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child health > global health paediatrics > Flashcards

global health paediatrics Flashcards

1
Q

what is the under 5 mortality rate?

A

-probability of a child dying before reaching age of 5

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2
Q

what is infant mortality rate?

A

-probability of a child dying before reaching the age of 1

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3
Q

what is a live birth?

A

-any sign of life after birth irrespective of gestation

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4
Q

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

A
  • preterm birth complications
  • pneumonia
  • intrapartum related complications
  • congenital abnormalities
  • diarrhoea
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5
Q

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

A
  • diarrhoea
  • pneumonia
  • malaria
  • preterm birth complications
  • intrapartum related complications
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6
Q

what causes pneumonia?

A
  • strep pneumoniae
  • haemophilus influenza
  • RSV
  • pneumocystis jiroveci (PCP)
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7
Q

what increases risk of getting pneumonia?

A
  • malnutrition
  • over crowded
  • indoor air population
  • parental smoking
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8
Q

what prevents pneumonia?

A
  • vaccinations
  • breastfeeding then complimentary nutrition
  • good hygiene
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9
Q

what is one of the most common causes of diarrhoea in developing countries?

A

faeces contained water

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10
Q

what does diarrhoea cuse?

A
  • malnutrition

- malnourished children

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11
Q

how can diarrhoea be prevented?

A
  • safe drinking water
  • good hygiene
  • sanitation
  • breastfeeding and good nutrition
  • vaccination
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12
Q

what is treatment for diarrhoea?

A

-oral rehydration solution (ORS)

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13
Q

what are 6 solutions to the most preventable causes of under 5 deaths?

A
  1. Immediate and exclusive breastfeeding
  2. Skilled attendants for antenatal, birth and postnatal care
  3. Access to nutrition and micronutrients
  4. Family knowledge of danger signs in a child’s health
  5. Water, sanitation and hygiene
  6. Immunisations
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14
Q

can HIV be transferred from mother to child?

A

yes

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15
Q

how can HIV be transmitted from mother to child?

A
  • pregnancy
  • delivery
  • breastfeeding
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16
Q

how is maternal to child transmission of HIV prevented?

A
  • maternal lifelong antiretroviral treatment
  • screen for and treat other STDs
  • infant prophylaxis for 6 weeks

test child at birth, 6 weeks of age, 9 months, 18 months and then 6 weeks after cessation of breastfeeding

17
Q

how does HIV present in a baby?

A
  • recurrent of severe common childhood illnesses
  • recurrent orl candidiasis not responding to treatment
  • recurrent severe bacterial infections (e.g. meningitis)
  • failure to thrive or growth failure
  • generalised lymphadenopathy, hepatosplenomegly
  • persistent fever
  • encephalopthy
  • chronic parotitis
  • PJP Kaposi sarcoma, TB, lymphocytic interstitial pneumonia…
18
Q

who do you offer HIV counselling and testing to?

A
  • all in countries with generalised HIV epidemics
  • all exposed infants at birth
  • any infant child with ant suspicion of HIV
19
Q

what is the diagnostic test for HIV for a neonate of <18 months?

A

-virological PCR for HIV DNA or RNA

20
Q

what is the diagnostic test for HIV for a neonate of >18 months?

A

-serology rapid antibody test

21
Q

what does staging do?

A

-determines the degree of damage the illness has done to your immune system (there are stage 1-4)

22
Q

why is serology test for HIV in a baby <18 months unreliable?

A

-due to maternal antibodies if. mother is breastfeeding

23
Q

what is HIV treatment in neonates?

A 
HAART (highly active antiretroviral therapy):
2 NRTIs (abacavir and lamivudine) plus one NNRTI (efavirenz for >3 years old) or protease inhibitor (kaletra for <3years)
24
Q

how does TB present?

A
  • chronic cough or fever >2 weeks
  • night sweats
  • weight loss
  • lymphadenopathy
25
Q

True or false

Most children infected with M. tubercolosis develop TB

A

False- most do not develop TB

26
Q

what are investigations for TB?

A
  • acid fast bacili
  • interferon gamma release assays
  • chest Xray
  • mantoux
27
Q

what test for TB is not used in under 5 years old?

A

interferon gamma release assay

28
Q

what is the treatment for TB?

A

two months of: Isoniazid, Rifampicin, Pyrazinamide +/- Ethambutol (RIPE)

4 monnths of: Rifampicin and Isoniazid (RI)

29
Q

what causes malaria?

A

Plasmodium parasite from females anopheles mosquite

30
Q

which is the most severe type of malaria and why?

A

P, falciparum

it crosses the BBB and can rapidly progress to severe cerebral malaria, seizure and coma

31
Q

how does malaria present?

A
  • fever
  • pallor
  • non specific malaise
32
Q

what is treatment for malaria?

A
  • artemisinin-based combination therapy (ACT) for 3 days
  • severe malaria treat with IM or IV artesunate until can tolerate oral
  • in high transmission areas give preventative treatment to all infants alongside routing vaccines (lon lasting insecticidal nests and/or pilot projects for malaria vaccine)
33
Q

what causes malnutrition?

A
  • lack of access
  • poor feeding practice
  • infection
34
Q

how may a child with severe acute malnutrition present?

A

mid-arm circumference <115mm

Weight for height

35
Q

how is malnutrition treated?

A

involves 10 steps in 2 phases: initial stabilisation and rehabilitation

child health (28 decks)

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