Nigeria is the second largest contributor of childhood mortality in the world and over 2,000 under 5 children die daily in Nigeria. The reason is not far-fetched, during childhood, the immune system is still developing hence most diseases that are rarely fatal in adulthood tend to cause severe disease and death in children. In this article, we are going to discuss 5 most common diseases affecting children under 5 years.
1. Acute diarrheal disease
In Nigeria, the tropics and in other less developed nations of the world, diarrheal disease remains the leading cause of morbidity and mortality in children. It is estimated that about 1.3 million episodes and 4 million deaths occur each year in under-fives. Acute diarrhea results in death within few hours of onset if proper health care is not given to such children. It causes death by dehydration from excessive loss of fluids (vomiting and passage of loose watery faeces) which leads to hypovolaemia and electrolyte derangement.
Certain household behavior and practices increases the risk of diarrhea disease in children. These include: Failure to breast feed exclusively for the first 6 months of life, using infant feeding bottles, storing cooked food at room temperature, drinking water that is contaminated with fecal bacteria, failure to observe the rules of hygiene such as; failure to wash hands after defecation and improper disposal of feaces (including infant feaces) hygienically.
2. Respiratory tract infection
Respiratory tract infection is another common disease affecting children but it has received far less attention when compared to other diseases. Statistically, it is the second cause of death in children less than 5 years worldwide and more than 80% of such deaths occur in Sub-Saharan Africa. It is caused by bacteria or viruses that gain access into the airway including the lungs. This can be via direct inhalation or by the spread of the micro-organism to the lungs via blood from distant organs. When this occurs, there is sudden onset difficulty in breathing, cough, fever, dehydration, inability of the lungs to exchange O2 for CO2 effectively hence respiratory failure occurs.
It is currently advocated that all children with difficulty in breathing and cough must see a physician for proper assessment and treatment
Malaria an infectious disease caused by plasmodium spp and spread by anopheles mosquito. The vector that transmits malaria is distributed worldwide but more in the tropics and subtropics and about 40% of world population lives in malaria endemic areas. Statistically, about 300 -500 million clinical cases are seen per year, with more than 80% occurring in Africa alone. Furthermore, it causes about 0.7 – 2.5million death per year mainly in Nigeria and tropical Africa. Common symptoms of malaria are fever, vomiting, anorexia, nausea, abdominal pain and distension, refusal of feeds and most often can lead to convulsions. It is important that all children with high temperature and any symptoms suggestive of malaria should be taken immediately to a hospital for proper assessment and treatment.
Measles is a highly contagious disease that mainly affects children less than 5 years of age. It occurs suddenly and is characterized by the presence of respiratory disease with koplik’s spots which are eruptions on the membranes that covers the gums and the mouth. About 1 million children die of measles each year. The problem is worst in sub-Saharan Africa, which has the highest incidence, the highest mortality and the lowest vaccine coverage in the world. It is a droplet-born infection, thriving at low humidity. Thus it spreads during the dry season when Africans don’t travel, resulting in devastating outbreaks with a peculiarly high morbidity and mortality compared to industrialized countries.
Measles is a preventable disease because of the wide availability of measles vaccine given to children between the ages of 9-11 months. This alone is highly effective in reducing the childhood death caused by measles.
5. HIV/ AIDS
Because of the prevalence of HIV/AIDS, thousands and millions of new infection occurs in children every year because of poor health facilities, lack of skilled manpower, distance from nearest health facility, poor adherence to drugs by mothers and poor health seeking behavior. More than 95% of HIV infection in children below 5 years is as a result of maternal transfer of the virus which can occur during pregnancy, childbirth or via breast milk.
In Africa, Prevention of Mother to Child Transmission (PMTCT), a Package of care given to pregnant women, their families and communities, aimed at preventing transmission of HIV from mothers to their babies was designed and implemented in all health facilities with the sole aim of reducing the incidence of this dreaded disease in children. In this package, women are encouraged to abstain from casual sex and use condoms consistently and correctly. For women who are already infected, a unique care and delivery protocol has been designed for them and this has shown to be 99% effective in reducing the transmission of HIV from infected mothers to their children.