milieux hospitaliers. Le Newbom Individualized Developmental Care Assessment Program (NIDCAP), programme néonatal individualisé d’évaluation et de soutien au développement, est un exemple particulier de soins au développement regroupés dans une stratégie globale de prise en charge qui s’articule autour des capacités et des besoins de chaque enfant (Bustani, 2008). Certains services de néonatalogie et de maternité proposent des soins de développement tels que le massage. Une trentaine d’années d’études a prouvé les effets positifs du massage pour les nourrissons et plus particulièrement pour les prématurés. Au vu de toutes les constatations positives concernant le massage pour bébé, il pourrait sembler évident que l’application du massage pour le nourrisson ait lieu dans les milieux hospitaliers de façon systématique. Cependant nous n’en connaissons pas l’application réelle dans le milieu hospitalier car malgré nos recherches sur “PubMed” et “Google Scholar” avec comme mots-clés : “Infant, Newbom - Massage - Neonatology - Matemity - Complementary thérapies”, nous n’avons pas trouvé d'étude satisfaisante pouvant expliquer ces différences. L’objectif de cette étude est de décrire et d’identifier les facteurs prédictifs de l’application effective des massages pour bébés dans les unités de néonatalogie et de maternité.

Infant, Newborn --- Massage --- Neonatology --- Infant Care