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Child Health > Global Child Health > Flashcards

Global Child Health Flashcards

1
Q

What terms are now to be used instead of “developing” or “third world” countries?

A

Low/middle/ income countries

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2
Q

What is meant by the “infant mortality rate”?

A

Number of children dying before the age of 1 year

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3
Q

What is the neonatal mortality rate?

A

Number of children dying before 1 month of age

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4
Q

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

A
  • Preterm birth complications
  • Pneumonia
  • Intrapartum-related complications
  • Diarrhoea
  • Neonatal sepsis
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5
Q

What are the top 5 causes of under 5 mortality in africa?

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

European infant mortality is mainly due to neonatal causes. TRUE/FALSE?

A

TRUE

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7
Q

Why is there a smaller percentage of neonatal mortality in africa compared to europe?

A

There are more communicable diseases in africa, therefore children are more likely to die of infection

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8
Q

What simple measures can be put in place for newborns in order to minimise neonatal deaths?

A

Antenatal care for mother
=>Tetanus vaccine
=> Tx of infections including HIV & syphilis

Steroids for preterm labour (to aid baby’s lungs)

Skilled birth attendant present

Antibiotics for sepsis and pneumonia

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9
Q

How do low income countries in Africa provide services such as an NICU?

A
  • homemade hand gel
  • DIY resuscitare
  • Kangaroo care (held close to mother)
  • “Hot rooms”
  • potential NG tube for breastmilk
  • Bubble CPAP (for infant resp. distress syndrome)
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10
Q

What are the benefits of “Kangaroo care” from the mother?

A

Regulates baby’s RR as they can feel the mother breathe

Synchronises mother and baby’s HR

Regulates temperature of the baby

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11
Q

What are the main causes of pneumonia in low income countries

A

Strep pneumoniae
Haemophilus influenza
RSV
Pneumocystis jiroveci

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12
Q

What pneumonia is most prevalent in HIV infected infants

A

Pneumocystis jiroveci

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13
Q

What are the main causes of pneumonia in low income countries?

A

Malnutrition
Over-crowding
Indoor air pollution
Parental smoking

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14
Q

How is diarrhoea prevented in low income countries?

A
  • Safe drinking water
  • good hygiene and sanitation
  • Breastfeeding and good nutrition
  • Vaccination
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15
Q

What can be used to treat diarrhoea in low income countries

A 
Oral rehydration solution (ORS)
Zinc supplements (aid water transport across intestine)
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16
Q

How can HIV be transmitted from mother to child?

A

Transmitted during:
Pregnancy
Delivery
Breastfeeding

17
Q

How can HIV transmission from mother to child be prevented?

A
  • Maternal lifelong antiretroviral treatment
  • Screen for and treat other STDs, especially herpes
  • Infant prophylaxis for 6 weeks
18
Q

What diagnostic tests can be used for children with suspected HIV infection?

A

<18 months of age: virological PCR for HIV DNA or RNA

> 18 months: serological rapid antibody test

19
Q

What is used to stage HIV?

A

Viral Load

20
Q

What treatment did WHO recommend for ALL children living with HIV, regardless of their clinical staging?

A

2 NRTIs + one NRTI OR protease inhibitor

NRTI = Nucleoside reverse transcriptase inhibitors
eg abacavir and lamivudine

NNRTI = Non-nucleoside reverse transcriptase inhibitors eg efavirenz for >3yr olds

Protease inhibitor eg kaletra for <3yr olds

21
Q

How does TB usually present in children?

A

Chronic cough or fever >2 weeks
night sweats
weight loss
lymphadenopathy

22
Q

What risk factors can increase a child’s chance of TB infection?

A

HIV
malnutrition
household contact

23
Q

What investigations can be used if TB is suspected in children?

A

Acid-fast bacilli (**BUT low yield in children)

Interferon-Gamma Release Assays (can pick up latent TB which is common)

Chest Xray (for intrathoracic lymph node enlargement)

Mantoux (difficult if child has had BCG vaccine)

24
Q

The BCG vaccination cant be given to children who are HIV positive. TRUE/FALSE?

A

TRUE

25
Q

How is malaria usually treated?

A

Treatment with artemisinin-based combination therapy (ACT) for 3 days

Severe malaria treat with IM or IV artesunate until can tolerate oral

26
Q

Why is P. falciparum the most severe form of malaria?

A

Crosses the blood-brain barrier

=> can rapidly progress to severe cerebral malaria, seizures and coma

27
Q

What are the most common causes of malnutrition?

A

Lack of access

Poor feeding practices (younger children get less food than older siblings. Mothers who cook the food also get less)

Infection

28
Q

What is used to diagnose severe acute malnutrition?

A

Mid-arm circumference <115mm

Weight for height

29
Q

If children are severely malnourished, what is the first step of treatment?

A

at risk of hypoglycaemia
given a feed on admission
=> 10% glucose or sucrose

30
Q

If a child presents in hypothermia due to malnourishment, how should they be treated?

A

treated routinely for hypoglycaemia and infection

=> glucose and antibiotics

31
Q

If children need rehydrated, this should be achieved IV. TRUE/FALSE?

A

FALSE
IV route is not for rehydration, except in cases of shock.
Rehydrate slowly, either orally or by nasogastric tube

32
Q

An appetite test can determine whether a child needs admitted or can be managed as an outpatient. TRUE/FALSE?

A

TRUE

If good appetite & no complications can be managed as outpatient

33
Q

What should be ensured when managing malnourishment as an outpatient?

A
  • Investigate cause
  • Vitamin A
  • De-worm (remove worms from intestines as these are using up all nutrients)
  • Ready to use therapeutic food (RUTF) – peanut butter, dried milk, vitamins & minerals
  • Make sure vaccinated
34
Q

Why do the majority of epilepsy sufferers live in low/middle income countires?

A

They have developed secondary epilepsy due to:

  • malaria
  • road traffic accidents
  • meningitis
  • birth asphysia

These are more common in these types of country

35
Q

War and conflict can reduce immunisation in certain countries. TRUE/FALSE?

A

TRUE
e.g. Syria 2010 pre-conflict = 80% immunised
Syria 2014 = 43% immunised
=> causing resurface of polio

36
Q

Maternal education has no effect on their children’s health. TRUE/FALSE?

A

FALSE

even going to the equivalent of primary school can decrease their childs death risk by 2/3

Child Health (21 decks)

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