Module 5

Module 5
Early Childhood Illnesses

Introduction
In this module, women will learn how to treat and
prevent common illnesses of children. They will also
learn about immunization and growth monitoring to
ensure their childrens survival and development.
Objectives
The module aims to:
1. Educate the participants on the common illnesses of
children;
2. Enable the participants to acquire the knowlede on proper
care and manaement of different illnesses of children;
!. "romote the importance of newborn screenin;
#. Inform the participants on the communicable immuni$able
diseases; and
%. Equip the participants with the knowlede and skills on
early detection and pre&ention of early childhood
disabilities.
1
Table of Contents
Topic Pag
e
Session Flow %
Session 1:
'e&er (
Session 2:
Couh)Colds !*
Session 3:
+iarrhea %,
Session 4:
-cabies *.
Session 5:
"arasitism //
Session 6:
0anaement of 1ther Childhood Illnesses (1
Session 7:
2ewborn -creenin 11#
Session 8:
-i3 Communicable Immuni$able +iseases 12%
Session 9:
Early +etection and "re&ention of Childhood
+isabilities 1!#
Annex A:
Saha ng Saging
1#.
Annex :
"ostural +rainae 1#(
Annex !:
-team Inhalation 1%!
2
Topic Pag
e
Annex ":
"roper 4andwashin "rocedure 1%#
Annex #:
The 4erbal 0edicines in the "hilippines 1%%
Annex F:
The 5ife Cycle of "inworm 1%(
Annex $:
Ang Buhay ng Hooworm
1*1
Annex %:
5ife Cycle of 6oundworm 78scaris9 1*2
Annex &:
5ife Cycle of Trichuris 7:hipworm9
1*!
Annex ':
4erbal 0edicines 1*#
3
Session Flow
Topics Me()odolog*
Ma(e+ials
,eeded
Ti-e
Allo(-en(
Session
1:
'e&er
8cti&ity 1:
-harin on
'e&er
5ecture;
+iscussion
8cti&ity 2:
+emonstration
)6eturn
+emonstration
on 4ow to
0ake 5ar&ae
Traps for
+enue
0osquitoes
5ecture;
+iscussion
8cti&ity !:
+emonstration
on the <se of
=anana Trunk
!Saha ng
Saging" to
5ower =ody
Temperature
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker>
empty plastic
bottles of 1.%
soft drinks>
black paint>
small pieces of
wood>
chemical solution
from +1-T>
scissors
2 hours
Session
2:
8cti&ity 1.
-harin on
handouts>
"owerpoint>
1.% hours
4
Topics Me()odolog*
Ma(e+ials
,eeded
Ti-e
Allo(-en(
Couh)
Colds
Couh>
Common
Colds and
"neumonia
8cti&ity 2:
+emonstration
)6eturn
+emonstration
on "ercussion
and "ostural
+rainae
5ecture;
+iscussion
5C+>
laptop>
chalk>
whiteboard
marker>
doll 7si$e of a
baby9 if a&ailable
Session
3:
+iarrhea
8cti&ity 1.
-harin on
diarrhea
5ecture;
+iscussion
8cti&ity 1:
+emonstration
)6eturn
+emonstration
on 4ow to
"repare
16E-15
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker>
sample packs of
1ral 6ehydration
-olution 716-9>
salt>
suar>
teaspoon>
tablespoon>
. lasses> pitcher
of water
1.% hours
Session
4:
8cti&ity 1.
-harin on
handouts>
"owerpoint>
1.% hours
5
Topics Me()odolog*
Ma(e+ials
,eeded
Ti-e
Allo(-en(
-cabies -cabies

5ecture;
+iscussion
8cti&ity 2:
+emonstration
on 4ow to
"repare a
?arlic
1intment
5C+>
laptop>
chalk>
whiteboard
marker>
sto&e>
wooden spoon for
cookin
7sando9>
fryin pan>
empty medicine
bottle>
arlic clo&es>
candle>
coconut oil
Session
5:
"arasitis
m
8cti&ity 1.
-harin on
"arasitism

5ecture;
+iscussion
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker
1 hour
Session
6:
0anae
ment of
1ther
Childho
od
Illnesses
8cti&ity 1.
-harin on
Childhood
Illnesses
5ecture;
+iscussion
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker
1 hour
Session
7:
8cti&ity 1.
-harin on
handouts>
"owerpoint>
1 hour
6
Topics Me()odolog*
Ma(e+ials
,eeded
Ti-e
Allo(-en(
2ewbor
n
-creenin
2ewborn
-creenin
5ecture;
+iscussion
5C+>
laptop>
chalk>
whiteboard
marker
Session
8:
-i3
Commu
nicable
Immuni
$able
+iseases
8cti&ity 1.
-harin on
Immuni$ation
5ecture
+iscussion
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker
1 hour
Session
9:
Early
+etectio
n and
"re&enti
on of
Childho
od
+isabilit
ies
8cti&ity 1.
-harinin on
Childhood
+isabilities
5ecture;
+iscussion
handouts>
"owerpoint>
5C+>
laptop>
chalk>
whiteboard
marker
1 hour
S#SS&., 1
7
F#/#0
Introduction
@oun children particularly ,;* years old are easily prone to
disease because it is the time when their immune system is not
fully de&eloped. :omen and other members of the family should
be aware and should know early ways to respond when a child has
a fe&er.
Session Objectives
8t the end of the session> the participants should be able to:
1. <nderstand that a fe&er is Aust a symptom of an illness;
2. Identify the different diseases that ha&e fe&er as one of the
symptoms;
3. 8dminister the proper care and manaement of a person
with fe&er;
4. 5earn the proper care and manaement of different diseases
that caused the fe&er; and
5. "repare and plant lar&ae trap for denue mosquitoes.
Estimated time
8
2 4ours
Methodology
?roup sharin
5ecture)discussion
+emonstration
Materials
4andouts
"owerpoint> 5C+> 5aptop
Chalk>:hiteboard marker
Empty plastic bottles
=ottles of 1.% softdrinks
=lackpaint
-mall pieces of wood
Chemical solution from +1-T
-cissors
Procedure
Ac(i1i(* 1: S)a+ing on Fe1e+
9
1. 8sk the participants the followin
questions:
a. 4ow do you determine if your
child has fe&erB
b. :hat do you usually do if your
child has fe&erB
c. :hat do you think are the
causes of fe&erB
2. :rite key words of the responses on
the board.
!. -ynthesi$e all the responses and
proceed to the discussion of the Cey 5earnin "oints.
ey !earning Points
The Cey 4ealth 0essaes for Emerencies: "hilippines of
the +epartment of 4ealth 7+149 in 2,,/ is the reference
for this session.
12 Fe1e+ 3 body temperature which is hiher than normal
temperature of !/DC. 'e&er is not a disease it is only a
sin)symptom of a disease or an infection that is normally
contaious.
22 Fe1e+3!ausing "iseases
10
a2 T*p)oid Fe1e+
T*p)oid Fe1e+ is a life;threatenin illness with fe&er
for at least % days accompanied by weakness>
constipation or diarrhea> and abdominal discomfort
with Salmonella typhi rown from blood or stool.
!ause
Infection is caused by salmonella typhi bacteria
that li&e only in humans.
Mode o4 T+ans-ission
Inestion of food and water contaminated with
human waste.
"ersons with typhoid fe&er carry the bacteria in the
bloodstream and intestinal tract. 8 small number of
persons> called carriers> reco&er from typhoid fe&er
but continue to carry the bacteria. =oth sick persons
and carriers shed Salmonella typhi in their stools.
Signs and S*-p(o-s
-ustained hih fe&er
4eadache
:eakness
5oss of appetite
+iarrhea or constipation and abdominal discomfort
=lood in stools
11
In some cases> patients ha&e a rash of flat> rose;
colored spots.
P+e1en(ion
=oil water for drinkin. 7<pon reachin boilin
point> e3tend boilin for two or more minutes9 or
+o water chlorination
Cook food well and always use food co&er to
pre&ent flies and other insects from contaminatin
them.
:ash thorouhly all &eetables and fruits especially
those that are eaten raw.
8&oid eatin street &ended foods.
:ash hands with soap and water after usin the
toilet and before eatin.
Ceep surroundin clean to pre&ent breedin of flies.
?et &accinated aainst typhoid fe&er
%ow (o Manage5&--edia(e T+ea(-en(
=rin suspected cases immediately to the nearest
health center or hospital.
#44ec(s
Infection
Intestinal bleedin
0eninitis
+eath
12
62 Mala+ia
Mala+ia is a disease transmitted throuh a bite of an
infected female Anopheles mosquito. It usually bites
durin nihttime.
!ause
Caused by an infected Anopheles mosquito.
0alaria is spread when an infected Anopheles
mosquito bites a person. This is the only type of
mosquito that can spread malaria. The mosquito
becomes infected by bitin an infected person and
drawin blood that contains the parasite. :hen that
mosquito bites another person> that person becomes
infected.
Signs and S*-p(o-s
Chills
4ih fe&er rade
-weatin
-e&ere headache
P+e1en(ion
<se mosquito nets. It is
more effecti&e if the mosquito net is treated with
insecticide.
13
<se lon slee&es and
pants.
<se repellants)coils and
screens on doors and windows.
Clear hanin branches
of trees alon the streams.
4a&e your blood
e3amined if you ha&e the sins and symptoms of
malaria.
'ollow the ad&ice of
health workers on how to take anti; malaria drus.
If symptoms persist> ot to the nearest health center
or hospital.
#44ec(s
"ossible kidney or li&er failure
Coma
+eath
c2 "engue
"engue %e-o++)agic Fe1e+ is a se&ere often fatal
complication of denue. It is an acute infectious disease
initially with fe&er. "engue is a flu;like &iral disease
spread by the bite of infected mosquitoes.
!ause
14
Infection caused by: Aedes Aegypti, the
transmitter of the disease is a day;bitin mosquito
Mode o4 T+ans-ission:
Aedes Aegypti, the transmitter of the disease>
is a day;bitin mosquito which lays es in clear
and stanant water found in flower &ases> cans> rain
barrels> old rubber tires> etc. The adult mosquitoes
rest in dark places of the house.
It is spread by the bite of an Aedes mosquito>
The mosquito transmits the disease by bitin an
infected person and then bitin someone else.
Signs and S*-p(o-s
-udden onset of hih fe&er which may last 2 to
/ days
Eoint F muscle pain and pain behind the eyes
:eakness
-kin rashes G maculopopular rash or red tiny
spots on the skin called petechiae
2osebleedin when fe&er starts to subside
8bdominal pain
Homitin of coffee;colored matter
+ark;colored stools
P+e1en(ion
15
-earch and destroy breedin places of
mosquitoes
-ince there is no &accine to pre&ent denue>
eliminatin mosquito breedin sites is one of
the key pre&enti&e measures.
+iscard items that can collect rain or run;off
water> especially old tires. +enue;carryin
mosquitoes often lay their es in artificial>
rather than natural containers that ha&e fairly
clean water like rainwater.
Co&er water drums and water pails at all
times to pre&ent mosquitoes from breedin.
6eplace water in flower &ases once week.
Clean all water containers once a week.
-crub the sides well to remo&e es of
mosquitoes stickin to the sides.
Clean utters of lea&es and debris so that
rain water will not collect as breedin places
for of mosquitoes.
1ld tires used as roof support should be
punctured or cut to a&oid accumulation of
water.
Collect and dispose all unusable tins> Aars>
bottles and other items that can collect and
hold water.
6eularly chane the water in outdoor bird
baths> flower &ases> and pet and animal
water containers.
"rotect self from mosquito bites
<se personal protecti&e measures from
mosquito bites like:
16
- 8pplyin mosquito repellants on skin
- :earin lon slee&ed shirts and lon
pants tucked into socks when outside the
house
- 8&oid hea&ily populated residential
areas.
- :earin lon slee&es and paAamas at
niht
-leep under mosquito net 7insecticide;
treated mosquito net> if possible9.
If a person has a symptoms of denue> report
tra&el history to a doctor.
There is no specific treatment for denue. "ersons
with denue fe&er should rest and drink plenty of
fluids. +enue hemorrhaic fe&er is treated by
replacin lost fluids. -ome sick persons need
transfusions to control bleedin.
'ollow treatment reimen. Take medicines as
prescribed. +o not take aspirin.
#44ec(s
4ih fe&er
"ossible death
17
"##lication
'or the participants to:
1. 8dminister the proper care and
manaement of a fe&er associated with &arious diseases
when a child is sick in the family.
This is the continuation of the lecture;discussion.
&nno1a(ion (o Fig)( "engue 3 P+epa+a(ion o4 7a+1ae
T+aps 4o+ "engue Mos8ui(oes
8s seen in www.Inquirer.net> the +epartment of
-cience and Technoloy 7+1-T9 has de&eloped a
mosquito trap that checks the spread of the &irus.
The trap has successfully passed laboratory tests
and was subAected to field tests in %,, households in
Iue$on City and %,, households in 0arikina City.
+1-T in&ented a mosquito trap> a small plastic
black container with a black JoranicK solution
de&eloped by epidemioloists and a piece of wood.
The mosquitoes are attracted by the color> as well as
the solution> which has fumes. The insects ather
inside the container and lay their es> but the
lar&ae end up bein killed there. The solution will
kill 1,,L of the lar&ae. The trap will pre&ent
mosquitoes from multiplyin since the es and
lar&ae will be killed durin har&est time.
18
The container and solution cost "!, or less from
+1-T or people can Aust come up with their own
plastic container and buy the solution> which> in
turn> will cost only "% a pack.
%ow (o p+epa+e ()e la+1ae (+aps:
Collect 1.% liters empty bottles of soft
drinks.
Cut the bottles into hal&es.
+iscard the upper portion of the bottles and
use black paint to paint the lower portion.
"ut the solution and the piece of wood.
Plan(ing ()e (+aps and )a+1es(ing ()e la+1ae
"lant)"lace the trap in strateic places.
4ar&est the killed lar&a after a week
+estroy the lar&a.
Procedure
19
Ac(i1i(* 2: "e-ons(+a(ion50e(u+n "e-ons(+a(ion in Ma9ing
7a+1ae T+aps 4o+ "engue Mos8ui(oes
This acti&ity will ser&e as a break from the continuous session on
the fe&er;causin diseases.
1. "rior to the dayDs session> the
participants are informed that they ha&e to brin empty
plastic bottles of 1.% liters soft drinks to make lar&ae traps.
2. 1ther materials should be prepared like
scissors> black paint> pieces of small wood and chemical
solution.
!. +emonstrate how to prepare a lar&ae
trap while the participants obser&e.
#. The participants will do the return
demonstration.

