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CHILD HEALTH IN COMPLEX EMERGENCIES

Urinary tract infection (UTI) is the most common bacterial disease responsible for long term morbidity in children [6]. Accurate and prompt diagnosis and treatment are crucial and may prevent renal scarring. Diagnosis of UTI requires a high degree of suspicion because of the nonspecific nature of symptoms in younger children such as unexplained fevers, gastrointestinal symptoms, and irritability. The diagnosis is established by a quantitative urine culture. Because of the high association of UTI with vesicoureteral reflux and other urinary tract abnormalities, imaging studies should be considered | Child health in complex emergencies William J Moss a c Meenakshi Ramakrishnan b Dory Storms c Anne Henderson Siegle c William M Weiss c Ivan Lejnev d Lulu Muhed Abstract Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict population displacement and or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization WHO United Nations Children s Fund UNICEF and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia prematurity and infection in neonates diagnosis and management of children with human immunodeficiency virus HIV infection active case-finding and treatment of tuberculosis paediatric trauma and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health supported by WHO and UNICEF and disseminated to international relief organizations to ensure appropriate effective and uniform care. Keywords Child welfare Child health services Emergencies Disasters Diarrhea therapy Measles epidemiology HIV infections diagnosis therapy Malaria prevention and control Nutrition disorders therapy Infant mortality Child mortality Refugees Infant Newborn Child Practice guidelines Review literature .