Child Health And Illnesses Flashcards
Childhood deaths in England and Wales
More than 5000 infants , children and adolescents die every year in England and Wales
Mortality is highest in infancy , dropping to very low rates in middle childhood rates before rising again in adolescence
Patterns of mortality vary with age and sex
Patterns of mortality
Perinatal and congenital causes predominate in infancy
Acquired natural causes become prominent in later childhood and adolescence
> 50% of deaths in adolescents occur from external causes
Males in all age groups have higher mortality rates with 15-19 age range being the most different and highest - adolescent death rates exceed those of younger children with much higher rate in boys
Illness in children
Congenital abnormality
- chromosomal anomalies
- cardiac lesions
Infection Respiratory disorders Trauma Malignancy Neurological disease
External causes of child death is highest in 15-19 yrs age group and males being higher than females
Patterns of illness
Acute illness - in a previously well child
Acute child with underlying chronicity - e.g SKA with IDDM , asthma excerbation
Chronic long term illness e.g cystic fibrosis , chronic renal failure and cerebral palsy
Timing of illness
Prenatal Perinatal Neonatal Infant Toddler School age Adolescent
Boys >70% more likely to die or be injured
Traffic accidents account for > 50% of all external deaths in adolescents with 10-14 age group being highest
Causes of deaths in infants
Congenital Prematurity Asphyxia Unexplained Other
With prematurity being highest in pre term babies and congenital highest in term infants
Other non intentional causes of child death
Two peaks in occurrence : infancy and early childhood and adolescence
- drowning
- falls
- fire related injuries
Suffocation and strangulation (young infants with SUDI and toddlers )
Fatal maltreatment and deaths from assault
- infanticide and covert homicide
- severe physical assaults ( shaking )
- abuse , neglect or deprivation
- deliberate or overt homicides
- deaths related to but not directly caused by maltreatment
Suicide and deliberate self harm
Rare in children younger than 10 yrs
Higher in older adolescents boys (>60 deaths per year )
Ligature , jumping , poisoning
Types of injuries
Falls
Head injuries
Road traffic collisions
Drowning - mostly in bath or outdoor pools - 4x as likely if epileptic - 50% reduction with pool fencing
Swallowed foreign body
Majority child pedestrians hit by vehicles , reminder unrestrained children
Poisoning
50% occur in under 5s
Almost all occur in child’s home
Over half are non medicinal - cosmetics , cleaning substances
Declining due to child resistant containers and safer medicines
Medicines - analgesics , cough products , antibiotics and vitamins
Childhood cancers 2001-2005
Three most common types of cancer diagnosed in children are leukaemias , brain and CNS tumours and lymphomas collectively accounting for around 2/3rds of all cancers diagnosed in 0-14 yrs old
CNS diseases
Many as a result of perinatal problems
- birth asphyxia /hypoxic- ischeamic encephalopathy
- low birth weight / prematurity
Epilepsy
Cerebral palsy
Neuro developmental disorders
Chronic illness in UK
Cystic fibrosis Diabetes mellitus Epilepsy IBD Neuro disability /CP Psychiatric illness Obesity Asthma
Implications of chronic illness
Child - physical , mental , social School - repeated absences Family - parents and siblings Financial family and community National health provision / planning Lifelong - ex- premature baby
Cost implications
5 million asthmatic children in US Annually 170 000 admissions $38 dollars acute admissions 10 million school days missed <20 children special needs / disability but spend > 80% of allocated budget
Why children die
In 2012 in the UK
> 3,000 babies died before 1 year
2,000 children and young people died between 1-19 yrs
50% deaths in childhood occur during the first year of a child’s life
Pre term birth and low birth weight are the major causes with risk factors including -
Maternal age , smoking and socioeconomic disadvantage
After infancy , injury is the most frequent cause of death , > 75% of deaths due to injury in the age bracket of 10-18 year olds are related to traffic accidents
Suicide remains a leading cause of death in young people in the UK and the number of deaths due to intentional Injuries and self harm have not declined in 30 years
Next steps
- reduce risk of preterm babies and LBW and promote maternal health
- improve recognition and management of serious illness across the health service
- implement policies for common causes of deaths from accidents and injuries
- improve management of chronic diseases ( asthma , epilepsy , diabetes ) and long term conditions inclu mental health
Role of society and government
Resource availability and equity impact on mortality and on life chances
- poverty kills children
- equity saves lives
- social protection is life saving