P+ocessing
20
?!
?!
1. 8sk the participants the followin questions:
a2 A44ec(i1e 7e1el
:hile you are preparin the lar&ae trap> what was
your reactionB
62 !ogni(i1e 7e1el
:hat benefit can you deri&e from the acti&ityB
"##lication
1. =rin their lar&ae trap and plant them in
their homes.
2. 4ar&est and kill the lar&ae that are
trapped.
!. <ndertake cleanin operation if there
are lar&ae> to pre&ent mosquitoes from breedin
21
$ote to the Facilitator
#larify with the participants that though the traps can
catch the larvae to be illed, it is also a way of
$detecting% the presence of mos&uitoes. 'f mos&uitoes
thrive in their areas, then the participants should tae
actions by eradicating them through staging cleaning
operations and also having personal preventive
measures.
ey !earning Points
This is the continuation of the 5ecture;+iscussion.
d2 Measles
Measles is a &iral disease G a hihly communicable
disease. It spreads easily from person to person. It is
characteri$ed by an itchy skin rash. The rash often starts
on the head and mo&es down the body.
22
!ause
Caused by rubeola and rubella &iruses. The
rubeola &irus is one of the most contaious &iruses
known to man.
=y droplets spread from person to person
caused by snee$in> couhin> and close personal
contact.
Signs and S*-p(o-s

?enerali$ed blotchy rashes> lastin for ! or
more days
'e&er 7 abo&e !.MC or JhotK to touch9 and
8ny of the followin:
Couh
6unny nose
6ed eyes)conAuncti&itis
P+e1en(ion
Immuni$ation with measles &accine at ( months
old.
Hitamin 8 supplementation durin routine
measles &accination
23
2utritional support and oral rehydration to increase
body resistance and replace lost body fluids caused
by couhin> diarrhea and perspiration.
8ntibiotics as prescribed by physician to treat body
infections.
?i&in of supplementation amon infants and
children dianosed with measles.
#44ec(s5!o-plica(ions
+iarrhea
(titis media
"neumonia
)ncephalitis
0alnutrition
=lindness
e2 !)ic9enpox
Chickenpo3 is one of the classic childhood diseases. 8
child may de&elop hundreds of itchy> fluid;filled
24
blisters that burst and form crusts. It is caused by a
&irus.
!ause
Infection caused by varicella virus.
"erson to person by direct contact> droplet or air
borne spread of fluid or secretions from persons
with chickenpo3. Contaious fi&e days before and
fi&e days after the appearance of blisters.
Signs and S*-p(o-s
8ppearance of reddish skin lesions which later
become blisters on the !rd;#th day of fe&er
:eakness
0uscle and Aoint pains
-udden onset of fe&er
P+e1en(ion
8&oid crowded areas durin epidemics
Isolate known cases
Haccine is a&ailable as precautionary measures
and as per doctorDs ad&ice.
25
Chickenpo3 rashes will disappear in 1;2 weeks
time e&en without treatment
-eek immediate medical care. Cnow the
location of the nearest health worker) health facility.
6efer any person suspected of ha&in
chickenpo3 to the health worker)hospital.
Those who had the disease before are already
immune and will not ha&e the disease aain.
#44ec(s
-cars
42 Tu6e+culosis
Tu6e+culosis is a bacterial infection. The bacteria
attack the luns> but it can also damae other parts
of the body.
0an or deceased cattle ser&e as the reser&oir of the
bacteria.
Incubation period is about # to 12 weeks from
infection or a year or two after infection of
pulmonary or e*trapulmonary tuberculosis.
8 person who e3cretes tubercle bacilli is
communicable. The deree of communicability
depends upon the number of e3creted bacilli in the
air> &irulence of the bacilli and en&ironmental
conditions like o&ercrowdin.
26
-usceptibility to infection is eneral. The risk of
de&elopin the disease is hihest in children under
three years. 8 person with weak immune system
will likely to et T=.
!ause
Caused by mycobacterium tuberculosis.
=y droplets infection> that is throuh
inhalation of bacilli when a person with T=
couhs> snee$es or talks.
=y dust inhalation of bacilli which ha&e
dried on the surface of the round or floor and
become suspended in the air.
Signs and S*-p(o-s
8 history of contact with a suspected or
confirmed case of pulmonary tuberculosis.
+oes not return to normal health after
measles or whoopin couh
-inificant weiht loss> couh and whee$e
which do not respond to antibiotic therapy for
acute respiratory disease.
8bdominal swellin with a hard painless
mass and free fluid
27
"ainful firm or soft swellin in a roup of
superficial lymph nodes
8ny bone or Aoint lesion of slow onset
-ins suestin meninitis disease in the
central ner&ous system
P+e1en(ion
If infected with T=> the followin should be
practiced to a&oid infectin others:
Co&er your mouth when couhin and your
nose when snee$in.
+o not couh nor snee$e directly in front of
other people.
:ash your hands with soap and water after
co&erin mouth)nose when couhin)snee$in.
#44ec(s
0orbidity and mortality rates are hiher in
de&elopin countries
g2 7ep(ospi+osis
7ep(ospi+osis is caused by e3posure to se&eral types of
the +eptospira bacteria with an incubation period of /
G 1, day> which can be found in fresh water that has
been contaminated by animal urine.
28
!ause
Infection caused by leptospira bacteria.
Entry of the leptospira bacteria throuh
wounds when in contact with flood waters>
&eetation
0oist soil contaminated with the urine of
infected animals> especially rats.
Signs and S*-p(o-s
'e&er
2on;specific symptoms of muscle pain>
headache
Calf;muscle pain and reddish eyes for some
cases
-e&ere cases result to li&er in&ol&ement> kidney
failure or brain in&ol&ement. Thus some cases may
ha&e yellowish body discolori$ation> darkGcolored
urine and liht stools> low urine output> se&ere
headache.
P+e1en(ion
8&oid swimmin or wadin in potentially
contaminated water or flood water.
<se of proper protection like boots and
lo&es when work requires e3posure to
contaminated water.
29
+rain potentially contaminated water when
possible
Control rats in the household by usin rat
traps or rat poison> maintainin cleanliness in the
house.
Take medicines)antibiotics duly prescribed by a
doctor.
6eturn on the scheduled follow;up &isit.
Early reconition and treatment within two days
of illness to pre&ent complications so an early
consultation is ad&ised.
2. 'or all the aforementioned fe&er;causin diseases> brin
suspected cases immediately to the nearest health center or
hospital.
32 %ow (o Manage5P+o1ide an &--edia(e T+ea(-en( 4o+
Fe1e+
a. "lace the child in a comfortable room with open
windows
b. 5et the child wear comfortable clothes.
c. +o not wrap the child with thick blanket
d. -pone bath the child with tap water
e. 5et the child drink plenty of water.
f. ?i&e paracetamol to lower down the body temperature
. "ut cold compress in the forehead
h. 6emo&e the childDs clothes if he)she has hih fe&er.
=rin immediately to the nearest hospital.
30
i. <se banana trunk to lower body temperature. ,efer to
Anne* A !Saha ng Saging".
"##lication
manaement of fe&er associated with &arious diseases
when a child is sick in the family.
Procedure
Ac(i1i(* 3: "e-ons(+a(ion on ()e :se o4 anana T+un9 %Saha
ng Saging&
1. ?et a banana trunk.
2. -how the participants what part to cut and how.
!. +escribe the saha and e3plain that it has a cold part that
can be used to lower body temperature.
31
#. 5et the participants ha&e the chance to feel and touch the
saha.
"##lication
1. Try to use banana trunk in lowerin body temperature of a
person with fe&er.
Synthesis
4a&in fe&er is not a disease rather it is a sin)symptom of a
disease or an infection that normally is contaious. +iseases that
manifest fe&er at the onset of acquirin them include typhoid fe&er>
malaria> denue> measles> chicken fo3> tuberculosis and
leptospirosis. "roper care and manaement of a child with fe&er
should be undertaken and persistence of fe&er after ! days> the
child must be brouht immediately to the doctor for medical
attention.
32
S#SS&., 2
C1<?4> C10012 C15+-
82+ "2E<012I8
Introduction
Couh> common colds and pneumonia are also common diseases
in childhood. Early symptoms and sins as well as causes of these
diseases shall be discussed in this session to equip women and
other members of the family to pro&ide early inter&ention to
children with couh> common colds and pneumonia.
Session Objectives
33
1. 5earn about couh> common colds and pneumonia; and
2. 8dminister the proper care and manaement of couh>
common colds and pneumonia.
Estimated time
1 4our and !, 0inutes
Methodology
?roup sharin
+emonstration)6eturn +emonstration
5ecture)+iscussion
Materials
4andouts
"owerpoint> 5aptop> 5C+
Chalk> :hiteboard marker
+oll
34
Procedure
Ac(i1i(* 1: S)a+ing on !oug); !o--on !olds and Pneu-onia
1. -tart the discussion by askin the participants the followin
questions:
:hat do you think are the causes and sins and
symptoms of couh> common colds and pneumoniaB
4ow do you usually treat couh> common colds and
pneumoniaB
2. :rite the responses on the board.
!. -ynthesi$e the responses of the participants and lead the
discussion to the Cey 5earnin "oints.
ey !earning Points
1. 'rom 'acts for 5ife published by the "hilippine
Information 8ency in cooperation of the <nited
ChildrenDs 'und in 1((%> coug) and colds can indicate
pneu-onia; which kills millions of children. This does not
include yet pneumonia deaths which are a result of measles
and diphtheria> and which can be treated by immuni$ation.
"neumonia is the leadin cause of infant and child deaths.
The followin can sa&e the li&es of children:
35
a. If the child with a couh is breathin much more
rapidly than normal> then the child is at risk. It is
essential to et the child to a health center or hospital
quickly.
b. 'amilies can help pre&ent pneumonia by makin sure
that babies are breastfed for at least the first si3 months
of life and that all children are well;nourished and fully
immuni$ed.
c. 8 child with a couh or colds should be helped to eat
and drink plenty of liquids.
d. 8 child with a couh or cold should be kept warm but
not hot> and should breathe clean> non;smoky air.
22 !oug)
!oug) is a symptom of other illnesses related to throat>
bronchi and luns.
Couh can be:
a. +ry couh with phlem !pharyngitis> colds>
smokin> flu> measles and worm9
b. Couh with phlem
c. Couh with asthma
d. Couh with difficulty in breathin
e. 1n and off couh> emphysema and smokers couh
f. Couh with combination of blood
g. Couh with weiht loss

!ause
36
Chronic couh is caused by asthma> allergic rhinitis,
sinus problems 7for e3ample sinus infection9> and
esophageal reflu* of stomach contents.
In rare occasions> chronic couh may be the result of
aspiration of forein obAects into the luns 7usually in
children9.
Signs and S*-p(o-s
'e&er
-hortness of breath
'lu;like symptoms
5abored breathin
Chest pain
1ther coe3istin symptoms may include headache>
fatiue> weakness> sore throat> strider> whee$in>
paleness> blueness of the skin !cyanosis" and rash.
"erson to person transmission throuh couhin
P+e1en(ion
+o not i&e medicines immediately to stop couhin
?i&e child plenty of water e&ery day.
8&oid crowded places.
If couh is se&ere> do the postural drainae after the
steam inhalation twice a day. ,efer to Anne* B
!-ostural .rainage".
37
?i&e steam inhalation for 1% minutes. ,efer to
Anne* # !Steam 'nhalation".
8&oid smoke particles and dusty places.
T+ea(-en(
Couhs are not necessarily danerous. If you ha&e a
simple dry couh with a runnin nose> then they are the
classical symptoms of a common cold which can be
easily cured by merely waitin.
1&er treatin a common cold with drus is not
ad&isable as it is a protecti&e mechanism and hence
should not be stopped. The therapies may end up
maskin a deeper underlyin problem. <se
con&entional or alternati&e couh remedies for no
loner than se&en to 1, days> and preferably only for
temporary relief from nihtGtime couhin.
#44ec(s
2o clear effects.
22 !o--on !old
The co--on cold> also known as a &iral upper respiratory
tract infection> is a self;limited contaious illness that can
be caused by a number of different types of &iruses that the
body ne&er builds up resistance aainst all of them. 'or this
reason> colds are a frequent and recurrin problem.
!ause
38
Caused by many &iruses
Signs and S*-p(o-s
2asal stuffiness or drainae
-ore or scratchy throat
-nee$in
4oarseness
Couh
'e&er
4eadache
Tiredness
=ody ache
-pread by direct hand;to;hand contact with infected
secretions or from contaminated surfaces.
T+ea(-en(
There is no cure for the common cold.
4ome treatment is directed at alle&iatin the
symptoms associated with the common cold and
allowin this self;limitin illness to run its course.
-upporti&e measures for the common cold include
rest and drinkin plenty of fluids.
1&er;the;counter medications such as throat
lo$enes> throat sprays> couh drops> and couh syrups
may also help brin relief.
39
#44ec(s
:eakened immune system
If the illness continues> the body becomes e&en weaker.
-usceptibility to other more danerous and complicated
diseases such as pneumonia and influen$a> which at
times can be fatal.
Can lead to sinusitis> bronchitis> hypothermia> strep
throat and otitis media.
If chronic lun disease is present> such as asthma> there
is a risk of the illness bein ara&ated> leadin to
frequent attacks.
32 Pneu-onia
Pneu-onia is a eneral term that refers to an infection of
the luns> which can be caused by a &ariety of
microoranisms> includin &iruses> bacteria> funi> and
parasites. 1ften pneumonia beins after an upper
respiratory tract infection 7an infection of the nose and
throat9. :hen this happens> symptoms of pneumonia bein
after 2 or ! days of a cold or sore throat.
!auses
Caused by a &ariety of &irus> bacteria and
sometimes funi.
Signs and S*-p(o-s
-ymptoms of pneumonia &ary> dependin on the
ae of the child and the cause of the pneumonia.
40
Common symptoms include:
'e&er
Chills
Couh
<nusual rapid breathin
=reathin with runtin or whee$in sound
5abored breathin that makes the childDs ribs retract
7when muscles under the ribs cae or between the
ribs draw inward with each breath9
Homitin
Chest pain
8bdominal pain
+ecreased acti&ity
5oss of appetite 7in older kids9 or poor feedin 7in
infants9
In e3treme cases> bluish or ray color of the lips and
finernails
-ometimes a childNs only symptom is rapid
breathin. -ometimes when the pneumonia is in the
lower part of the luns near the abdomen> there may
be no breathin problems> but there may be fe&er
and abdominal pain or &omitin.
:hen pneumonia is caused by bacteria> an infected
child usually becomes sick relati&ely quickly and
e3periences the sudden onset of hih fe&er and
unusually rapid breathin. :hen pneumonia is
caused by &iruses> symptoms tend to appear more
radually and are often less se&ere than in bacterial
pneumonia. :hee$in may be more common in
&iral pneumonia.
41
-ome types of pneumonia cause symptoms that i&e
important clue about which erm is causin the
illness. 'or e3ample> in older kids and adolescents>
pneumonia due to /ycoplasma 7also called
walkin pneumonia9 is notorious for causin a sore
throat and headache in addition to the usual
symptoms of pneumonia.
In infants> pneumonia due to chlamydia may cause
con0unctivitis 7pink eye9 with only mild illness
and no fe&er. :hen pneumonia is due to whoopin
couh 7pertussis"> the child may ha&e lon
couhin spells> turn blue from lack of air> or make
a classic OwhoopO sound when tryin to take a
breath.
-ome cases of pneumonia are contracted by breathin in
small droplets that contain the oranisms that can cause
pneumonia. These droplets et into the air when a person
infected with these erms coug)s or snee$es. In other
cases> pneumonia is caused when bacteria or &iruses that
are normally present in the mouth> throat> or nose
inad&ertently enter the lun.
P+e1en(ion
-top smokin.
8&oid contact with people who ha&e respiratory
tract infections> such as colds and influen$a 7flu9.
If a person has not had measles or chickenpo3 or
otten &accines aainst these diseases> a&oid contact
with people who ha&e these infections. "neumonia can
42
be a complication of measles or chickenpo3> so ettin
these infections can put you at risk for ettin
pneumonia.
:ash hands often.
Haccination
+octors use antibiotics to treat pneumonia caused
by bacteria> the most common cause of the condition.
The number of days you take antibiotics depends on
your eneral health> how serious your pneumonia is>
and the type of antibiotic you are takin.
#44ec(s
=acteria in the bloodstream
Infection and fluid accumulation
8bscess of the lun
8cute respiratory distress syndrome
Procedure
Ac(i1i(* 2: "e-ons(+a(ion50e(u+n "e-ons(+a(ion on
Pe+cussion and Pos(u+al "+ainage
1. =e ready with the bi doll for this acti&ity.
43
2. Tell the participants to obser&e carefully since they will be
asked to do a return demonstration.
!. -it the doll on your lap.
#. 4old the doll in your left hand. To do the percussion> cup
your hand by bendin from the wrist and tap the doll ently
on the chest so it will not hurt. +o the percussion only o&er
the rib cae and not on the abdomen.
%. This time> lay the doll face down on the lap as if it is
inhalin the steam from a hot water in the basin on the
floor. 4old the doll and tap it ently on the back.
*. 8nne3 = 7"ostural +rainae9 will pro&ide more
information on how to do this acti&ity.
"##lication
1. +o the percussion with postural
drainae when necessary.
Synthesis
Couh> colds and pneumonia are diseases related to upper and
lower respiratory infections. Couh and colds can indicate
44
pneumonia the leadin cause of infant and child death. :omen and
their family members should be aware that persistent couh and
colds can be a symptom already of pneumonia and should be
brouht immediate to the nearest health center or hospital.
S#SS&., 3
"&A00%#A
Introduction
+iarrhea is one of the most common childhood diseases and can be
&ery fatal if nelected. E&ery home should know how to respond
to when there is somebody in the family who has diarrhea
especially when the health center is away from the community.
Session Objectives
1. 5earn about diarrhea;
45
2. 8dminister the proper care and manaement of diarrhea;
and
!. 5earn how to prepare an 1ral 6ehydration -olution
716E-159.
Estimated time
Methodology
?roup sharin
+emonstration)6eturn demonstration
5ecture)+iscussion
Materials
4andouts
Chalk> :hiteboard marker>
-ample packs of oresol
Teaspoon> Tablespon
46
?lasses
"itcher of water
Procedure
Ac(i1i(* 1: S)a+ing on "ia++)ea
4ow do you determine if your
child has diarrheaB
:hat do you usually do if your
child has
diarrheaB
:hat do you think are the
causes of diarrheaB
2. :rite key words of the responses on the
board.
!. -ynthesi$e all the responses and proceed to the discussion
of the Cey 5earnin "oints.
ey !earning Points
47
2. 'rom 'acts for 5ife> dia++)ea causes
de)*d+a(ion and malnutrition. It kills millions of children
e&ery year. In the "hilippines> it is the third leadin cause
of death and the second leadin cause of infant and child
illness. The followin can sa&e the li&es of children and
most of the malnutrition caused by diarrhea.
a. +iarrhea can kill children by drainin too much
liquid from the body. -o it is essential to i&e a child
with diarrhea plenty of liquid to drink.
b. 8 child with diarrhea needs food.
c. :hen a breastfed child has diarrhea> it is important
to continue breastfeedin.
d. 8 child who is reco&erin from diarrhea needs an
e3tra meal e&ery day for at least two weeks.
e. +iarrhea is more serious than usual if it persists for
more than two weeks or if there is blood in the stool.
f. 0edicines or 1ral 6ehydration -olution 716E-15
or 16-9 or -a&e;a;5ife;+rink. -hould not be used for
diarrhea> e3cept on medical ad&ice.
. +iarrhea can be pre&ented by breastfeedin> by
immuni$in all children aainst measles> by usin
latrines> by keepin food and water clean> and by
washin hands before touchin food.
The publication Cey 4ealth 0essaes for Emerencies:
"hilippines of the +epartment of 4ealth published in 2,,/
is the source for the succeedin information.
48
32 "ia++)ea
"ia++)ea is the passae of loose and watery stools 7more
than ! bowel mo&ements per day9 often associated with
assiness> bloatin> and abdominal pain. It may also be
accompanied by nausea> &omitin> and fe&er.
!auses
Infection due to:
&irus 7,otavirus, Hepatitis B virus9
bacteria 7cholera, shigella9
Intestinal parasites 7), histolytical,
pinworm9
These microoranisms are usually spread by
contaminated hands> or throuh food and water.
+iarrhea can be caused by malnutrition> parasites
and allery.
Pa+asi(e
Contaminated water and food brins serious
oranisms like amoeba> bacillary and cholera that
can only be seen in microscope e3cept for ascaris
that is commonly and easily seen. It causes diarrhea.
Alle+g*
49
8llery in some food causes diarrhea. 0ilk>
seafoods> o&er;ripe also causes diarrhea for some
people. 8lleric reactions from different medicines
like erythrosine and penicillin also cause
diarrhea.

