Guidelines

29 entries

NDoH Hospital-level paediatric STG

TB Preventive Therapy (TPT) For TB Exposure/ InfectionScreen all children in close contact with an infectious pulmonary TB case for TB disease. Screening includes clinical history and examination with appropriate investigations of children with suspected TB disease. Give full anti-tuberculosis treatment if the diagnosis of TB disease is confirmed or suspected. Indications for TB Preventive Therapy (TPT): All asymptomatic children and adolescents, i.→
Takayasu ArteritisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: M31.4 DESCRIPTION Takayasu arteritis is a chronic inflammatory disease involving large vessels, including the aorta and its main branches and the pulmonary vasculature. Lesions are typically segmental – obliterative and aneurysmal. Symptoms reflect end-organ ischaemia. DIAGNOSTIC CRITERI→
TetanusDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A35 *Notifiable condition. DESCRIPTION Tetanus is an acute spastic paralytic illness caused by tetanospasmin, the neurotoxin produced by Clostridium tetani . The toxin prevents neurotransmitter release from spinal inhibitory neurons. Complications include: asphyxia, bronchopneumonia, deh→
Tetanus, NeonatalDescription Diagnostic criteria Referral ICD-10 code: A33 *Notifiable condition. DESCRIPTION Tetanus is an acute spastic paralytic illness caused by tetanospasmin, the neurotoxin produced by C. tetani. Neonatal tetanus is the most common form of the disease, usually caused by umbilical stump infections or contamination. The disease only occurs in infants of non-immunised mothers or mothers→
Tetralogy of FallotDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: Q21.3 DESCRIPTION Ventricular septal defect with aortic override, right ventricular outflow tract obstruction and right ventricular hypertrophy. Suspect tetralogy of Fallot in a child with cyanosis after the neonatal period. DIAGNOSTIC CRITERIA Clinical Child with central cyanosis. May b→
ThalassaemiaDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: D56 DESCRIPTION Hereditary single gene defect causing abnormal production or translation of beta-globin mRNA, resulting in foetal haemoglobin (HbF) production. Presents with pallor, jaundice, fever, failure to thrive, abdominal distension hepatosplenomegaly, and skeletal changes. DIAGNOSTIC CRITERIA Investigations Micr→
The HIV Exposed InfantDescription Management of HIV-Exposed Infants HIV Testing ICD-10 code: Z20.6 DESCRIPTION Infants and children born to mothers living with HIV until HIV infection in the infant or child is reliably excluded and the infant or child is no longer exposed through breastfeeding are defined as HIV-exposed. Transmission of HIV infection may occur during pregnancy, during delivery, or via breastfeed→
The HIV Infected Infant/Child (< 10 Years)Description General and supportive measures Standardised national monitoring for infants & children with HIV Medicine treatment ART Regimens Recommended regimen in ART-naïve Neonates, Infants, Children 0 to < 10 years of age Switching existing clients to DTG-containing regimens Transition from ABC/3TC/LPV/r to DTG based regimens Switching children on PI-containing regimens to DTG reg→
The HIV Infected Neonate (< 1 Month of Age)Description Medicine treatment ICD-10 codes: B20-B24 DESCRIPTION Defined as an infant < 1 month of age, in whom HIV infection has been confirmed with two appropriate tests. For confirmation of HIV infection, see: Human immunodeficiency virus infections . MEDICINE TREATMENT This treatment protocol is meant as a guide, and there is allowance for flexibility after discussion with→
The Infant Of A Diabetic Mother (IDM)Description Diagnostic criteria General and supportive measures Medicine treatment Referral DESCRIPTION Infants born to a mother with established or newly diagnosed diabetes mellitus. The foetus will be exposed to high levels of insulin in utero if maternal glycaemic control is not achieved, with foetal pancreatic hypertrophy as an adaptive measure. The infant of a diabetic mother is at increased→
Theophylline PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T48.6 DESCRIPTION Agents such as aminophylline and caffeine have similar features in overdose. Sustained release preparations can cause prolonged toxicity. Toxicity can occur with therapeutic dosing. DIAGNOSTIC CRITERIA Clinical Mainly affects the gastrointestinal, cardiovascular and cen→
Thromboprophylaxis In ICUThe incidence of venous thrombosis is likely underappreciated in critically ill children. All children with at least one organ failure and central venous access likely require pharmacological prophylaxis against venous thrombo-embolism. Drug Dose Comments Low molecular weight heparin (LMWH), e.g. enoxaparin. < 2 months of age: 0.75 mg/kg/dose, SC, 12 hourly. > 2 months of age: 0.5 mg/kg/dos→
Thrombotic Thrombocytopaenic Purpura/Haemolytic Uraemic SyndromeDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: M31.1/D59.3 DESCRIPTION An acute syndrome that presents with diarrhoea/dysentery (although diarrhoea-negative cases are increasingly recognised) with varying combinations of the following: Non-immune microangiopathic haemolytic anaemia with fragmentation haemolysis (schistocytes), thrombocytopenia often with purpura, a→
Tic DisordersTic Disorders→
