Objectives: Identifying factors that can lead to an outbreak in an orphanage is important. This study describes a COVID-19 outbreak in an orphanage in the Philippines. The clinicodemographic profile of the children and employees, safety protocols implemented and outbreak response are reported. Methodology: This is a descriptive study of the COVID-19 outbreak which occurred at a local orphanage in Metro Manila. The clinicodemographic profile of children and employees were obtained from the orphanage’s health records. Interview of employees and administrators and focused group discussions (FDG) were done. A questionnaire on how the orphanage dealt with the COVID-19 pandemic was administered. Results: A total of 128 children and 34 staff were in the orphanage during the COVID-19 outbreak. Majority (96%) of children were symptomatic and 15% of them have co-morbidities. While 82% of the employees were symptomatic, majority had a positive rapid antigen test or RT-PCR for SARS-CoV2. All the children and employees had mild illness and recovered with no complications. The orphanage implemented strict infection control measures when the COVID-19 pandemic was declared. There was a halt in the adoption processes and in the movement of persons in the orphanage. With the decline of COVID-19 cases in Metro Manila, the orphanage resumed accepting new admissions and processing adoption papers. A few weeks later, a child became symptomatic but was not immediately considered as a case of COVID-19. This was followed by the majority of the children and the employees becoming symptomatic, thus the COVID-19 outbreak was called. Foremost in the response was to attend to the medical needs of the children. Strict lockdown was enforced by the City Health Office until all cases were deemed not contagious. Conclusion Factors that can lead to an outbreak in an orphanage include missed opportunities for early diagnosis, contact tracing and intervention. Despite strict infection control measures, a single breach undermined all the efforts done to prevent an outbreak in a closed community.
COVID-19 ; Orphanages

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.
Adolescent ; Animals ; Child ; Child, Preschool ; Enterobiasis/*epidemiology/parasitology ; Enterobius/genetics/*isolation & purification/physiology ; Female ; Humans ; Hygiene ; Lice Infestations/*epidemiology/parasitology ; Male ; Orphanages/statistics & numerical data ; Pediculus/genetics/*physiology ; Prevalence ; Republic of Korea/epidemiology

PURPOSE: To call on health authorities to construct an organized surveillance and investigation system with national financial support for sudden unexpected infant death (SUID) in Korea. METHODS: A single-center retrospective study was conducted on 19 SUID cases, including an analysis of vital statistics for Korean infants, estimation of costs, and suggestion of plans. RESULTS: SUID is the second most common cause of infant deaths in the ER. Most of the deceased infants in this study were discovered in a prone position and bystanders had not in any of the cases started cardiopulmonary resuscitation (CPR) at the scene. Immediate intraosseous (IO) access was not performed in the ER. All cases were categorized as "unclassified sudden infant death" according to the San Diego definition because autopsies and various screening tests were not performed. The assumed rate of incidence of SUID in Korea is 0.3~0.56 per 1000 live births per year. The cost for a response per SUID case was estimated to be over one million won. CONCLUSION: 1) Immediate launching of nation-wide "back-to-sleep campaign" is urgent. 2) Certification in infant resuscitation and prevention of sudden infant death syndrome (SIDS) should be required for workers in day care centers, orphanages or caregivers companies. 3) IO access should be performed immediately for infant cardiac arrest cases in the ER. 4) A nation-wide campaign would also be helpful to change irrational ideas about dead bodies, get public agreement on performing autopsies and raising the autopsy rate. 5) Legislation should be promoted to mandate autopsies and to organize and maintain a surveillance and investigation system with multi-agency support.
Autopsy ; Cardiopulmonary Resuscitation ; Caregivers ; Certification ; Day Care, Medical ; Financial Support ; Heart Arrest ; Humans ; Incidence ; Infant ; Infusions, Intraosseous ; Korea* ; Live Birth ; Mass Screening ; Orphanages ; Prone Position ; Resuscitation ; Retrospective Studies ; Sudden Infant Death* ; Vital Statistics

OBJECTIVES: This present study was conducted to explore the reliability and the validity of Clinician Administered PTSD Scale for Children and Adolescents Korean version (CAPS-CA). METHODS: The Subjects were children and adolescents (8-13yrs) from different places: a certain elementary school, three orphanages, a general hospital, and two neuropsychiatric local clinics. Only subjects who experienced a catastrophic traumatic event were tested by CAPS-CA, CDI, RCMAS, and TSC. RESULTS: The range of correlations between item-criterion were .67-.84. The coefficients of internal consistency were .87. and test-retest reliability was .90, were all the coefficients in the proper range. Inter-correlations of CAPS-CA, CDI, RCMAS, and TSC scale showed significant correlation. TSC showed the highest correlation coefficient. CAPS-CA can be a useful clinician- administered diagnostic instrument for children and adolescents PTSD symptoms. CONCLUSION: The reliability and the validity of CAPS-CA were confirmed. CAPS-CA could be applied for diagnostic purposes of PTSD in children and adolescents.
Adolescent* ; Child* ; Hospitals, General ; Humans ; Orphanages ; Reproducibility of Results* ; Stress Disorders, Post-Traumatic*

