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Child Healthcare

Quick mobile reference for nurses

  • Welcome
  • Acknowledgements
  • The history and examination
    • Objectives
    • Introduction
      • What are the steps in the general examination of a child?
    • The first meeting
      • Why is the introduction important?
      • How should you address a child?
      • Why is it important to listen to mothers?
      • Why is it important to keep the language simple?
    • The review of any referral information
      • What is the value of a referral letter?
      • What is the value of the Road-to-Health Card?
    • Basic information
      • What basic information is needed?
      • Why are the age and gender important?
      • How should the child’s size be recorded?
      • How should you measure the child’s temperature?
    • The history
      • How do you start taking a history?
      • Why is it important to obtain a good history?
      • Who should give the history?
      • What are the main parts of the history?
      • What is important to ask about in the present history?
      • What is important in the past history?
      • What is needed in the immunisation history?
      • Why may the social (home, family, school, economic) history be important?
      • What question in the social history should not be forgotten?
      • What special questions should be asked?
      • When can an interpreter help in taking a history?
      • Why is confidentiality important in history taking?
      • What can be learned by observing the mother and child during history taking?
    • The physical examination
      • What are the steps in the physical examination?
      • In what order should the steps of the examination be done?
      • What are the components of each step of the physical examination?
      • What is the most important component of the examination?
      • Where should the examination be done?
      • Should the child be undressed for the examination?
      • What is the best approach to the general and regional inspection?
      • How are the body systems examined?
      • What are important danger signs?
      • What are the early signs of dehydration?
      • What special examination may be needed?
      • What are the 10 common errors in the general examination of a child?
    • Special investigations
      • What special investigations are usually needed?
      • What additional investigations may be needed?
    • The assessment
      • What is the assessment?
      • What is a problem list?
      • How do you make a diagnosis?
    • A plan of action
      • What is a plan of action?
    • Writing good clinical notes
      • What is the importance of good clinical notes?
      • How detailed should your notes be?
      • How should the notes of the first visit be laid out?
      • How should progress notes be written?
      • Should notes always be made in the Road-to-Health Card?
  • Immunisation
    • Objectives
    • Introduction
      • What is immunity?
      • What is immunisation?
      • What are the advantages of immunisation?
      • What immunisations should be given to young children?
      • What is the expanded programme on immunisation
      • How are immunisations given?
      • Which vaccines are used in South Africa?
      • When should immunisations be given?
      • Why is it important to give immunisations at the recommended time?
      • What should be done if immunisations are missed or never started?
      • Why are immunisations opportunities often missed?
      • How should immunisations be recorded?
      • What should be done if the Road-to-Health Card is lost?
      • Should infants born to HIV-positive women be immunised?
      • Should infants with HIV infection be immunised?
      • Should malnourished infants be immunised?
      • Should small or sick newborn infants be immunised?
      • Should routine immunisations be given to a sick child?
      • Can immunisations be safely given to an allergic child?
      • When are immunisations contraindicated?
      • Is immunisation safe?
    • Bcg immunisation
      • What is BCG?
      • How should BCG be stored and mixed?
      • When should BCG be given?
      • How is BCG given?
      • What are the side effects of BCG immunisation?
      • What are the contraindications to BCG immunisation?
    • Polio immunisation
      • Which polio vaccine is used?
      • How should polio vaccine be stored?
      • How is live polio vaccine given?
      • Should oral polio immunisation be given to a breastfeeding infant?
      • What are the contraindications to polio immunisation?
    • Immunisation against diphtheria, pertussis and tetanus (dpt)
      • What is DPT vaccine?
      • How should DPT vaccine be stored?
      • How is DPT vaccine given?
      • What are the side effects of DPT immunisation?
      • What are the possible serious reactions to pertussis immunisation?
      • When should pertussis vaccine not be given?
      • What is DT vaccine?
      • Why is pertussis vaccine not given after 18 months?
    • Measles immunisation
      • What measles vaccine is used?
      • How should measles vaccine be stored?
      • How is measles vaccine given?
      • When should measles immunisation be given?
      • What are the complications of measles immunisation?
      • What are the contraindications to measles immunisation?
      • What is MMR vaccine?
    • Immunisation against hepatitis b
      • What is hepatitis B ?
      • When and how is hepatitis B vaccine given?
      • What are the side effects of hepatitis B vaccine?
      • What is the management of an infant born to a mother who is infected with hepatitis B ?
    • Immunisation against haemophilus influenzae
      • What is Haemophilus influenzae?