Tick Bite FeverDescription Diagnostic Criteria General and supportive measures Medicine Treatment Referral ICD-10 code: A79.9 DESCRIPTION A tick-borne febrile illness caused by Rickettsia conorii or africae . The rash appears on days 3–5 of the illness. It spreads from the extremities to the trunk, neck, face, palms, and soles within 36 hours. The lesions progress from macular to maculopapular and may per→
Tinea CapitisICD-10 code: B35.0 Refer to the Primary Healthcare Standard Treatment Guidelines and Essential Medicines List, 2020: Skin Conditions, Scalp infections – Tinea capitis. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, 5.3 Macules And Papules, 5.3.8 Tinea Capitis→
Tonsillitis And PharyngitisICD-10 code: J03 See: Primary Healthcare Standard Treatment Guidelines and Essential Medicines List, Ear, Nose and Throat Conditions, Tonsillitis and Pharyngitis . Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 17: Ear Nose & Throat, 17.2 Tonsillitis And Pharyngitis Click here for 17.3 Tonsillitis, Compl→
Tonsillitis, Complicated (Peritonsillar Cellulitis, Peritonsillar Abscess)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: J03.9 DESCRIPTION An infective process involving the tonsils with spread of infection into the adjacent tissue. It must be differentiated from hypertrophy of the tonsils without infection and a viral upper respiratory tract infection (these are associated with rhinorrhoea , nasal conges→
ToxoplasmosisDescription Diagnostic criteria Referral ICD-10 code: B58.9 DESCRIPTION Rarely occurs in children caused by infection with Toxoplasma gondii. Usually presents as encephalitis, with focal neurological abnormalities occurring in association with headache. Ocular and pulmonary disease is also seen. DIAGNOSTIC CRITERIA Investigations Diagnosis may be made on blood and CSF serology. CSF PCR for→
Traumatic Brain InjuryDescription Diagnostic Criteria General and Supportive Measures Referral ICD-10 code: S06.2 See Traumatic Brain Injury (TBI) and neuroprotection in the ICU DESCRIPTION Types: Concussion (minor), e.g. shaken baby. Contusion Penetrative Anoxic – commonest, e.g. falls, vehicle collusion, violence, sport injuries. DIAGNOSTIC CRITERIA Symptoms: Headache Eating/nursing habits. Unusual or easy irri→
Traumatic Brain Injury (TBI) And Neuro-Protection In The ICUDefinition Medicine treatment ICD-10 code: S06.2 DEFINITION Traumatic brain injury (TBI) is a form of Acquired Brain Injury. It is a nondegenerative, non-congenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness. Se→
Treatment Of Children Who Were Previously Successfully Treated For TB (Retreatment)A child who was previously successfully treated for pulmonary TB is at increased risk for re-infection with TB. It is imperative to exclude drug-resistant TB by carrying out a sputum rapid TB molecular test (e.g. GeneXpert®) plus culture with drug susceptibility testing (DST), and also determine DST of any known TB source case. If the above does not indicate resistant TB, treat as drug susceptibl→
Treatment Of VTEThe duration of treatment (anticoagulation) depends on the cause of VTE: 3 months for CVC-related or secondary VTE and 6 months for idiopathic or recurrent VTE. Initial anticoagulation with LMWH or UFH for 5–10 days followed by maintenance warfarin or LMWH. Routine use of thrombolytic therapy is not recommended unless there is a major vessel occlusion. Protamine sulphate can be used to reverse th→
TriageEmergencies Priority signs Non-urgent (queue) Early recognition of life-threatening emergencies and rapid provision of appropriate care can prevent childhood deaths and reduce associated morbidity. Triage aims to identify those children most in need of resuscitation and emergency care. It involves the rapid examination of all sick children when they first arrive in hospital in order to appr→
Tricyclic Antidepressant PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T43.0 DESCRIPTION Poisoning with tricyclic antidepressants (TCAs) represent a large portion of poisoning fatalities. There is a high risk of tricyclic antidepressant toxicity in children because of its narrow therapeutic index. Serious toxicity may occur with low doses in children. →
Tuberculosis and HIVDescription Medicine treatment ICD-10 codes: B20.0 DESCRIPTION TB and HIV are often comorbid conditions. Exclude TB by a history of TB contacts, clinical examination, chest X-ray, tuberculin skin test (TST), or lateral flow urine lipoarabinomannan (TB-lam), M tuberculosis PCR test and mycobacterial culture (where TB disease is suspected on clinical or radiological grounds) in all patients b→
Tuberculosis, PerinatalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P37.0 *Notifiable condition. DESCRIPTION Tuberculosis acquired in the first 3 months of life . Perinatal tuberculosis may be acquired in one of the following ways: Transplacental transmission – usually extrapulmonary or disseminated TB. Via the passage of swallowed maternal blood or amni→
Tuberculosis, Pulmonary In ChildrenDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A16.9 *Notifiable condition. DESCRIPTION A chronic, granulomatous disease of the lungs caused by M. tuberculosis. Most children acquire tuberculosis from infected adults by inhalation. Malnourished, immunosuppressed (HIV-infected) and children < 3 years of age with pulmonary tuberculo→
TyphoidDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A01.1 *Notifiable condition. DESCRIPTION A systemic disease caused by Salmonella typhi. DIAGNOSTIC CRITERIA Clinical Fever Anorexia Headache Vomiting Diarrhoea or constipation Ileus Abdominal pain or tenderness Epistaxis Cough Delirium Hepatomegaly and/or splenomegaly Meningismus Stupor→