PURPOSE: The purpose of this study was to evaluate the effectiveness of sensory stimulation therapy on the physical growth and behaviors of infants accommodated at two Korean orphanages. METHOD: Thirty-eight full term infants were assigned to a control (n=20) or an experimental (n=18) group within 14 days of birth. In addition to routine orphanage care, infants in the experimental group received 15 minutes of massage twice a day, 5 days a week for 4 weeks. RESULT: Compared to the control group, the experimental group had gained significantly more weight and had larger increases in length and head circumference after the 4-week intervention period. In addition, the experimental group showed significantly better behavioral performance in the scoring of habituation (e.g., light), motor (e.g., motor maturity), and state range (e.g., peak of excitement, rapidity of build-up) behavioral clusters of Brazelton's NBAS. CONCLUSION: These data demonstrate that sensory stimulation therapy may facilitate the physical and behavioral development of the newborn infants placed in the orphanages.
Head ; Humans ; Infant* ; Infant, Newborn ; Massage ; Orphanages ; Parturition ; Child Health

There are currently 214 orphanages in Korea which house approximately 13,873 orphans aged between 3 and 18; this accounts for about 0.12% of all children in the same age range. Some have lost their parents, but most have come after their parents divorced or broke up. This means majority of the children in Child Care Centers have parents. Traditional virtue of obedience to parents (Hyo) was regarded as one of the highest value in Korea. Also the interaction between parents and their children was regarded as basic human nature that parents look after, both physically and spiritually, their children until they become one of the matured social member. Raised without having a chance to realize their filial duty and not having been cared for by their parents, most orphans feel that they lack something in their lives when compared with friends. In the end, they live their lives longing for their parents and go through mental discord about their parents. This paper is focused on understanding orphans' experience and views on parents. I approached the issue by applying van Manen's Hermeneutic Phenomenological Approach. The interviews, along with other reference material were phenomenologically reflected to draw essential themes as follows; 1. Orphans of pre-school age hazily long for parents without having any practical image of their parents. 2. They occasionally dream meeting their parents with image that can only last in their dreams, and this continues up through middle school. 3. At the age of elementary school, they crave the image of parents as they see their friends with their parents. 4. They start to despise their parents for having abandoned them when they reach puberty. 5. Meanwhile, as their vague image of parents fade away, they attempt to give up their thoughts toward their parents. 6. Highteens start to think in terms of fate. 7. They don't long for their parents anymore as they used to, but still wishes to meet them at least once. However, they don't want to start any kind of a relationship with them. 8. They fear that they will also fail in raising families of their own, and making their children orphans too, just like their parents have. They simply don't want to follow their footsteps. 9. Thinking that they were abandoned by their parents, they are reluctant to believe other people.
Adolescent ; Child ; Child Care ; Child, Orphaned ; Divorce ; Friends ; Human Characteristics ; Humans ; Korea ; Orphanages ; Parents* ; Puberty ; Thinking ; Virtues

There are currently 214 orphanages in Korea which house approximately 13,873 orphans aged between 3 and 18; this accounts for about 0.12% of all children in the same age range. Some have lost their parents, but most have come after their parents divorced or broke up. This means majority of the children in Child Care Centers have parents. Traditional virtue of obedience to parents (Hyo) was regarded as one of the highest value in Korea. Also the interaction between parents and their children was regarded as basic human nature that parents look after, both physically and spiritually, their children until they become one of the matured social member. Raised without having a chance to realize their filial duty and not having been cared for by their parents, most orphans feel that they lack something in their lives when compared with friends. In the end, they live their lives longing for their parents and go through mental discord about their parents. This paper is focused on understanding orphans' experience and views on parents. I approached the issue by applying van Manen's Hermeneutic Phenomenological Approach. The interviews, along with other reference material were phenomenologically reflected to draw essential themes as follows; 1. Orphans of pre-school age hazily long for parents without having any practical image of their parents. 2. They occasionally dream meeting their parents with image that can only last in their dreams, and this continues up through middle school. 3. At the age of elementary school, they crave the image of parents as they see their friends with their parents. 4. They start to despise their parents for having abandoned them when they reach puberty. 5. Meanwhile, as their vague image of parents fade away, they attempt to give up their thoughts toward their parents. 6. Highteens start to think in terms of fate. 7. They don't long for their parents anymore as they used to, but still wishes to meet them at least once. However, they don't want to start any kind of a relationship with them. 8. They fear that they will also fail in raising families of their own, and making their children orphans too, just like their parents have. They simply don't want to follow their footsteps. 9. Thinking that they were abandoned by their parents, they are reluctant to believe other people.
Adolescent ; Child ; Child Care ; Child, Orphaned ; Divorce ; Friends ; Human Characteristics ; Humans ; Korea ; Orphanages ; Parents* ; Puberty ; Thinking ; Virtues

