Hesperian Health Guides

Hesperian Health Guides

Childhood illnesses

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HealthWiki > Helping Children Who Are Deaf > Chapter 15: Why children lose their hearing and what we can do > Childhood illnesses


Infection during childhood by diseases such as malaria, measles, mumps, or meningitis can damage the hearing nerve. Sometimes only one ear is affected, but meningitis usually affects both ears. For more about these illnesses, see Hesperian's book Where There Is No Doctor.

Contents

Prevent childhood illnesses with immunizations

Immunize children against all the childhood diseases — especially those that can cause deafness, such as measles, mumps, and rubella (German measles). Vaccinations are usually given free. It is better to take your children to be immunized than to take them for treatment when they are sick or dying.

If health workers do not immunize in your village, take your children to the nearest health center to be immunized. Or work together with other people in your area to bring health workers to your community. Immunizations save lives and hearing — they should be made easily available.


Treatment for childhood illnesses
Children should stay in bed, drink lots of liquids, and eat nutritious food. If a baby cannot breastfeed, give breast milk in a spoon.
For fever:
Give paracetamol (acetaminophen).
If fluid starts draining from the ear
Give an antibiotic by mouth as for sudden infections.
If signs of chronic ear infection develop
See information about treatment.
If the child has diarrhea
Give rehydration drink in small sips, 1 glass for each watery stool.
In 1 liter of clean water mix half a teaspoon of salt with 8 teaspoons of sugar. Or make a watery porridge with 1 liter of clean water, half a teaspoon of salt and 8 heaped teaspoons of powdered cereal (rice flour, maize flour, wheat flour, sorghum, or cooked and mashed potatoes).
If signs of pneumonia, meningitis, or severe pain in the ear or stomach develop, get medical help.
A boy with a skin rash.

Measles

Measles causes ear infections in many children. Measles may damage the inner ear and also may cause a middle ear infection with an ear discharge and hole in the ear drum. A few children also get encephalitis, an inflammation of the brain that can lead to fits, and can leave children deaf.

Sometimes there are black spots caused by bleeding into the skin. This means the infection is very severe. Get medical help.

Prevention:
A man speaking as he sits with his wife and 2 children.
No school for you, Lan, until Thuy is all better.

Children from other families should not go to a house where someone has measles. They should stay away from children with measles and their brothers and sisters. To prevent the illness from spreading, children in a family where someone has measles should not go to school, stores, markets, or other public places for 10 days, even if they are not sick themselves.

Children who are weak, poorly nourished, or who have tuberculosis or HIV/AIDS need to be carefully protected from measles. It is especially dangerous for them.

Mumps

A boy with swelling on his neck.

Mumps infection begins with fever, and pain when opening the mouth or eating. In 2 days, swelling develops on the side of the neck. Sometimes mumps can cause severe hearing loss, usually in only one ear. The swelling goes away after about 10 days, without need for medicine. For pain or fever give paracetamol (acetaminophen). Feed the child soft, nutritious foods and keep his mouth clean. Get medical help if signs for meningitis appear.

Malaria

Children who are seriously ill with malaria can become deaf. Malaria is an infection of the blood, spread by mosquitoes, that causes chills and high fever (40°C or 104°F or more). Sometimes this deafness may go away within 2 to 3 days. But children who have been sick with malaria are weaker and get ear infections more easily, which can also cause deafness.

Prevention:
  • Cover beds or cradles where children sleep with mosquito nets or a thin cloth. Nets treated with insecticide work best.
  • Reduce standing water, which is the breeding ground for the mosquitos that pass malaria. Clear away cans, pots, or old tires that collect water. Drain, fill, or release fish into pools of water, or marshes. Fill the tops of bamboo posts with sand.
  • Prevent or reduce the effects by taking anti-malaria medicines.

If malaria is suspected, get treatment quickly. This will keep malaria from being passed to others.

Meningitis

Meningitis (brain fever) is a serious infection of the brain that can spread to the ear nerves and cause deafness. An ear infection can also spread to the brain and cause meningitis. Meningitis may begin after another childhood illness, such as measles, mumps, or whooping cough. It may also be caused by a virus.

soft spot bulges up
(babies under 1 year)
A baby with a swelling on top of his head.
Image of a baby describing the below.
stiff neck
back arched,
knees forward
Signs of meningitis:

The signs of meningitis are severe headache and fever. The child may be sleepy and have fits or jerks. Sometimes there is vomiting and a rash. A child with meningitis may faint (quickly go unconscious).

