Phongsavath Ammaly
CHILD HEALTH REPORT
The Lao People's Democratic Republic is located in South East Asia at the center of the Indochina peninsula. Lao is landlocked with a total area of about 236.800 square kilometers. Three quarters of which is mountainous and forest-covered. According to the 1995 census the total population is 4.58 million, with an average annual population growth rate of 2.6%. Life expectancy is 50.9 years.
Vientiane is the capital city of Lao's seventeen provinces with a populatiop of 330.000.
Setthathirath Hospital is the second largest provincial hospital, with a 200 bed capacity and the 298 staff includes 60 doctors.
The Pediatric Department is divided into 3 sections; general pediatric wards; pediatric intensive care; nursery wards.
In 1995, in-patient for admission had about 2125 cases. The reasons for admissions to the pediatric department were:
first, Dengue Hemorragic Fever (DHF) (28.32%),
second pneumonia (15.38%,),
third diarrhea (7.67%),
fourth malaria (4%),
fifth meningitis (3.95%),
sixth deficiency of vitamin B1 (2.87%),
seventh encephalitis (1 .17%),
eighth neonatal infection (0.51%),
ninth malnutrition (0.14%)
and tenth other diseases (35 .95%) .
Dengue Hemorragic Fever:
An epidemic outbreak happens every year or two.
In 1995, there were approximately 602 cases which 3 cases was died.
The biggest epidemic was in 1985 and in 1987. The main symptoms of DHF are fever 2-7 days long, Tourniquet Test + , bleeding tendency and hemoconcentration with low platelet count. The major causes of mortality were prolonged shock, bleeding tendency and disseminated intra-vascular clotting (DIC).
Pneumonia:
is the major cause of pediatric morbidity and mortality. Pneumococcus and Heamophillus Influenza are the first causes of pneumonia. According to WHO, current treatment of pneumonia is using an antibiotic (penicillin, ampicillin, amoxicillin, bactrim, chloramphenicol,...). For pneumonia caused by staphylococcus aureus, we use the antibiotic anti staphylococcus depending on the hemoculture and antibiotic testing, such as cloxacillin, cephalosporin (these drug¤ are still very expensive in Laos).
Staphylococcus aureus trends to be resistant to Methio-penicillin (Methi-R).
The mortality causes were related to the severity of pneumonia (severe pneumonia with malnutrition) .
Diarrhea:
is playing an important role in health problems in Laos. Mortality causes were diarrhea associated with severe malnutrition. The main cause of diarrhea in the monsoon rains season is Rota-Virus; in the wet season is Shigella and Salmonella which leads to becoming dysenteria.
Diarrhea caused by Entameba histolitica is rare.
Malaria:
is one of the important health problem in Laos. Commonly affecting persons living in the rural area. Most of the patients were infected by plasmodium, especially plasmodium falciparum (P.F.). We had had 85 cases in 1995. There were some patients who carried P.F.++++ without any symptoms because of their high immunity. In Laos, the most current and successful anti malaria treatment is Quinine.
Cerebral malaria remains a major cause of prematurity.
Malaria, Ieading to an anemia, malnutrition, coma ... is still a problem in pediatric malaria and pregnancy.
