Paediatric General Clinic

The pediatric clinic deals with children with special conditions.

At the Gertrude`s children Hospital we have a team of specialists  that will make sure your child`s conditions are looked into and provided with proven treatment guidelines.  This will include accurate tests. We have a team of pediatricians in our main hospital and across all our satellite clinics. This is to ensure that we are able to provide you with the best medical care and advice.

Antibiotic safety 

What is antibiotic safety? 

It is prescribing the right antibiotic, at the right time, in the right dosage and for the right duration to help fight antibiotic resistance, protect one from unnecessary side effects  and to ensure these lifesaving medications will be available for future generations.  

 

What is antibiotic resistance? 

This is when a particular type of drug is unable to destroy a particular type of infective organism that it previously destroyed. This may occur in an individual and cause a mutation of the organism that is later spread to other people in the same lifetime and future generations. It is therefore a public health concern and not only an individual problem. 

 

What does it mean, when one says I am using an antibiotic unsafely? 

There are various ways we can use antibiotics in the wrong way and increase resistance to ourselves and future generations.  Here are a few examples:- 

  1. When you purchase an antibiotic over the counter that may not be necessary in treating the symptoms or infection that your child is having. This is common when one takes antibacterial medication like amoxicillin for a viral throat infection or common cold. This is common when your child has fever and your doctor has not prescribed an antibiotic after the consultation and blood tests.   
  1. When you do not complete the dose of your medication after feeling better 
  1. When you share antibiotics among siblings, neighbours or friends 
  1. When you do not follow the correct timings  e.g. if your child has to go to school and you have a prescription that requires to be administered when they are in school. It is advisable to raise this concern with your doctor 
  1. When you do not have means of refrigeration and take an antibiotic that requires to remain in certain temperatures. Inform your doctor before taking the prescription  
  1. When you adjust the dose that may have been calculated by a qualified medical practitioner to what you may think is the right dose probably from previous experiences. Antibiotic doses are specific to the type of infection, age and weight of the child therefore the same type of medication may have different doses.  

Consult our medical team if you have any concern about antibiotics. This may be any registered medical doctor, paediatrician, pharmacist at the outpatient general paediatric department.  

 

Malaria in Children  

What is malaria? 

Malaria is an infection caused by a parasite known as plasmodium. It is transmitted by a specific type of mosquito commonly found in some areas of Kenya and other parts of the world. The endemic areas in Kenya include Western Kenya, Nyanza and some parts of Coast.  

What are the symptoms of malaria? 

  • Fever is the major symptom of malaria within 3 months of  travel to a malaria endemic area.  
  • Chills and rigors 
  • Headaches 
  • Muscle and joint aches 
  • Reduced appetite, nausea and vomiting 

How is malaria diagnosed?  

Your child`s blood will be taken for testing in the laboratory. The best  confirmatory test is known as a blood slide. An antigen test may also be undertaken. Other blood tests may also be conducted to determine how severe the malaria is and whether it has affected any other organs or functions in various body tissues.    

If your child`s laboratory test is negative yet your child has a fever and  had travelled to a malaria endemic area, your doctor will advise repeated testing and follow-up.  

How is malaria in Children treated? 

When malaria is uncomplicated it is treated as outpatient using a tablet known as Artemether/Lumefantrine (AL). These tablets are calculated according to the child`s weight and are taken twice a day for three days.  

It is very important to adhere to the treatment dosage as prescribed.  

If you are travelling to an area that may not have access to healthcare you may be advised to carry a dose of AL after a review consultation with your doctor at the general outpatient clinic.(xxxxlink)  

The treatment for malaria applies even for children who are HIV positive 

For children who are below 2 months of age( 5kg) they should be carefully re-examined for all other causes of fever at the general paediatric clinic (xxxxlink) or specialist neonatology clinic.(xxxxlink) They are treated using quinine.  

In the case of treatment failure, your paediatrician should assess your child and advice on second line treatment.  

What is complicated malaria? 

This is malaria characterised by fever plus one of the following:- 

  • Loss of consciousness 
  • Inability to drink or take orally 
  • Low blood glucose 
  • Difficulty breathing with severe anaemia (xxxxlink to anemia article) 

Severe malaria is a medical emergency . Your child may also be unable to walk, have convulsions, start bleeding , have jaundice( yellowing of the eyes) or pass discoloured urine known as haemoglobinuria.  

Severe malaria is treated using intravenous medication( antimalarial given through the veins) and requires immediate assessment , confirmation of diagnosis and onset of treatment,.  

How can I prevent my child from getting malaria? 

  1. Let your child always sleep under an insecticide treated net 
  1. Apply mosquito repellent when travelling to malaria endemic area 
  1. Try and return indoors when it begins to get dark in a malaria endemic area. 
  1. If possible avoid  travelling to malaria endemic areas when your child is below 5 years of age and as an expectant mother.  
  1. Put on long sleeve clothing while in these areas 
  1. You may be advised to give you child medication that prevents their chances of getting malaria known as prophylaxis.  Remember no antimalarial gives 100% protection 
  1. Below is a chart of recommended dosing for atovaquone-proguanil which is administered daily commencing one day before departure to the malaria endemic area and throughout the stay there , continuing up to seven(7) days after departure from the  

endemic area.  

 

Weight (kg)  Tablets  Strength of Atovaquone/proguanil 
<11kg    Not recommended 
11-20kg  1  62.5mg A + 25mg P 
21-30kg  2  125mg A + 50mg P 
31-40kg   3  187.5mg A + 75mg P 

 

  1. Another type of medication  known as Mefloquine may also be used for prophylaxis.  

It is given as a weekly dose. It should be started 2-3 weeks before departure and throughout the child`s stay and continued for 4weeks after departure from the malaria endemic area 

The tablet usually comes in 250mg. Below is a table showing the various number of tablets according to weight and approximate age.  

 

Weight  Age  Number of tablets 
<5kg   <3 months  Not recommended 
5-12kg  3-23months  ¼ tablet (62.5mg) 
13-24kg  2-7years  ½ tablet (125mg) 
25-35kg  8-10years  ¾ tablet (187.5mg) 
>36kg  11 years and above  1 tablet (250mg)  

 

Other medications are also available for prophylaxis. Consult the general outpatient clinics or infectious diseases clinic (xxxxlink) for medical advice on  what is appropriate for your child and for accurate dosing.  

 

Remember to seek medical advice if your child gets fever within 3 months of travelling to a malaria endemic area.  

 

Keywords: Malaria, Nyanza, Western, Coast , AL, fever  

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