Antibiotics Are Drugs Not Sweets

skittlestYesterday I was at Sarit and I saw a young boy crying frantically at the sweets shop. He wanted sweets but the mother was busy shopping for jewelry at the next shop. He was very ambitious in his crying and knew that if he just cried a bit louder and a bit more, the mother would give in and he’ll get what he wants. He did. Just to silence him, the mother bought him some chocolates and almost immediately, he stopped crying and was all smiles. Easy solution, right?

 Similarly, a Kenyan mother was woken up in the middle of the night by the racking coughs of her daughter. She comforted the child, gave her 5 ml of antibiotics syrup that she had in the cupboard, and went back to bed feeling accomplished, and assured that the child will feel better. The next morning she walked into a pharmacy, purchased more of the antibiotic syrup and continued the antibiotics for another 3 days without using the prescribed dosage or frequency. Once the cough had subsided, she stopped.

 In contrast, another mother in Amsterdam woke up in the night under similar phamacycircumstances. She gave her daughter an inhaler and saline nasal drops to alleviate the cough, and the next morning she visited her doctor who advised that that was a viral infection, not needing antibiotics and discharged the child on treatment to manage the symptoms. Unfortunately for her, she is unable to get any over the counter antibiotics from the pharmacy.

 In the first case, the most likely cause of the cough was probably a viral infection and the antibiotics were probably not necessary.

antibioticsAntibiotics are often natural substances produced by other bacteria and fungi to kill each other, therefore eliminating the competition.

Antibiotics work by destroying the structure of the bacteria and by stopping the bacteria to work well, leaving it to die off.

Nevertheless, as bacteria are exposed more to antibiotics, they develop their own mechanisms to survive attack by antibiotics. This is called resistance. Antibiotics only kill the susceptible bacteria, leaving the ones not affected. This creates a process of natural selection. Unfortunately, out of ignorance, we are helping bacteria to develop more and more resistance.

Bacteria resistance is developing rapidly and we now have some bacteria that can only be killed by one antibiotic, and some by none. Illness from one of these bacteria would almost certainly mean death as the ability to develop new antibiotics is now quite limited.

What are the factors leading to increased antibiotic resistance?

  1. Frequent and widespread misuse of antibiotics for the wrong reasons.
  • Use of antibiotics for the wrong infections (viral or parasitic)
  • Not completing the full course of antibiotics
  • Taking antibiotics at a lower non-effective dose
  • Use of poor quality antibiotics.
  1. Improper use of antibiotics in the clinical setting
  2. Increasing development of severe bacterial infections in vulnerable populations e.g. immunocompromised persons

Each of us has the ability to address number 1 immediately. How do we do this?

  1. We must avoid antibiotic use unless directed by a doctor. Viruses cause most of the cases of the common flu and cough we acquire frequently. Antibiotics only work on bacteria, not viruses.
  2. Purchase of antibiotics over the counter, for actual or perceived bacterial infections is a leading cause of resistance development. Without the guidance of an understanding medical professional, one could use antibiotics that are not effective against the infection they have.
  3. We should be especially careful about giving antibiotics to our children. Most of us did not grow up with easy access to antibiotics, but many of our children have been over-exposed since birth. We might be bestowing upon them a very difficult future.anti

Implications of Antibiotic Resistance

Morbidity: An infection that is not controlled leads to gradual breakdown of the body’s normal processes. After spreading to involve the whole body, it then gradually causes failure of the main systems such as the breathing, blood pressure, kidney function, even brain function. This is why patients with sever infection need Intensive Care Unit (ICU) care.

Mortality: According to the WHO, there are 440,000 new cases of multi-drug resistance, and 150,000 associated deaths in the treatment of pulmonary tuberculosis. Please note that this is just one bacterium.

Cost: When one gets a super bug infection, the antibiotics that can cure them could cost up to Ksh 20,000 per dose, and need to be imported. When one has to take two doses every day for 10 to 14 days, the total cost could come to Ksh 560,000. Only for one medication, that is not guaranteed to work.

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Are Your Children Safe?

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There have been recent outbreaks of infectious diseases in Kenya in the last 3 years. Increased infections with previously controlled diseases.

Vaccines are made from dead or modified germs that are harmless to the human body. These vaccines are given early to prepare your immune system against future attack by the actual germ. The vaccines work by tricking the body’s immune defence into thinking that an infection has occurred. The immune defence system attacks the vaccine and prepares itself for future infections. By doing this the body is not overwhelmed when the actual infection happens.seases like polio and

measles has created some concern about how we can protect ourselves during these epidemics. Vaccinations are the best way to keep your children protected from these outbreaks.

