Paediatric Global Health & HIV in children

Question 1

describe what the definition of Under 5 mortality rate is

Answer 1

probability of a child dying before the age of 5, expressed as deaths per 1000 live births

Question 2

describe the definition of Infant Mortality Rate

Answer 2

probability of a child dying before reaching the age of 1, expressed as deaths per 1000 live births

Question 3

what are the top 5 global causes of child mortality

Answer 3

preterm complications, pneumonia, intrapartum complications, congenital abnormalities, diarrhoea

Question 4

what is an example of a intrapartum complication

Answer 4

birth asphyxia from obstructed labour

Question 5

what simple measures are effective for reducing neonatal deaths (4)

Answer 5

antenatal care, steroids for preterm labour, skilled birth attendant present, antibiotics for sepsis and pneumonia

Question 6

what is involved in antenatal care when talking about reducing neonatal deaths

Answer 6

tetanus vaccine, treatment of maternal infections including HIV, syphilis + malaria

Question 7

what are the first 3 solutions to the most preventable causes of deaths in under 5s
(by WHO)

Answer 7

immediate and exclusive breastfeeding
skilled attendants for antenatal birth and postnatal care
access to nutrition and micronutrients

Question 8

what are the other 3 solutions to the most preventable causes of deaths in under 5s
(by WHO)

Answer 8

family knowledge of danger signs in child health
water, sanitation and hygiene
immunisations

Question 9

what treatment has resulted in 45% decrease in HIV deaths

Answer 9

anti-retroviral therapy(ART)

Question 10

describe what is involved in the prevention of HIV

Answer 10

maternal lifelong ART, screen for and test other STDs(esp herpes), infant prophylaxis for 6 weeks

Question 11

when should a child be tested for HIV if maternal HIV

Answer 11

at birth, 6 weeks, 9 months, 18 months, then 6 weeks after cessation of breastfeeding

Question 12

what recurrent signs are seen in HIV presentation

Answer 12

recurrent; common childhood illness,(eg otitis media), oral candidiasis not responding treatment, severe bacterial infections

Question 13

what are some of the signs that are seen in HIV presentation

Answer 13

failure to thrive/grow, generalised lymphadenopathy or hepatosplenomegaly, persistent fever, encephalopathy, chronic parotitis

Question 14

what diagnostic test for HIV is used in <18 months and >18 months

Answer 14

<18 months = virological PCR for HIV DNA/RNA

>18 months = serological rapid antibody test

Question 15

describe what is involved in the HAART(highly active antiretroviral therapy) HIV treatment for children

Answer 15

2 NRTIs plus 1 NNRTI or protease inhibitor

Question 16

what is a NRTI and give an example

Answer 16

nucleoside reverse transcriptase inhibitors

example = abacavir

Question 17

what is an NNRTI and give an example

Answer 17

non-nucleotide reverse transcriptase inhibitor

example = efavirenz

Question 18

what treatment is given as prophylaxis for HIV in children

Answer 18

co-trimoxazole and routine vaccines