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Lecture 9


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HLTB02H3—LECTURE NINE. Diseases of Children  Under 5 Global Mortality (2000)  33% Neonatal disorders  22% Diarrhoea (gastrointestinal infections, nutritional deficiencies, environmental context— sanitation)  21% Pneumonia  12% Other  9% Malaria  3% AIDS o Almost 50% or deaths thought to be related to low birth weight Variables in Human Disease 1. Biology: genes, degree of immunity, susceptibility (prior illness), nutritional status 2. Demography: age, sex, ethnicity, SES 3. Behaviour: nature of risk behaviours, cultural traditions influencing disease transmillion and persistence, psychological factors influencing manifestation of disease, interventions/treatments 4. Environment: physical, biotic and socio-cultural 5. Pathogen traits: behaviour, evolution, resistance Malaria.  Protozoan parasitic infection o Plasmodium falciparum (most common), vivax, ovale, malariae  Vector = Female Anopheles mosquito  Flu-like symptoms: fever, chills, headache, muscle pains, sweats, tiredness, nausea, diarrhea, anemia, vomiting….respiratory distress, convulsions, liver damage (inflammation, infection), coma, death  Wide range, from mild flu-like to severe coma, death  No vaccine, but prophylactic deugs to keep it at bay o Quinine, chloroquine, and artemisnin derivatives o Preventive measures: bed nets, screens, activity timing, insecticdes, reducing water sources  SYNDEMIC W/ OTHER DISEASES OF POVERTY o Works together w/ malnutrition, etc. o If not malnourished before, w/ malaria, will become so and vicious cycle begins  Children can be affected by CEREBRAL malaria o Neurological and cognitive impairment  Represents a hidden and poorly defined public heath consequence of malaria  Loss of function in cognitive and motor skills, including coordination, speech/language, vision, and hearing, as well as epilepsy and behavioural impairment  This long-term consequence for children, if they survive, compromised quality of life  Cost of drugs, supportive care  Unlikely to attend school w/ household resources for education scarce  Contribution to the household income is limited  Survivors of CM more likely to die than those never exposed to CM  > 2/3 malaria cases in poorest 1/5 of world’s pop.  300-500 annually, killing 1-3 mil.  Majority of deaths—sub-Saharan Africa, w/ 900k+ deaths, most of which are children  Up to 5% episodes are severe, case fatality rate for severe epi
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