Vaccines for children

There are several vaccines for children. However, the main vaccines found in the vaccineKenya Expanded Programme on Immunization (KEPI) are:

  • Given at birth:

1) BCG (Bacillus Calmette-Guerin) Vaccine: This is given as single injection under the skin of the right upper arm. BCG helps protect the child against Tuberculosis (Tb).

2) Polio Vaccine: This can either be given as an injection or through mouth drops. It helps protect the child against poliomyelitis (polio) that causes crippling in children.

  • Given at 6 weeks, 10 weeks and 14 weeks of age:

When the baby is 6 weeks, 10 weeks and 14 weeks they are given 2 vaccines during those intervals. The vaccines are:

1)   Pentavalent Vaccine: This is a vaccine that contains a combination of 5 vaccines against diphtheria, pertussis, tetanus, Hepatitis B and Haemophilus Influenzae. This is where the vaccine derives the prefix “penta” which means five. The last two vaccines were introduced later.

2)   Polio Vaccine: The second, third and fourth rounds of the polio vaccine are given during these 3 rounds. Your children can safely receive the polio booster any time before they are 5 years old.

3)   Pneumococcal Vaccine: This was introduced in 2012. This vaccine helps to prevent pneumonia.

  • Given at 9 months of age:

The measles vaccine is given at 9 months of age. Since birth, the baby has protection against measles which they have inherited from their mother. This protection begins to wane at about 9 months and the child requires their own vaccine. Measles kills more children than any other vaccine preventable disease. A booster of the measles vaccine can be given before 2 years just in case the child’s immune system did not respond properly to the first vaccine.

The measles vaccine can be combined with two other vaccines and given at 9 months. The additional vaccines are against mumps and rubella which are both caused by viruses. Mumps leads to painful and swollen salivary glands and may lead to infection of a boy’s testes. Rubella is also known as German measles that causes general malaise and fever.

In areas of Kenya where yellow fever is present the yellow fever vaccine is given at the age of 9 months. Yellow fever is a disease that causes the destruction of blood. The virus causing yellow fever is transmitted by mosquito.

  • Every 6 months up to 5 years:

Children should have Vitamin A supplementation as part of building their immunity. Vitamin A is a vitamin found in foods like breast milk, carrots, liver, eggs and fish. However poor diets lead to Vitamin A deficiency that makes children susceptible to infection. Also the use of Vitamin A reduces the deaths from measles by 50%.

  • Yellow fever vaccine
  • other Vaccines
  • Rota Virus Vaccine: Rota Virus leads to diarrhoea and vomiting with a high risk of dehydration and death. The vaccine is given orally in 2 or 3 doses at 2 months, 4 months and at times 6 months.
  • Flu vaccine: The flu is caused by the influenza that may lead to pneumonia in children. This vaccine is given as an injection annually especially before the season when there will be cold weatherbaby

Save Your Food From Contamination

food-safety_istockphoto Contamination of food or water  by , parasites, viruses or chemicals is what is commonly termed as food poisoning. Up to three-quarters of all food poisoning are caused by bacteria.

Contamination of food and water may occur due to:

  • leaving cooked foods at temperatures that allow for bacterial growth
  • infection transmitted from the persons handling the food
  • under-cooking or inadequate reheating of food especially meats, poultry and seafood
  • Contamination of cooked foods by contact with dirty surfaces or raw foods.
  • Unpasteurized dairy products such as milk, cheese etc.
  • Raw seafood

Mostly, food poisoning is a mild illness which resolves even without treatment. However, in some cases, this can be a severe illness that requires admission into hospital for treatment.

Symptoms

Food poisoning mainly affects the gastrointestinal tract with symptoms including:

  • Abdominal painFamily Eating Lunch Together
  • Vomiting
  • Diarrhea
  • Headache
  • Fever
  • Dehydration
  • Bloating

In severe cases, complications such as dehydration may affect the kidneys, liver or even the central nervous system leading to death.

The organisms associated with food poisoning infect the bowel with or without invading the lining of the intestines. This difference is usually evident in the diarrhea that results. Where the lining of the intestines is not invaded or inflamed, the diarrhea tends to be watery without blood or pus, and the abdominal pain is minimal. However, where the lining of the intestines is invaded and inflamed, abdominal pain is severe and is accompanied by bloody or mucus-like. In this later case, fever may also be a symptom.

The diarrhea without inflammation is often voluminous, leading to loss of water and subsequent dehydration. This is not common in the cases of inflammation since the diarrhea tends to be less.

hospitalFor a diagnosis of food poisoning to be made, the symptoms usually affecting the gastrointestinal tract should be present in at least 2 people, with specific food identified as the source of the infection.

The symptoms usually help to narrow down the possible cause of the infection. After examination, laboratory tests are required to confirm the diagnosis.

