Child health
2021年5月12日 (水) 16:42時点におけるVaccipedia.admin (トーク | 投稿記録)による版 (→prescribing antimicrobials for children and pregnant women)
目次
why child health
- children and young people are still large proportion in whole population
- large disease burden in children
- 60% of malaria deaths, 10% of TB cases
- children are very vulnerable not only to infectious diseases but also injuries of all causes
- neonate and other children groups are still neglected and lacking epidemiological data
- children are not little adults
- preterm birth, neonatal and childhood health affect long-term health and wealth in later adulthood
- children are future
children death
- 5.9 mil. < 5 y/o died in 2015
- 16,000 children death everyday
- most in sub-Sahara and SE Asia
- pneumonia, malaria, diarrhea, poverty...
- the top death cause < 5 y/o is pneumonia
- 47% of <5 y/o deaths are neonates
pneumonia
framework for pneumonia control
- WHO
- protect
- exclusive breastfeeding for 6 months
- adequate nutrition
- prevent LBW
- smoking cessation, maternal health control, prevent of young marriages
- reduce indoor air pollution
- handwashing
- prevent
- vaccine - pertussis, pneumococcal and Hib
- prevention of child HIV
- cotrimoxazole prevention for HIV children
- zinc supplementation for diarrheal children
- treat
- appropriate medical treatment
- protect
IMCI Integrated Management of Childhood Illness
Integrated Management of Childhood Illness (IMCI)
injury, accident, disability in LMICs
epidemiology of injuries
- 5 mil. deaths (in all ages) due to injuries per year
- 9% of global mortality
- more than three major IDs with 3 mil. deaths
- injuries are neglected more than infectious diseases
- proportions of injuries-caused deaths in 2012
- road traffic 24%
- falls 14%
- suicide 16%
- children deaths in HICs
- <1 y/o suffocation is the major
- 1-4 y/o traffic accident, drowning, fall
- 5-9 y/o traffic accident, drowning, burn
suffocation
- overlay by other person
- entrapment (wedging)
- strangulation of neck
- choking
- confinement like in fridge or laundry machine
burn
- 100,000 deaths <20 y/o per year
- girls are more suffered from burn than boys
- possibly because girls tend to help cooking
drowning
- leading cause of children death in WPRO and South East Asian countries
poisoning
- seasoning, alcohol, fuel in kitchen
- medicine, drug
bite
- wild or strayed animal bites
- poisonous insect bites
road traffic accident
- deaths due to road traffic are increasing in LMICs contrary to HICs because of accelerated motorization without improvement of road conditions, traffic safety education and traffic legal system
- Haddon Matrix
violence
- child abuse
- human trafficking
- illegal organ trade
- sexual exploitation
- child labor
- 158 mil. children 5-14 y/o
- hazardous work; mines, chemical work,
- child soldier
- witch hunt
disability
- sharp decline of children deaths directly linked to increase of children in disabilities
- "impairment, disability, handicap" transformed into social model
- disability is activity prevented by society
- handicap is participation prevented by society
- vicious cycle of disability and poverty
neonatal health
- year to year decline rate of neonatal deaths is lesser than that of overall child death
- another neglected health problem in LMICs
prescribing antimicrobials for children and pregnant women
- first line empiric antimicrobials for neonatal sepsis:
- ampicillin and gentamycin
- cefotaxim and gentamycin
- ceftriaxone is not recommended because of risk of bilirubiuria
- but in fact AMPC/GM or CTX/GM doesn't cover well neonatal sepsis pathogens now.... meropenem might be the best
- dose varies not depending on weight but also on age, especially in neonates and preterm babies because of differences of absorption, distribution, metabolism and excretion