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Flashcards in WK 3- Critical Diseases of Children Deck (26):

What is anaemia

the reduced capacity of blood to transport oxygen as haem→due to decreased red cell numbers or decreased haemoglobin concentrations within cells


Roughly how many people in developing countries does anaemia affect

Anaemia affects over half of pre-school children and pregnant women in developing countries and at least 30-40% in industrialized countries


What is the most prevalent cause of anaemia

Iron deficiency is the most prevalent cause (around 75%)


What complications can arise from anaemia

-heart failure and arrhythmia (due to decreased volume and viscosity of blood)
-reduced immunity to infection/decreased immune function
-worsen prognosis for other diseases-> ie. worsen pneumonia due to decreased oxygen
-it can impact negatively on cognitive development, reduced school attendance and educational attainment, decreased national productivity in countries with high levels of anaemia


What are the different types of anaemia

Anaemia can be defined by aetiology, lab findings or cellular process


What are the different aetiologies (causes) of anaemia

-Genetic-eg haemoglobinopathies
-Nutritional-eg iron deficiency, folate deficiency
-Reactive-eg anaemia of chronic disease, CKD
-Functional-eg blood loss (childbirth), cell destruction (splenomegaly)
-Infection-MALARIA, HIV/AIDS, parasitic
-Combinations-more than one cause


What is the WHO 3 pronged approach to tackling anaemia

Increase iron intake
→Dietary diversification, food fortification, iron supplementation (avoid going straight to supplementation unless in high resource country where small number of people are affected→ not feasible to do in countries where majority of population is affects)
-Control infection
→Control measures for infections that contribute to iron deficiency (eg malaria, hookworm, schistosomiasis) & preventable illnesses (diarrhoea, vaccine preventable diseases)
-Improve nutritional status
→Manage and improve other nutritional deficiencies (egB12, folate, VitA)


What are the 2 most common causes of child mortality

pneumonia and malaria


How can children be PROTECTED against pneumonia

exclusive breast feeding for 6 months, adequate complementary feeding and preventing low birth weight
-children who are not breast fed within first 6 months are more likely to die of pneumonia


How can pneumonia be PREVENTED in children

vaccinate against pneumococcal (strep causes pneumonia), HIb, pertussis and measles, hand washing, reduce household air pollution, prevent HIV in children, cotrimoxazole prophylaxis for HIV-infected children


How can pneumonia be TREATED in children

→ improved care seeking and referral, case management at the health facility and community level, antibiotics/oxygen availability, continued breastfeeding


What are some signs of pneumonia in children

difficult/fast breathing, cough, fever, fatigue, irritability, stop eating/feeding


What are the abnormal resp rates of children

<1= ABOVE 50
2= ABOVE 40
4= ABOVE 30


What are the effects of uncontrolled malaria

-Child mortality
-Sick or anaemic adults
-Reduced productivity / economic activity
-Costs to health system
-Loss of productivity of a community (if large proportion of community is affected)


What are the 2 types of transmission of malaria

Stable= constant high rates of transmission . Over time adults develop a level of immunity. May have parasitaemia and anaemia, but less severe illness unless pregnant/HIV. Children at risk of severe disease
Unstable= usually low transmission with epidemic outbreaks-> no immunity so severe disease results


What is an uncomplicated presentation of malaria

patient who presents with symptoms of malaria and a positive parasitological test (microscopy or RDT) but with no features of severe malaria is defined as having uncomplicated malaria


What are some early symptoms of malaria

headache, lassitude, fatigue, abdominal discomfort, and muscle and joint aches→Followed by fever, chills, anorexia, sweating, vomiting and worsening malaise→May also have cough or diarrhea making differential even wider


What key factor differentiates between malaria and pneumonia

checking respiratory rate differentiates between malaria and pneumonia


What investigations are conducted to test for malaria

-using RDT and thick/thin blood films
-Thick films to make the diagnosis –higher sensitivity, Thin films to look at parasite count and species


What tx is available for malaria

Artemesinin Combination Therapy for P Falciparum→ Artemesinin plus another antimalarial –combination to reduce resistance.


What are symptoms seen with severe malaria

prostration, impaired consciousness (GCS below 11), seizures, acidosis, shock, renal failure, significant bleeding, severe jaundice, hypoglycaemia, anaemia


What are the 4 major ways that malaria can be controlled/eliminated

1. vector control
2. case diagnosis and effective tx
3. intermittent preventative tx in pregnancy and intimacy
4. vaccine developement


What are the 2 main ways in which malaria vectors can be controlled

IRS (indoor residual spraying) and ITN (insecticide treated nets)


How can early diagnosis aid in being an effective tx

takes around 10 days for gametes to be present in the blood→ if treat before 10 days can prevent spread and development


What are the 3 stages that malaria vaccines can work at

pre-erythrocytic phase: short phase, stop replication and movement into RBC
-blood stage: target where the protozoa is in RBC→ stops them getting as sick
-anti-transmission: prevent gamete formation/stop spreading of the disease


Why can developing a malaria vaccine be difficult

→ vaccines are difficult to maintain as the parasites mutate easily and are short lived