These include:

  • Examination of a stool sample under the microscope to identify the infective organism and check for any presence of blood, or pus or white blood cells in the stool.
  • Stool culture – this allows for growth of the bacteria causing the infection in the laboratory.
  • Blood tests – these are done for patients with fever and include blood counts and culture.
  • Other tests such as electrolyte levels may do in cases of dehydration.

Treatment

As mentioned earlier, most mild cases resolve even without specific treatment within 3 days.

However, moderate to severe cases require treatment which is as follows;

  • Rehydration – this is the main goal of treatment, together with replacement of the electrolytes that are lost due to diarrhea and/or vomiting. This is mainly achieved by use of oral rehydration salts (ORS), which are readily available. In severe cases of dehydration or where vomiting is persistent. Intravenous (IV) solutions can be used to replace lost fluids and electrolytes.
  • Diet – when diarrhea is ongoing, it is advisable to avoid milk and other dairy products since diarrhea reduces an enzyme in the intestines that digests foods containing lactose.
  • Anti-diarrheal – these are drugs that reduce the number of bowel movements, antibiotics usually by increasing the absorption of water in the intestines, reducing the secretion of fluids by the intestines or reducing the peristaltic movements of the intestines. These reduce the frequency of diarrhea but do not alter the course of the illness. These should however be avoided where fever is present or diarrhea is bloody.
  • Specific treatment with antibiotics – where symptoms persist after 3 days, it is crucial for the specific organism causing infection to be identified. Based on the findings, an appropriate antibiotic will be prescribed.

Prevention

  • Strict personal hygiene when handling food
  • Proper washing of the hands using 24_food-hygiene2soap and water before handling any food
  • Food handlers need to be tested and treated for diseases like amoeba and typhoid fever
  • Store foods at appropriate temperatures
  • Cook foods adequately
  • Avoid contamination of cooked foods by raw foods
  • Avoid unpasteurized dairy products
  • Treat any cases of food poisoning as soon as possible

Related topics:

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Upper Airway Illnesses

Upper airway illnesses are the leading cause of sickness in children all over the world.

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They result in many missed school days for the child, and many sleepless nights for the parent. Interestingly most parents do not understand why they occur, and that something can be done to prevent them as well as reduce the severity when they do occur.

What are upper airway illnesses?

The upper airway is the area between the nose and mouth and the larynx (voice box). When we breathe, air passes through this area first before getting into the lower airway (from larynx to the deepest parts of the lungs).

How does this area get sick?

The leading cause of sickness in this area is acute viral infection. This area protects the happy-doctor-2lower airway. This means, all the dirt and many germs that we take in from the air as we breathe are arrested in the upper airway so that what gets into the lower airway is “clean”. The lymph node collections in the upper airway include the tonsils and the adenoids. They act like police stations, where the body has a collection of the germ fighting cells. Occasionally the system succumbs to invective agents and sickness results.

What sickness is this?

Most common is what we call upper respiratory tract infection. Over 90 % of the time this is due to viruses. Commonly we talk of flu or influenza. Medically there are different classifications depending on the location and nature of infection. These include pharynx- pharyingitis, tonsils- tonsillitis, adenoids,-adenoiditis, sinus- sinusitis and larynx-laryngitis. In less than 10 % the resulting infection is bacterial. It is important to make this distinction because bacterial infections have to be treated with antibiotics.

What can I give my child when they have a viral upper airway infection?

The treatment shall be symptomatic. This means the child, or even adult, is given
medication to control symptoms such as fever, pains, sore throat, running or blocked nose, and their body has to fight off the virus on its own.

 Are there medicines for viruses?

Mostly no, there are a few viruses for which there is specific medicine. This is the main reason there is always major global concerns when there is an outbreak of a dangerous viral infection, such as swine flu or bird flu. If this were to spread out of control, millions would die.

 Why is it that it seems children less than six years are the ones that suffer from flu most?

It is because after birth children have their mothers’ antibodies (the soldiers that fight off

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viral infections) for about 6 months. They also get antibodies from mother’s breast milk. After 6 months they loose these antibodies, and have to make their own. The body’s way of making antibodies involves exposure to the germs, especially viruses. The body then fights off the virus and makes antibodies in the process. Once made, these are stored for life, even if the virus is destroyed. This then means that the same virus can not affect that person twice. By about the age of six years, most children have made adequate antibodies to keep off most viruses.

What can I do to help my child keep off viral upper airway infections?

There are some infections that your child must get, as this is the process of acquiring immunity. However, we know that some factors increase the likelihood of having repeated or frequent viral infections. Such factors are diet that is poor in natural anti-oxidants. These

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are special components of our food that work our antibodies and fighter cells to kill viruses. Anti-oxidants are found in fruits, vegetables and most natural foods. These should then

form the bulk of what your children eat. Being physically active also plays a part in enhancing natural immunity. There are special circumstances such as children with asthma. This is a genetic disorder affecting the upper and lower airway and if not well managed, will result in the child having recurrent infections of the upper airway. When well managed the child has a perfectly normal life.

