Global Child Health Flashcards
what is infant mortality rate?
probability of a child born in a specific year dying before age of 1
expressed per 1000 live births
what is neonatal mortality rate?
probability of a child dying before age of 1 month
expressed per 1000 live births
what is a live birth?
ant sign of life after birth irrespective of gestation
what are the top 5 causes of under 5 mortality globally?
preterm birth complications pneumonia intrapartum-related complications diarrhoea neonatal sepsis
what are the top 5 causes of death under 5 in Africa?
diarrhoea pneumonia malaria preterm birth complicaitons intrapartum-related complications
give 2 aspects of antenatal care which can be effective in preventing newborn deaths
tetanus vaccine
treatment of maternal infections including HIV and syphilis
how can newborns be protected at birth?
steroids for pre-term labour provide clean delivery dry baby and keep warm resuscitate asphyxiated babies recognise warning signs for referral antibiotics for sepsis and pneumonia
give 6 sustainable solutions for neonatal intensive care
hygiene including homemade hand gel for cleaning
DIY resuscitare - light, heater, clock, drawers
kangaroo care
“hot rooms”
establish breastfeeding/nasogastric expressed breastmilk if possible
bubble CPAP
what are the risk factors for pneumonia in the under 5s?
malnutrition
over-crowding
indoor air pollution
parental smoking
how can pneumonia be prevented in under 5s?
vaccinations (pneumococcal vaccine)
breastfeeding then complimentary nutrition
good hygeine
how can pneumonia be treated in under 5s?
adequate access to community health or hospital
what causes diarrhoea across the world in children?
mostly contaminated water and food sources
how can diarrhoea be prevented and treated in children?
safe drinking water, good hygiene and sanitation
breastfeeding and nutrition
vaccination
treatment = oral rehydration solution (ORS) and zinc supplements
what is ORS?
oral rehydration solution sodium glucose co-transport system creates osmotic pull for water which is instantly absorbed into jejunum avoiding most of the intestine cheap for mild and moderate dehydration avoids IV fluids
what is the impact of HIV in children?
90% in sub-Saharan Africa 90% transferred from mother to child 25-30 die before age of 1 50-60% die before 3-5 years 5-25% live beyond 8 years - "long term survivors"
how is HIV transmitted from mother to child?
15-45% of children to infected mothers are infected transmitted during - pregnancy - delivery - breastfeeding
how can mother to child transmission of HIV be prevented?
maternal lifelong antiretroviral treatment
screen for and treat other STDs, esp herpes
infant prophylaxis for 6 weeks
test child at birth, 6 weeks old, 9 months, 18 months, then 6 weeks after cessation of breastfeeding
how can HIV present in children?
recurrent/severe common childhood illnesses
recurrent oral candidiasis not responding to treatment
recurrent severe bacterial infections
failure to thrive or growth failure
generalised lymphadenopathy, hepatosplenomegaly
persistent fever
encephalopathy
chronic parotits
PJP, Kaposi sarcoma, TB, lymphocytic intestinal pneumonia
diagnostic test for HIV in <18 months?
virological PCR for HIV DNA or RNA
diagnostic test for HIV in >18 months?
serological rapid antibody test
how is HIV staged in children?
clinical staging 1-4
immunological staging: CD4 count
virological staging: viral load
how is HIV managed in children?
HAART: two NRTIs plus one NNRTI or protease inhibitor
- nucleoside reverse transcriptase inhibitors
- non-nucleoside reverse transcriptase inhibitors for >3 y/o
- protease inhibitor for <3 y/o
what are 2 complications of HIV treatment?
compliance and side effects
immune reconstitution inflammatory syndrome (IRIS): NSAIDs
how can HIV be treated?
co-trimoxazole
routine vaccinations