Inestion of contaminated food and water
Signs and s*-p(o-s
"assae of watery stools at least !3 a day
E3cessi&e thirst
-unken eyeballs and fontanels
P+e1en(ion
+rink water only from safe sources. If unsure> boil
water for three minutes or do water chlorination
Eat only foods that are well;cooked and properly
prepared. 8&oid eatin in street &ended foods.
Ceep the food away from insects and rats by
co&erin them.
:ash fruits and &eetables with clean water before
eatin or cookin.
<se toilet when defacatin.
:ash your hands before and after usin the toilet
"roper waste and e3creta disposal.
50
Thorouh washin of hands with soap and water.
,efer to Anne* . !-roper Handwashing
-rocedure".
Take $inc supplement.
"olluted surroundins)en&ironment attracts more
mosquitoes> cockroaches> rats> flies that brin
poison> erms and microoranisms in food. -o it is
important to maintain cleanliness in our
surroundins like:
"eople must use toilet properly at a&oid
throwin e3creta)human waste anywhere.
8nimals like pi> do should be placed in clean
caes.
+rainae must be clean.
Trash should be disposed properly or buried in
soil)land.
"ractice waste sereation and eco;waste.

"re&ent e3cessi&e loss of fluid and salt by i&in
16-.
?i&e other recommended home fluids like rice
water)soup 7am9> clear soup> coconut Auice> water to
replace lost body fluid.
+rink water> especially if there is fe&er.
51
+o not i&e soft drinks or enery drinks like
?atorade.
Eat to pre&ent or minimi$e nutritional damae.
Easily diested food that can be i&en in small
amount like the followin:
Tea> am
=raised beef soup> rilled fish
=oiled e
=iscuit toasted bread
=oiled amote or potato
=anana like latundan
=reastmilk
6ice> porride
=oiled squash
=eans like mono
Tofu
8&oid the followin food:
CowDs milk
1ily food
Chocolate
"eanut
'ruits like papaya> mano> a&ocado
Heetables like cabbae> beans
'ood with pepper> arlic
8lcoholic be&eraes
Continue breastfeedin.
'or child who is fed with cowDs milk or bottled milk>
temporarily stop in i&in milk.
52
-ince most of diarrhea;causin micro;oranisms are
spread by contaminated hands with human waste> there
should thorouh hand washin with soap and water and
careful cleanin of all parts of the hand.
?i&e $inc supplement
8ntibiotic is needed)required when the bowel
mo&ement has blood
Consult the doctor if diarrhea is se&ere especially in
children and the elderly.
0onitor the sick person closely> particularly children
who do not show a clear impro&ement.
0e-inde+s in T+ea(ing "ia++)ea
+o not control diarrhea because to3ins need to be
dischared from the body.
+o not immediately i&e medicines to cure
diarrhea. There are some medicines that can cause
irritation to intestines and miht worsen the bowel
dischares)mo&ement.
+ehydration can be pre&ented or controlled if
enouh liquid is i&en to the sick person.
?o to the nearest hospital if there is flu> &omitin or
con&ulsion or if diarrhea is more than two days and has
worsen that it becomes a daner and can lead to
dehydration due to loss of body fluids.
-e&ere dehydration may cause death especially to
children and the elderly
0alnutrition is caused by diarrhea. +iarrhea
becomes a symptom of malnutrition.
32 "e)*d+a(ion
53
"e)*d+a(ion is the condition of losin too much liquid
from the body.
a2 "ange+ Signs o4 "e)*d+a(ion
+rinks eaerly and thirsty
5ack of appetite
5oss of weiht
+ehydrated skin> lips and tonue
Enlarement of eyes
:eakenin of body
-low &oice
+ifficulty in breathin
-low and fast rate)heart beat
Coldness of skin
+i$$iness> con&ulsion> death
62 Fou+ 0ules in ()e Manage-en( o4 "e)*d+a(ion
?i&e e3tra fluids 7as much as the child can take9.
+o not stop breastfeedin. Tell the mother to
breastfeed frequently and for loner at each
feed. If the child is e3clusi&ely breastfed>
i&e 16E-15 in addition to breastmilk.
If the child is not e3clusi&ely breastfed> i&e
one or more of the followin: food ; based
fluids 7e..> thin porride or lugaw> soup>
rice water or am> yourt drinks9 or suitable
drinks 7e.. fresh fruit Auices> reen coconut
54
water> water from the cleanest possible
brouht to boil and then cooled9

-how the mother how much fluid to i&e in
addition to the usual fluid intake.
- <p to two years G %, to 1,, ml. after
each loose stool
- Two years or more G 1,, to 2,, ml. after
each loose stool
Tell the mother:
- ?i&e frequent small soups from a cup
- If the child &omits> wait for 1, minutes
then continue G but more slowly
- Continue i&in e3tra fluid until the
diarrhea stops.
?i&e $inc supplements 7ae two months up to fi&e
years9
Tell the mother how much $inc to i&e 72,
m tab9
- two months up to * months G P tablet
daily for 1# days;
- si3 months or more G 1 tablet daily for
1# days.
-how the mother how to i&e $inc
supplements.
55
- Infants G dissol&e tablets in a small
amount of e3pressed breastmilk>
16E-15 or clean water in a cup.
- 1lder children G tablets can be chewed
and dissol&ed in a small amount of clean
water in a cup.
8d&ice mother when to return to the health center
or hospital.
c2 .+al 0e)*d+a(ion Solu(ion <.0#S.7=
In the 'acts for 5ife> it says that a special drink for
diarrhea can be made usin a packet of 16-. This
drink is used by doctors and health workers to treat
dehydrated children. =ut it can also be sued in the
home to pre&ent dehydration from startin. To make
the drink:
+issol&e the content of the packet in the amount
of water indicated in the packet. If too little
water is used> the drink can make the diarrhea
worse. If too much water is used> the drink will
be less effecti&e.
-tir well and i&e to the child to drink in a cup
or feed with a spoon.
If there is no ready 16- packet> this is the way to
prepare an 16E-15:
1 teaspoon salt
! tablespoon suar
. lasses or 1 liter of water
This can be easily prepared at home.
56
32 Ad1iso+* on Food Sa4e(*
Food Sa4e(* is the assurance)uarantee that food will not
cause harm to the consumers when it is prepared and)or
eaten accordin to its intended use:
Food and >a(e+36o+ne "isease is a roup of illness
caused by any infectious aents 7bacteria> &iruses and
parasites9 and non;infectious aents 7chemical> animal and
plant to3ins9.
a2 !o--on !auses o4 Food and >a(e+3o+ne "iseases
<nsafe sources of drinkin water
Improper disposal of e3creta)human waste
<nhyienic practices like spittin anywhere>
blowin or pickin the nose
<nsafe food handlin and preparation practices 7e..
street food9
62 Fi1e ?e*s (o Sa4e+ Food
The information came from the :orld 4ealth
1rani$ation 7:419.
Ceep clean.
-eparate raw and cooked food.
Cook food thorouhly.
Ceep food at safe temperatures.
<se safe water and materials.
c2 &n !ase o4 Suspec(ed Food3o+ne &llnesses
57
"reser&e the e&idence.
If a portion of the suspected food is
a&ailable> wrap it securely and free$e it.
-eek treatment as necessary.
If symptoms persist or are se&ere 7e..
bloody diarrhea> e3cessi&e nausea and
&omitin or hih body temperature9>
immediately consult a doctor.
6eport the incidence to the local health
department.
"##lication
manaement of diarrhea and dehydration when a child is
sick in the family.
Procedure
Ac(i1i(* 1: "e-ons(+a(ion50e(u+n "e-ons(+a(ion on %ow (o
P+epa+e .0#S.7
58
#. =e ready with salt> suar and water and the utensils.
%. Count the number of lasses of water needed as water is
poured in a pitcher. 7This is a way of interatin numeracy
in the demonstration.9
*. -how the proper way of mi3in the 16E-15.
"##lication
1. "repare 16E-15 at home to pre&ent dehydration of
children with diarrhea.
Synthesis
+iarrhea at the early stae can cause malnutrition> and if nelected
can lead to infant and child death. +iarrhea can be pre&ented by
breastfeedin> by immuni$in all children aainst measles> by
usin latrines> by keepin food and water clean> and by washin
hands before touchin food.
Infant with diarrhea should be continued with breastfeedin.
Children with diarrhea should be i&en more liquid and easy to
diest food. They can also be i&en with medicines or oral
dehydration solution 716E-15 or 16-9 under the direct medical
ad&ice of a doctor.
59
1ther key pre&enti&e measures include food safety such as 19 keep
clean> 29 separate raw and cooked food> !9 cook food thorouhly>
#9 keep food at safe temperature> and #9 use safe water and
materials. 1thers include 19 obser&e proper sanitation by
obser&in proper waste and e3creta disposal and 29 seek medical
ad&ice for persistent diarrhea.
1ive enough warning to the participants about
dehydration. ,emind them to prepare (,)S(+ when
necessary.
1ive emphasis that the simple washing of hands with
soap and water can prevent children from contracting
diseases and can save their lives.
S#SS&., 4
S!A&#S
Introduction
60
-cabies is a skin disease and most often it is nelected as it is
always percei&ed as ordinary skin irritation unless the scabies has
almost affected most of the parts of the body of the child. In this
session> sins and symptoms of scabies shall be discussed and the
proper care and manaement of scabies.
Session Objectives
1. 5earn about scabies;
2. 8dminister the proper care and manaement of scabies; and
3. "repare arlic ointment for scabies.
Estimated Time
Methodology
?roup sharin
+emonstration
5ecture +iscussion
61
Materials
4andouts
-to&e
:ooden spoon for cookin
'ryin pan
Empty medicine bottle
?arlic lo&es
Candle
Coconut oil
Procedure
Ac(i1i(* 1: S)a+ing on Sca6ies
child has scabiesB
:hat do you usually do if
your child has scabiesB
reasons why children are ha&in scabies B
62
2. :rite key words of the responses on the board.
ey !earning Points
12 Sca6ies < 'alis("so =
Sca6ies is an itchy> hihly contaious skin condition
caused by an infestation by the itch mite Sarcoptes
scabiei. 0ites are small eiht;leed parasites 7in contrast
to insects> which ha&e si3 les9. They are tiny> Aust 1)!
millimeter lon> and burrow into the skin to produce
intense itchin which tends to be worse at niht. The mites
that infest humans are female and are ,.! mm;,.# mm lon;
the males are about half this si$e. -cabies mites can be seen
with a manifyin lass or microscope. The scabies mites
crawl but are unable to fly or Aump. They are immobile at
temperatures below 2, C> althouh they may sur&i&e for
proloned periods at these temperatures.
!ause
Caused by the itch mite Sarcoptes scabiei.
63
+irect skin;to;skin contact is the mode of
transmission.
Transmission of the mites in&ol&es close
person;to;person contact of the skin;to;skin &ariety.
It is hard> if not impossible> to catch scabies by
shakin hands> hanin your coat ne3t to someone who
has it> or e&en sharin bedclothes that had mites in them
the niht before.
8 mother huin her children is sufficient to
spread the mites.
4oldin or usin the thins owned by the sick
person like clothes> face towel> towel and bed sheets.
5ack of personal hyiene maybe due to scarcity
of water for bathin and washin clothes.
+elay in ettin medicines due to lack of
medicines or no money to buy medicines.
P+e1en(ion
6eularly take a bath and chane into clean clothes.
:ash clothes and blanket e&eryday and allow it to dry
under the sun.
The hands should be washed with water and soap after
usin the toilet.
If treatin scabies> treat the whole body not only the
affected area.
Treat all the members of the family who are affected.
64
Signs and S*-p(o-s
Itchin that is usually e3perienced at niht
Thin and rued)wrinkled skin of the affected area of
the body
:ound due to serious itchiness that could lead to
infection
'lu)fe&er and swollen lymph nodes
The fa&orite spot of scabies is between finers and toes>
in under arms> na&el> waist> side of the fist> elbow> les>
and pri&ate oran of the male.
"repare an ointment with 1 part indane and 1% part
vaseline.
=athe the patient with soap and rub the whole body
4eat the vaseline and put vaseline or sulfur ointment
the whole body e3cept on face. 8llow it for whole day
and rinse. +o it aain after a week.
To stop the itchiness> put hot water on the affected area
that the sick person can bear.
%e+6al Medicine 4o+ Sca6ies
The +epartment of 4ealth issued the list of ten appro&ed
herbal medicines. ,efer to Anne* ) !Ten Herbal
/edicines in the -hilippines". This module only uses
appro&ed herbal medicines from such listin.
65
The use of herbal medicine is resorted to with the
reconition that most of disad&antaed women are
financially hard;up that alternati&es should be a&ailable for
them.
$a+lic 7)awang& Q Cook one cup of crushed arlic
into one cup of coconut oil. 8dd P cup of
scraped)shreded candle. -train. 5et it cool. 8pply in the
affacted area.
i((e+ $ou+d !"m#alaya& Q 'ry the lea&es of bitter
ourd in coconut oil. +rain and apply in affected area.
$ua1a !)ayabas& Q :ash)6inse the affected area
with boiled ua&a lea&es. ?ua&a lea&es can clean well.
"##lication
manaement of scabies when a child is sick in the family.
Procedure
Ac(i1i(* 1: "e-ons(+a(ion50e(u+n "e-ons(+a(ion on %ow (o
P+epa+e $a+lic .in(-en(
66
1. =e ready with sto&e> wooden spoon for cookin> fryin
pan> medicine bottle.
2. =e ready with sufficient amount of arlic cloa&es> candle
and coconut oil.
!. Crush the arlic.
#. -crape)-hred the candle.
%. "ut the coconut oil in the pan.
*. "lace the candle to melt.
/. 8dd the crushed arlic.
.. -train and let it cool.
(. "lace in a co&ered medicine bottle that has been washed
and dried earlier.
1,. 5et the arlic ointment cool then co&er the medicine bottle.

