Common diseases in infancy and childhood

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Common diseases in infancy and childhood
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• Child mortality that is death before age of five
  accounts for about 40 or more of total mortality
  in most developing country.
• In many developing countries nearly one of every
  four children born reaches the fifth birthday.
• The situation have improved in some countries due
  to major interventions in child health in past
  decade
• Infant mortality rate which is a measure of death
  within the first year of life .

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• It ranges from 50 to 150 per thousand in most
  developing countries.
• It is 10 times greater than that of industralised
  countries.
• Infant mortality rate is a sensitive measure of
  effectiveness of health services as well as
  socio-economic progress in the country

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• In Infant Mortality Rate (IMR) various causes of
  infant death, namely DIRECT (both immediate and
  chronic medical problems), and INDIRECT (social,
  economic, and environmental causes.
• In addition to those factors affecting infant
  mortality, it should be obvious that our first
  step should be to start with a healthy baby. The
  fetus and baby do not have any control of this.

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DIRECT Causes of Infant Death

• Immediate
• Immaturity
• Birth injury
• Genetic disease
• Congenital anomaly

• Chronic
• Malnutrition
• Infection

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• Low birth weight infantis more likely to lead to
  infant death.
• In developed countries, 2/3 of low birthweight
  (LBW) babies are premature.
• In developing countries, only 1/5 of LBW are
  premature, while 4/5 are full term but short or
  thin.
• Prematurity is not decided by birthweight, but
  rather by length of gestation, or pregnancy

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• Undernutrition of a young girl may be a chronic
  problem, affecting her own health, her
  pregnancies, and her babies. It can become a
  vicious cycle.
• We tend to blame poverty for this situation, but
  ignorance can be an even more deadly foe of
  infants that is poverty.

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• Adult female with stunted height lt151 cms
• Poor nutrition in pregnancy
  with anemia
• Smoking
• Frequent infection (e.g. malaria)
• 10 of birth weights under 2500 grams
• More infections and deaths of small babies, and
  other effects which continue till fourth year
• More undernutrition
• More backward children
• A Vicious Cycle

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• Health of a mother is important to the well-being
  of the child, before, during, and after
  pregnancy.
• The health status of the mother directly affects
  her childs survival.
• We tend to blame poverty for this situation, but
  ignorance can an even more deadly foe of infants
  than is poverty.

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INDIRECTCauses of Infant Death

• Social
• Economic
• Environmental

Indirect causes are non-medical conditions that
make infants more vulnerable to Direct causes.
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• Factors affecting infant mortality rate
• Personal factors- educational status of mother,
  socioeconomic status, family stability, family
  size, cultural practices and belief and
  utilisation of available health care services.
• Health service factors-availability,
  accessibility, acceptability of health services,
  availability of qualified personnel and resources
• Environmental factors- water supply, sewage and
  refuse disposal. Housing condition, vector
  control, food supply and hygiene, vector control

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• Community factors- extent of community
  involvement and participation of local people and
  level of development of the country.
• Genetic factors- prevalence of genetic diseases.

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• Causes of infant mortality- protein energy
  malnutrition, diarrhea, pneumonia, malaria,
• tuberculosis, measles , worm infestation ,
  anemia of various causes.
• Although substantial variation occur, a similar
  pattern in the distribution exist in most
  developing countries.
• PEM, diarrhea and pneumonia occur everywhere.
• Other cause of mortality in infants include
  meningitis , tetanus, sepsis , septicemia and
  prematurity.

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• Some of the variuos causes interact with each
  other e.g the interaction between malnutrition
  and infections is well recognised.
• Repeated , severe or chronic infections (
  measles, malaria, cough, diarrhea , worm
  infestation) will lead to decreased food intake
  by way of failure of appetitie , vomiting ,
  restriction of meals by caregiver, increase loss
  through diarrhea , poor absorption, raised
  temperature and increased body need.
• This may assist in producing PEM .
• Malnutrition can lead to poor immunity exposing
  the child to infection

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Child Mortality in Nigeria

• Nigeria was ranked 14th among 190 countries in
  descending order of U5MR in 2005
• Average annual rate of reduction of U5MR is 0.3
• There are strong zonal and socio-economic
  variations in child mortality

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Residential and zonal distribution of neonatal,
infant and child mortality rates in Nigeria
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Distribution of under-5 mortality by reported
causes