Infant Toddler Development Training
Module 6, Lesson 1
What is Disease?
Disease is precise and involves pathological information that can be communicated to another individual so that a course of treatment can be planned and the results of the treatment can be determined. The causes of disease include environmental elements, infection and defects that may be inherent in the individual. Disease can be acute or chronic. Acute disease generally has a more rapid onset and the duration of the disease is for a shorter period of time. A chronic disease or condition is one that is recurrent and lasts a lifetime.
A disease or health condition is one that is manifested by symptoms and positive laboratory results or other medical diagnostics. The condition may be present long before the signs (objective physical evidence) and symptoms (subjective complaints) of the disease are manifested. If a person is diagnosed with a chronic disease, it remains a condition of the person for life. In general terms, the disease cannot be cured by medical treatment although the external signs and more pronounced symptoms can be treated or ameliorated. A key characteristic of disease is the presence of a disability represented by loss or absence of function due to sequelae (aftermath associated with the disease).
Disease is an unhealthy condition of the mind and body. It can suggest either a physical or a social state. It includes both the physical well being of an individual as well as the state of mind and may encompass the cultural beliefs of the individual.
Aspects of Chronic Disease in Children
One or more of the following are present in chronic disease for a child:
- Limitations of functions appropriate for age or development
- Dependency on medication or special diet for normal functioning or control of condition
- Dependency on medical technology for functioning
- Need for more medical care or related services than usual for the child's age
- Special ongoing treatments at home or in school
Generally, chronic diseases in children are relatively rare given the entire population of children. They are not particularly stable, often leading to periods of worsening and remission. This episodic nature is overlapped onto the development of the child and can affect the child's functioning in all domains.
Incidence and Prevalence of Chronic Health Conditions
Overall incidence (number of cases) of rare health conditions has not changed much over time. However, because of the advances in medical care and improvements in technology, children who would have died (mortality) at an early age are surviving and there is an increased prevalence of morbidity (effects of the condition) in the survivors. Therefore, the percentage of chronic conditions in the pediatric population is increasing. Facts relating to the declines in mortality include:
- advances in technology
- improved treatment of infectious diseases
- improved diagnoses and case finding of children with unrecognized conditions, and implementation of public and preventive health measures.
While thirty-one percent (31%) of all children have some sort of chronic health condition, two-thirds of these do not have significant functional limitation. Only, about ten percent (10%) have varying amounts of disability. Reduction of functional impairment is a goal of intervention and treatment.
Improvement in Infant Mortality Results in Increased Morbidity
Although progress has been made in reducing infant death (mortality), increased morbidity or effects associated with the conditions that require medical or surgical intervention has been the result. Listed below are some examples of conditions where medical science has made progress in increasing life expectancy and where this has resulted in increased morbidity that must be addressed by the medical team:
- Cystic fibrosis data and follow-up shows more children are surviving into adulthood with improved technology and medications
- Spina bifida data and follow-up shows improved life expectancy with better surgical interventions and improved control of urinary tract infections
- Phenylketonuria data and follow-up shows that many children with this error of metabolism have benefited due to the detection of the disorder with newborn screening programs and early dietary interventions. This intervention has drastically reduced the number of individuals with this condition who have mental retardation or autism and the life expectancy for the individuals has improved so that they survive to adulthood. These children must be managed in the prenatal and post- natal periods to reduce disabilities.
- The survival rate for children with traumatic injuries has improved; however, this has created an increase in numbers of children with more debilitating disabilities.
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