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Paediatric global health Flashcards

Definition of infant and child mortality rate Top 5 causes of child mortality (11j) World Health Organization’s 6 solutions to preventable deaths (10e, 11e, 11h) HIV: prevention, presentation, diagnosis and treatment (8c,e) Non-health factors influencing child health (10e, 11a)

1
Q

How is the probability of death expressed as?

A

As per 1000 live births and doesnt include still births

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2
Q

What do the red countries signify?

A

probablity of dying before the age of 5 is 1/5

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3
Q

top 5 causes of under 5 mortality globally

A 
Preterm birth complications
Pneumonia
Intrapartum-related complications
Diarrhoea
Neonatal sepsis
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4
Q

What are causes of under 5 mortality in africa?

A 
Diarrhoea
Pneumonia
Malaria
Preterm birth complications
Intrapartum-related complications
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5
Q

How common in pneumonia in causing deaths?

A

kills more than AIDS, measles, meningitis, pertussis and tetanus combined

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6
Q

has the global under 5 mortality increased or decreased?

A

decreased

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7
Q

Why do 2.7 million of babies die every year in their first month?

A

mpst still born
1st 24 hours –> most dangerous as either they aren’t delivered properly
in sout-east asia and sub-saharan africa

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8
Q

Do tetanus affect men or women?

A

Men more as women usually vaccinated

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9
Q

How to prevent neonatal syphilis attacks during death?

A

give them a dose of penicillin during pregnancy

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10
Q

If the baby is born premature what is given?

A

steroid to help development the resp system

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11
Q

What do you do if the babies is born not crying, not breathing and blue?

A

dont leave them like that, stimulate the baby and rub them -> baby will cry
use a bag and mask to stimulate the baby –> basic resuscitation device

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12
Q

What is the best option for regulating temperature when no incubators are presnt?

A

Kangaroo care best

  • keeps the temperature warm
  • stabilises the heart rate
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13
Q

How is bubble cpap?u

A

sing pumps and a tank of water - resp support

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14
Q

What can you do if there are no incubatal units?

A

“hot rooms” use heaters to incraese the heat of the room in which the baby is kept

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15
Q

35% of premature babies

A

born after 36 weeks

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16
Q

how to manage good feeding to the children?

A

Establish breastfeeding/nasogastric expressed breastmilk if possible

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17
Q

half of the kids who have aids die from what?

A

PCP/ PJP

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18
Q

What are the risk factors for pneumonia?

A

Malnutrition
Over-crowding
Indoor air pollution
Parental smoking

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19
Q

What leads to an increased risk of bronchiolitis in kids?

A

Parental smoking

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20
Q

What prevents the kids from pneumonia?

A

Vaccinations
Breastfeeding then complimentary nutrition
Good hygiene

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21
Q

how to treat pneumonia?

A

Adequate access to community health or hospital

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22
Q

What causes kids to die from diarrhoea?

A

due to faecdes-contaminated water

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23
Q

How to prevent diarrhoea in kids?

A

Safe drinking water, good hygiene and sanitation
Breastfeeding and good nutrition
Vaccination

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24
Q

Why is Zn important in treating diarrhoea?

