Just received news of a new study published in the Lancet, which may
be of interest to Lactnetters (excerpt from the news release below)
See
http://uk.news.yahoo.com/afp/20080111/tts-health-children-neonatal-disease-c1b2fc3_1.html
AFP - Friday, January 11 02:17 am
PARIS (AFP) - A simple checklist of symptoms for severe illness could
save tens of thousands of newborns in poor countries, according to a
study published Thursday.
The guidelines could help village caregivers make speedy, accurate
diagnoses of ailing infants, helping to identify those who need
urgent hospitalisation, it says.
Some four million babies die every year during the first 28 days of
life, three-quarters of them within seven days from causes ranging
from infection, birth asphyxia and sepsis to pneumonia and meningitis.
Researchers in Bangladesh, Bolivia, Ghana, India, Pakistan and South
Africa drew up the guidelines after selecting for study 3,177 babies
under seven days old and 5,712 infants aged seven to 59 days.
Frontline healthworkers were asked to look for any of 12 important
symptoms, any of which would prompt a referral to the next level of healthcare.
The results, checked afterwards by specialised paediatricians, showed
a "sensitivity" rating of 87 percent, meaning that only 13 percent of
the children who should have been referred to hospital were not.
The results also showed 74-percent accuracy for diagnosis.
When the list of symptoms was reduced to seven of the commonest
items, the ratings remained virtually the same, which thus opened the
way to a simpler format, said the study, published in the British
weekly journal The Lancet.
............The UN Millennium Development Goal is to reduce child
mortality by two-thirds by 2015 as compared to 1990 levels. At
present, the world in on course for a reduction of only 27 percent,
the authors say.
The seven symptoms named in the checklist are:
-- difficulty in feeding
-- movement only when stimulated
-- temperature below 35.5 C (95.9 F)
-- temperature above 37.5 C (99.5 F)
-- respiratory rate over 60 breaths per minute
-- severe chest indrawing
-- a history of convulsions
-----------------------
Note that the first symptom is difficulty in feeding. Should perhaps
read difficulty in Breastfeeding??
Pamela Morrison IBCLC
Rustington, England
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