"##lication
1. "repare arlic ointment for a child with scabies.
Synthesis
-cabies is a hihly transmitted disease. Transmission is skin;to;s
kin contact such as huin> holdin or usin the thins owned by
the person who has scabies. This is also caused by lack of personal
hyiene. Its main symptom is itchiness and is caused by mites
whose fa&orite areas are the finers and toes> under arms> na&el>
waist> side of the fist> elbow> les and pri&ate oran of the male.
67
-cabies can be treated at home throuh the use of herbal
medicines. These include usin arlic> bitter ourd 7ampalaya9 and
ua&a 7bayabas9. ?arlic can be crushed and cooked into a one cup
coconut oil and can be applied when cool in the affected skin of
the child. The bitter ourd lea&es can also be fried also in the
coconut oil for application also in the skin> and the clean ua&a
lea&es can be boiled in the water.
The best way to pre&ent scabies from transmittin to other family
is to reularly take a bath and chane into clean clothes> wash the
clothes and blanket e&eryday by dryin it under the sun and to
always wash the hands after usin the toilet.
,eiterate to the participants to only use the $safe%
herbal medicines which are in the list of ten approved
herbal medicines by the .epartment of Health !.(H".
68
S#SS&., 5
PA0AS&T&SM
Introduction
5earnin about parasitism is &ery crucial in determinin how to
pre&ent and treat parasitism. This is &ery common in youn
children and this is often not noticed at the early stae.
<nderstandin the nature of parasitism will help pre&ent its
destructions in the health of a child.
Session Objectives
1. 5earn about parasitism; and
2. 8dminister the proper care and manaement of parasitism.
Estimated time
1 4our
Methodology
69
?roup sharin
5ecture)+iscussion
Materials
4andouts
Procedure
Ac(i1i(* 1: S)a+ing on Pa+asi(is-
1. 8sk the participants the followin
questions:
child has parasitesB
:hat do you usually do if your
child has parasitesB
reasons why children are ha&in parasitesBB
2. :rite key words of the responses
on the board.
70
ey !earning Points
12 %u-an Pa+asi(es
'rom www.alleryescape.com> )u-an pa+asi(es are
oranisms that li&e inside the human body which ser&es as
their host. -ince these parasites are unable to produce food
on their own> they depend on their hosts for their sur&i&al.
<nfortunately> parasites harm human beins because they
consume their food and nutrients. They can destroy our
tissues and cells. They produce to3ic waste products that
can make human beins &ery ill.
S*-p(o-s o4 %u-an Pa+asi(es &n4ec(ions
+iarrhea with foul;smellin stool that becomes worse
in the later part of the day
-udden chanes in bowel habits 7e.. constipation that
is now soft and watery stool.
Constant rumblin and urlin in the stomach area
unrelated to huner or eatin
4eartburn or chest pain
'lu;like symptoms such as couhin> fe&er> and nasal
conestion
'ood allery
71
Itchin around the nose> ears> and anus> especially at
niht
5oss of weiht with constant huner
8nemia
8n3iety caused by the metabolic waste products of the
parasites
.()e+ s*-p(o-s of human parasite infections include:
=lood in the stool
=loatin
+iarrhea
?as
5oss of appetite
Intestinal obstruction
2ausea
Homitin
-ore mouth and ums
E3cessi&e nose pickin
?rindin teeth at niht
Chronic fatiue
4eadaches
0uscle aches and pains
-hortness of breath
-kin rashes
+epression
0emory loss
Modes o4 T+ans-ission
72
8nimal feces
:alkin barefoot
4andlin raw meat and fish
Eatin raw or undercooked pork> beef or fish
4andlin soiled litter pans 7cats9
Eatin contaminated raw fruits and &eetables
Eatin meals prepared by infected food handlers
+rinkin contaminated water
Inhalin contaminated dust 7parasitic es or cysts9
22 !o--on Pa+asi(es ()a( !an &n4ec( %u-ans
a2 Pinwo+- G This is one of the most common human
parasites. This worm makes its home in the hostDs
colon> but it lays es outside of the hostDs body.
Transmission can occur throuh unclean hands> clothes
and bed sheets.
Pinwo+- is a white thread;like worm measurin 1 cm.
lon. "inworm rows in the lower part of the small
intestines and upper part of the bier intestines. If the
worm is ready to lay es> it crawls out and lays
thousand of es outside the anus. This will lead to
scratchin. The es will be attached to the nails and
will be transferred to the mouth of the host. 1ther
73
members of the family will also be infected throuh
sharin of blanket> clothes> food and other thins. The
whole cycle lasts for three to si3 weeks. ,efer to
Anne* 2 !+ife #ycle of a -inworm".
Sign5s*-p(o-
Irritation and scratchin in the anal area.
62 %oo9wo+- G This is an intestinal human parasite
beins its life outside of the body> in soil or water>
where humans become infected. 4umans can drink
water that contains hookworm lar&ae> or humans can
inest contaminated fruits and &eetables. This worm
attaches itself to the human intestines where it drinks
blood 7this worm actually has teethR9.
%oo9wo+- can penetrate the skin of humans which
causes itchin. In a few days> the es of a hookworm
will reach the luns and this will cause dry couh. If
human couh and swallow> the es attach themsel&es
in the intestines and they will suck the blood there. 8
female hookworm lays !,>,,, es in one day. If the
es et out of the body throuh waste in a wet soil>
they hatch and ready to enter the skin of human beins
aain. ,efer to Anne* 1 !Ang Buhay ng
Hooworm".
Signs and S*-p(o-s
:eakness
8bdominal pain
74
2ausea
+iarrhea
8nemia
c2 0oundwo+- G 1ne of the most common human
parasites in the entire world. This worm is as lare as a
writin pencil. "eople are infected by inestin the es
which can be in the soil> fruits> and &eetables. The
es find their way from the intestines to &arious
orans where they can cause se&ere damae.
0oundwo+- is also called ascaris. It is the most
common worm amon 'ilipino children aes % G #
years old. 'ood with es of ascaris when eaten by
humans will become small worms in the small
intestines oin to the luns. They can be swallowed
while couhin and will reach the intestines aain
where they will row. 8 female ascaris is pink in
color and 2, G !, cm lon. It can lay 2#,>,,, es)day.
The es lea&e the body throuh the e3creta)human
waste. ,efer to Anne* H !+ife #ycle of
,oundworm3Ascaris".
Signs and S*-p(o-s
:eiht loss
:eakness
Infection
8bdominal pain.
75
d2 Tapewo+- G This is common in dos and cats but rare
in humans. To become infected with this parasite>
humans must swallow fleas that are infected with
tapeworm lar&ae. This worm can li&e in the intestines>
where it will steal &aluable nutrients and e3pel
danerous waste. The human host infected with this
worm may not show any symptoms.
Tapewo+- is a white worm that rows up to se&en
meters and is di&ided into 1 cm. each. 1ld tapeworm
lays es in the intestines of humans and these es o
out of the human body throuh the e3creta)human
waste. If humans do not know proper e3creta)waste
disposal> a pi eats the waste and the es of tapeworm
will be hatched in the intestines of the pi. This is the
reason why humans who eat a not well;cooked pi)pork
can ha&e tapeworm in their intestines.
Signs and S*-p(o-s
0ineral imbalance
=loatin and as
+i$$iness
4uner pains
J'u$$yK thinkin
+iesti&e problems
-ensiti&ity to touch
8lleries
e2 7i1e+ Flu9e ; 8 flat worm that attacks the hostDs li&er
by causin inflammation and makin holes. It can
sur&i&e inside a human host for appro3imately !, years.
76
4umans acquire this parasite throuh eatin
undercooked fish> contaminated &eetables> human
feces used as fertili$er> or by drinkin 7or swimmin9 in
contaminated water.
Signs and S*-p(o-s
Enlared li&er
"ain in the riht side of the body
+epression
Edema
Hertio
=ile stones
Cancer
42 Adul( >o+- @ It is white> creamy> or pinkish yellow
when freshly e3pelled. Its shape is elonated and
cylindrical.
0ale worm
measures 1% G !, cm. 3 ! mm. with cur&ed
posterior end
smaller> shorter and more slender than the
female
'emale worm
measures 2, ; #% cm. 3 % mm. with straiht
posterior end
lays about 2#,>,,, es per day
one female produces appro3imately
*%>,,,>,,, es in ( months
77
32 Signs i4 a Pe+son )as >o+-s
T*pes o4 >o+- Signs
12 "scaris S 5are stomach)tummy
S -e&ere stomach ache)pain
S <nderweiht
S :eak body
S +ry couh
S Itchin in the pri&ate parts
S :atery -tools
22 Pinwo+- S Itchin in the pri&ate parts
especially durin niht time
S -tomach ache)pain
32 Tapewo+- S -liht stomach ache)pain
S :atery stools
S :eak body
42 %oo9wo+- S 8nemia
S +ry couh
S -tomach pain
S +iarrhea
S :eak body
S Easily to et tired
.S "eelin of the skin particularly in
the finers and back of the foot
52 T+ic)u+is S 8nemia
S +ry couh
S -tomach pain
S +iarrhea
S :eak body
S 6ectal prolapse
,efer to Anne* ' !+ife #ycle of Trichuris
!4hipworm".
78
42 Tips on %ow (o P+e1en( !on(a-ina(ion 4+o-
Mic+oo+ganis-s
a. Co&er left;o&er food to a&oid flies and any other insects
from ettin in the food.
b. :ash hands before and after ser&in food.
c. Throw waste properly.
d. <se toilet)comfort room properly.
e. +o not use e3creta)human waste as plant fertili$er.
f. Teach the child not to put his)her hand or any obAect in
her the mouth to a&oid erms.
g. Cut the nails short.
h. Teach the child to wash their pri&ate parts and hands
e&ery mornin and after each bowel mo&ement.
i. 5et the mats and blankets dry under the sun.
j. 8lways wear slippers> sandals or shoes.
52 T+ea(-en( 4o+:
a2 Asca+is; Pinwo+-; %oo9wo+-; T+ic)u+is
1 G 2 years old ; 8lbenda$ole 2,, m. or P tab
e&ery si3 months
1 G % years old ; 0ebenda$ole %,, m. or 1 tab
e&ery si3 months.
2 G % years old ; 8lbenda$ole #,, m or 1 tab
e&ery si3 months
62 Tapewo+-
"ra$iquantel 1, m)k. G sinle dose
79
62 %e+6al Medicines 4o+ ()e T+ea(-en( o4:
2ot all herbal medicines are appro&ed for safe use. ,efer
to Anne* 5 !Herbal /edicines" 2
a2 Asca+is
Eat * G * pieces of $niyog6miyogan% fruit
62 Pinwo+-
8pply coconut oil around the anus to et a relief
from itchin
-it for % G !, minutes in a basin with hot or
lukewarm water that can be endured
c2 %oo9wo+-
?i&e Bepenium, Hitamin 8> =
12
and 2erous
Sulfate. 8lso i&e niyog6niyogan. 1ne seed for
each year of the sick person 7so 1 seed for one year>
2 seeds for two years old9 which should not e3ceed
2, seeds.
"##lication
80
manaement of parasites when a child is sick in the family.
Synthesis
"arasites harm human beins because they consume the food and
nutrients of the children. "arasites can destroy the cells and tissues>
and they produce to3ic waste products that can make human beins
&ery ill.
"arasites include pinworm> hookworm> roundworm and
tapeworm> li&er fluke and adult worm. -ymptoms of ha&in
human parasites infections include ha&in diarrhea> loss of weiht>
anemia> rumblin and urlin in the stomach area> heartburn or
chest pain> and itchin around the nose> ears and anus especially at
niht.
To pre&ent this disease> proper personal hyiene and proper
sanitation in thehome and community should be obser&ed
particularly ha&in a toilet in e&ery home> ensurin food safety and
habitual washin of hands before and after eatin> proper use of
toilet and proper waste disposal> and use of slippers and sandals
e&eryday. Treatment should be under medical ad&ice and some
appro&ed herbal medicinces for safe use.
81
S#SS&., 6
MA,A$#M#,T
.F .T%#0 !%&7"%.." &77,#SS#S
Introduction
1ther childhood illness will be introduced in this session and
pro&ide you information on how to pro&ide proper care and
manaement of children with other common childhood illnesses.
Session Objectives
1. 5earn about other childhood illnesses; and
82
2. 8dminister the proper care and manaement of other
childhood illnesses.
Estimated time
1 4our
Methodology
?roup sharin
5ecture)+iscussion
Materials
4andouts
Procedure
Ac(i1i(* 1: S)a+ing on !)ild)ood &llnesses
83
1. 8sk the participants what are the
common childhood common illnesses and how do they
usually treat such based on their e3perience.
2. :rite key words of the responses on
the board.
!. -ynthesi$e all the responses and
proceed to the discussion of the Cey 5earnin "oints.
ey !earning Points
12 !a+e o4 .()e+ !o--on !)ild)ood &llnesses
The information for this session is sourced from the 0anual on
Effecti&e "arentin> printed by the +epartment of -ocial :elfare
and +e&elopment in 2,,1.
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
12 ,eona(al
Te(anus
Te(anus is a
deadly
disease
caused by a
erm that
li&es in the
soil and
feces of
animals and
humans> and
enters the
body
throuh any
The first
sins of
tetanus in
the
newborn
baby
enerally
appear !
days after
birth.
T The child
8s soon as
the sins
are
e&ident>
rush the
baby to the
nearest
doctor>
health
center or
hospital.
84
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
kind of
wound.
'or a
newborn
baby> erms
can enter the
umbilical
cord>
particularly
in the
followin
cases:
T The cord has
been cut with in
instrument that
has not been
boiled and kept
completely
clean.
T The cord has
not been cut
close to the
body.
T The newly cut
cord is not kept
dry and clean.
T The newly cut
cord is smeared
with ashes>
beins to cry
continuously
and has
difficulty
suckin milk
from the !
rd

