Child health

Question 1

Describe interventions that would decrease morbidity/mortality due to diarrhea in developing countries?

Answer 1

1. Early and exclusive breastfeeding to 6 months of age with policies and programs that support mothers
2. Vitamin A supplementation for children with measles
3. Rotavirus and measles vaccination programs/increased uptake
4. Hand washing promotion with soap and water particularly after defecation and for pregnant mothers before breastfeeding
5. Improved water supply quantity and quality with treated water and suitable water storage
6. Community wide sanitation promotion with establishing appropriate latrines
7. Increasing availability and promotion of fluids and ORS treatment to prevent and treat mild dehydration
8. Zinc treatment
9. Increased overall nutritional status through health promotion and improving accessibility and availability of nutrient rich foods
10. Healthcare provider education and training to improve case management of children with diarrhea with appropriate rehydration using oral rehydration and zinc supplementation

Question 2

List 10 factors that contribute to high levels of morbidity/mortality due to diarrhea in developing countries

Answer 2

1. Lack of safe drinking water
2. Lack of proper sanitation and hygiene
3. High rates of malnutrition
4. Low rotavirus vaccination rates
5. Lack of robust primary healthcare system for early interventions and to provide immunisations and education
6. Low rates of appropriate case management with rehydration and zinc treatment
7. High rates of low birth weight babies increases susceptibility to infection
8. Low rates of exclusive breastfeeding reduces childhood immunity levels from passive antibody transfer and affects nutritional status
9. Lack of availability and affordability of nutritious food
10. Low rates of maternal education and young maternal age

Question 3

What factors contribute to high morbidity and mortality of childhood pneumonia in developig world (10)?

Answer 3

1. Burden of HIV increases population that is more susceptible to severe pneumonia
2. Lack of robust healthcare systems and funding to achieve high immunization rates for children and mothers
3. Inadequate food supply leads to high proportion of children with malnutrition making them more susceptible to pneumonia and increased severity
4. Low birth weight due to a combination of maternal and environmental factors increases susceptibility to infection
5. High levels of indoor air pollution due to cooking and heating with solid fuels increases susceptibility to infection
6. Overcrowding in housing leads to increased spread of disease
7. Lack of adequate antenatal services leads to poorer antenatal care, lower maternal immunisations, and lower breastfeeding rates
8. Lack of healthcare system and providers with adequate training and system for early recognition and treatment of pneumonia with antibiotics
9. Higher rates of comorbid diseases and infections e.g. diarrhea further leads to increased susceptibility and poorer nutritional status
10. Lower socioeconomic status and younger maternal age are associated with less antenatal care, lower birthweight that lead to increased susceptibility

Question 4

Describe the interventions that would reduce morbidity/mortality from childhood pneumonia (10)

Answer 4

1. Immunisations against certain pathogens as part of routine childhood immunizations e.g. pneumococcal, Haemophilus influenzae B, annual influenza vaccinations, measles-mumps-rubella, pertussis
2. Improvement in nutritional status
3. Increased exclusive breastfeeding rates to 6 months of age
4. Maternal immunization - pertussis
5. Supplementation - vitamin A for measles, zinc, vitamin D for general nutrient status that alters immune function
6. Reduction in household air pollution through use of clean air stoves
7. Education awareness to adults who smoke not to smoke indoors and away from children
8. Effective recognition and treatment of pneumonia with antibiotics at healthcare facilities
9. Improved awareness of pneumonia signs/symptoms for families and communities and education on when to seek care from a healthcare provider
10. Co-trimoxazole preventive therapy for children with HIV in areas where there is high burden of bacterial pneumonia