      • What is Hib vaccine?
      • How is Hib vaccine stored?
      • When and how is Hib vaccine given?
      • Which other immunisations are available?
      • Why is a booster dose of vaccine given?
      • Why are some immunisations given on the left and others on the right side of the body?
      • What equipment is used to give intramuscular immunisations?
      • What is ‘herd immunity’?
      • Which infectious diseases in children are notifiable?
      • What are mass immunisation campaigns?
    • Handling vaccines
      • What is important about storing and handling vaccines?
      • What is ‘the cold chain’?
      • What is the correct use of a vaccine fridge?
      • What is a cool box?
      • What is an opened multidose vial policy?
    • Immunisation references
  • Growth and development
    • Objectives
    • Introduction
      • What is growth?
    • Measuring body size
      • How is body size determined in children?
      • How is weight measured?
      • How are height and length measured?
      • How should head circumference be measured?
      • How often should the size of children be measured?
      • How is a child’s size used to assess growth?
    • The importance of growth monitoring
      • What is growth monitoring?
      • What is the value of weight in growth monitoring?
      • What is the value of measuring height and head circumference?
      • Can an infant’s growth be determined at a single clinic visit?
    • Centile charts
      • What is a centile chart?
      • What are the important centiles on a centile chart?
      • What is the normal size for children of a given age?
      • What size measurements are usually plotted on a centile chart?
      • When is a child larger than normal?
      • When is a child smaller than normal?
      • How should you plot a child’s weight on a centile chart?
      • Can length and height both be plotted on the same chart?
      • What is the value of knowing a child’s weight-for-height?
    • Growth curves
      • What is a growth curve?
      • What is the value of a growth curve?
      • What is the normal growth rate?
      • How fast should most children grow?
      • Is weight or height the better measure of growth?
      • Is it important if a child is heavier than normal?
      • Is it important if a child is lighter than normal?
      • What should you do if a child is heavier or lighter than normal?
    • Growth patterns
      • What is a growth pattern?
      • What other growth patterns are common?
      • How can you recognise a large-for-age child?
      • Which children weigh too much?
      • What is a wasted child?
      • What is growth faltering?
      • How can you recognise stunting?
      • What is the long term effect of stunting?
      • What is the common growth pattern in poor communities?
      • When does the puberty growth spurt occur?
      • What is the effect of emotion on growth?
    • Overweight and obesity
      • How do you decide whether a child is overweight?
      • When is a child overweight?
      • What is obesity?
      • How do you manage childhood obesity?
    • The road-to-health card
      • What is the Road-to-Health Card?
      • What is the importance of the growth chart?
      • When should the Road-to-Health Card be used?
      • What is growth promotion?
      • When and where should children with growth problems be referred?
    • Neurodevelopment
      • What is neurodevelopment?
      • How is neurodevelopment monitored?
      • What are normal milestones?
    • Sexual development
      • What is puberty?
      • What are the physical changes during puberty?
  • Nutrition
    • Objectives
    • Introduction
      • What is nutrition?
      • What is the nutritional state?
      • What is normal nutrition?
      • What are the main nutrients in the diet?
      • What are energy foods?
      • Which foods are carbohydrates?
      • Which foods are rich in fats and oils?
      • Which foods are rich in protein?
      • What are micronutrients?
      • What is a well-balanced diet?
      • What foods are needed by children?
    • Malnutrition
      • What is malnutrition?
      • How is malnutrition recognised clinically?
      • Which children are underweight?
      • Which children are stunted?
      • Which children are wasted?
      • Why is malnutrition important?
      • How is a clinical diagnosis of malnutrition confirmed?
      • What are the common forms of malnutrition?
    • Protein energy malnutrition
      • What is protein-energy malnutrition?
      • What are the forms of protein-energy malnutrition?
      • Which children are underweight-for-age?
      • Why is it important to detect underweight-for-age children?
      • What is marasmus?
      • What is kwashiorkor?
      • What is marasmic kwashiorkor?
      • How can you determine whether a child has malnutrition?
      • How can the history help in the diagnosis of malnutrition?
      • How can a general examination help in the diagnosis of malnutrition?
      • How common is protein-energy malnutrition?
      • What factors are commonly associated with malnutrition?
      • What are the complications of severe malnutrition?
      • How are malnutrition and infection related?
      • Is malnutrition always due to a poor diet?
      • What is the management of an underweight-for-age child?
      • What is the management of severe malnutrition?
      • What resuscitation is needed?