to %
th
day
after ha&in
a hearty
appetite for
milk durin
the first two
days.
T 1ften the
umbilical
area is dirty
or infected>
after se&eral
days>
lockAaw sets
in> the facial
muscles
twitch and
the whole
body is
wracked with
con&ulsions.
"re&ention
of tetanus
in the
newborn
baby:
T +urin
prenancy>
mothers
should be
&accinated
aainst
tetanus. 2o
other
protection is
as effecti&e
as
immuni$atio
n.
T +urin
childbirth>
make sure
the
instrument
used in
cuttin the
cord is
thorouhly
clean and
sterili$ed.
85
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
powder and
other unclean
forein
substances.
T 8fter the
baby is
born> make
sure that the
newly cut
cord is
always dry
and clean.
22
"ip)()e+ia
"ip)()e+ia
is a hihly
contaious
infection
caused by a
erm. It
usually
affects the
throat.
+iphtheria
can be
pre&ented by
ha&in your
baby
immuni$ed
by
diphtheria,
pertussis
and tetanus
7+"T9
&accine. The
child is
i&en three
+iphtheria
beins like
a common
cold. The
child has
fe&er>
headache
and sore
throat.
It usually
affects the
nose and
throat and
causes a
bad sore
throat>
swollen
lands>
fe&er and
chills.
ChildDs
4a&e the
child
immuni$e
d with
+"T
&accine.
8&oid
brinin
the child
to hea&ily
crowded
places.
The erms
from the
mouth>
nose or
throat of
an infected
child can
easily
spread
86
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
doses of
+"T &accine
between the
aes 1 and
12 months.
=einnin at
* weeks.
neck may
become
swelled.
ChildDs
breath has a
foul smell.
Child
beins to
lose his)
her appetite
and does
not want to
play. Child
ets tired
easily.
1ften
diphtheria
spreads to
the
windpipe>
resultin in
difficulty
of
breathin
and raspy
couhin.
:ithin the
when
he)she
couhs or
snee$es.
Ceep the
child
away
from
children
infected
with
diphtheria
.
+o not let
the child
use
spoon>
fork and
plate>
beddins>
clothes
and other
articles
that ha&e
been
touched
by an
infected
child.
87
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
first two
weeks> it
can spread
to the
heart and
can cause
heart
failure.
:hen it
spreads to
the ner&es>
and causes
e3treme
difficulty
in
breathin
or
swallowin
> the
child may
die.
32 Te(anus
Te(anus is
caused by a
erm that
li&es in soil
or feces of
animals or
humans. It
enters the
human body
throuh a
8n
infected
wound
7which
may or
may not
be &isible9
+iscomfor
0ake sure
that the
child has
completed
the three
doses of
+"T>
i&en from
1 and P
88
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
wound. +eep
and dirty
wounds are
especially
danerous
since these
are hihly
susceptible to
the erm.
The wounds
most likely
to cause
tetanus are
the
followin:
T 8nimal bites
especially of
dos and cats
T ?unshot and
knife wounds
T 4oles made
by dirty needles
T InAuries
caused by
barbed wire
T "uncture
wounds caused
by steppin on
t and
difficulty
in openin
mouth or
swallowin
-tiffenin
of the Aaw
7lockAaw9
"ainful
twitchin
of facial
muscles>
and
finally>
con&ulsion
s
throuhout
the whole
body
+ifficulty
in
breathin
'e&er
months to
12 months
of ae.
:hen a
child has
a wound>
that is
dirty or
deep>
clean it
well and
take care
of it. <se
lukewarm
water and
soap to
clean out
the dirt.
Then
apply the
antibiotic
ointment.
Ceep the
wound
dry and
clean.
If the
wound is
bi> deep
89
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
thorns> splinters
and rusty nails
and dirty>
see the
doctor or
o to the
nearest
clinic or
health
center
riht
away.
42 Polio
Polio is
caused by a
&irus that
commonly
strikes
children
below two
years old.
-ome parts
of the body
become
paraly$ed>
especially
the les and
feet. The
paraly$ed
limb
becomes
thin and
does not
row as
normally as
'irst sins
include
colds>
runny
nose>
&omitin
and sliht
fe&er.
4eadache>
fe&er>
sliht cold
and couh
S :eakness
or paralysis
of the
muscles>
which may
occur from
one to se&en
6ush the
child to
the
nearest
hospital.
=ecause
there is
no known
cure for
polio>
immuni$a
tion of
the child
is &ery
important
.
90
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
the affected
limb.
The upper
portion of
the body can
also et
paraly$ed.
1nce the
polio has set
in> no
medicine
can stop the
paralysis.
2ot e&en
antibiotics
or &itamins
can help.
The &ictim
will ha&e to
bear the
disease for
the rest of
hisUher life.
"olio can be
a life;
threatenin
disease
when &ital
centers of
the brain or
the muscles
of
days after
fe&er while
the other
symptoms
ha&e
subsided.
6estlessnes
s
91
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
respiration
are affected.
52 Mu-ps
Mu-ps is
caused by a
&irus
transmitted
by a person
with a
disease.
Complicatio
ns include:
T 0umps in
male teenaers
or adults
sometimes
causes swellin
of the testicles.
-terility can
result.

The first
symptoms
bein two
or three
weeks after
bein
e3posed to
someone
with
mumps.
'e&er 7not
always
present9
"ain when
chewin
or openin
the mouth.
8 soft
swellin
below the
ears at the
anle of
the Aaw.
8 eneral
Isolate the
sick child.
=ed rest is
not
necessary
if the child
has no
fe&er.
"lace a
hot or
cold
compress
to ease
the pain
of the
swollen
lands.
'eed the
child>
soft> easy
to diest>
nourishin
food>
and i&e
him) her
plenty of
92
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
feelin of
weakness
in the
body.
The swellin
usually
subsides
from one
week to ten
days after the
onset> e&en
without
treatment.
Auices and
fluids.
Ceep the
mouth
clean by
makin
him)her
brush the
teeth and
tonue or
makin
him)her
arle
after
eatin.
?i&e
herbal
medicine
or aspirin
for fe&er.
62
&n4luenAa
&n4luenAa or
flu is caused
by a &irus>
which lowers
the bodyDs
resistance to
bacterial
infection. 8n
unhealthy>
Chills>
fe&er and
headache.
+ry couh>
sore throat
0uscle and
Isolate
the sick
person
from
others
5et
him)her
93
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
malnourished
person or one
who has
tuberculosis
is much more
susceptible to
influen$a
than a healthy
person. The
flu &irus is
spread
throuh the
air.
Aoint pains
?eneral
weakness
of the
body.
5oss of
appetite.
ha&e
plenty of
bed rest.
?i&e
him)her a
spone
bath>
herbal
medicine
or aspirin
to brin
down the
fe&er.
?i&e
him)her a
balanced
diet.
'or the
couh>
i&e
him)her
plenty of
water to
drink> as
well as
fruit
Auices> or
local
94
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
nati&e
preparatio
ns.
Call a
doctor if
fe&er
persists
for a
week or
loner.

72
Tonsilli(is
Tonsillitis
occurs when
the tonsils
et infected
with the
microorani
sms they
filter. The
disease is
common in
children but
not in adults
who usually
e3perience
sore throat
or
pharyngiti
s instead.
-ome
children et
-wollen
tonsils on
either side>
which
sometimes
ha&e white
spots on
them
'lu;like
symptoms>
fe&er>
headache>
tiredness>
weakness>
loss of
appetite
"ain when
+rink
plenty of
liquid
?arle
with
lukewarm
water
with salt
-uck
antiseptic
lo$enes
or couh
drops.
8 doctor
will
prescribe
95
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
recurrin
attacks.
Caused by
&iral 7more
common9 or
bacteria
infection of
the tonsils
swallowin
"ain when
swallowin
Earache
'oul;
smellin
breath
In some
cases:
8bdomina
l pain
Couh
Homitin
-wellin
on either
side of the
neck due to
enlared
lymph
nodes
7other than
the tonsils9
antibiotic
for
bacterial
infection.
In rare
cases>
tonsillect
omy will
be
performe
d
7surical
remo&al
of the
tonsils9
#.
82 :+ina+*
8 urinary
@oun +rink
96
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
T+ac(
&n4ec(ion
<:T&= in
!)ild+en
tract infection
7<TI9 is a
bacterial
infection of
the urinary
tract.
The urinary
tract includes
the bladder>
kidneys>
ureters 7the
tubes that
take urine
from each
kidney to the
bladder9 and
urethra 7the
tube that
empties urine
from the
bladder to the
outside9.
<TI can
occur when
bacteria find
their way into
the bladder or
the kidneys.
These
bacteria are
normally
children
with <TIs
may only
ha&e a
fe&er> poor
appetite>
&omitin>
or no
symptoms
at all.
0ost
urinary
tract
infections
in children
only
in&ol&e the
bladder. If
the
infection
spreads to
the
kidneys> it
is called
pyeloneph
ritis and
may be
more
serious.
plenty of
liquid to
flush the
bacteria
out of the
bladder
throuh
frequent
urination.
?o to the
health
center or
hospital
to see a
doctor.
%.
97
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
found on the
skin around
the anus or
sometimes
around the
&aina.
-ymptoms
of a bladder
infection in
children
include:
T =lood in
the urine
T Cloudy
urine
T 'oul or
stron urine
odor
T 'requent or
urent need
to urinate
T ?eneral ill
feelin
7malaise9
T "ain or
burnin with
urination
98
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
T "ressure or
pain in the
lower pel&is
or lower
back
T :ettin
problems
after the
child has
been toilet
trained
-ymptoms
that the
infection
may ha&e
spread to
the kidneys
include:
T Chills with
shakin
T 'e&er
T 'lushed>
warm> or
reddened
99
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
skin
T 2ausea
T "ain in the
side 7flank9
or back
T -e&ere
pain in the
belly area
T Homitin
92 %ead
7ice
The louse
7or lice9 is a
flat>
winless
insect. These
pinhead;si$e
bloodsuckin
parasites
are most
common in
school
children> as
they tend to
share combs>
hats and
other hair
accessories.
Intense itch
on the scalp
and neck
caused by
certain
substances
in the
sali&a of
lice. 8
child with
lice is seen
constantly
scratchin
his)her
<se
medicate
d
shampoo
or lotion
to kill the
lice.
<se a
fine;
toothed
comb
7lice
comb9 or
suyod.
100
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
8 female
louse lays
about si3
es 7nits9
each day>
which it
firmly
attaches to
hair shafts.
They hatch
in a week or
so. In its
lifetime> a
sinle
female lays
some %, G
1,, nits.
4ead lice
infest both
dirty and
clean hair
indiscrimina
tely.
head.
6ed bite
marks on
the scalp
and neck>
which h are
often
&isible
behind the
ears.
Hery small>
shiny white
specks
7nits9 on
the hair that
look like
dandruff. It
clins
firmly to
the strands.
-wollen
lymph
nodes
behind the
ears> in
se&ere
cases of
infestation.
-oaked all
brushes>
combs and
hair
accessorie
s in a lice
shampoo
solution or
alcohol for
se&eral
hours> then
wash them
thorouhly
.
:ash all
used bed
sheets>
blankets>
pillow
cases and
towels in
hot water
and dry
under the
heat of
the sun.
Consult a
doctor if
101
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
there is
bacterial
infection
7e..
boils> pus
dischare
9 on the
scalp.
1B2
*e#atitis
<7i1e+
"isease=
4epatitis
means
inflammatio
n of the
li&er> usually
producin
JswellinK
and
tenderness
and
sometimes
permanent
damae to
the li&er.
The
hepatitis
&iruses are
hepatitis 8>
=> C> +> E
and ?. The
most
common are
hepatitis 8>
hepatitis =
'lu;like
symptoms
'e&er
=ody aches
7Aoints and
muscles9
Tiredness>
weakness
5oss of
appetite
2ausea>
&omitin
5aundice
7yellowin
of the skin
and whites
of the eyes9
Consult a
doctor.
?et plenty
of rest and
nourishme
nt.
+o not
perform
hea&y>
strenuous
physical
acti&ity.
+o not
take
alcohol.
102
T*pe "esc+ip(ion
Signs and
S*-p(o-s
Manage-e
n(
and
hepatitis C.
The information about tonsillitis> head lice and hepatitis came from
4ealth ?uide: @our 'amilyDs ?uide to =etter 4ealth printed by =ayer in
2,,!. 0eanwhile> the data on urinary tract infection 7<TI9 is from
www.nlm.nih.com)medline.or.
"##lication
manaement of other childhood illnesses when a child is
sick in the family.
Synthesis
1ther common childhood illnesses include neonatal tetanus> diphtheria>
tetanus> polio> mumps> influen$a> tonsillitis> urinary tract infection> and
hepatitis. These types of common childhood illnesses should be brouht
in to the attention of a medical doctor once specific sins and symptoms
occur.
103
S#SS&., 7
,#> .0, S!0##,&,$
A," !A0# .F T%# ,#>.0,
Introduction
The 2ewborn -creenin 8ct (2.. of 2,,# pro&ides for all
newborn children to undero simple procedure to find out if a baby
has a conenital metabolic disorder that may lead to mental
retardation or e&en death if left untreated.
This session will pro&ide you what> when> how and where to a&ail
the newborn screenin and how will benefit the newborn.
Session Objectives
104
1. <nderstand the importance of new born screenin;
2. 5earn the proper way of carin for the newborn.
Estimated time
1 4our
Methodology
?roup sharin
5ecture)+iscussion
Materials
4andouts
Procedure
105
Ac(i1i(* 1: S)a+ing on ,ew6o+n Sc+eening and !a+e o4 ()e
,ewo+n
:hat is your understandin of
newborn screeninB
4ow do you care for the new
bornB

