Global child health Flashcards
Define child (<5) mortality rate
Probability of a child born in a specific year or period dying before reaching the age of 5
Define infant mortality rate
Probability of a child born in a specific year or period dying before reaching the age of 1
Define live birth
Any sign of life after birth irrespective of gestation
What are the top 5 causes of infant death globally ?
- Preterm (premature birth) birth complications
- Pneumonia
- Intrapartum-related (the period from the onset of labor to the end of the third stage of labor) complications
- Diarrhoea
- Congenital abnormalities
What are the top 5 causes of infant mortality in sub-saharan africa
- Pneumonia
- Preterm birth complications
- Intrapartum-related complications
- Diarrhoea
- Malaria
What is the main point about the difference in child deaths between sub-saharan africa and Europe ?
That children in sub-saharan Africa are 14x’s more likely to die before 5 than in Europe and more than half of these deaths are preventable
How many of all child deaths are linked to under nutrition ?
45%
Define what is meant by a still born baby?
A stillbirth is a baby born dead after 24 completed weeks of pregnancy.
If the baby dies before 24 completed weeks, it’s known as a miscarriage or late foetal loss.
What is the prevention and treatment method for pneumonia in kids ?
Prevention:
- Vaccinations
- Breastfeeding then complimentary nutrition
- Good hygiene
Treatment:
- Adequate access to community health or hospital
What is the treatment and prevention for diarrhoea in kids ?
Due to it mainly caused by contaminated water and food prevention follows:
Prevention:
- Safe drinking water, good hygiene and sanitation
- Breastfeeding and good nutrition
- Vaccination
Treatment:
- Oral rehydration solution (ORS)
- Zinc supplements
What are WHO’s 6 solutions to preventable deaths under 5yrs old ?
- Immediate and exclusive breastfeeding
- Skilled attendants for antenatal, birth, and postnatal care
- Access to nutrition and micronutrients
- Family knowledge of danger signs in a child’s health
- Water, sanitation, and hygiene
- Immunizations
How is HIV trasmitted to kids ?
- Pregnancy
- Delivery
- Breastfeeding
What are the prevention methods to try to prevent spread of HIV to infants ?
- Maternal (mother) lifelong antiretroviral treatment
- Screen for and treat other STDs, especially herpes
- Infant prophylaxis for 6 weeks or throughout breastfeeding
Describe the presentation of HIV in infants
- Recurrent or severe common childhood illnesses eg otitis media, diarrhoea
- Recurrent oral candidiasis not responding to treatment
- Recurrent severe bacterial infections eg meningitis
- Failure to thrive or growth failure
- Generalised lymphadenopathy, hepatosplenomegaly
- Persistent fever
- Encephalopathy
- Chronic parotitis
- PCP, Kaposi sarcoma, TB, lymphocytic interstitial pneumonia….
How is HIV diagnosed in kids <18months old?
virological PCR for HIV DNA or RNA
How is HIV diagnosed in kids >18 months old?
serological rapid antibody test
Describe the treatment of HIV
HAART: Two NRTIs plus one NNRTI or protease inhibitor
◦Nucleoside reverse transcriptase inhibitors (NRTI) eg abacavir and lamivudine
◦Non-nucleoside reverse transcriptase inhibitors(NNRTI) eg efavirenz for >3yr olds
◦Protease inhibitor eg kaletra for <3yr olds
Also give Co-trimoxazole prophylaxis and routine vaccinations
Describe the presentation of TB
- Chronic cough or fever >2 weeks
- night sweats
- weight loss
- lymphadenopathy
- Associated with HIV
Describe the treatment of TB
Treatment:
◦Two months of : Isoniazid, Rifampicin, Pyrazinamide +/- Ethambutol (RIPE)
◦Then four months of isoniazid and rifampicin
How is TB prevented ?
Give BCG vaccination
Why should you not give the BCG vaccination to someone with HIV ?
It can cause BCG disseminated disease. i.e. giving a live virus will result in it spreading due to the immunodeficiency caused by HIV
What is the presentation of malaria ?
- Fever
- Pallor (unhealthy pale)
- Non-specific malasie (discomfort/illness)
What is the treatment of malaria ?
- Treatment with artemisinin-based combination therapy (ACT) for 3 days
- Severe malaria treat with IM or IV artesunate until can tolerate oral
What are some of the non-health factors influencing child health?
- War and conflict
- Maternal education (Secondary school education decreases chance of child dying by two thirds)