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Food Allergies and Intorelance in Children

Food-Allergies

Food allergies and intolerance are a common occurrence in children especially to those under one year when new foods are being introduced regularly. Although food allergy and intolerance may present with similar symptoms, it should be clear that a food allergy is more severe and can be life threatening if appropriate measures are not taken.

Differences between food allergy and food intolerance

A food allergy occurs when the immune system reacts to a substance in food as if it weresmile toxic. The immune system protects the body by releasing chemicals like histamines into the tissues hence the subsequent effect can be major with a small amount of food taken. A food allergy occurs suddenly, it’s caused by just a small amount of food, occurs each time the food in question is consumed and it is life threatening.

Food intolerance are caused by non-immunologic mechanisms such as metabolic/ biochemical abnormality associated with ingestion of a food or dietary component whether the latter is a nutrient or non-nutrient substance. It is less severe and a child can withstand a small amount of the food in question. Food intolerance is gradual and only occurs when the suspected food is consumed in plenty. It is not life threatening.

Intolerance occurs when a given food irritates the stomach and the food cannot be digested properly for example gluten and lactose intolerance (a child cannot digest lactose sugar found in cow’s milk). Symptoms of food intolerance include nausea, stomach pain, vomiting and diarrhea.

shutterstock_4059385_nurse_practice_smAccording to a pediatric nurse at Nanyuki District Hospital, food allergies unlike intolerance, affects a child’s whole body and not just the stomach. The symptoms include rash or itchy skin (eczema), chest pain, abrupt drop in blood pressure and a child has difficult in swallowing.

Anaphylaxis- this is a severe form of allergic response whereby the throat swells thus preventing normal breathing and swallowing, blood pressure drops abruptly and the heart rate rises. A child diagnosed with this condition is prescribed an epinephrine (adrenalin) auto injector which should be administered immediately the child shows a sign of anaphylactic reaction.

Common triggers to food allergies and intolerance (Allergens)

Peanuts, shell fish, cow’s milk, eggs, soy and wheat.

Diagnosis of allergies

Diet history and physical examination

j0290950-doctorsThis is whereby the doctor or an allergist takes the food history of the child. The description   of symptoms accompanied by information as to the time of onset of reaction following ingestion, most recent occurrence, the quantity of food required to produce the symptoms and the number of times the problem has occurred is obtained. The physical examination is directed towards the systems in which food reactions are more likely, especially the GIT, cutaneous and respiratory systems.

Clinical examination

This involves examination of signs and symptoms such as breathing difficulty, abdominal pain, eczema, rash, nausea/vomiting and running nose.

Laboratory tests

A small amount of food in question is applied on the skin (mostly on the arm). If there appears a red itchy bump within 15 minutes of applications, then there is an allergy.

Treatment of allergies

The only cure for food allergies is to avoid the allergens (foods causing allergy). However, most children will outgrow the allergy by the time they reach adolescent, more so those allergic to products such as eggs, soy beans, wheat and milk. On the other hand, allergies related to fish and treenuts (such as almonds) are likely to be lifelong.

  How to prevent allergies

To prevent allergies, learn the foods in question and how much causes symptoms. Avoid such foods or consume an amount that cannot cause symptoms. Also one can ask how the food is prepared especially when eating outside home. Read food labels to establish the content.

Did You Know

If a child parents have a history of allergies, the child has higher risks of developing at least one of the allergic problems such as hay fever, eczema and asthma. However, the allergy may not necessarily be the same as the parent.

Introducing highly allergic foods to children (such as fish, peanut butter and eggs) as early as six months (during weaning) may help prevent development of allergies. This is because, if introduced later in life, the immune system may consider them as foreign substances and as a result attack them hence allergic reactions.

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11 Tips on buying life insurance

 

Tips on Buying Life Insurance

Tips on Buying Life Insurance

  1. Understand your needs.
  2. Understand the different types of life insurance policies (term life versus permanent life).
  3. Find the right policy that suits your needs.
  4. Determine how much coverage you need.
  5. Recognize that some insurance products are for protection — not investing.
  6. Ask the tough questions.
  7. Compare similar products.
  8. Don’t replace your already existing life policies. If you have had a life policy for several years, try not to replace it. You may lose all the premiums you have paid. If your situation has changed and you need more insurance, just buy more. (This does not apply to term life.)
  9. Do your homework. Make sure you do your homework before purchasing an insurance product. Make sure it fits your needs and budget, and make sure you understand the contract.
  10. Take a 30-day free look period. You have 30 days to look at the policy and understand it. If you are not satisfied with it during that time, contact the insurance company to answer your queries.
  11. Keep it simple. Do not make your insurance planning complicated. Because it is based on protecting your family, it should be based on your needs.

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