ey !earning Points
The information in this session came from the Community;
0anaed 0aternal and 2ewborn Care published by the
+epartment of 4ealth 7+149 in 2,,*.
12 >)a( is ,ew6o+n Sc+eeningC
,ew6o+n sc+eening is a simple procedure to find out if a
baby has a conenital metabolic disorder that may lead to
mental retardation or e&en death if left untreated.
6epublic 8ct (2.. 72ewborn -creenin 8ct of 2,,#9 with
its Implementin 6ules and 6eulations i&es the mandate
for newborn screenin.
106
a2 >)* is i( i-po+(an( (o )a1e new6o+n sc+eeningC
0ost babies with metabolic disorder look normal at
birth. 1ne will ne&er know that the baby has the
disorder until the sins and symptoms are manifested.
=y this time> irre&ersible consequences are already
present.
62 >)en is new6o+n sc+eening doneC
2ewborn screenin is ideally done on the #.th to /2nd
hour of life 7first 2 to ! days of life9. 4owe&er> it may
also be done 2# hours from birth. -ome disorders are
not detected if the test is done earlier than 2# hours
from birth.
c2 %ow is new6o+n sc+eening doneC
<sin the heel prick method> a few drops of blood are
taken from the babyDs heel and blotted on a special
absorbent filter card. The blood is dried for # hours and
sent to the 2ewborn -creenin Center.
d2 >)o will collec( ()e sa-ple 4o+ new6o+n sc+eeningC
8 trained doctor> nurse> midwife of medical
technoloist may collect the blood sample for newborn
screenin.
e2 >)e+e is new6o+n sc+eening a1aila6leC
107
It is a&ailable in participatin 2ewborn -creenin
'acility that includes hospitals> lyin;in centers> 6ural
4ealth <nits 764<9 and health centers. If babies are
deli&ered at home> the baby may be brouht to the
nearest 2ewborn -creenin 'acility.
42 >)en a+e new6o+n sc+eening +esul(s a1aila6leC
6esults are a&ailable se&en workin days from the time
the newborn screenin samples are recei&ed at the
2ewborn -creenin 'acility. "arents should claim the
results from their physician> nurse> midwife or health
worker. 4owe&er> any laboratory result indicatin an
increased risk of a heritable disorder 7i.e. positi&e
screen9 shall be immediately released> within 2# hours>
so that confirmatory testin can be immediately done.
8 positi&e screen means that the newborn must be
referred at once to a specialist for confirmatory testin
and further manaement.
. >)a( a+e ()e Fi1e "iso+de+s !u++en(l* &ncluded in
()e ,ew6o+n Sc+eening Pac9ageC
Conenital metabolic disorders are serious illnesses. It
causes death and mental retardation and physical
disabilities. It affects around !!>,,, 'ilipino babies a
year.
2ewborn screenin detects % more common metabolic
disorders to include:
"iso+de+
Sc+eened
#44ec(s i4 no(
Sc+eened
#44ec(s i4
Sc+eened and
108
T+ea(ed
Conenital
4ypothyroidis
m 7C49
-e&ere mental
retardation
2ormal
Conenital
8drenal
4yperplasia
7C489
+eath 8li&e and
normal
?alactosemia
7?859
+eath or cataracts 8li&e and
normal
"henylketonuri
a 7"C<9
-e&ere mental
retardation
2ormal
?*"+ -e&ere anemis>
kernicterus
2ormal
)2 >)a( a+e ()e +oles o4 ()e 0%: s(a44C
8d&ocacy for the newborn screenin of e&ery baby.
This starts durin prenancy. The family should
start sa&in at the start of the prenancy.
-ample collection.
8ssures transport of specimen to the nearest
2ewborn -creenin 'acility within 2# hours
followin collection of the sample.
8d&ice and counsel parents upon recei&in the
screenin results.
22 !a+e 4o+ ()e ,ew6o+n
109
8 newborn is one of the most helpless creatures on earth.
The quality of care i&en to a child durin the first two
years of his)her life is most critical not only for his)her
sur&i&al but also for determinin the health for the rest of
his)her life.
The newborn is a &ery delicate creature and he needs all
our help in carin and protectin him from diseases and
infections.
a2 >a*s o4 !a+ing 4o+ ()e a6* include:
!a+e o4 ()e co+d
The babyDs cord is prone to infection.
The babyDs cord must be kept clean and dry to
a&oid infection.
'or the cord to dry up immediately> it is better
not to use a belly band.
+iapers should not co&er the na&el so that the
cord does not et wet with urine.
If the cord appears normal> Aust pour /,L
alcohol directly on the cord for quick dryin.
If there is bleedin> dischare or foul smell>
refer the newborn to a doctor or midwife riht
away.
2e&er pull the cord stump.
a()ing ()e 6a6* p+ope+l*
=ath the baby e&ery day.
110
It keeps the baby clean and refreshed; and
soothes him)her> too.
=athe the baby on your lap or in a basin.
'or the first two weeks> bathe the baby on your
lap. There is less accident and will keep the
babyDs umbilical cord dry.
8lways bathe the baby at the same time of the
day so he)she forms a reular habit.
The baby is most likely to take the lonest nap
after a bath.
+eas(4eeding
1ne of the critical points to remember is that the
baby should be e3clusi&ely breastfed
immediately after birth.
0otherDs milk is the best food for the baby. It is
a complete food in itself.
The first milk secretion that comes out of a
motherDs breast is thick> yellowish fluid called
colos(+u-2
Colostrum is rich in protein and contains
antibodies that protect the baby from infection
and food alleries.
Colostrum is ood for the baby and should not
be wasted or thrown away.
=reastfeedin also strenthens the emotional
and physical bond between mother and the
child.
111
=reastfeedin promotes child spacin because it
delays resumption of o&ulation and return of
menstrual cycle up to si3 months of the mother.
=reastfeedin offers important economic
ad&antaes to families.
The mother benefits from breastfeedin too. 4er
chances of bleedin after deli&ery are
considerably reduced.
0ost babies do not need any other food 7or
water9 until about si3 months of ae.
?et immuni$ation for newborn.
"##lication
1. E3ecute the proper way of takin
care of a newborn; and
2. -ubmit their babies for newborn
screenin.
Synthesis
2ewborn screenin is &ery important to ensure that babies with
metabolic disorder shall be assessed and treated early. 2ewborn
screenin is done on the first 2 to ! days of life of a newborn baby.
The newborn screenin is done throuh collection of blood sample
112
and appropriate assessment. It is a&ailable in participatin
newborn screenin hospitals> lyin;in centers> rural health units
and health centers. 6esults can be a&ailed after / workin days
from the time the newborn screenin sample was recei&ed at the
2ewborn -creenin 'acility.
2ewborn -creenin helps pre&ent death> mental retardation and
physical disabilities. It pro&ides the basis on how to properly care
and appropriate treatment for the newborn found to ha&e metabolic
disorder.

S#SS&., 8
S&D !.MM:,&!A7#
&MM:,&EA7# "&S#AS#S
Introduction
0any children are spared of life due to lack of immuni$ation and
some become disabled for the rest of their li&es. This session will
emphasi$e on the importance of ensurin that children recei&ed
proper and complete immuni$ation.
Session Objectives
1. <nderstand the importance of immuni$ation;
113
2. Identify the &accines needed> their indications> frequency> and
taret aes; and
3. 5earn the care and manaement of the immuni$ed child.
Estimated time
1 4our
Methodology
?roup sharin
5ecture)+iscussion
Materials
4andouts
114
Procedure
Ac(i1i(* 1: S)a+ing on &--uniAa(ion
:ho amon you subAected your
children for immuni$ation
:hy did you do soB
!. -ynthesi$e all the responses and proceed to the discussion of
the Cey 5earnin "oints.

ey !earning Points
'acts for 5ife and the 0anual on Effecti&e "arentin are the
source of information in this session.
12 :ithout immuni$ation> an a&erae of ! out of e&ery 1,,
children born will die from measles. 8nother 2 will die
from tetanus. 1ne m ore will die from whoopin couh.
8nd out of e&ery 2,, children born> one will be disabled
for life for polio.
In the "hilippines> 1,>,,, children die yearly from si3
common communicable diseases7 measles,
tuberculosis, poliomyelitis, pertussis and tetanus.
115
Children can be protected aainst those si3 serious diseases
by a course of immuni$ation which is usually a&ailable free
of chare throuh the health ser&ices.
The followin are the important messaes:
a. &--uniAa(ion protects children aainst se&eral
danerous diseases. 8 child is immuni$ed by &accines
which are inAected or i&en by mouth. The &accines
work by buildin u the childDs defenses. If the disease
strikes before a child is immuni$ed> immuni$ation is
too late. 8 child who is not immuni$ed is more likely to
become undernourished> to become disabled and to die.
b. Immuni$ation is urent. 8ll immuni$ations should be
completed in the first year of the childDs life.
c. It is safe to immuni$e a sick child.
22 /accine
To fiht illnesses> the body needs antibodies that i&e
protection. The newborn baby can et antibodies from the
mother while he)she is still in the womb> or throuh
&accination)immuni$ation. 8 1accine is weak or dead
microoranisms which can be inAected in the body or taken
in orally to kill the bad microoranisms in the body to
pre&ent ettin sick.
22 $uide on /accina(ion
116
/accine Agains(
w)a(
&llness
Fo+
w)a(
Age
F+e8u
enc*
0eac(ion
a4(e+ ()e
/accina(i
on
Manage-e
n(
12 !$ T=
7tisis9
8fter
deli&ery
1nce
6edness
in the
area
where
the
&accine
is
inAected
"us
formatio
n * G .
weeks
after
&accinat
ion
+o not
e3pose
under the
sun two
hours after
the
&accinatio
n.
8&oid
scratchin
the wound
caused by
&accinatio
n.
22 .P/ "olio 1 P ; 2
months
!
times
2one +o not eat
or drink
within one
hour after
the
&accinatio
n.
32 "PT
.iphth
eria
!tuspir
ina"
-ertus
sis
1 P ; 12
months
!
times
'e&er
-wellin
and pain
in the
area
where
&accine
+rink lots of
water.
?i&e
acetamino
phen for
pain and
fe&er.
117
/accine Agains(
w)a(
&llness
Fo+
w)a(
Age
F+e8u
enc*
0eac(ion
a4(e+ ()e
/accina(i
on
Manage-e
n(
Tetanu
s
is
inAected
-oothe)
+amp
with hot
towel
7warm
compress9
the area
inAected
with
&accine.
42 AM/ 0easles ( G 11
months
once
'e&er
=ump
7$butlig
%9 within
eiht
days
after the
&accinat
ion
-ame with
the
manaement
of +"T
+rink lots of
water.
?i&e
acetamino
phen for
pain and
fe&er.
-oothe)
+amp
with hot
towel the
area
inAected
with
118
/accine Agains(
w)a(
&llness
Fo+
w)a(
Age
F+e8u
enc*
0eac(ion
a4(e+ ()e
/accina(i
on
Manage-e
n(
&accine
32 Sc)edule o4 /accina(ion
Age /accine Agains( w)a( &llness
8t birth =C?
4E" =1
+isseminated form of
T=
4epatitis = infection
* weeks +"T1
1"H1
4E" =2
.iptheria,
pertussis> tetanus
1ral "olio Haccine
aainst poliomyelitis
1, weeks +"T2
1"H2
1# weeks +"T!
1"H!
( months 80H 8nti;0easles Haccine
8 child may de&elop fe&er after immuni$ation. ?i&e
paracetamol> tempra and water spone bath. "ut warm
compress on the area where &accine was inAected. If
symptoms persist> brin the child to a doctor.
119
"##lication
1. -ubmit their babies for
immuni$ation; and
2. 8dhere strictly to babiesD
immuni$ation schedule.
Synthesis
Immuni$ation protects children aainst se&eral danerous diseases.
It builds the child defenses to infections and it should be completed
at the first year of the childDs life.
Immuni$ation helps fiht illnessess throuh buildin of antibodies
in youn children. Immuni$ation may cause fe&er but it is only
temporary.
120
S#SS&., 9
#A07F "#T#!T&.,
A," P0#/#,T&., .F !%&7"%.."
"&SA&7&T&#S
Introduction
@oun are helpless and hihly dependent on others and the
en&ironment for their care and protection. 8ppropriate care and
protection as well as early detection helps pre&ent children from
ha&in disabilities.
Session Objectives
1. 5earn the impairments)disabilities that can affect children
ae ,;* years;
121
2. Identify the common causes of childhood disabilities; and
3. <ndertake measures to pre&ent childhood disabilities.
Estimated time
1 4our
Methodology
?roup sharin
5ecture)+iscussion
Materials
4andouts
Procedure
122
Ac(i1i(* 1: S)a+ing on !)ild)ood "isa6ili(ies
1. 8sk the participants of their understandin of
childhood disabilitiesB
!. -ynthesi$e all the responses and proceed to the
discussion of the Cey 5earnin "oints.
ey !earning Points
0odule / 74ealth and 2utrition9 of the 0anual on
Effecti&e "arentin of the +epartment of -ocial :elfare
and +e&elopment> published in 2,,1 is the source of
information for this session.

