Introduction to child care

Child is a young human being who has not reache the age of discretion or maturation. This literally childhood is the period from the birth until the achieves full maturation: physically, mentally and socially. the period of childhood ends with the initiation o adulthood period.
The branch of medicine dealing with children is called paediatrics. The term paediatrics is derived from the Greek words "paidos", "iatrike" and "ics". The word "paidos" means a child, iatrike" means treatment and "ics" means science. The paediatrics means the science of child care and treatment of childhood diseases. Since the intrauterine health of child greatly affects his extrauterine health, the intrauterine period of the child is also included in paediatrics. thus, broadly speaking the term paediatrics would mean the study of the child from conception to adolescence.

The specialist doctor who treats children is called paediatrician. The intra uterine health of the child is usually taken care by the obstetrician andmidwife through regular antenatal care.
Paediatric nursing is the branch of nursing that is concerned with the care of children not only during illness but also during health by providng preventive care to them.

The facts about trachoma:

Trachoma (a repeated conjunctivitis infection) is found worldwide. Though eradicated in most developed countries, it remains a significant public health problem in parts of the developing world. It is closely linked to poverty.

The facts about trachoma:

• The World Health Organization estimates that trachoma affects about 84 million people
• 8 million of these are visually impaired
• Trachoma is the second most common cause of blindness after cataract.

Where is it found?

Trachoma is found in hot and dusty parts of the world. It is often endemic in rural areas without basic sanitation, where washing hands and faces is difficult. Trachoma spreads rapidly in crowded households or neighbourhoods.

Children and trachoma

Demographically, active trachoma is most prevalent in children, although the scarring doesn't usually become visible until the early 20s. For those who have suffered since childhood, trichiasis normally sets in during their 40s - or even earlier in the worst-affected areas.

Women and trachoma

Women are much more susceptible to trachoma than men because they spend far more time in contact with children, providing childcare.

Prevention

Although trachoma was eliminated from much of the developed world in the last century, this disease persists in many parts of the developing world particularly in communities without adequate access to water and sanitation. In many of these communities, women are three times more likely than men to be blinded by the disease, due to their roles as caretakers in the family.

Without intervention, trachoma keeps families shackled within a cycle of poverty, as the disease and its long-term effects are passed from one generation to the next.

National governments in collaboration with numerous non-profit organizations implement trachoma control programs using the WHO-recommended SAFE strategy, which includes:

Surgery to correct advanced stages of the disease;

Antibiotics to treat active infection, using Zithromax (azithromycin) donated by Pfizer Inc through the International Trachoma Initiative;

Facial cleanliness to reduce disease transmission;

Environmental change to increase access to clean water and improved sanitation.

Surgery: For individuals with trichiasis, a bilamellar tarsal rotation procedure is warranted to direct the lashes away from the globe. Early intervention is beneficial as the rate of recurrence is higher in more advanced disease.

Antibiotic therapy: WHO Guidelines recommend that a region should receive community-based, mass antibiotic treatment when the prevalence of active trachoma among one to nine year-old children is greater than 10 percent.[8] Subsequent annual treatment should be administered for three years, at which time the prevalence should be reassessed. Annual treatment should continue until the prevalence drops below five percent. At lower prevalences, antibiotic treatment should be family-based.

Antibiotic selection: (single oral dose of 20 mg/kg) or topical tetracycline (one percent eye ointment twice a day for six weeks). Azithromycin is preferred because it is used as a single oral dose. Although it is expensive, it is generally used as part of the international donation program organized by Pfizer through the International Trachoma Initiative. Azithromycin can be used in children from the age of six months and in pregnancy.

Facial cleanliness: Children with grossly visible nasal discharge, ocular discharge, or flies on their faces are at least twice as likely to have active trachoma as children with clean faces. Intensive community-based health education programs to promote face-washing can significantly reduce the prevalence of active trachoma, especially intense trachoma  . If somebody is already infected washing one’s face is strongly encouraged, especially a child, in order to prevent re-infection.
Environmental improvement: Modifications in water use, fly control, latrine use, health education and proximity to domesticated animals have all been proposed to reduce transmission of C. trachomatis. These changes pose numerous challenges for implementation. It seems likely that these environmental changes ultimately impact on the transmission of ocular infection by means of lack of facial cleanliness. Particular attention is required for environmental factors that limit clean faces.