The Use of the Road to Health Card in Monitoring Child Health

Objectives: The Road to Health Chart (RTHC) provides a simple; cheap; practical and convenient method of monitoring child health. The RTHC could assist with vaccine compliance and early identification of growth faltering; to improve general health. The purpose of the study was to assess whether the RTHCs were adequately completed and interpreted at primary; secondary and tertiary care levels in South Africa.Methods: The study was carried out at a primary; secondary and tertiary care centre. A questionnaire was administered to 100 subjects from each; seeking demographic information; whether the RTHC was brought along; and if not why it was not brought.Results: Most children were brought by their mothers. The RTHC was not brought to 48 of the consultations; of those; about 72 thought that bringing the RTHC along was not necessary. Health workers seldom asked to see the RTHC at the primary and secondary care settings; but 50 of them did so at Ga-Rankuwa Hospital (p = 0;002). In only 8 cases overall were the children below the 3rd percentile of weight-for-age. Approximately 20 had incomplete immunisations.Conclusions: Many parents believe that the RTHC is only required for Well-baby-clinic visits; not for consultations. The RTHC is not often asked for at consultations; the fact that this is more often done at the tertiary care centre may be that much of the service is supplied by paediatricians-in-training. Health workers should ask to see the RTHC; in order for mothers to understand the importance of the information. The study showed that the RTHC is not used to its full potential

Central nervous system involvement in neonatal rotavirus infection.

Rotavirus is an ubiquitous virus associated with severe gastro-enteritis in children under 2 years of age. However, serious conditions, including central nervous system involvement, have been associated with rotavirus infection. We investigated the clinical signs and symptoms of rotavirus infection in 156 neonates, specifically focusing on neurological signs. Neurological signs identified were apnoea, jitteriness, convulsions and poor sucking. Of the 156 babies, 66 were rotavirus-positive and 90 rotavirus-negative. In the rotavirus-positive group, 19.7% manifested apnoea compared with 22.2% in the rotavirus-negative group. The other three symptoms occurred in <10% of the neonates. Rotavirus dsRNA was detected by RT-PCR in the CSF of two. One had apnoea, the other no CNS symptoms. Although rotavirus infection in neonates is hardly ever asymptomatic and may cause death, it has not been associated with CNS symptomatology in our studies.