      • What nutritional rehabilitation is required?
      • How can you prevent malnutrition recurring?
      • How should you address the underlying causes of malnutrition?
      • What can be done to prevent malnutrition in poor communities?
      • What is the effect of severe malnutrition on a child’s mental development?
      • What are micronutrients?
    • Vitamin deficiencies
      • What are vitamins?
      • What are the common vitamin deficiencies in children?
      • Which children are at greatest risk of vitamin A deficiency?
      • How does vitamin A deficiency present?
      • How is vitamin A deficiency prevented?
      • How is vitamin A deficiency treated?
      • What are the B group vitamins?
      • What is pellagra?
      • What is scurvy?
      • What is rickets?
    • Trace element and mineral deficiencies
      • What are trace element and mineral deficiencies?
    • Iron deficiency
      • How common is iron deficiency?
      • What are the common causes of iron deficiency in children?
      • What are the clinical signs of iron deficiency?
      • How is the diagnosis of iron deficiency confirmed?
      • How can iron deficiency be prevented?
      • What is anaemia?
      • What are the presenting symptoms and signs of anaemia?
      • What are the common causes of anaemia in children?
      • What is the simplest method of confirming anaemia due to iron deficiency?
      • What is the treatment of iron deficiency anaemia?
  • Diarrhoea
    • Objectives
    • Diagnosis and causes of diarrhoea
      • What is diarrhoea?
      • Is diarrhoea common?
      • Can diarrhoea be dangerous?
      • What are the common causes of diarrhoea?
      • What infections cause diarrhoea?
      • What food intolerances cause diarrhoea?
      • What is gastroenteritis?
      • What is acute diarrhoea?
      • What is persistent diarrhoea?
      • What is the relationship between diarrhoea and malnutrition?
      • Is diarrhoea common in children with HIV infection?
      • Which infants are at greatest risk of dying from diarrhoea?
      • What is cholera?
      • What is dysentery?
      • What is typhoid?
    • The complications of acute diarrhoea
      • What are the complications of acute diarrhoea?
      • How can you recognise dehydration?
      • How can you recognise loss of skin turgor?
      • How can the degree of dehydration be assessed?
      • How can weight loss help to decide the degree of dehydration?
      • What is shock?
      • How is a delayed capillary filling time measured?
      • What causes acidosis in children with diarrhoea?
      • Why do children with diarrhoea lose electrolytes?
      • What is ileus?
      • What is the danger of hypoglycaemia?
      • How is septicaemia recognised?
      • What signs suggest that the diarrhoea may have a surgical cause?
    • Treatment of diarrhoea
      • What is the management of a child with acute diarrhoea?
      • Will milk feeds make acute diarrhoea worse?
      • Can children with acute diarrhoea continue to be fed solid food?
      • Should anti-diarrhoeal medication be used to treat acute diarrhoea?
      • Should antibiotics be routinely given to children with acute diarrhoea?
      • What should you do if the child vomits a lot?
      • Can a child with acute diarrhoea be treated at home?
      • What is oral rehydration therapy?
      • What is oral rehydration solution?
      • What is commercial oral rehydration solution?
      • How can a sugar and salt solution be made at home?
      • Who should know how to make up sugar and salt solution for oral rehydration?
      • When should oral rehydration therapy be started?
      • How much oral rehydration solution should be given?
      • Which children with acute diarrhoea should be referred to hospital?
      • What is the management of persistent diarrhoea?
      • What is the management of dysentery?
    • Management of dehydration
      • What is the management of a child with diarrhoea but no visible dehydration?
      • What is the treatment of a child with some dehydration?
      • What is the treatment of a child with severe dehydration?
      • What is the treatment of dehydration resulting in shock?
      • What fluids should be given once dehydration has been corrected?
      • What is the value of zinc supplements in managing a child with diarrhoea?
    • Prevention of diarrhoea
      • Is acute diarrhoea preventable?
      • Why do children commonly get diarrhoea?
      • How can the risk of diarrhoea be reduced?
      • How can a safe water supply be obtained?
      • How can sanitation be improved?
      • Why is cup-feeding safer than bottle-feeding?
      • How can hygiene be improved?
  • Upper respiratory tract conditions
    • Objectives
    • Introduction
      • What is the upper respiratory tract?
      • What is the lower respiratory tract?
    • Common cold
      • What is a common cold?
      • What is the cause of a common cold?
      • What are the signs and symptoms of the common cold?
      • What are the complications of a common cold?
      • How can the common cold be prevented?
