Week 1 - I - Paediatric global health Flashcards
Define infant mortality rate?
Probability of a child born in a specific year or period dying before the age of 1
Define child mortality rate?
Under 5 mortality rate - Probability of a child born in a specific year or period dying before the age of 5
What are the top 5 causes of under 5 years old morality?
- Preterm birth complications
- Pneumonia
- Intrapartum-related complications
- Diarrhoea
- Congenital abnormalities
What are 45% of all child deaths in the world linked to?
45% linked to malnutrition
What causes of pneumonia do we vaccinate against?
We vaccinate against pneumococcal, measles, Haemophilus influenza b
malnutrition, and malnourished children are more likely to fall ill from diarrhoea What is a major cause of diarrhoea?
Mostly caused by contaminated water and food sources
What is the treatment of diarrhoea in children?
Oral rehydration solution
Zinc supplements
What is the function of zinc in the body? What senses require zinc?
Needed for the body’s immune system to work properly
Plays a role in cell growth, cell division and wound healing
Also required for the sense of taste and smell
What does Oral rehydration solution (ORS) contain and how does it work?(where is it absorbed) (what transport system)
Contains water + modest amounts of sugar and salt
It is instantly absorbed into the jejunum into the blood and works via the sodium glucose transporter system (SGLT1)
This causes the osmotic pull of water to drive water from the jejunum into the bloodstream
Recap What are the 5most common of under 5 deaths?
Preterm birth complications
Pneumonia
Intrapartum-related complications
Diarrhoea
COngenital abnormalities
- 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
What is this list?
WHO’s six solutions to the most preventable causes of under 5deaths
What is the most common way for a child to get human immunodeficiecny virus?
Mother to infant transmission
What percentage of children will die before 5 years of age if having HIV?
Around 80%
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 What are these signs of in a child/baby/infant?
HIV
What pnemonia is found in patients with HIV?
Pneumocystis pneumonia (PCP)
How are patients with Pneumocystis pneumonia (PCP) treated?
Treated with co-trimoxazole
What cancer can form due to HIV?
Kapos’s sarcoma (HHV8 (human herpes virus 8) )
What other disease is Human herpes virus 8 associated with?
Associated with glandular fever (Epstein Barr virus)
How is HIV diagnosed at less than and greater than 18months of age?
Less than 18 months - virological PCR for HIV DNA or RNA
More than 18months - serological rapid antibody test (ELISA test - enzyme linked immunosorbent assay test)
HIV treatment involves Two NRTIs plus one NNRTI or protease inhibitor What do the acronyms stand for?
Nucleoside reverse transciptase inhibitors
Non-nucleoside reverse transcriptase inhbitors
What is HAART when regarding HIV therapy?
Highly active antiretroviral therapy (HAART)
Involves 2NRTI + 1NNRTI or a protease inhibitor
Can a BCG vaccine be given to a person with HIV?
No as this can causes widespread dissemination of the BCG
What does widespread dissemination of BG show on x-ray?
Miliary nodules in the lungs
How does TB present?
Chronic cough +/- haemoptysis
fever for greater than 2 weeks
Night sweats
Weight loss
How is TB diagnosed?
Acid-fast bacilli test - low yield in chidlren
How is TB treated?
2 months RIPE - rifampicin, isoniazid, pyrazinamide, ethambutol
4 months rifampicin and isoniazid
What bacteria causes TB?
Mycobacterium tuberculosis
What does plasmodium falciparum cause?
Generally, the most dangerous form of malaria is caused by Plasmodium falciparum.
One reason why this species of malaria is so dangerous is that is replicates very quickly in the blood
What is the current recommended treatment of malaria?
Artemisinin-based combination therapy for 3 days (ACT)
What is the treatment of HIV, TB and Malaria?
HIV - Highly active Antiretroviral therapy (HAART) (2NRTI + 1NNRTI or protease inhibitor)
TB - 2RIPE 4 RI
Malaria - artemisinin-based combination therapy (ACT)
