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Child Health Week 1 2017/18 > 3: Global Child Health > Flashcards

3: Global Child Health Flashcards

1
Q

Rather than “developing / developed” or first/second/third-world, what terms are used to describe countries now?

A

Low / middle / high income countries

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2
Q

What is infant mortality rate?

A

Probability of dying before the age of 1

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3
Q

Are stillbirths / miscarriages included in infant mortality rates?

A

No, live births only

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4
Q

Countries where the infant mortality rate is high tend to have less ___.

A

doctors

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5
Q

What parts of the world have the highest infant mortality rates?

A

Africa

SE Asia

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6
Q

Neonatal mortality describes the death of a child in what period of life?

A

First 28 days

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7
Q

What simple measures taken at birth reduce the infant mortality rate?

A

Skilled attendant > clean deliver

Vaccination

Treatment for infection

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8
Q

What is the most common respiratory cause of infant mortality?

A

Pneumonia

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9
Q

What is the most common GI cause of infant mortality?

A

Diarrhoea

secondary to gastroenteritis caused by contaminated water and food

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10
Q

How can pneumonia be prevented?

A

Vaccination

Good hygiene

Nutrition support

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11
Q

How is diarrhoea prevented?

A

Safe drinking water and food

Good hygiene and sanitation

Vaccination

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12
Q

How is infant diarrhoea treated?

A

Oral rehydration solution (relearn SGLT2)

Zinc supplements - micronutrient replacement

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13
Q

How does SGLT work?

A

Cotransporter for Na+ and Glucose INTO small bowel / kidneys (1/2)

Water follows sodium so effectively rehydrates

(Oral rehydration solutions contain water, sodium and glucose to take advantage of SGLT and rehydrate quicker)

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14
Q

What is a viral infection which causes a large proportion of paed deaths in Africa?

A

HIV

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15
Q

How can babies contract HIV?

A

Transmission from mother

across placenta, during delivery or via breastfeeding

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16
Q

How is mother-child HIV transmission prevented?

A

Put mother on anti-retrovirals

Screening

Give infant anti-retrovirals prophylactically after birth

17
Q

In a child with recurrent widespread infections, what should be suspected?

A

HIV infection

18
Q

As with many viruses, how is HIV tested for?

A

Viral PCR

19
Q

Why can’t the blood of breastfeeding babies be tested for HIV?

A

If mother is on anti-retrovirals then the baby will receive remnants from breast milk - not a representative of baby w/o antibodies

20
Q

Why is compliance for anti-retrovirals poor?

A

Disgusting medication

21
Q

How does HIV cause immune suppression?

A

Attacks CD4+ T cells, inhibiting body’s ability to produce an immune response

22
Q

What distinctive tumour(s) are associated with HIV infection?

A

Kaposi sarcomas

23
Q

Which type of pneumonia is associated with HIV?

A

Pneumocystis jirovecci

24
Q

What sort of vaccines should be avoided in people with HIV?

A

Live attenuated

weakened immune system so can cause actual infection

25
Q

What infection commonly accompanies HIV in infected children?

A

Tuberculosis

chronic cough, fever, weight loss, night sweats, lymphadenopathy…

so treatments are often given together

26
Q

How is suspected childhood TB investigated?

A

Ziehl-Neelson test for Acid-fast bacilli in sputum (not common in kids)

CXR (for cavitating lesions)

Mantoux test

27
Q

How is tuberculosis treated?

A

2 RIPE 4 RI

2 months of rifampicin, isoniazid, pyrazinamide and ethambutol

then 4 months of rifampicin and isoniazid only

28
Q

What immunisation are people with HIV commonly given?

A

BCG for TB

29
Q

What is a common parasitic infection causing child mortality?

A

Malaria

30
Q

Which organism causes malaria?

A

Plasmodium falciparum

31
Q

What are the common symptoms of malaria?

A

Prodromal headache (migraine-y)

Myalgia

Anorexia

progressing to fever and reduced conscious level

32
Q

Any child in a low income country with a fever, pallor and malaise should be tested for what?

A

Malaria

33
Q

Is malaria immunity life-long?

A

No, must be immunised before travel

34
Q

How is malaria prevented?

A

Mosquito nets

Intermittent vaccination

35
Q

What is a dietary cause of child mortality?

A

Malnutrition

36
Q

What is a common neuro problem in children of low income countries?

A

Epilepsy

37
Q

What disrupts healthcare delivery in middle/low income countries?

A

Conflict

Child Health Week 1 2017/18 (14 decks)

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