      • What is the management of a common cold?
    • Acute sinusitis
      • What is acute sinusitis?
      • What are the symptoms and signs of sinusitis?
      • What is the treatment of sinusitis?
    • Allergic rhinitis
      • What is allergic rhinitis?
      • What are the symptoms and signs of allergic rhinitis?
      • What is the cause of allergic rhinitis?
      • What is the management of allergic rhinitis?
    • Pharyngitis and tonsillitis
      • What is pharyngitis?
      • What are the causes of pharyngitis?
      • What are the symptoms and signs of pharyngitis?
      • What are the complications of pharyngitis?
      • What is the management of pharyngitis?
      • What is tonsillitis?
      • What are the signs of tonsillitis?
      • What is the management of tonsillitis?
      • What are the signs and management of enlarged adenoids?
    • Otitis media
      • What is otitis media?
      • What are the symptoms and signs of acute otitis media?
      • What is the management of acute otitus media?
      • What is chronic suppurative otitis media?
      • What is the management of chronic suppurative otitis media?
      • What is chronic secretory otitis media?
      • What is the management of chronic secretory otitis media?
      • What is otitis externa?
      • What is the treatment of otitis externa?
    • Epiglottitis
      • What is the epiglottis?
      • What is epiglottitis?
      • How is acute epiglottitis recognised?
      • How must acute epiglottitis be managed?
    • Influenza
      • What is influenza?
      • What are the symptoms and signs of influenza?
      • What is the management of influenza?
      • How can acute respiratory conditions be prevented?
  • Lower respiratory tract conditions
    • Objectives
    • Introduction
      • What is the lower respiratory tract?
      • What are the signs of breathing difficulty?
      • What are the signs of respiratory distress?
      • What is stridor?
      • What is chest indrawing?
      • What is a wheeze?
      • How can you tell when a child is breathing too fast?
      • What is central cyanosis?
    • Viral croup
      • What is viral croup?
      • What are the presenting signs of viral croup?
      • How is the degree of stridor assessed?
      • What is the correct management of viral croup?
    • Bronchitis
      • What is bronchitis?
      • What are the symptoms and signs of acute bronchitis?
      • What is the management of acute bronchitis?
    • Bronchiolitis
      • What is bronchiolitis?
      • What are the signs of bronchiolitis?
      • What is the correct management of bronchiolitis?
      • When should children with bronchiolitis be referred to hospital?
    • Pneumonia
      • What is pneumonia?
      • What are the causes of pneumonia?
      • What are the symptoms and signs of pneumonia?
      • Should all children with pneumonia have chest X-rays?
      • Is pneumonia a serious infection?
      • How can you recognise severe pneumonia?
      • What is the correct management of pneumonia?
      • What antibiotics are used in pneumonia?
    • Asthma
      • What is asthma?
      • How common is asthma?
      • What are the symptoms of asthma?
      • What are the clinical signs of asthma?
      • What is the cause of asthma?
      • How do inherited factors increase the risk of asthma?
      • What is allergy?
      • What trigger factors may start an attack of asthma?
      • How is asthma diagnosed?
      • How is the severity of asthma graded?
      • What is the correct management of asthma?
      • How is the severity of acute asthma assessed?
      • How should acute asthma be treated?
      • What should you do if there is no response?
      • How should inhaled and nebulised drugs be given?
      • How can repeated attacks of asthma be prevented?
      • How can trigger factors be avoided?
      • What education and support is useful in asthma?
    • An approach to lower respiratory tract conditions
      • What is the syndromic approach to acute respiratory tract disorders?
      • What are the important causes of a cough?
      • What is the management of a cough?
      • What signs of breathing difficulty suggest specific diagnoses?
      • When and how should oxygen be given?
  • Tuberculosis
    • Objectives
    • Introduction
      • What is tuberculosis?
      • What causes tuberculosis?
      • How is tuberculosis spread from person to person?
    • Tuberculosis
      • Do all children infected with Mycobacterium tuberculosis develop tuberculosis?
      • Is tuberculosis common?
      • In which communities is tuberculosis common?
      • Why is tuberculosis an important disease?
      • Which infected children are at greatest risk of developing tuberculosis?
      • Which children have a weak immune system?
      • What is primary tuberculosis of the lung?
      • Can the primary infection cause illness due to spread of the infection within the lung?
      • Can one have a tuberculous infection more than once?
      • Can tuberculous infection spread from the lung to other parts of the body?
      • Which other organs can be involved in tuberculosis?
