global health paediatrics Flashcards
(35 cards)
what is the under 5 mortality rate?
-probability of a child dying before reaching age of 5
what is infant mortality rate?
-probability of a child dying before reaching the age of 1
what is a live birth?
-any sign of life after birth irrespective of gestation
what globally are the top 5 causes of under 5 mortality?
- preterm birth complications
- pneumonia
- intrapartum related complications
- congenital abnormalities
- diarrhoea
in Africa what are the top 5 causes of under 5 mortality?
- diarrhoea
- pneumonia
- malaria
- preterm birth complications
- intrapartum related complications
what causes pneumonia?
- strep pneumoniae
- haemophilus influenza
- RSV
- pneumocystis jiroveci (PCP)
what increases risk of getting pneumonia?
- malnutrition
- over crowded
- indoor air population
- parental smoking
what prevents pneumonia?
- vaccinations
- breastfeeding then complimentary nutrition
- good hygiene
what is one of the most common causes of diarrhoea in developing countries?
faeces contained water
what does diarrhoea cuse?
- malnutrition
- malnourished children
how can diarrhoea be prevented?
- safe drinking water
- good hygiene
- sanitation
- breastfeeding and good nutrition
- vaccination
what is treatment for diarrhoea?
-oral rehydration solution (ORS)
what are 6 solutions to the most preventable causes of under 5 deaths?
- Immediate and exclusive breastfeeding
- Skilled attendants for antenatal, birth and postnatal care
- Access to nutrition and micronutrients
- Family knowledge of danger signs in a child’s health
- Water, sanitation and hygiene
- Immunisations
can HIV be transferred from mother to child?
yes
how can HIV be transmitted from mother to child?
- pregnancy
- delivery
- breastfeeding
how is maternal to child transmission of HIV prevented?
- maternal lifelong antiretroviral treatment
- screen for and treat other STDs
- infant prophylaxis for 6 weeks
test child at birth, 6 weeks of age, 9 months, 18 months and then 6 weeks after cessation of breastfeeding
how does HIV present in a baby?
- recurrent of severe common childhood illnesses
- recurrent orl candidiasis not responding to treatment
- recurrent severe bacterial infections (e.g. meningitis)
- failure to thrive or growth failure
- generalised lymphadenopathy, hepatosplenomegly
- persistent fever
- encephalopthy
- chronic parotitis
- PJP Kaposi sarcoma, TB, lymphocytic interstitial pneumonia…
who do you offer HIV counselling and testing to?
- all in countries with generalised HIV epidemics
- all exposed infants at birth
- any infant child with ant suspicion of HIV
what is the diagnostic test for HIV for a neonate of <18 months?
-virological PCR for HIV DNA or RNA
what is the diagnostic test for HIV for a neonate of >18 months?
-serology rapid antibody test
what does staging do?
-determines the degree of damage the illness has done to your immune system (there are stage 1-4)
why is serology test for HIV in a baby <18 months unreliable?
-due to maternal antibodies if. mother is breastfeeding
what is HIV treatment in neonates?
HAART (highly active antiretroviral therapy): 2 NRTIs (abacavir and lamivudine) plus one NNRTI (efavirenz for >3 years old) or protease inhibitor (kaletra for <3years)
how does TB present?
- chronic cough or fever >2 weeks
- night sweats
- weight loss
- lymphadenopathy