Get medical help fast — every minute counts. Take the child to the hospital!



To treat meningitis while taking the child to a hospital
Inject one of the following combinations of medicines in the muscle or in the vein. Injections in the vein should be done only by a well-trained health worker. If a health worker is not available, it is best to inject the child in a muscle.
  • ampicillin and ceftriaxone
Dilute a 500 mg vial of ampicillin powder for injection with 2.1 ml sterile water. This makes a concentration of 500 mg per 2.5 ml.
Dilute a 1 gram vial of ceftriaxone powder for injection with 3.5 ml sterile water. This makes a concentration of 1 g per 4 ml.
ampicillin inject 50 mg per kilo of body weight, 4 times a day for at least 5 days
AND
ceftriaxone inject 100 mg per kilo of body weight, once a day for at least 5 days.
If you cannot weigh the child, dose by age:
age 2 to 12 months inject 2 ml ampicillin 4 times a day, AND
2 ml ceftriaxone once a day, for at least 5 days.
age 1 to 3 years inject 3 ml ampicillin 4 times a day, AND
4 ml ceftriaxone once a day, for at least 5 days.
age 4 to 5 years inject 5 ml ampicillin 4 times a day, AND
6 ml ceftriaxone once a day, for at least 5 days.
Note: Do not give ceftriaxone to a baby younger than 2 months.
OR
  • ampicillin and gentamicin
Dilute a 500 mg vial of ampicillin powder for injection with 2.1 ml sterile water. This makes a concentration of 500 mg per 2.5 ml.
Use an undiluted 2 ml vial of gentamicin at 40 mg per ml.
ampicillin inject 50 mg per kilo of body weight, 4 times a day for at least 5 days,
AND
gentamicin inject 7.5 mg per kilo of body weight, once a day for at least 5 days.
If you cannot weigh the child, dose by age:
age 2 to 4 months inject 1.5 ml ampicillin 4 times a day, AND
1 ml gentamicin once a day, for at least 5 days.
age 4 to 12 months inject 2 ml ampicillin 4 times a day, AND
1.5 ml gentamicin once a day, for at least 5 days.
age 1 to 3 years inject 3 ml ampicillin 4 times a day, AND
2 ml gentamicin once a day, for at least 5 days.
age 4 to 5 years inject 5 ml ampicillin 4 times a day, AND
3 ml gentamicin once a day, for at least 5 days.
Note: Gentamicin is a very strong antibiotic of the aminoglycoside family that can only be given by injection. This drug can damage the kidneys and hearing, and therefore only should be used in emergencies. If the child is dehydrated (very dry mouth or not urinating) give oral rehydration drink until the dehydration is better before you give the gentamicin. See Where There Is No Doctor, published by Hesperian, for how to make and give oral rehydration drink.

If other medicines are not available
  • give benzylpenicillin AND chloramphenicol by injection in the muscle or the vein.
benzylpenicillin inject 125,000 units per kilo of body weight, 4 times a day for up to 14 days.
Do not give more than 4,000,000 units in each dose.
AND
chloramphenicol inject 25 mg per kilo of body weight, 4 times a day for up to 14 days.

Do not give more than 1 g in each injection. As soon as the child improves, give the same dose of chloramphenicol by mouth instead of injection, but do not give more than 750 mg by mouth each time.

Note: Chloramphenicol should only be used for severe, life-threatening infections such as meningitis when other medicines are not available.

Jaundice

A woman breastfeeding a baby while another woman looks on.

Sometimes a baby becomes yellow soon after birth. This is a sign of jaundice. If the baby is energetic and breastfeeding well, a little yellow color is normal between 2 and 5 days old — the mother should keep breastfeeding often and let the baby get plenty of sun. The jaundice may be more severe if the yellow color starts from the first day after birth, if it extends to the hands and feet, or if the baby is unusually sleepy and sucks poorly. Get medical help. Severe jaundice can be dangerous, and may also cause hearing loss.

HIV/AIDS

Children with HIV/AIDS have low resistance to infections. Their lower immunity leads to increased risk of infections such as cytomegalovirus (CMV), syphilis, tuberculosis (TB), and some types of meningitis. All these illnesses can damage the ear.


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