There are six disease in the tropics that are so common and spread easily. Their mortality rate is so high among children that they have been named killer diseases.
These diseases are:-
- Tuberculosis
- Diphtheria
- Pertussis (Whooping Cough)
- Tetanus
- Poliomyelitis
- Measles.
1. TUBERCULOSIS
The greatest incidence of tuberculosis in children are not specific as would be found in adults. The features are outline below:
- General malaise and apathy.
- Loss of appetite.
- Loss of weight.
- Slight dry cough.
- Evening pyrexia and night sweat are not common but may appear.
The child looks emaciated and there is chronic reddening of the conjunctiva called phlyctenular conjunctiva. There is also generalised lymphadenopathy but hilar lymph nodes are more prominent and occur on the right side.
Complications of Tuberculosis:
The infection affects virtually all the organs of the body.
a. Brain = Tuberculous Meningitis.
b. Kidney = Haematuria and Sterile pyuria.
c. Abdomen = Tuberculosis of the abdomen.
d. Bone = Kyphosis
Treatment of Tuberculosis
Adequate nutrition with balanced diet and vitamin supplements.
Drugs should be taken or injection. Drugs Used are Streptomycin, Rifampicin, Isoniziad, thiacetazone, Pyrimidone and others.
Prevention Of Tuberculosis:
BCG Vaccine should be given to the baby at birth. It produces chronic granuloma at the sight of injection within six weeks. The body thereby produces antibody against the vaccine.
Seek for medical Advice.…
2. DIPHTHERIA
This is an infection by bacteria called Coryne bacterium diphtheria. It produces its effects by the release of toxins. It is transmitted by droplet infection.
These are its features:
- Sore throat
- Nasal discharge
- Fetor oris
- Upper respiratory tract obstruction with barking cough and laboured breathing.
Complications of Diphtheria:
a. Myocarditis
b. Neuritis
c. Palatal palsy
Treatment of Diphtheria
Antitoxin should be given to the baby.
Penicillin or Erythronmycin should also be given if there is allergy to penicillin.
Prevention Of Diphtheria:
DPT Vaccine should be given to the baby at six weeks, ten weeks and fourteen weeks with a booster dose at eighteen months.
3. PERTUSSIS (WHOOPING COUGH)
This is an infectious disease occurring worldwide but more common in developing countries due to poor sanitary conditions. In an UN-immunised population about 70% would been affected by the age of five years.
The infective organism is a bacteria called Bordettela Pertussis. There is a high morbidity and mortality rate and the younger the age of onset the worst the mortality.
It acts by causing inflammatory reaction in the trachea and bronchioles leading to production of copious amount of mucus.
The organism has a slow onset of action. In the first ten days, there is:
- Dry cough
- Clear nasal discharge
By the second week:
- Cough appear in paroxysms , there is whooping
- Facial swelling
- Watering of the eyes
- Protrusion of the tongue
- Difficult to lie down
Complications of Pertussis
a. Bleeding
b. Malnutrition
c. Pulmonary collapse
d. Bronc hop pneumonia
Treatment of Pertussis
a. Frequent small meal
b. Erythromycin or ceporex syrups
Prevention Of Pertussis
DPT Vaccine at six weeks, ten weeks, fourteen weeks and a booster dose at eighteen months of age. Do not give DPT after the age of seven year as it may cause encephalitis.
4. POLIOMYELITIS
This is one of the most crippling diseases in the tropics. It is a disease of poor hygiene and it is spread by droplet infection.
Stages Of Poliomyelitis
There are four stages of the disease but these are grouped into two:
Minor illness
1. Inapparent
2. Abortive
Major illness
3. Pre-paralytic
4. Paralytic
Features of the minor illness:
a. Fever
b. Nausea and vomiting
c. Loss of appetite
d. Diarrhoea
e. Nasal discharge
f. Abdominal pain
The fever usually abort on its own but after one week the fever comes again and this heralds the major illness.
Features of the major illness:
a. Muscle pain.
b. Pain and stiffness on neck, leg and back.
c. Inability of the child to kiss his knee.
d. Tripod sign
e. Absent reflex
f. Paralysis
Treatment of Poliomyelitis
a. Rest the paralysed limb by splinting.
b. Analgesic antipyretic.
c. Nasogastric tube in bulbar polio.
d. Calipers when necessary.
e. Give intermittent positive pressure ventilation (IPPV) if breathing is compromised.
5. MEASLES
Measles otherwise known as Rubeola is an acute illness that is very communicable. It is endermic in large metropolitan areas but seasonal, usually dry season, in small areas. It is caused by paramyxovirus. The mode of transmission is by droplet infection.
There are three phases of this disease:
a. Prodromal phase
b. Specific enanthem (salt over rice appearance)
c. Stage of rash.
The prodromal phase has the following features:
a. Fever
b. Nasal discharge
c. Barking cough
d. Bilateral conjuctivitis.
Other Associated Features of Measle:
a. Irritable and unable to sleep.
b. Refusal of food.
c. Diarrhea.
Symptoms are more common amongst mainurished children in whose fatality rate is very high.
Other Forms Of Measle:
A. Atypical Measle: This is a form of measle found in children previosly immunised with inactivated measle vaccine. It occurs about two to three years after.
Features are:
i. Fever
ii. Uticaria rash mostly in the extremites
iii. Muscle pain
B. Modified Measle: A form of measle found in children previously immunised with gamma globulin.
It has a longer incubation period and the disease period is short.
Complications of Measle
a. Upper respiratory tract infection
b. Diarrhoea
c. Protein energy malnutrition
d. Dehydration
e. Pneumonia particularly bronchopneumonia
f. Skin infections especially fungal infection.
Treatment Of Measle
a. Broad Spectrum Antibiotics
b. Calamine lotion
c. Restrain the hand from the eyes and ears.
6. TETANUS
Do not immunize any child who is running temperature. The fever must be treated first. Tetanus are Fatal disease cause by the infection of an open wound with the anaerobic bacterium.
Treatment Of Tetanus
Drugs and injections should be taken.