      • What are the most common complications of primary tuberculosis in children?
      • How is tuberculosis diagnosed?
      • What are the clinical signs and symptoms of tuberculosis?
      • What are the signs and symptoms of pulmonary tuberculosis?
      • How can a clinical diagnosis of pulmonary tuberculosis be confirmed?
      • What are the signs of tuberculosis on a chest X-ray?
      • What is a tuberculin skin test?
      • How is the Mantoux skin test done?
      • How should you read a Mantoux skin test?
      • Does a negative Mantoux test exclude infection with tuberculous bacilli?
      • How can tuberculosis bacilli be identified?
      • Which adults with tuberculosis are most infectious?
      • How can a sample of sputum be obtained in a child?
      • What is miliary tuberculosis?
      • How is miliary tuberculosis diagnosed?
      • What are the signs and symptoms of tuberculous meningitis?
      • What are the signs and symptoms of abdominal tuberculosis?
      • What are the signs of tuberculous infection of the peripheral lymph nodes?
      • How is tuberculosis affected by HIV infection and AIDS?
      • How does tuberculosis affect HIV infection and AIDS?
      • How can tuberculosis be prevented?
      • What is the value of BCG immunisation?
      • How is the diagnosis of tuberculosis classified in children?
      • What is the management of tuberculosis?
      • What drugs are used to treat tuberculosis in children?
      • What is short course treatment of tuberculosis?
      • How is the response to treatment monitored?
      • What are the side effects of anti-tuberculous drugs?
      • What is the most common cause of failure to cure tuberculosis?
      • What is the DOTS strategy?
      • When are anti-tuberculous drugs given prophylactically to young children?
      • What is the management of a newborn infant if the mother has tuberculosis?
      • Is tuberculosis a notifiable disease?
      • Should adults with tuberculosis be isolated?
      • How can tuberculosis be controlled in a community?
      • What are the main responsibilities of the staff in a primary care TB clinic?
  • HIV infection
    • Objectives
    • Introduction
      • What is HIV?
      • Are there different types of HIV?
      • What is HIV infection?
      • What is AIDS?
      • Can a person have HIV infection but remain well?
      • How common is HIV infection?
    • Transmission of HIV to children
      • How can a person become infected with HIV?
      • How are children usually infected with HIV?
      • What is the risk of a child becoming infected with HIV by mother-to-child transmission?
      • How can the risk of mother-to-child transmission be reduced?
      • What factors influence the risk of HIV transmission in breast milk?
      • How can the risk of HIV transmission in breast milk be reduced?
      • When is it best not to breastfeed?
    • Diagnosing HIV infection in a child
      • How is HIV infection diagnosed?
      • What are the advantages of diagnosing HIV infection early?
    • The clinical diagnosis of HIV infection and aids
      • How does HIV infection present clinically in children?
      • What are the clinical stages of HIV infection?
      • How is symptomatic HIV infection diagnosed?
      • What are the signs of stage 1 HIV infection?
      • What are the clinical signs of stage 2 HIV infection?
      • What are the signs of stage 3 HIV infection?
      • What are the signs of stage 4 HIV infection?
      • How is damage to the immune system documented in children?
      • How is the clinical severity of HIV infection classified in children?
    • Management of HIV-exposed infants
      • How should an infant born to an HIV-infected woman be managed after delivery?
      • How should HIV prophylaxis be given to the newborn infant to reduce the risk of HIV infection during labour and delivery?
      • What is the management of HIV-exposed infants during the first year of life?
      • Is it safe to give immunisations to infants who may be infected with HIV?
      • What is the role of good nutrition in children with HIV infection?
      • How and when should prophylactic co-trimoxazole be given?
      • What is the value of antiretroviral therapy in children?
      • What is the expected outcome for children with HIV infection?
      • What factors other than age determine how fast HIV infection will progress?
      • What are important respiratory problems in children with HIV infection?
      • What is pneumocystis pneumonia?
      • Is tuberculosis common in children with HIV infection?
      • What forms of tuberculosis are common in children with HIV infection?
      • What gastrointestinal problems are common in children with HIV infection?
      • What skin conditions are common in children with HIV infection?
      • What is the effect of HIV infection on neurodevelopment?
    • Management of children with symptomatic HIV infection
      • What are the major components of management?
      • How important is nutrition support?
      • How should opportunistic infections be managed?
      • What are the goals of antiretroviral therapy?
      • When should antiretroviral treatment be started?
      • What are the guidelines for antiretroviral therapy?