1. Children at the ae , G * years are dependent on others and
the en&ironment for their care and protection. +isabilities
are quite pre&entable and re&ersible at the , G * ae le&el.
The earliest these disabilities are detected> the less chance
for lastin handicaps to occur. 6econi$in early sins of
disabilities can help parents take appropriate actions to
pre&ent disabilities and further deterioration.
22 !o--on !auses and Possi6le P+e1en(i1e Measu+es o4
!)ild)ood "isa6ili(ies
a2 Malnu(+i(ion
123
=reastfeedin and supplementary feedin at
appropriate ae:
-er&e nutritious> well;balanced meals
1bser&e cleanliness> safe sanitation
<se clean water
62 !o--unica6le "isease
Immuni$ation
Clean water
-afe sanitation
c2 #n1i+on-en(al %aAa+ds5Acciden(s
-uper&ision of children durin accident prone ae
Teach youn children to stop> look and listen before
crossin streets
=uild humps across the roads in front of the school
to slow down the &ehicles
6emo&e broken lass> sharp stones and arbae in
play areas.
d2 %o-e Acciden(s
=etter super&ision of children
Ceep matches out of reach of children
-ee that children do not et close to the sto&e when
cookin
Ceep pans> hot contents out of reach of children.
124
6emo&e splinters> and sharp obAects in play areas of
children.
Ceep small obAects like beans and stones which can
be swallowed or put into the ears> out of reach of
children.
5abel properly and keep out of childrenDs reach
poisonous liquids or obAects.
e2 $ene(ic "iso+de+s
Counselin to discourae marriaes amon first to
third deree relati&es
8d&ise child spacin
-tress importance of prenatal care
42 !)ild ,eglec( and A6use
'amily and community efforts to pre&ent child
nelect and abuse
-trict compliance or law enforcement to pre&ent
child nelect and abuse
g2 A6sence57ac9 o4 P+e3,a(al and Pos(3,a(al !a+e
4ealth nutrition of mother durin prenancy
"arent education on appropriate child care practices
)2 Alco)ol and "+ug A6use
"arent education to pre&ent use and abuse of
alcohol and drus.
125
i2 &-pai+-en( !aused 6* Medicines
"ut medicines out of reach of children
"arent education on the proper use of medicines.
22 #a+l* "e(ec(ion
Early detection of a childDs disability is &ery important and
could be crucial to treatment. 4ere are some practical ways
of testin the different disabilities in children. @ou can try
them out by followin or demonstratin the simple
instructions for the child to either follow you or to respond
to your demonstration.
a2 Tes( 4o+ "i44icul(* in Seeing
!)ild+en 3 -on()s 3 3 *ea+s
5et the child sit on the motherDs lap. 4old a
lihted candle about !, to %, cm. 712;2, inches9
in front of the child. 0o&e the candle from side
to side and up and down. 1bser&e.
+o the childDs eyes follow the candle as you
mo&e itB If the answer is Jyes>K then the child
can see.
If the childDs eyes do not follow the candle>
repeat the test three times. :hen you sure that
the childDs eyes do not follow the candle> then
the child may ha&e difficulty seein.
!)ild+en 3 *ea+s and o1e+
126
8 person should stand at a distance of ! meters
in front of the child. 4old up three finers of
one of the hands. 8sk the child to hold up the
same number of finers.
If the child holds up three finers> then he)she
has no difficulty in seein.
If the child does not hold up three finers> then
repeat the test with two finers> then repeat it
aain with four finers. If the child does not
respond correctly to these tests> then heUshe may
ha&e difficulty in seein.
a2 Tes( 4o+ "i44icul(* in %ea+ing
a6ies 6elow 6 -on()s
+o the followin test with e&ery baby in the
household who is below * months of ae. +o
the test in a quiet place.
5ay the baby so that he or she cannot see the
person doin the test. Clap the hands loudly.
+id the baby blinkB +id the baby appear
startledB +id the baby turn hisUher head towards
the noiseB
If the answer is Jyes>K then the baby can hear
you.
If the answer is Jno>K then the baby may ha&e
difficulty hearin. 6epeat the test three times>
waitin a little in between tests.
If the baby does not appear to hear the noise>
repeat the test on another day to be certain. Tell
the other family members to obser&e the baby to
127
find out if he)she seems to hear people talk or
react to any loud noises.
!)ild+en 4+o- 6 -on()s (o 3 *ea+s
+o the followin test with e&ery child in the
household between si3 months aned three years
of ae.
0ake a rattle by puttin a few pebbles inside a
tin can or a piece of bamboo.
5et the mother sit and hold the child. 8sk a
family member to sit in front of the child. 8sk
the family member to et the childDs attention
and to speak softly to the child.
:hile the child is preoccupied with the family
member in front of him)her> stand up and walk
about two steps away from the side of the child.
-lowly step back one more step so that the child
can no loner see the person doin the test.
-hake the rattle from where you are standin.
=e sure that the child does not see the person
mo&in the hand. Eust shake the rattle from
behind.
+id the child turn his)her head towards the
rattleB
If the answer is Jyes>K then the child can hear.
If the answer is Jno>K hold the rattle at different
distances from the child. 6epeat three times at
each distance to be sure. +o not shake the rattle
abo&e or behind the childDs head
128
6epeat the test on the other side of the child.
6epeat the test on another day to be sure.
If the child still does not turn his)her head
towards the rattle> then the child may ha&e
difficulty hearin.
32 >a*s (o &den(i4* !o--on !)ild)ood "isa6ili(ies
a2 7ea+n a6ou( ()e !)ild
2ote unusual e&ents from conception to birth.
6ecord all illnesses and drus taken durin
prenancy.
Ceep a record of doctorDs dianosis and
prescription> weiht and heiht of child
Ceep pictures of child if possible
?ather information from brothers> sisters and
playmates on what child does and says.
62 .6se+1e ()e !)ild !a+e4ull*
E3amine the child at birth for any deformities or
missin parts> difficulty in breathin> feedin>
sleepin> or mo&ement.
:atch what the child does.
5isten to what the child says.
Take note of unusual beha&ior or difficulties when
playin or eatin.
Compare what the child can do with other children
of the same ae> but do not force him)her to be like
the others.
129
c2 >a(c) 4o+ Speci4ic Signs o4 &-pai+-en(
5ike difficulty in sittin> hearin> mo&in> mental
retardation> difficulty in learnin and in speech and
emotional problems.
42 A !)ild wi() "isa6ili(* is S(ill a !)ild
Eust because a child is with disability does not mean that
he)she has to be set apart from his)her siblins or be i&en
special treatment> includin special discipline. 8s much as
possible> the child with disability should be treated as a
reular member of the family> subAect to the same rules as
the rest of the members. Each child> howe&er> may require
special uidance to help him deal with his)her problems or
adAust to certain situations. 1nly under these circumstances
should he)she should be i&en particular attention.
8 child with disability has the riht to all the opportunities
for rowth and de&elopment like any other child.
a2 %ow (o %andle a !)ild wi() "isa6ili(*
It is the responsibility of the parents> family and
community to help a child with disability de&elop as
much as any other normal child. The child with
disability deser&es as much care and affection>
medical care and education. The child with
disability should be i&en the chance to sociali$e
and play with other children. The child with
disability should be allowed to e3press his)her
feelins> thouhts and needs.
1ther children can help a child with disability by
playin with him)her> o to the day care center or
130
school with him)her> show concern by i&in e3tra
time> let him)her know that other children do care.
The family> community and other children should
not feel pity for the child with disability. They
should not look at the weakness of the child with
disability but instead reconi$e and encourae the
strenth of the child.
Encourae the child with disability to do as much as
he can for himself)herself. 4elp him)her only when
he)she really needs it or when he)she asks for it.
4elp the child with disability to learn new thins.
+o it little by little> do not push too far or too fast
nor force the child.
"lay often with the child to help him)her de&elop
physically and mentally. Talk with him)her> tell
stories> establish physical warmth by carryin
sometimes and brin the child with disability out or
&isit friends.
It is not easy to accept a child with disability.
4owe&er> people around this child should reali$e
that the attitude and treatment reatly affect the
perception of the child about himself)herself and the
childDs potential for adAustment to different
situations. 5earnin how to deal with the problem
positi&ely can be a rewardin e3perience for all
concerned. 6emember that the child with disability
may ha&e strenths that may compensate for the
weaknesses. 8 child with disability must de&elop
the skills that she has and cope with those which she
lacks. "ro&ide plenty of learnin opportunities.
0ost importantly> the child with disability must be
treated as an equal member of the family with no
special rihts. -he may ha&e special needs that
131
require more attention or care> but these should not
pre&ent her from functionin like a normal member
of the family.
Synthesis
Childhood disabilities are caused by malnutrition> communicable
diseases> en&ironmental ha$ards or accidents> accidents in the
home> enetic disorders> child nelect and abuse> absence or lack
of pre;natal and post;natal check up> alcohol and dru abuse and
impairment caused by medicines.
To pre&ent children from> the abo&e causes should be responded
by undertakin pre&enti&e measures such as ensurin that infants
and youn children be breastfed and be i&en supplementary
feedin accordin to their ae. There is a need to complete their
immuni$ation> pro&ision of safe water and pro&ide safe sanitation.
There is a need to pro&ide close super&ision to pre&ent accidents in
the home and community. "ractice child spacin and undero
reular pre;natal check up and post natal within % weeks after
prenancy and i&in of medicines with the ad&ice of a doctor.
Early detection can be undertaken if there are sins or symptoms
of impairment in children.
132
Annex A
Sa)a ng Saging
133
Annex
Pos(u+al "+ainage
Cun an pa;ubo ay rabe at hindi maalis an malakit na plema>
awin an Jpostural drainaeK. 8n ina ay kailanan naka;upo at
idadapa an bata sa kanyan kandunan para lumanhap n
sinaw. Tapikin o haplusin an likod n bata haban siya ay
lumalanhap n sinaw. Ito ay makakatulon sa palabas n
plema.
Continuation:
134
Pe+cussion wi() Pos(u+al "+ainage
2ote: There are &arious positions for postural drainae.
-ome infants and children ha&e difficulty remo&in secretions
from the luns by the normal cleansin mechanisms. In such cases>
it is necessary to loosen the mucus by performin percussion and
postural drainae. =efore dischare> your childNs physician will
re&iew the techniques for percussion and postural drainae
135
Pe+cussion
"ercussion is a tappin technique that loosens secretions and
causes drainae of mucus from the luns while your child is in
different positions. The procedure in&ol&es entle rhythmic
poundin on the chest with cupped hands> manual percussor> or
percussion machine.
@our childNs doctor will prescribe this procedure if it is needed.
1therwise> it can be used if your child has a cold or increased
secretions.
%and Posi(ioning 4o+ Pe+cussion
The correct hand position for percussion
=end from the wrist to tap your childNs chest so the poundin does
not hurt. 8 loud> hollow sound should be produced by the trapped
air between the cupped hand and the chest. 8 slappin sound
indicates that your hand is not cupped enouh. "ercuss only o&er
the rib cae. 8&oid the abdomen. If performed properly>
percussion is painless.
Pos(u+al "+ainage
"ostural drainae is the positionin of the child so that ra&ity will
help mo&e secretions from the smaller bronchial airways to the
trachea. The secretions can then be remo&ed by couhin and
suctionin.
136
:hile performin postural drainae> you should remo&e any
constrictin clothin and make your child as comfortable as
possible. To minimi$e discomfort durin the procedure> place a
lihtweiht shirt between your hand and your childNs chest. =e sure
to suction your child before and after the postural drainae
procedure. +o not perform postural drainae immediately after
meals; it may cause &omitin.
www.uchicaokidshospital.or. J"ercussion and "ostural
+rainae.Khttp:))www.uchicaokidshospital.or)specialties)pulmon
ary)patient;uides)breathin)percussion)inde3.html
7+ecember !,> 2,1,9
Annex !
137
S(ea- &n)ala(ion
Annex "
"roper 4and :ashin "rocedure
138
Illustration courtesy of +epartment of 4ealth.
Annex #
The 4erbal 0edicines in the "hilippines as 8ppro&ed by
+14
139
These is the list of the ten 71,9 medicinal plants that the "hilippine
+epartment of 4ealth 7+149 throuh its OTraditional 4ealth
"roramO ha&e endorsed. 8ll ten 71,9 herbs ha&e been thorouhly
tested and ha&e been clinically pro&en to ha&e medicinal &alue in
the relief and treatment of &arious aliments:
1. A9apul9o 7#assia alata9 ; also known as Obayabas;
bayabasanO and Orinworm bushO in Enlish> this herbal medicine
is used to treat rinworms and skin funal infections.
2. A-pala*a 7/omordica charantia9 ; known as Obitter ourdO
or Obitter melonO in Enlish> it most known as a treatment of
diabetes 7diabetes mellitus9> for the non;insulin dependent patients.
!. awang 7Allium sativum9 ; popularly known as OarlicO> it
mainly reduces cholesterol in the blood and hence> helps control
blood pressure.
#. a*a6as 7-sidium gua0ava9 ; Oua&aO in Enlish. It is
primarily used as an antiseptic> to disinfect wounds. 8lso> it can be
used as a mouth wash to treat tooth decay and um infection.
%. 7agundi 78ite* negundo9 ; known in Enlish as the O%;lea&ed
chaste treeO. ItNs main use is for the relief of couhs and asthma.
*. ,i*og3ni*ogan 79uis&ualis indica +.9 ; is a &ine known as
OChinese honey suckleO. It is effecti&e in the elimination of
intestinal worms> particularly the 8scaris and Trichina. 1nly the
dried matured seeds are medicinal ;crack and inest the dried seeds
two hours after eatin 7% to / seeds for children F . to 1, seeds for
adults9. If one dose does not eliminate the worms> wait a week
before repeatin the dose.
140
/. Sa-6ong 7Blumea balsamifera9; Enlish name: =lumea
camphora. 8 diuretic that helps in the e3cretion of urinary stones.
It can also be used as an edema.
.. Tsaang $u6a( 7)hretia microphylla +am.9 ; "repared like
tea> this herbal medicine is effecti&e in treatin intestinal motility
and also used as a mouth wash since the lea&es of this shrub has
hih fluoride content.
(. :lasi-ang a(o G Pansi(3Pansi(an 7-eperomia pellucida9 ;
It is effecti&e in fihtin arthritis and out. The lea&es can be eaten
fresh 7about a cupful9 as salad or like tea. 'or the decoction> boil a
cup of clean chopped lea&es in 2 cups of water. =oil for 1% to 2,
minutes. -train> let cool and drink a cup after meals 7! times day9.
1,. Fe+6a uena 7#linopodium douglasii9 ; commonly known
as "eppermint> this &ine is used as an analesic to reli&e body
aches and pain. It can be taken internally as a decoction or
e3ternally by poundin the lea&es and applied directly on the
afflicted area.
Tips on %andling Medicinal Plan(s 5 %e+6s:
If possible> buy herbs that are rown oranically ; without
pesticides.
141
0edicinal parts of plants are best har&ested on sunny
mornins. 8&oid pickin lea&es> fruits or nuts durin and
after hea&y rainfall.
5ea&es> fruits> flowers or nuts must be mature before
har&estin. 5ess medicinal substances are found on youn
parts.
8fter har&estin> if dryin is required> it is ad&isable to dry
the plant parts either in the o&en or air;dried on screens
abo&e round and ne&er on concrete floors.
-tore plant parts in sealed plastic bas or brown bottles in a
cool dry place without sunliht preferably with a moisture
absorbent material like charcoal. 5ea&es and other plant
parts that are prepared properly> well;dried and stored can
be used up to si3 months.
Tips on P+epa+a(ion 4o+ &n(a9e o4 %e+6al Medicines:
<se only half the dosae prescribed for fresh parts like
lea&es when usin dried parts.
+o not use stainless steel utensils when boilin decoctions.
1nly use earthen> enamelled> lass or alike utensils.
8s a rule of thumb> when boilin lea&es and other plant
parts> do not co&er the pot> and boil in low flame.
+ecoctions loose potency after some time. +ispose of
decoctions after one day. To keep fresh durin the day>
keep lukewarm in a flask or thermos.
8lways consult with a doctor if symptoms persist or if any
sin of alleric reaction de&elops.
142
www.philippineherbalmedicine.or. JThe 4erbal 0edicines in the
"hilippines as 8ppro&ed by +14.K
http:))www.uchicaokidshospital.or)specialties)pulmonary)patient
;uides)breathin)percussion)inde3.html
7+ecember !,> 2,1,9
Annex F
5ife Cycle of a "inworm
143
JCommon "arasites of the Intestinal Tract.K
http:))www.drnatura.ru)imaes)EnterobiusV5ifeCycle.if
7+ecember !,> 2,1,9
1. Es are deposited on perennial folds
2. -elf;inspection occurs by transferrin infecti&e es to the
mouth with hands that ha&e scratched the perennial area.
!. "erson;to person transmission can also occur throuh handlin
of contaminated clothes or bed linnens. Enterobiosis may also
be acquired throuh surfaces in the en&ironmnet that are
144
contaminated with pinworm es 7e.. curtains carpetin9.
-ome small number of es may become airbone and inhaled.
These would be swallowed and follow same de&elopment as
inested es. 'ollowin inestion of infecti&e es> the
lar&ae hatch in the small intestine
#. 8dults establishe themsel&es in the colon
%. The time inter&al from inestion of ineffecti&e es to
o&iposition by the adult females is about one month. The life
span of the adults is about two months. ?ra&id females
mirate nocturnally outside the anus and o&iposit while
crawlin on the skin of the perianal area.
*. The lar&ae contained inside the es de&elop 7the es
become inefecti&e9 in # to * hours under optimal conditions
.6etroinfection> or the miration of newly hatched lar&ae from
the anal skin back into the rectum> may occur but the
frequency with which this happens is unknown.
1
Annex $
7i4e !*cle o4 %oo9wo+-
1
www.biosci.ohio;sate.edu)Wparasite)life cycle)pinworm;lifecycle.html
7+ecember 2.> 2,1,9
145

