Introduction:
Chronic conditions in children have increased over time. Children spend many hours at school and in other environments every day. Clinical studies suggest that children with chronic conditions may experience a lower health-related quality of life (HRQOL).
What Are the Common Childhood Conditions and Their Management?
1. Asthma: Asthma is a leading chronic disease in children and adolescents. In a class of thirty children, three are likely to have asthma. Low-income groups, minorities, and children living in towns visit the emergency department frequently. As a result, they require more hospitalizations. Further, they experience more deaths than the general population. When children are exposed to dust mites and tobacco smoke, an asthma episode can occur. It is because dust mites and tobacco smoke can act as asthma triggers.
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Management: Asthma symptoms can be prevented by avoiding triggers. Furthermore, children should be managed by a pediatrician. Asthma is frequent but can be managed. The treatment based on current scientific knowledge can reduce illness and asthma episodes. Current analysis reveals that asthmatic children live in a single-parent family compared to children without asthma. The greatest impact of asthma is observed on HRQOL. The parents perceive their child’s health as poor and likely to get worse.
2. Diabetes Mellitus (DM): Type I DM affects children and teens. It is also called juvenile diabetes. However, the incidence of type 2 diabetes (T2DM) is rising in the pediatric population. In type I DM, the pancreas does not make insulin (a hormone that converts glucose into energy). As a result, excess glucose is found in the blood in insulin absence.
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Management: A proper approach to managing type I DM in children involves adequate blood glucose monitoring, regular carbohydrate supplementation, and proper insulin dose regulation. Physical activity is one of the most critical aspects of managing DM. Pediatric patients must be treated differently from adults with diabetes. DM is a chronic disease that requires constant vigilance. It also requires major adjustments as pediatric patients progress through childhood. Examples that highly influence treatment are age at diagnosis, the child’s communication ability, eating patterns, exercise or activity, pubertal status and development, and daycare and school training. The therapy goals are to maintain normal growth and avoid short and long-term complications.
3. Migraine: Migraine or severe headache is a commonly diagnosed condition in children. Various studies suggest that children with migraine or severe headaches had a lower education level than their parents. Some studies indicate that a low family income is a risk factor for migraine or headaches. It is because education is associated with income status. Their impaired HRQOL may be due to the painful nature of this condition. But, children suffering from migraine also have weak mental health. It suggests the psychosocial burden of this condition. Recurrent migraine or severe headaches can affect school performance. Further, recurrence may limit social activities and decrease family activities.
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Management: Migraine is a frequently underdiagnosed complaint in children. Further, fewer studies regarding the treatment in children make it difficult to broaden the therapeutic options. The first step in avoiding migraine attacks is eliminating dietary (excess caffeine, artificial sweeteners, and monosodium glutamate), environmental (media abuse and certain odors), medications (antihistamines, calcium channel blockers, nitroglycerin, and ranitidine), and physical and mental triggers (anxiety, depression, fever, poor sleep, and irregular meals).
4. Epilepsy: Epilepsy is a common chronic brain illness that can cause recurring seizures. Children are more likely to suffer from absence seizures (a type of epilepsy). A Centers for Disease Control and Prevention (CDC) study shows that students aged six–seventeen with epilepsy were more likely to be absent for more than ten days. Also, epileptic students were more likely to use special education services and had many limitations. These include less participation in sports as compared to other students. Epilepsy can be managed by medication in children.
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Management: Any child who experiences a first-time seizure needs immediate attention. They should also have a follow-up visit with the primary care pediatrician. If seizures are recurrent, the child should be taken to a pediatric neurologist. There are many anti-seizure drugs. But, anti-seizure drugs may have side effects. However, most drugs are well-tolerated. Sleepiness is a common adverse effect. But, the child’s body gets used to the medication after some time.
5. Obesity: Many factors contribute to childhood obesity, including genetic factors, metabolism (how the child’s body converts food and oxygen into energy), eating patterns, physical activity, sleep quality, and negative childhood events. Genetic factors cannot be modified. However, environmental changes can prompt children to eat nutritious foods and exercise.
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Management: Schools should adopt policies to help young people eat more fruits and vegetables, eat fewer sugary foods and beverages, and increase daily physical activity. Obesity prevention and treatment in children include lifestyle modification. However, if lifestyle modification is insufficient, additional medication is recommended. Orlistat is approved for the treatment of childhood obesity. Orlistat has minimal systemic absorption. Hence, it provides a safer side effect profile compared to other anti-obesity drugs. Another anti-obesity drug is Metformin. Multivitamin supplementation is advised while giving Orlistat or Metformin due to vitamin malabsorption. Other drugs include growth hormone, Octreotide, and Topiramate. However, they need full evaluation in the pediatric population.
What Are the Responsibilities of the Parents and Schools Toward Childhood Illnesses?
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Emergency Plan: The pediatrician’s help is important. The child’s needs can be written down. The school staff should reach the pediatrician in case of an emergency.
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Health Plan: If the child takes medication at school, it should be in the school policies. Further, the child should take medicine in a comfortable place.
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Give Consent: The pediatrician needs written permission from the parents to discuss the child's condition with the school. If the child needs medications, the school should have the pediatrician’s written instructions.
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Plan Ahead: Meet the child's teachers regularly to discuss the child’s activity at school. If the child is absent due to illness, a discussion with the teacher can help keep up the work.
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Talk to the School: The school should be informed about the child’s illness. Some parents may worry about sharing information. However, prior information helps in better preparation for emergencies.
Conclusion:
Children can have more than one chronic condition. Children who have more than one chronic condition have a lower HRQOL compared to children with only one specific condition. The healthcare needs of children with chronic illnesses are complex and continuous. These also include the daily management of potential emergencies.