      • What drugs are used for antiretroviral therapy?
      • What side effects are seen with antiretroviral drugs?
      • What monitoring is need with antiretroviral therapy?
      • Is there a vaccine against HIV infection?
      • How can emotional and family support be provided?
      • What is palliative and terminal care?
  • Childhood infections
    • Objectives
    • Introduction
      • Which are the common childhood infections?
    • Measles
      • What is the cause of measles?
      • What are the signs and symptoms of measles?
      • What are the complications of measles?
      • What is the relationship between measles and malnutrition?
      • How can measles be prevented?
      • What is the management of a child with measles?
    • Chickenpox
      • What is the cause of chickenpox?
      • What are the signs and symptoms of chickenpox?
      • How is a child with chickenpox managed?
    • Mumps
      • What are the clinical features of mumps?
      • What are the complications of mumps?
      • What is the management of children with mumps?
    • Herpes stomatitis
      • What is herpes stomatitis?
      • What is the management of a child with herpes stomatitis?
      • What are fever blisters?
    • Acute viral hepatitis
      • What is hepatitis?
      • What are the common causes of acute viral hepatitis?
      • What is the clinical presentation of acute viral hepatitis?
      • What are the complications of acute viral hepatitis?
      • How can viral hepatitis be prevented?
      • What is the management of a child with acute viral hepatitis?
    • Tickbite fever
      • What is tickbite fever?
      • What is the treatment of tickbite fever?
    • Acute conjunctivitis
      • What are the common causes of acute conjunctivitis?
      • What are the clinical features of acute conjunctivitis?
      • What is the treatment of acute conjunctivitis?
      • What are the less common childhood illnesses?
  • Parasites
    • Objectives
    • Introduction
      • What are parasites?
      • Which are the common intestinal parasites?
    • Roundworms
      • What is a roundworm?
      • How do children get roundworms?
      • Do roundworms in the gut cause clinical problems?
      • How can roundworms cause chest problems?
      • How are roundworms treated?
      • How can infection with roundworms be prevented?
      • When is deworming recommended?
    • Whipworms
      • What are whipworms?
      • What are the clinical features of whipworm infection?
      • What is the treatment of whipworm infection?
    • Pinworms
      • What are pinworms?
      • What are the clinical features of pinworm infection?
      • How is pinworm infection diagnosed?
      • What is the treatment of pinworms?
    • Hookworms
      • What are hookworms?
      • What are the clinical features of hookworm infection?
      • How is hookworm infection diagnosed?
      • What is the treatment of hookworm infection?
    • Tapeworms
      • What are tapeworms?
      • How is tapeworm infection diagnosed?
      • What is the treatment of tapeworm infection?
      • How can tapeworm infection be prevented?
      • Can tapeworm cysts enter the brain?
    • Hydatid disease
      • What is hydatid disease?
    • Giardiasis
      • What is giardiasis?
      • What are the clinical features of giardia infection?
      • What is the treatment of giardia infection?
    • Amoebiasis
      • What is amoebiasis?
      • What are the clinical features of amoebiasis?
      • What is the treatment of amoebiasis?
      • How can infection with many types of intestinal parasite be prevented?
      • What is the treatment of intestinal parasites?
    • Bilharzia
      • What is bilharzia?
      • What are the clinical features of bilharzia of the bladder?
      • How is the diagnosis of bilharzia of the bladder confirmed?
      • What is the treatment of bilharzia?
      • How can bilharzia be prevented?
    • Malaria
      • What is malaria?
      • What are the clinical signs of malaria?
      • How is the diagnosis of malaria confirmed?
      • How can you tell whether malaria is uncomplicated or severe?
      • What is cerebral malaria?
      • How is uncomplicated malaria treated?
      • How is severe malaria treated?
      • How is malaria prevented?
      • What malaria prophylaxis is recommended?
      • How can the number of mosquitoes be reduced?
  • Skin conditions
    • Objectives
    • Introduction
      • Are skin conditions common in children?
      • What is a rash?
      • What are the common types of rash?
      • Do all skin conditions present as a rash?
      • How are skin conditions managed?
      • Which groups of skin conditions are common in children?
    • Local viral infection
      • What local viral infections are common?
      • How is molluscum contagiosum recognised and treated?
      • How are warts recognised and managed?
      • What are cold sores and how are they managed?
    • Local fungal infections
      • What local fungal infections are common in children?
      • What is ringworm?
      • How is ringworm recognised?
      • How should ringworm be treated?
      • What is tinea versicolor?
