Common Childhood infections Flashcards
1
Q
Leading Childhood infections globally
A
- Pneumonia
- Diarrhoeal disease
- Sepsis
- Malaria
- Pertussis, Tetenus, meningitis
- HIV/AIDS
- Measles
2
Q
Leading causes of death in South Africa Age < 1 year.
A
- Respiratory and cardiovascular disorders specific to the perinatal period (14.8%)
- Influenza and pneumonia (8.3%)
- Intestinal infectious diseases (6.7)
- Other disorders originating in the perinatal period (5.9%)
- Disorders related to the length of gestation and fetal growth (5.4%)
- *Infections specific to the perinatal period (5.3%)
- Fetus and newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (4.8%)
- Malnutrition (3.2)
- Congenital malformations of the circulatory system (2.8%)
- *Other bacterial diseases (1.8)
3
Q
22.1% of natural causes of death in this age [0-1 year] group are due to infections. What infections?
A
Other bacterial diseases (1.8%)
*Infections specific to the perinatal period (5.3%) include:
- Congenital viral infections, HIV CMV co-infection most prevalent
- Bacterial sepsis of the newborn
- Other congenital infectious and parasitic infections including TB, malaria, etc.
4
Q
Leading causes of death in South Africa Age 1 - 14 years
A
- Influenza and pneumonia
- Intestinal infectious diseases
- Malnutrition
- Tuberculosis
- Other forms of heart disease
- Human immunodeficiency virus [HIV] disease
- Other viral diseases
- Cerebral palsy and other paralytic syndromes
- Inflammatory diseases of the central nervous system
5
Q
What are the risk factors for Pneumonia?
[Things or conditions that make it likely that you’ll contract pneumonia if and when you get exposed]
A
- If one has Pre-existing illnesses e.g. symptomatic HIV infections increase a child’s risk of contracting pneumonia.
- Environmental factors also increase a child’s susceptibility to pneumonia:
>indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung)
>living in crowded homes
>parental smoking
6
Q
Pneumonia (globally)
A
- An estimated 156 million new episodes each year worldwide, of which 151 million episodes are in the developing world (2)
- Annual new pneumonia cases are concentrated in just five countries where 44% of the world’s children aged less than 5 years live i.e. India (43 million), China (21 million) and Pakistan (10 million), and in Bangladesh, Indonesia, and Nigeria (6 million each) (2)
- Remains the leading infectious cause of death among children under five
- Accounting for approximately 16 percent of the 5.6 million under-five deaths, killing around 880,000 children in 2016
An estimated 53% of deaths occurring in Sub-Saharan Africa
7
Q
Childhood Pneumonia in South Africa.
A
- Under 5 pneumonia admission increased from 39 000/yr. to 53 000/yr. from 2010 t0 2015
- A case fatality (CFR) of 2.3% in 2015/2016
- Highest case fatality rates observed in Eastern Cape, Mpumalanga, and North West provinces
- The more deprived groups of Under-5s showed the highest CFR
- Poorer provinces with poorer outcomes
8
Q
Diarrhoeal Risk Factors
A
- Ingestion of contaminated food
- or drinking water,
- Poor sanitation
- or from person to person as a result of poor hygiene.
- Formula feeding in infection susceptible settings
- Most common contaminants are Rota Virus and E. Coli
9
Q
Diarrhoeal Disease (Globally)
A
- Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year
- The second most common cause of death in childhood
- accounting for approximately 8 percent of all deaths among children under age 5 worldwide in 2016 (UNICEF)
- killing around 525 000 children every year (WHO)
- a symptom of an infection in the intestinal tract
- caused by a variety of bacterial, viral, and parasitic organisms (Awotiwon et.al.)
10
Q
Childhood Diarrhoea in South Africa.
A
- Leading cause of under-5 mortality
- Accounting for approximately 20% of under-five deaths
- There were an estimated 13million cases in 2014 (Chola et.al.)
- mostly due to either bacterial or viral pathogens
- those caused by protozoan pathogens being more frequently seen in people with HIV infection
- A total of 47 758 under-5 cases were admitted in South Africa in 2015 where 1049 (2.2%) died Although the number of admissions had been increasing since 2010, the fatality rate had been declining (from 7.0%)
- Highest fatality rates were observed in the North West, Eastern Cape, Limpopo, Free state and Mpumalanga provinces
- Most socio-economically deprived under-5 had the highest case fatality rates (District Health Barometer 2016)
11
Q
Paediatric Sepsis
A
Definition(2005 International Pediatric Sepsis Consensus Conference criteria):
1. two or more *Systemic Inflammatory Response Syndrome(SIRS) criteria
2. confirmed or suspected invasive infection, and
3. cardiovascular dysfunction, acute respiratory distress syndrome, or two or more organ dysfunctions
*SIRS criteria is at least two of the following:
Fever or hypothermia, tachycardia, tachypnoea and change in blood leucocyte count
12
Q
Severe Paediatric sepsis Globally
A
- Prevalence of 8.2% globally
- African region worst affected with an estimated prevalence of 23%
- 77% of patients have comorbid conditions
- With respiratory conditions being the most common
- Mortality estimated at 24% for patients in PICU and 25% for patients in general hospital wards
- Survival is compromised by the presence of comorbid conditions
13
Q
Severe Paediatric Sepsis in SA.
A
- Neonatal sepsis incidence of 8 – 10% in SA
- Mortality of up o 23%, for early-onset(EOS) neonatal sepsis
- E.coli, Klebsiella spp. and S. Aureus responsible for most cases of early-onset (EOS)
- EOS risk factors: maternal intrapartum infections, low birth weight, low Apgar score, prolonged rupture of membranes >18hrs
- Risk factors late-onset (LOS) – prolonged hospital stay, repeated invasive procedures, deep IV lines, parenteral nutrition, prolonged antibiotics use, and mechanical ventilation
14
Q
Malaria Globally
A
Malaria
- About 3.2 billion people – almost half of the world’s population – are at risk of malaria
- There were216 million malaria cases that led to440,000 deaths in 2016.
- Of these deaths about two thirds (290,000) were children under five years of age
- A daily toll of nearly 800 children under age 5
- Although these numbers show a significant decline with a decline of 34% reported in 2016
- 90% of deaths that occur, occur in Sub-Saharan Africa
15
Q
Malaria causes
A
Human malaria is a parasitic infection caused by four species of the Plasmodium parasite:
Plasmodium falciparum (P. falciparum) Plasmodium malariae (P. malariae) Plasmodium ovale (P. ovale) Plasmodium vivax (P. vivax)
