Pediatric care: Common diseases to watch out for

Children are more prone to infections due to their weak immune systems. It’s for this reason that medics advise parents to make an effort of taking their children for regular checkups to avert any likely medical complications. Common childhood diseases Dr Charles Nuwagaba, a pediatrician at Polyfarm Clinic in Remera, Kigali, says there are common symptoms that manifest in children, which should prompt a parent to consult a physician. The common symptoms children tend to have are flu, fever, diarrhea, cough, as well as vomiting. Howevever, he says most of the time all these are brought about by change in weather and seasons. He points out that for children from the age of 0 to 5 years, there are common diseases which come during rainy and dry seasons. When a child is brought for consultation with such symptoms, Nuwagaba says the doctor should carry out different tests to find out precisely what the child is suffering from. In cases of high fever, Dr Ally Kambale, a general practitioner at Kabaya Hospital in Western Province, advises that parents can give such children paracetamol or ibuprofen depending on their age, but they should do that to cool down the fever in case it’s an emergency or when far away from a hospital. But again, he notes that they should seek medication immediately for a pediatrician to rule out the exact cause of the fever. “In most cases, we normally find out that diseases such as malaria, tonsillitis, ear throat (ENT) infection, urinary tract infections as well as otitis media are common in children, and they bring about fever and other symptoms,” says Kambale. How they come about and treatment According to Raymond Awazi, a pediatrician at Heritage Clinic in Kicukiro, 80 per cent of most of these diseases are caused by viruses, while 20 per cent are brought about by bacteria. He notes that when it’s a viral infection, there is no need of giving antibiotics; rather, symptomatic treatment is required to cure the condition. The child can be given paracetamol or any other medicine depending on the symptoms they have. However, Awazi says it’s important to do laboratory tests because it is from the blood test that a physician can rule out if there is viral or bacterial infection, which will help them either to put the child on antibiotics or deal with the symptoms. “In case of bacterial infection, antibiotics should be given. Even if it is a viral infection, when put on treatment, the parent is advised to give the medicine for four days, and if the symptoms persist, they are supposed to take the child back to a medic so that more tests can be done,” he explains. Further, Awazi says normally viral infections decrease the immunity, and when the immunity is low, there are high chances that the child can contract other diseases. This is why parents are supposed to go back for treatment so that they prevent further complications. From the second tests, he explains that most of the time they find bacterial infections in the blood because of the low immunity. At this point, antibiotics can be prescribed for the child depending on which bacteria has caused the infection. For urinary tract infection (UTI), Kambale says there is upper and lower infection. For the upper, its s always accompanied by high temperature, but for lower UTI, the child will not have fever but when urinating they feel pain. He adds that in case of bacterial infections, there is a test known as urinal culture which helps in ruling out the exact bacteria that has caused the infection. After that, again a text known as antibiogram is carried out in the laboratory to find out which antibiotics can treat the bacteria. When diagnosis is done, the child can be found to be having fever or other diseases, but at this point, a physician is not in a position to know the exact bacteria that has caused the infection. To find out, he says urinal culture and hamo culture tests should be done. “This will show you the exact bacteria that have caused the infection. Further, another test known as antibiogram test which is the result of an antibiotic sensitivity test is done. This will help in ruling out the specific antibiotic that can treat bacteria that has caused a certain infection,” he explains. Awazi explains that in most cases resistance occurs when the physician has not done all the tests and prescribes the medication without knowing the exact bacteria to treat. “There are many bacteria that can bring about different diseases; this is the reason why it’s important to carry out all the tests that are required in order to provide the right medicine for specific bacteria,” he says. Complications Yvan Ntwari, a general practitioner in Kigali, says pediatricians should be more careful when it comes to treating infections in children. He says when all the laboratory tests are not done well; the drugs given to the child to treat certain diseases can cause resistance, which can lead to further complications. Ntwari says if these complications are not well followed up, the infection can spread to other parts of the body, which can even cause death because they have not prescribed the right medicine. “With proper antibiotic treatment, most of the diseases in children clear up within a short period of time,” he says. Ntwari points out in cases where UTIs are not well treated in children, complications resulting to kidney failure are more common. Other diseases Nuwagaba says infections such as respiratory diseases are common in children during rainy seasons. He adds that this can be categorised into upper and lower respiratory diseases. For the upper cases, he notes that they normally include common colds, flu, tonsillitis, while pneumonia and bronchitis are lower respiratory diseases. Nuwagaba adds that in most cases, these diseases are brought about by different viruses. “Lower respiratory truck infections are all about the lungs and this is how the pneumonia comes about, which is inflammation of the lungs. That’s when you find a child is coughing, has difficulty in breathing, wheezing as well as having fever,” he says. Chest x-rays can be done to a child to identify if its pneumonia so that they are put on the right medication, he adds. Nuwagaba, however, says during dry seasons, diarrheal diseases are common. He explains that this is so because during this time, there is scarcity of water and even the little available most of the time is not clean enough for use. “The children tend to eat dirt food due to lack of water to clean it properly. In homes, there are issues of hygiene in such periods and that’s why diarrheal diseases become common.” Prevention Since these diseases are mainly common in small children below the age of five, Ntwari says sometimes it’s a challenge for the parent to practice prevention measures. During the rainy seasons, such children especially the school-going ones spend most of their time at school where they mingle, play and even share drinks with other children. He notes that this poses a high risk for them to get contaminated by each other, making it difficult to prevent such situations. For the small ones, he cautions that parents should not allow them to mix with other old people or even school-going children to prevent contamination. For the diarrheal infections, Private Kamanzi, a nutritionist at Amazon Complimentary Clinic in Remera, Kigali, says the best approach is to improve the hygiene. He is however quick to add that even with good hygiene it’s hard to prevent this because most of the time the water used is from the tap and it’s also not that good during the dry season. Kamanzi notes that lower respiratory diseases are more likely to bring about complications if they are not well treated. “The lungs help us in breathing, and once they are affected, it means the child’s life is in danger of losing oxygen which can lead to death,” he says. Whenever parents find that their children are sick, Nuwagaba says they should take them for check up immediately to prevent further complications. “For instance, when the child has diarrhoea, it’s very risky because they can easily get dehydrated, lose a lot of fluids and electrolytes, which can lead to hypoxemic shock and death,” he says. Those who are not very sick can be given oral hydration salts to use them while at home. However, those who are seriously sick, they are supposed to be admitted and given fluids. Nuwagaba cautions that parents should be in a position to know that in both rainy and dry seasons, children are prone to getting different diseases, and the best way to reduce the infection is ensuring good hygiene. Experts share tips Haston Charlotte Haston Charlotte, midwife at King Faisal Hospital: In cases an adult has flu, they should not be allowed to carry or move near the baby as they may infect them as well. Children’s food, utensils as well as beddings should be kept clean always and never mixed with those of other people in the house. Claudine Uwajeneza Claudine Uwajeneza, nurse: Allergies are also most common in children; therefore, reducing foods such as peanuts, eggs and cow’s milk as well as soy products is important, as most of the time they tend to trigger allergies. Joseph Uwiragiye Joseph Uwiragiye, nutritionist: Children should be given foods rich in vitamin C which help in fighting against germs that bring about infections. Additionally, vaccinating children is also important and it should be done on schedule. Iba Mayale, gynecologist: Breastfeeding mothers should make sure that they take a balanced diet so that they can pass these nutrients to their infants. Besides, breastfeeding helps in boosting the baby’s immunity, which keeps them away from infections. Iba Mayale

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Pediatric care: Common diseases to watch out for