      • How should you manage dandruff?
      • How should you recognise and treat a candida rash?
    • Local bacterial infections
      • What local bacterial infections are common?
      • What is impetigo?
      • How are boils diagnosed and managed?
    • Rashes due to systemic infections
      • What common systemic infections cause a rash?
      • How do you know that the rash is due to a systemic infection?
    • Local parasitic infestations
      • What local parasites cause skin conditions in children?
      • What is scabies?
      • What are the typical symptoms and signs of scabies?
      • How is scabies treated?
      • How does lice infestation present?
      • How should you treat head lice?
      • How are sandworms recognised and treated?
    • Rashes due to skin irritants
      • What skin irritants are common?
      • How should sunburn be managed?
      • What is nappy rash?
      • How should common insect bites and stings be managed?
      • What is miliaria?
    • Rashes due to allergies
      • What rashes are caused by allergies?
      • What is atopic eczema?
      • What are the clinical features of atopic eczema?
      • How should atopic eczema be managed?
      • What is ‘lick eczema’?
      • What is seborrhoeic dermatitis?
      • How is acute urticaria diagnosed and treated?
      • What is papular urticaria?
      • How is papular urticaria managed?
    • Other skin conditions in children
      • What is ichthyosis?
      • What is psoriasis?
      • What is acne?
      • What is the management of acne?
      • What is ‘vaseline dermatitis’?
    • Typical presentation of rashes
      • Which rashes typically cause itching?
      • Which rashes are typically painful?
      • Which rashes are typically scaly?
  • Serious illnesses
    • Objectives
    • Introduction
      • What serious bacterial infections are seen in children?
    • Acute rheumatic fever
      • What is acute rheumatic fever?
      • What are the clinical features of acute rheumatic fever?
      • What are the signs of carditis?
      • How is the clinical diagnosis of acute rheumatic fever made?
      • How is acute rheumatic fever treated?
      • How can the first attack of acute rheumatic fever be prevented?
      • How can repeated attacks of acute rheumatic fever be prevented?
      • What are the possible outcomes of acute rheumatic fever?
      • What are the features of chronic rheumatic heart disease?
      • What are the clinical symptoms and signs of heart failure?
    • Acute glomerulonephritis
      • What is acute glomerulonephritis?
      • What are the presenting signs of acute glomerulonephritis?
      • What is the clinical course of acute glomerulonephritis?
      • What are the complications of acute glomerulonephritis?
      • What is the management of a child with acute glomerulonephritis?
      • How can acute glomerulonephritis be prevented?
    • Septicaemia
      • What is septicaemia?
      • What are the clinical features of septicaemia?
      • What is shock?
      • How is the capillary filling time measured?
      • How is the clinical diagnosis of septicaemia confirmed?
      • What is the management of septicaemia?
      • What is the treatment of shock?
      • What is meningococcal septicaemia?
      • What is the typical presentation of meningococcal septicaemia?
      • How is meningococcal septicaemia managed?
      • How is meningococcal infection prevented?
    • Meningitis
      • What is meningitis?
      • What are the symptoms and signs of meningitis?
      • How is the clinical diagnosis of meningitis confirmed?
      • Is it easy to tell clinically whether meningitis in a child is due to a bacterial or viral infection?
      • What is the correct management of bacterial meningitis?
      • Can meningitis be prevented?
      • What are the complications of meningitis?
    • Pyelonephritis
      • What is pyelonephritis?
      • What are the clinical features of a urinary tract infection?
      • How is the clinical diagnosis of a urinary tract infection confirmed?
      • How should a urinary tract infection be managed?
    • Other bacterial infections
      • What serious bacterial infections are less common?
    • Diabetes
      • What is diabetes?
      • What are the presenting symptoms and signs of diabetes?
    • Convulsions
      • What are convulsions?
      • How are convulsions stopped?
      • What are febrile convulsions?
      • What is epilepsy?
    • Cancer
      • Are malignancies common in children?
      • What malignancies occur in children?
      • What are the warning signs of malignancy in children?
  • Home and society
    • Objectives
    • Children’s rights
      • What are the rights of children?
      • What threatens children’s rights?
    • Poverty
      • What is the role of poverty in child health?
      • Why does poverty place children at risk?
      • What political factors play a role in poverty?
      • What can health workers do to help obtain social grants for children?
      • What grants are available?
    • Social environment
      • What home environmental factors can affect a child’s health?
      • What environmental factors outside the home can affect a child’s wellbeing?
      • When do children not have access to health care?