According to economical status, malnutrition and overnutrition coexist among preschool children in Korea. Malnutrition have been a serious problem for children in some of rural. Many children have deficiencies of some nutrients such as riboflavin A, and simultaneously they have overcarloric intakes with empty calorie foods. Preschool children have nutritional problems which can affect the growth and development. To investigate whether nutritional intakes can influence on the growth or not, nutritional intakes and anthropometric measurements were determined for infants aged 4~6 years old in three different kinds of preschools. Daily nutrient intakes were calculated by the combination of a direct measurement and 24 hour recall, and the diet consumption patterns were determined by diet quality index. Overall growth of infants in Cheonan area was under the normal growth in Korea. Preschool children in orphanage consumed almost all nutrients much less than the recommended daily allowances, on the other hands, children in private preschool had over-intakes of nutrients when it is compared with the daily requirements. However, the scores of the diet quality index were similar in three preschools since children in private preschool consumed more fat and junk food than those in orphanage. The weight and height of preschool children in orphanage was lower than those in private preschools. This was due to the lower consumption of the important nutrients in infants in orphanage. The consumption of all nutrients except fat did not show any correlation with height or weight. The quality index of fat, cholesterol, grains and protein intakes was higher in children in private preschool than in orphanage. In conclusions, 1)the private preschool children had worse nutrient intake patterns. Better consumption of vitamin B2, calcium and grains were, bigger height and chest circumferences children obtained. 2)Since most of energy intake of preschool children came from junk foods, they needed to consume more supplementation of vitamins and minerals, which is necessary for normal growth. 3)It is desirable for the children to cut down junk foods and empty calorie foods.
Anthropometry ; Calcium ; Edible Grain ; Child* ; Child, Preschool ; Cholesterol ; Chungcheongnam-do* ; Diet ; Energy Intake ; Growth and Development ; Hand ; Humans ; Infant ; Korea ; Malnutrition ; Minerals ; Nutritional Status* ; Orphanages ; Overnutrition ; Recommended Dietary Allowances ; Riboflavin ; Thorax ; Vitamins

Research study of Hepatitis B infection has been much advanced recently and the incidence of the Hepatitis B infection, such as acute viral hepatitis, chronic active hepatitis, chronic persistant hepatitis, acute fulminating hepatitis and carrier states are increasing significantly. The authors evaluated HBsAg and AntiHBs in the child age group and the results are summarized as follows: Of 271 children who were admitted during the period of June 1, 1981 to August 31, 1981, 15(5.9%) were HBsAg positive and 24(8.86%) were antiHBs positive. The highest incidence of HBs Ag among the children was school age group. The highest incidence of AntiHBs was newborn age group. Of 92 children who were living in the orphanage, 12(13.0%) were HBsAg positive and 8 (8.71%) were AntiHBs positive. There was no significant difference in comparison by each room.
Australia* ; Carrier State ; Child ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; Incidence ; Infant, Newborn ; Orphanages ; Prevalence*

Research study of Hepatitis B infection has been much advanced recently and the incidence of the Hepatitis B infection, such as acute viral hepatitis, chronic active hepatitis, chronic persistant hepatitis, acute fulminating hepatitis and carrier states are increasing significantly. The authors evaluated HBsAg and AntiHBs in the child age group and the results are summarized as follows: Of 271 children who were admitted during the period of June 1, 1981 to August 31, 1981, 15(5.9%) were HBsAg positive and 24(8.86%) were antiHBs positive. The highest incidence of HBs Ag among the children was school age group. The highest incidence of AntiHBs was newborn age group. Of 92 children who were living in the orphanage, 12(13.0%) were HBsAg positive and 8 (8.71%) were AntiHBs positive. There was no significant difference in comparison by each room.
Australia* ; Carrier State ; Child ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; Incidence ; Infant, Newborn ; Orphanages ; Prevalence*