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Child Health > Global Child Health > Flashcards

Global Child Health Flashcards

1
Q

what is infant mortality rate?

A

probability of a child born in a specific year dying before age of 1
expressed per 1000 live births

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2
Q

what is neonatal mortality rate?

A

probability of a child dying before age of 1 month

expressed per 1000 live births

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3
Q

what is a live birth?

A

ant sign of life after birth irrespective of gestation

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4
Q

what are the top 5 causes of under 5 mortality globally?

A 
preterm birth complications
pneumonia
intrapartum-related complications
diarrhoea
neonatal sepsis
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5
Q

what are the top 5 causes of death under 5 in Africa?

A 
diarrhoea
pneumonia
malaria
preterm birth complicaitons
intrapartum-related complications
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6
Q

give 2 aspects of antenatal care which can be effective in preventing newborn deaths

A

tetanus vaccine

treatment of maternal infections including HIV and syphilis

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7
Q

how can newborns be protected at birth?

A 
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
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8
Q

give 6 sustainable solutions for neonatal intensive care

A

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

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9
Q

what are the risk factors for pneumonia in the under 5s?

A

malnutrition
over-crowding
indoor air pollution
parental smoking

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10
Q

how can pneumonia be prevented in under 5s?

A

vaccinations (pneumococcal vaccine)
breastfeeding then complimentary nutrition
good hygeine

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11
Q

how can pneumonia be treated in under 5s?

A

adequate access to community health or hospital

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12
Q

what causes diarrhoea across the world in children?

A

mostly contaminated water and food sources

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13
Q

how can diarrhoea be prevented and treated in children?

A

safe drinking water, good hygiene and sanitation
breastfeeding and nutrition
vaccination
treatment = oral rehydration solution (ORS) and zinc supplements

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14
Q

what is ORS?

A 
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
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15
Q

what is the impact of HIV in children?

A 
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"
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16
Q

how is HIV transmitted from mother to child?

A 
15-45% of children to infected mothers are infected
transmitted during
- pregnancy
- delivery
- breastfeeding
17
Q

how can mother to child transmission of HIV be prevented?

A

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

18
Q

how can HIV present in children?

A

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

19
Q

diagnostic test for HIV in <18 months?

A

virological PCR for HIV DNA or RNA

20
Q

diagnostic test for HIV in >18 months?

A

serological rapid antibody test

21
Q

how is HIV staged in children?

A

clinical staging 1-4
immunological staging: CD4 count
virological staging: viral load

22
Q

how is HIV managed in children?

A

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
23
Q

what are 2 complications of HIV treatment?

A

compliance and side effects

immune reconstitution inflammatory syndrome (IRIS): NSAIDs

24
Q

how can HIV be treated?

A

co-trimoxazole

routine vaccinations

25
Q

how does TB present in children?

A

chronic cough or fever >2 weeks
night sweats
weight loss
lymphadenopathy

26
Q

what are the risk factors for TB?

A

HIV
malnutrition
household contact

27
Q

how is TB investigated?

A

acid fast bacilli (not great in children)
Inferferon gamma release assays
CXR
Mantoux

28
Q

how is TB treated?

A

2 months RIPE
4 months RI
loner if TB meningitis, spinal or osteo-articular disease

29
Q

how can TB be prevented?

A

BCG vaccine

pre and post exposure isoniazid

30
Q

what causes malaria?

A

plasmodium parasite from female anopheles mosquito

31
Q

what can malaria cause?

A 
fever
pallor
non-specific malaise
cerebral malaria
seizures
coma
32
Q

how is malaria diagnosed?

A

blood film for microscopy

rapid diagnostic test

33
Q

how can malaria be prevented?

A

artemisinin based combination therapy (ACT) for 3 days

if severe - IM or IV artesunate until can tolerate oral

34
Q

how can malaria be prevented?

A

long lasting insecticidal nets (LLINs)

Pilot projects for malaria vaccine

35
Q

how doe severe acute malnutrition present?

A

mid arm circumference <115mm
weight for height < -3SD
oedema of both feet

36
Q

how can malnutrition be managed if good appetite and no complications?

A 
investigate cause
vit A
De-worming
ready to use therapeutic food (RUTF)
make sure vaccinated
37
Q

which 4 non-communicable diseases are responsible for the majority of diseases?

A

cardiovascular diseases
cancers
diabetes
chronic respiratory diseases

38
Q

what 4 behavioural risk factors cause deaths in adults?

A

tobacco
alcohol
lack of exercise
unhealthy diet/obesity

39
Q

where is epilepsy most common and which type is more common, primary or secondary?

A

most cases in low and middle-income countries

secondary more common

Child Health (19 decks)

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