Annex %
146
7i4e !*cle o4 0oundwo+- <Asca+is=
2
Annex I
Life Cycle of Trichuris Trichiuria
2
http:))www.frequencyrisin.com)imaes)parasiteVascarisVcycle.if
147

http:))www.pathobio.sdu.edu.cn)sdAsc)parasiteimaes)trichurisVlife
cycle.html
Annex '
148
%e+6al Medicines
$a6a* sa Pagga-i( ng Sa-pung %ala-ang $a-o(:
Mga "apa( Tandaan
Pag(a(ani-
Ano: "inutol na sana 7cuttins na may tatlon buko9
Paano: "atulisin an sana at ibaon sa lupa na may kasaman isan
buko
Pag3aalaga
?umamit laman n natural na pataba aya n dumi n
manok o bulok na dahon.
4uwa umamit n pesticide dahil ito ay maaarin ma;
iwan n lason sa halaman.
Pag3aani
8nihin laman an ma maluluso na dahon.
"atuyuin sa mahanin at malilim na luar hanan main
maluton.
4uwa ibibilad an dahon sa init n araw.
Pag3ii-6a9
Ilaay sa plastic an pinatuyon dahon.
Iimbak sa arapon may kulay at may ulin sa ilalim.
Takpan mabuti.
Pag)a)anda
149
0a Caamitan
?umamit laman n palayok> enamel> o kaamitan hindi
yari sa aluminum para hindi malayan n tina an niluton
amot.
4uasan mabuti an palayok bao o matapos amitin sa
bawat halaman.
"apili
?amitin laman an bahai n halaman
iminumunkahi.
"apapakulo
4uasan mabuti an ma dahon.
Ilaay sa malinis na palayok an ma dahon at
tubi.
salan at pakuluan sa mahinan apoy sa loob n 1%
minuto. 4uwa takpan an palayok.
"alamiin at salain.
Pagga-i(
-undin an waston dosis.
?umamit laman n isan uri n halaman sa bawat sintomas o
karamdaman.
Ihinto an paamit n halaman amot kun makaroon n
hindi kanais;nais na reaksyon o allery.
Cun walan nararamdaman pababao pakatapos n 2;!
araw na paamit> kumunsulta sa duktor.
12 +!agundi, </i(ex negundo 72=
7Tuas> 0ola&e;aso> 0aupay> +anla> 5ino;lino>
+abatan>5inei> -aarai> %;5ea&ed Chaste Tree9
"ara sa: 4ika> ubo at lanat
150
"akilala: "alumpon 7shrub9 na may liman dahon at tumataas
n may liman metro.
Pag(a(ani-
0a pinutol na sana na may kasaman tatlon 7!9 buko.
"utulisin an sana at ibaon sa lupa na may kasaman isan
buko.
Ilaay sa lilim an baon tanim sa loob n dalawan 729 lino;
ilabas sa araw kapa may sibol na.
Pag3aalaga
+iliin araw;araw.
8lisin an ma damo sa paliid.
Pag3Aani a( Pag3&-6a9
0as mainam kolektahin an dahon kun panahon n
pamumulaklak
0auulan at maluluso na dahon
Tiyakin may matitiran sapat na dahon sa halaman.
"atuyuin mabuti an ma dahon
Ilaay sa ba na plastic o arapon may kulay at takpan
mabuti.
Pag)a)anda
4uasan mabuti an ma dahon at saka tadtarin.
0atakal n dalawan bason tubi at dahon.
"akuluan sa mahinan apoy sa loob n 1% minuto.
4uwa takpan an palayok
"alamiin at salain.
151
#dad ?ailangang "a)on
Sa+iwa Tu*o
0atanda * kutsara # kutsara
/;12 taon ! kutsara 2 kutsara
2;* taon 1 P kutsara 1 kutsara
Pagga-i(
<bo at 4ika
4atiin sa tatlon bahai an pinalaaan.
Inumin an bawat bahai sa umaa> tanhali at abi.
5anat
Inumin an bawat bahai tuwin ika;apat na oras
22 Fe+6a uena <Men()a x co+di4olia .piA ex F+esen=
74ierba =uena> 4ibas> 8blebana> 0alipuen> 0int9
Pa+a sa
"ananakit n ibaDt iban bahai n katawan.
Pag9ilala
4alaman umaapan at amoy mint
0ay apat na kanto an tankay at kulay berde
0a dahon ay makakatapat maaspan at mukhan kulubot
Pag(a(ani-
0a pinutol na sana na may haban 1,;1% sentimetro at !;#
pares n dahon.
152
0asisitubo an ma uat sa loob n isan lino.
Pag3aalaga
=aon tanim ay dapat diliin upan hindi matuyo.
8lisin an damo sa paliid.
"atuyuin mabuti an ma dahon sa pamamaitan n
papapahanin
Ilaay sa ba na plastic o arapon may kulay ay takpan
mabuti.
Pag)a)anda
0atakal n dalawan bason tubi at dahon.
"akuluan sa mahinan apoy sa loob n 1% minuto
4uwa takpan an palayok.
"alamiin at salain.
#dad ?ailangan "a)on
Sa+iwa Tu*o
0atanda # kutsara ! kutsara
/;12 taon 2 kutsara 1 1)2 kutsara
Pagga-i(
4atiin sa dalawan bahai an pinalaaan.
Inumin an bawat bahai tuwin ika;apat na oras.
32 ,$iyug($iyugan, <Huis8ualis indical=
7=alitadham> "inones> "inion> bonor> bawe;bawe> kasumbal>
talolon> tanlon> tanulo> tataraok> taarau> taulo> tanolo>
totoraok> talulon> tartarau> taunon> burma creeper> Chinese
honeysuckl> 5iane &ermifue9
153
Pa+a sa
=ulatin askarsis
"akilala
"alumpon 7shrub9 na umaapan at tumataas hanan
walon 7.9 metro
2amumulaklak: pula> rosas> puti
8n buna ay maliit at huis balimbin
Pag(a(ani-
0a pinutorl na sana o stem cuttins na namy haban 2,
sentimetro at may tatlon 7!9 buko
Pag3aalaga
Itanim an sana sa malilim na luar
Ilipat sa permanenten tanima pakaraan n 2 , ! lino
0as mabilis tumubo kun nasisikatan n araw
Pag3aani a( Pag ii-6a9
Taun;taon kun mamuna
8nihan laman an ma maulan na buna 7kun kulay into
na9
"ahaninan upan matuyo
Ilaay sa arapon at takpan mabuti
154
Pag)a)anda
?umamit laman n ma buton maulan> tuyo at kabubukas
pa laman n buna
Pagga-i(
Cainin an ma buto dalawan oras pakatapos n hapunan
Cun hindi makabisa sa unan amit> ulitin an parehon dosis
pakaraan n isan 719 lino
#dad ?ailangang u(o
0atanda .;1,
/ G 12 taon * G /
* G . % G *
# G % # G %
Paalala
Cabilan sa hindi kanais;nais na epekto 7side effect9 an sinok>
sakit sa tiyan> at patatae
42 +"-a#ul-o, <!assia ala(a 7=
7=ayabas;bayabasan> Capurko> Catanda> Catandan
aso>"akaonkon> -ontin> 8ndadasi> 8ndadasi;a;dakdakel>
8ndadasi;bubuton> 8dadisi> 8ncharasi> 8ndalan>
=ayabasin>=ikas;bikas> kasitas> suntin> "alo china>
"akayomkom> Castila> 6inworm bush or shrub9
Pa+a sa
8n;an> =uni> 8lipuna> ?alis;aso
Pag9ilala
155
"alumpon 7shrub9 na tumaas n tatlon 7!9 metro o hiit pa
0ay bulaklak na kulay dilaw na matatapuan sa dulo n ma
sana
0a buto ay maliit at nakalay sa isan mahaban sisidlan
Pag(a(ani-
Ipahid an katas sa apektadon balat 1;2 beses mahapon
Paalala
"ara sa ma taon may allery sa sariwan dahon n akapulko>
awin iton dekoksyon: 0apakulo n isan 719 tasan tinadtad
na dahon sa dalawan 729 tasan tubi sa loob n 1% minuto o
hanan main isan 719 tasa na laman. Ihuas ito sa
apektadon balat 1;2 beses mahapon.
52 +)ayabas, <Psidiu- guaIa1e 7=
7?uayabas> kalimbahin> tayabas> baabas> bayabo> bayawas>
biabas> aiyabat> aiyabit> eyabas> uyabas9
Pa+a sa
"anlinis sa suat> impeksyon sa bibi> maan ilaid> o
bulok na nipin
Pag9ilala
Isan uri n puno na tumataas hanan #;% metro
2amumulaklak n kulay putin
=una ay bilo na may maliit na buto at kinakain n sariwa
Pag(a(ani-
156
"amamaitan n ma buto
Pag3aalaga
4indi kailanan n lubos na pa;aalaa
Pag3aani a( Pag3ii-6a9
0uran dahon o talbos an anihin
Tiyakin walan ma insekto o dumi
Pag)a)anda
4uasan an ma dahon at tadtarin
0apakulo n dalawan 729 dakot na dahon sa apat 7#9 na
bason tubi sa loob n 1% minuto sa mahinan apoy
"alamiin at salain
Pagga-i(
"ara sa suat; ipanhuas an pinalaaan tubin 2 beses
mahapon
"anmumo; amitin an maliamam na pinalaaan
Paalala
"iliin laman an nati&e na puno dahil ito laman and dumaan sa
pananaliksik
6. +.lasimang )ato, <Pepe+o-ia pellucida=
7"ansit;pansitan9
Pa+a sa
157
"ampababa n uric acid sa duo 7rayuma> out9
Pag9ilala
Isan uri n damo na makatas at huis puso n dahon
Pag(a(ani-
2akalat laman
0aaarin itanim an buto
0aluluso na dahon
Pag)a)anda sa Pagga-i(
-alad
4uasan mabuti an ma dahon
0ahanda n 1 P tasa n sariwan dahon 7hindi siksik9
4atiin sa tatlon 7!9 bahai at kainin an bawat bahai sa umaa>
tanhali at abi
"e9o9s*on
4uasan mabuti an ma dahon
0ahanda na 1 P tasa n sariwan dahon at 2 bason tubi
"akuluan sa mahinan apoy sa loob n 1% minuto 7huwa takpan
an palayok9X
"alamiin at salain
4atiin sa tatlon 7!9 bahai at inumin sa umaa> tanhali at abi
pakatapos kumain
158
72 ,)awang, <Alliu- sa(i1u-=
78Aos> ?arlic9
Pa+a sa
"ampababa n kolesterol
Pag9ilala
=util na inaamit na pampalasa
"ahaba an dahon; namumulaklak
Pag(a(ani-
-a pamamaitan n ma butil
Pag)a)anda
Iisa 7kaunti o walan mantika
5ihaw
Ibabad sa suka sa loob n !, minuto> o kayaDy banlian n
pinakulon tubi hanan % minuto
Pagga-i(
Cumain n dalawin 729 butil tatlon 7!9 beses bawat araw
pakatapos kumain
Paalala
159
Tiyakin may laman an tiyan bao kumain upan hindi
makasuat n tiyan at bituka
82 +"m#alaya, <Mo-o+dica c)a+an(ia=
78maroso> 0aroso> 8palaya> 8palia> 8pape> 8papet> "alia>
"aria> "ubia> -ulium> =itter ourd9
Pa+a sa
+iabetes 0ellitus 70ild non;insulin dependent9
Pag9ilala
=ain na namumulaklak at namumuna
=una at dahon ay kinakain na ulay
Pag(a(ani-
Itanim an mauulan na buto
8lalayan n tukod sa pa;usbon
Pag3aani
0uran dahon laman an anihin
Tiyakin malinis an ma dahon
Pag)a)anda
4uasan an dahon at tadtarin
0asukat n anim 7*9 na kutsara at dalawan 729 bason tubi
"akuluan sa loob n 1% minuto sa mahinan apoy
"alamiin at salain
160
Pagga-i(
<minom n 1)! tasa tatlon 7!9 beses mahapon> !, minuto
bao kumain
8n muran dahon ay maaarin pasinawan at kainin 71)2 baso
dalawan 729 beses mahapon9
92 +Sambong,
78libhon> 8limon> 8yoban> =ukadkad> ?abuen> ?intin;intin>
4aliban> Cambihon> 5alakdan> 5adanbulan> +alapot> 5abulan>
-ambun> -ob;sob> Caliban> Takamain> =lumea Camphor> 2ai
Camphor9
Pa+a sa
0anas 7pampaihi9> "antunaw n bato 7anti;urolithiasis9
"alumpon 7shrub9
Pag9a9ilala
"alumpon
0ay bulo an dahon
Pag(a(ani-
-uplin o suhi 7plantlets9: =aon halaman tumutubo sa paliid
n pinakapuno>may tatlo 7!9 o hiit pan dahon
0ainat na hukayin an suplin na kasama an uat at itanim
Pag3aalaga
Ilaay sa malalim na luar
+iliin n sapat at alisin an ma damo sa paliid nito
161
"atuyuin mabuti an ma dahon
Tiyakin may matitiran sapat na dahon sa halaman
Ilaay sa ba na plastic o arapon may kulay at takpan mabuti.
Pag)a)anda
0atakal n dalawan 729 bason tubi at dahon
"akuluan sa mahinan apoy sa loob n 1% minuto
"alamiin at salain
Sa+iwa Tu*o
0atanda * kutsara # kutsara
/;12 taon ! kutsara 2 kutsara
Pagga-i(
4atiin sa tatlon 7!9 bahai an pinalaaan
Inumin an bawat bahai sa umaa> tanhali> at abi
Paalala
4indi ito amot sa impeksyon sa bato o ihi
1B2+Tsaang 'ubat, <!a+-ona +e(usa </a)l= Masa-=
162
78libuno> 0alatadian> Calabono> 0araued>Talokot>
Talibuno> Calimuno> Tsa9
Pa+a sa
-akit n tiyan
Pag9ilala
"alumpon 7shrub9 na tumaas hanan liman 7%9 metro
0aliit an ma dahon na makintab at matinkad an paka
kulay berde
Pag(a(ani-
0a pinutol na sana na may haba na 2, sentimetro at may
tatlon 7!9 buko
0a buto
Pag3aalaga
+iliin araw;araw
8lisin an ma damo sa paliid
Tiyakin may matitiran sapat na dahon sa halamanU
"atuyuin mabuti an ma dahon sa pamamaitan n
papapahanin.
Ilaay sa ba na plastic o arapon may kulay at takpan mabuti
Pag)a)anda
163
4uasan mabuti an ma dahon at saka tadtarin
0atakal n dalawan 729 bason tubi at dahon
"akuluan sa mahinan apoy sa loob n 1% minuto. 4uwa
takpan an palayok
"alamiin at salain
Sa+iwa Tu*o
0atanda # kutsara ! kutsara
/;12 taon 2 kutsara kutsara
Pagga-i(
4atiin sa dalawan 729 bahai an pinalaaan
Inumin an bawat bahai tuwin ika;apat 7#9 na oras.
Paalala
0aaari rin iton imumo upan tumibay an nipin
?abay -a "aamit n 1, 4alaman ?amot> -enate ; Committee on
4ealth and +emoraphy
164

Module 5 - Early Childhood Illness Revised Dec15

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Early Childhood Illnesses

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