Integrated management of neonatal and childhood illness
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- 5.1 ASSESS FEVER A child has the main symptom fever if
| Deciding Malaria Risk: To classify and treat children with fever, you must know the malaria risk in your area. The National Anti-Malaria Program classifies areas as high or low malaria risk areas. * * * MEASLES: Fever and a generalized rash are the main signs of measles. Measles is highly infectious. Maternal antibody protects young infants against measles for about 6 months. Then the protection gradually disappears. Most cases occur in children between 6 months and 2 years of age. Overcrowding and poor housing increase the risk of measles occurring early. Measles is caused by a virus. It infects the skin and the layer of cells that line the lung, gut, eye, mouth and throat. The measles virus damages the immune system for many weeks after the onset of measles. This leaves the child at risk for other infections. Complications of measles occur in about 30% of all cases. The most important are - diarrhoea (including dysentery and persistent diarrhoea) - pneumonia - stridor - mouth ulcers - ear infection and - severe eye infection (which may lead to corneal ulceration and blindness. Encephalitis occurs in about one in one thousand cases. A child with encephalitis may have a general danger sign such as convulsions or lethargic or unconscious. Measles contributes to malnutrition because it causes diarrhoea, high fever and mouth ulcers. These problems interfere with feeding. Malnourished children are more likely to have severe complications due to measles. This is especially true for children who are deficient in vitamin A. One in ten severely malnourished children with measles may die. For this reason, it is very important to help the mother to continue to feed her child during measles. 5.1 ASSESS FEVER A child has the main symptom fever if: * the child has a history of fever or * the child feels hot or * the child has an axillary temperature of Cor above. Decide the malaria risk (high or low. Then assess a child with fever for how long the child has had fever history of measles stiff neck bulging fontanelle runny nose signs suggesting measles -- which are generalized rash and one of these cough, runny nose, or red eyes. if the child has measles now or within the last 3 months, assess for signs of measles complications. They are mouth ulcers, pus draining from the eye and clouding of the cornea. The box shown below lists the steps for assessing a child for fever. There are two parts to the box. The main box describes how to assess the child for signs of malaria, measles, meningitis and other causes of fever. The extended arm of the main box is connected to another box which describes how to assess the child for signs of measles complications if the child has measles now or within the last 3 months. |