Category Archives: Pediatrics

Urban slums report the highest death rates for children under five

Children in world’s urban slums are twice as likely to die before they reach the age of five than their richer counterpart, according to the State of the World’s Mothers 2015 report released by the Save the Children Foundation last 5 May 2015.

The first-ever assessment of disparities in health among the the rich and the poor in cities worldwide, the report warned of the widening gaps in child survival rates among the rich and poor in almost half of the 40 developing nations surveyed.

Death among newborns in cities is common, the report revealed. However, in some cities, such as in Brazil and India, death rates among newborns could be 50% higher in urban slums than in the richer neighborhoods.

Malnutrition increases susceptibility of children in slum areas to diarrheal diseases and respiratory infections, further increasing chances of  dying among children in slums. For instance, in Bangladesh, 50% of children living slums under the age of five are stunted, while 43% are underweight. The figures are 33% and 26% respectively in wealthier areas in the country.

Lack of access to medical and health services was cited as a major factor in the skewed death rates among rich and poor children in cities worldwide.

For instance, mothers giving births at home without the attendance of trained medical personnel can result to late recognition of newborn illnesses, inadequate newborn care, and delay in appropriate medical interventions.

“While urbanization in and of itself not inherently problematic, the pace and the sheer scale of urbanization has, in many places, far exceeded local government’s ability to provide essential services, including water, sanitation, and health care,” the report discussed.

Amidst the grim statistics, Dr. Carolyn Miles, President and CEO of Save the Children, found hope in cities such as Addis Ababa and Manila. “There is no simple solution to creating more equitable cities, but a number of cities cited in the report – such as Addis Ababa in Ethiopia and Manila in the Philippines – have been successful in addressing the health needs of the poorest families, and these examples could serve as models for other cities to follow,” she said.

Manila and Addis Ababa were among the major cities that were found to be making significant gains for the poorest children, which also includes Cairo, Guatemala City, Kampala and Phnom Penh. Dr. Miles explained that while these cities have conducted various programs to address the inequity in access to health care services, three major strategies were found to be consistent. These are 1) better care for mothers and babies before, during and after childbirth; 2) increased use of modern contraception to prevent or postpone pregnancy; and 3) effective strategies to provide free or subsidized quality health services for the poor.

Dr. Miles stressed that cities have the advantage of technology, highly skilled partners, and presence of health care services to address the growing divide in survivability of children in cities of the world. What must be done is to provide enough resources to fuel life saving programs to make health services accessible to everyone.

 

Filipino scientists seek to unravel mysteries of Kawasaki disease

Mysterious disease affecting children may be caused by infection, according to scientists from University of the Philippines – National Institute of Molecular Biology and Biotechnology (UP-NIMBB).

Kawasaki disease is a disease that causes inflammation of medium-sized blood vessels around the body. Mostly affecting children below five years old, it is the most common cause of acquired heart disease in children such as abnormalities in the coronary artery. If left untreated, the disease may result to death.

First reported in Japan in January 1961, more than half a century later, scientists from all over the world are still baffled with what was causing of the disease. Some studies point out that the disease may be caused by an infection of a still unknown causative agent. Other studies hypothesize that the disease may be hereditary as it is commonly seen on Asian descents.

Results of the study on Kawasaki disease on Filipino children supported claims of that the disease may be triggered by an infectious agent.

UP-NIMBB researchers found that the T cells of participating patients were activated by a superantigen. T cells are a type of white blood cells that helps the body’s immune system. During an infection, the T cells are activated as response to the release of antigens of the invading germs such as viruses, bacteria and other infectious agents. While ordinary antigen can trigger only about .001-.0001% of the body’s T-cells, a superantigen can activate as much as 25% of the immune system’s T cells.

During the study, the UP-NIMBB researchers performed tests on the patients’ T cells. Results of study showed that all Kawasaki disease patients were found to have dramatic elevation of T cells, suggesting involvement of a superantigen. Researchers discussed that the result of study supported claims of other studies that the disease might be triggered by an infection.

Even though it was not able to pinpoint the infectious agent that causes the illness, researchers believe that the study has been significant as it the first ever to be conducted on Filipino Kawasaki disease patients. They insisted that because most studies were done to Japanese and Korean patients, studies on the disease as it relates to the Filipinos are unheard of. The UP-NIMBB researchers believe their research laid down the foundation for future studies on Kawasaki disease in the Philippines.

Reference:

Natividad, M., Torres-Villanueva, C., & Saloma, C. (2013). Superantigen involvement and susceptibility factors in kawasaki disease: profiles of tcr vβ2 t cells and hla-drb1, tnf-α and itpkc genes among filipino patients. International Journal of Molecular Epidemiology and Genetics, 4(1), 70–76.