MSF Paediatric Days 2019 - Stockholm, Sweden

The Ebola virus disease (EVD) outbreak declared in August 2018 in the Democratic Republic of Congo (DRC) is associated with a 62% mortality rate, with children accounting for 1/3 of cases. Infection prevention & control (IPC) protocols, the limitations of care in a remote field setting, and psycho-social aspects (including fear & lack of community acceptance) renders the care of critically & terminally ill paediatric patients more complex.

Status epilepticus (SE) is a life-threatening neurological emergency. The international rupture of intravenous phenobarbital and phenytoin has made impossible to manage cases of convulsive status that do not respond to diazepam in MSF projects. Levetiracetam was recently introduced but has not made his way to many projects yet. The literature contains quite some evidence about efficacy and safety of Ketamine in the adult and pediatric refractory SE populations, nevertheless Ketamine is not part of international protocol consensus of management refractory status epilepticus. Ketamine acts by inhibiting N-methyl d-aspartate receptors (reduces excitation) and hence can be used as an alternative agent when common drugs (those which enhance inhibition throw GABA receptors-benzodiazepines, phenobarbital-) fail to abort the status epilepticus.

Neonatal intensive care unit at Al-Nassr Pediatric Hospital is the main neonatal unit in Gaza strip serving a big geographical area including Gaza city, Northern Gaza as well as critical babies referred from mid of Gaza. We have a total complement of 30 cots including 11 NICU, 3 isolation, 8 SCBU (Special care baby unit) and 8 open cots in a baby-friendly room (babies with mums). In low-resource countries like Gaza, low-cost interventions such as clinical audits with staff education and feedback are crucial for quality improvement.

Over 1 million infants die each year due to severe respiratory illness, making this a leading cause of death in children under 5 years of age worldwide. 99% of these deaths occur in low to middle income countries.

The Warmilu engineering team learned that immediate thermal care, including kangaroo mother care and plastic bags/wraps, could reduce neonatal morbidity and mortality. But existing thermal care solutions were not always accessible; mothers could be receiving postpartum care, incubators could be overcrowded, broken, or lacking electricity, and plastic bags/wraps might not be in stock. The design and development process included 50 interviews over the course of 1-3 years to identify current challenges and best practices for thermal management. With design input, including on-site field observations and digital conference calls, with senior practicing neonatologists, medical device regulatory experts, government health officials, nurses, and midwives, the Warmilu team used lean startup methodology (LSM) to accelerate development.

Migration due to political crisis, civil wars and climate disasters affects millions of people all over the world, with almost 3 millions of refugees in Europe and half of them are children or teenagers. The aim of our study is to evaluate the proportion of infectious diseases in migrant children at their arrival.