A

Zn - helps immunity and helps to transport water across the intestine

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25
How to treat diarrhoea?
ORS | Zn supplements
26
what is the importance fo ORS?
Sodium Glucose Co-transport System Creates osmotic pull for water Instantly absorbed in jejunum avoiding most of intestine For mild and moderate dehydration avoids IV fluids Only costs pennies
27
What are the 6 solutions to prevent the preventable causes of under 5 deaths?
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. Immunizations
28
What is the sustanaible development goal 3 by un?
Ensure healthy lives and promote well-being for all at all ages by 2030 Target 3.2: End preventable deaths of newborns and children under 5 years of age Target 3.3: End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases Target 2.2: End all forms of malnutrition Target 3.4: Reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
29
Where is the majority of children affected by AIDS (antenataly/ at birth/ breatfeeding)?
Sub-saharan africa
30
if the kids are affected by aids at birth, what are their mortality rates?
25-30% die before first birthday 50-60% die aged 3-5 years 5-25% live beyond 8 years: “long-term survivors”
31
What has helped to decrease the deaths of children due to AIDS?
Anti-retroviral therapy
32
If a mom is positive what do you do?
prophylxis for6 months
33
when do you keep hcecking that the baby is positive or not | ?
Test child at birth, 6 weeks of age, 9 months, 18 months then 6 weeks after cessation of breastfeeding.
34
How does HIV usually present as?
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 PJP, Kaposi sarcoma, TB, lymphocytic interstitial pneumonia….
35
which babies should be offered cousneling/ treating>
ALL in countries with generalized HIV epidemics (prevalence over 1% in pregnant women) ALL exposed infants at birth Any infant child with any suspicion of HIV
36
What are the diagnostic tests to check HIV in babies?
<18 months of age: virological PCR for HIV DNA or RNA | >18 months: serological rapid antibody test
37
What are the clinical stagings of HIV?
Clinical staging 1-4 Immunological staging: CD4 count ** Virological staging: viral load ** - number of viruses detectable in the body
38
which testing is the fastes?
Rapid antibody test
39
Who all should be given HIV treatment?
ALL children living with HIV, regardless of WHO clinical stage or at any CD4 cell count.
40
What happens oif a kid has a tb and HIV?
treat Tb for 2 weeks before starting HIV
41
what is the routine prophylaxis for tb in those with hIV?
co-trimoxazole
42
risk factors for tb
HIV, malnutrition, household contact
43
how can you test for HIV?
``` adults - acid fast bacilli kids - AFC low yield hence not useful IFG release assays (not useful as it cant tell the diff btw latent and active and in africa most have latent) chest x-ray mantoux ```
44
What are the treatments for tb?
Two months of : Isoniazid, Rifampicin, Pyrazinamide +/- Ethambutol Then four months of isoniazid and rifampicin
45
Would you give BCG vaccine in kis with HIV?
no
46
mosrt serious form of malaria caused by which organim?
P.Falciparun crosses BBB and causes serious seizures
47
other causes of organism?
P.ovale, P.vivax, P. malariae
48
What are the rapid malaria test?
best to check if malaria is there or not
49
What if a person comes from malaria endemic areas with fever?
check and treatment
50
what are the treatments for malaria?
Treatment with artemisinin-based combination therapy (ACT) for 3 days Severe malaria treat with IM or IV artesunate until can tolerate oral
51
What is the cause of most child deaths globally? (45%)
malnutrition
52
What are the causes of malnutrition?
Lack of access Poor feeding practices Infection
53
What are the causes of malnutrition?
older siblings prioritised
54
Is kwashiorkar and marasmus distinguished?
no, as the treatment for the both is the same kwashiorkar - protein-loss in diet
55
How do you diagnose severe acute malnutrition?
Mid-arm circumference <115mm | Weight for height
56
How do you treat malnutrition?
10-step plan 1. give them sugar (hypoglycaemia) 2. give antibiotics (if they come in with hypothermia as they are cold and have hypoglycaemia) 3. Rehydrate orally and slowly - every 2 hrs or so, IV - only if the child in shocl Don't give too much fluid at the same time (as too much fluid can cause heart failure) 4. Electrolytes (breast feeding) 5. sensory stimulation 6. prepare for follow up 7. micronutrients 8
57
how do you test malnutrition?
Good appetite or not, and if no complication - manage as OP ``` Investigate cause Vitamin A De-worm Ready to use therapeutc food (RUTF) – peanut butter, dried milk, vitamins & minerals Make sure vaccinated ```
58
What are the 4 major non-communicable diseases that cause the majority of the deaths?
Cardiovascular diseases Cancers Diabetes Chronic respiratory diseases
59
What are the 4 behavioural risk factors?
Tobacco use Harmful use of alcohol Insufficient physical activity Unhealthy diet/obesity
60
What are the causes of seconary epilepsy?
malaria, road traffic accidents, meningitis, birth asphysia etc
61
What is the importance of treatment in epilepsy?
70% respond to the treatment (but most dont have it)
62
Which country did polio resurface in are 14 years with no cases?
Syria (as immunication decreased by 43%)
63
Which areas have the highest newborn mortality rates?
Areas affected by humanitarian emergencies
64
What is a major determinant of child health and prevents child death by 2/3rds?
secondary school education for moms
65
What is the average weight of a newborn born in the UK?
3.4 kg
66
What is meant by under 5 mortality rate?
Probability of a child born at a specific period or year dying before reaching the age of 5/ 1000 live births per year.
67
What is meant by the infant mortality rate?
Probability of a child born in a specific year or period dying before reaching the age of 1/ 1000 live births per year.
68
What is meant by the neonatal mortality rate?
Probability of a child born in a specifc year or age dying before reaching the age of 1 month/ 1000 live births per year.
69
What is a leading indicator of the level of child health and the overall development in a country?
Under 5 mortality rate
70
What is the most common cause for child death?
malnutrition

Child Health (13 decks)

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