Global child health Flashcards

1
Q

Define child (<5) mortality rate

A

Probability of a child born in a specific year or period dying before reaching the age of 5

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2
Q

Define infant mortality rate

A

Probability of a child born in a specific year or period dying before reaching the age of 1

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3
Q

Define live birth

A

Any sign of life after birth irrespective of gestation

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4
Q

What are the top 5 causes of infant death globally ?

A
  • Preterm (premature birth) birth complications
  • Pneumonia
  • Intrapartum-related (the period from the onset of labor to the end of the third stage of labor) complications
  • Diarrhoea
  • Congenital abnormalities
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5
Q

What are the top 5 causes of infant mortality in sub-saharan africa

A
  • Pneumonia
  • Preterm birth complications
  • Intrapartum-related complications
  • Diarrhoea
  • Malaria
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6
Q

What is the main point about the difference in child deaths between sub-saharan africa and Europe ?

A

That children in sub-saharan Africa are 14x’s more likely to die before 5 than in Europe and more than half of these deaths are preventable

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7
Q

How many of all child deaths are linked to under nutrition ?

A

45%

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8
Q

Define what is meant by a still born baby?

A

A stillbirth is a baby born dead after 24 completed weeks of pregnancy.

If the baby dies before 24 completed weeks, it’s known as a miscarriage or late foetal loss.

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9
Q

What is the prevention and treatment method for pneumonia in kids ?

A

Prevention:

  • Vaccinations
  • Breastfeeding then complimentary nutrition
  • Good hygiene

Treatment:

  • Adequate access to community health or hospital
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10
Q

What is the treatment and prevention for diarrhoea in kids ?

A

Due to it mainly caused by contaminated water and food prevention follows:

Prevention:

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

Treatment:

  • Oral rehydration solution (ORS)
  • Zinc supplements
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11
Q

What are WHO’s 6 solutions to preventable deaths under 5yrs old ?

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. Immunizations
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12
Q

How is HIV trasmitted to kids ?

A
  • Pregnancy
  • Delivery
  • Breastfeeding
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13
Q

What are the prevention methods to try to prevent spread of HIV to infants ?

A
  • Maternal (mother) lifelong antiretroviral treatment
  • Screen for and treat other STDs, especially herpes
  • Infant prophylaxis for 6 weeks or throughout breastfeeding
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14
Q

Describe the presentation of HIV in infants

A
  • 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
  • PCP, Kaposi sarcoma, TB, lymphocytic interstitial pneumonia….
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15
Q

How is HIV diagnosed in kids <18months old?

A

virological PCR for HIV DNA or RNA

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16
Q

How is HIV diagnosed in kids >18 months old?

A

serological rapid antibody test

17
Q

Describe the treatment of HIV

A

HAART: Two NRTIs plus one NNRTI or protease inhibitor

◦Nucleoside reverse transcriptase inhibitors (NRTI) eg abacavir and lamivudine

◦Non-nucleoside reverse transcriptase inhibitors(NNRTI) eg efavirenz for >3yr olds

◦Protease inhibitor eg kaletra for <3yr olds

Also give Co-trimoxazole prophylaxis and routine vaccinations

18
Q

Describe the presentation of TB

A
  • Chronic cough or fever >2 weeks
  • night sweats
  • weight loss
  • lymphadenopathy
  • Associated with HIV
19
Q

Describe the treatment of TB

A

Treatment:

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

◦Then four months of isoniazid and rifampicin

20
Q

How is TB prevented ?

A

Give BCG vaccination

21
Q

Why should you not give the BCG vaccination to someone with HIV ?

A

It can cause BCG disseminated disease. i.e. giving a live virus will result in it spreading due to the immunodeficiency caused by HIV

22
Q

What is the presentation of malaria ?

A
  • Fever
  • Pallor (unhealthy pale)
  • Non-specific malasie (discomfort/illness)
23
Q

What is the treatment of malaria ?

A
  • Treatment with artemisinin-based combination therapy (ACT) for 3 days
  • Severe malaria treat with IM or IV artesunate until can tolerate oral
24
Q

What are some of the non-health factors influencing child health?

A
  • War and conflict
  • Maternal education (Secondary school education decreases chance of child dying by two thirds)