    • Child abuse
      • What is child abuse?
      • What are the forms of child abuse?
      • When should you consider child abuse?
      • What are the clinical signs of physical abuse in children?
      • What are the clinical signs of sexual abuse in children?
      • Why do people abuse children?
      • What should you do if you think a child is being abused?
      • Should the authorities be informed?
      • What is the long term goal of managing an abused child?
      • How should a child be managed if sexual abuse is suspected?
    • Street children
      • What are street children?
      • How do street children get onto the street?
      • How do street children survive on the streets?
      • How should the problem of street children be managed?
    • Orphans
      • What are orphans?
      • Are the number of orphans increasing in south Africa?
      • What are the risks of being an orphan?
      • What can be done to help orphans?
    • Developmental screening
      • What is normal neurological development?
      • Do all normal children reach the same milestones at the same age?
      • What is developmental screening?
      • What areas of development should be assessed?
      • What are the common milestones in gross motor development?
      • When do children develop fine motor skills?
      • Which children are at high risk of developmental delay?
      • What should be done if a child has developmental delay?
    • Neurodevelopmental disability
      • What is disability?
      • How is intellectual disability assessed?
      • What are the grades of intellectual disability?
      • What is cerebral palsy?
      • How should cerebral palsy be managed?
    • Behaviour and emotional problems
      • What problems are common in young children?
      • What problems are seen in older children?
      • What is the attention deficit disorder?
  • Childhood mortality
    • Objectives
    • Introduction
      • How are deaths during childhood counted?
      • What is a mortality rate for children?
      • What is the under-5 mortality rate?
      • How can under-5 deaths be grouped?
      • What is an annual mortality rate?
      • Should the mortality rates be calculated for a special area?
      • Are mortality rates the same for all health districts?
      • Do mortality rates remain the same?
      • Why is it important to know the infant and under-5 mortality rates?
      • What determines the infant and under-5 mortality rates?
      • What is the under-5 mortality rate in well resourced countries?
      • What is the under-5 mortality rate in under resourced countries?
      • What is the under-5 mortality rate in South Africa?
      • What is the infant mortality rate in South Africa?
      • What do under-5 mortality rates tell us?
    • Collecting information on under-5 deaths
      • Should childhood deaths be notified?
      • How should the causes of childhood deaths be accurately identified?
      • Why is it important to know the common causes of under-5 deaths?
    • Mortality review
      • What is a mortality review?
      • What are the aims of the mortality review?
      • How should a mortality meeting be managed?
      • What information is needed for each child who dies?
      • How is the cause of death decided?
      • How is the cause of death recorded?
      • How should you decide whether the management of a child was correct?
      • What is a modifiable factor?
      • How can modifiable factors be classified?
    • Causes of under 5 deaths
      • What are the common causes of under-5 deaths in South African hospitals?
      • How will the AIDS epidemic affect the common causes of death?
      • Why is it important to determine the HIV status of each child that dies?
      • How important is malnutrition as a cause of death?
    • The analysis of mortality data
      • What data are needed to analyse childhood deaths?
      • How is the data analysed?
      • What results are obtained from the analysis?
      • What should be done with the results of the analysis?
      • What is a mortality report?
      • What ongoing assessments are needed?
      • What is the Child Health Care Problem Identification Programme?
    • Ways of avoiding the common causes of under 5 deaths
      • What steps can be taken to reduce the under-5 mortality rate?
      • How can under-5 mortality data be used to improve the quality of care in a health system?
      • What should be done to address specific causes of under-5 deaths?
      • What should be done once the modifiable factors have been identified within a region?

Treatment of diarrhoea

  • What is the management of a child with acute diarrhoea?
  • Will milk feeds make acute diarrhoea worse?
  • Can children with acute diarrhoea continue to be fed solid food?
  • Should anti-diarrhoeal medication be used to treat acute diarrhoea?
  • Should antibiotics be routinely given to children with acute diarrhoea?
  • What should you do if the child vomits a lot?
  • Can a child with acute diarrhoea be treated at home?
  • What is oral rehydration therapy?
  • What is oral rehydration solution?
  • What is commercial oral rehydration solution?
  • How can a sugar and salt solution be made at home?
  • Who should know how to make up sugar and salt solution for oral rehydration?
  • When should oral rehydration therapy be started?
  • How much oral rehydration solution should be given?
  • Which children with acute diarrhoea should be referred to hospital?
  • What is the management of persistent diarrhoea?
  • What is the management of dysentery?

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