SAPA believes the wearing of masks by school children could be better managed

SAPA believes the wearing of masks by school children could be better managed

The South African Paediatric Association believes that the issue of wearing of masks by school children could be better managed.

The Association says it supports the use of masks in appropriate and selective circumstances, rather than continuing with its universal use.

Professor Mignon McCulloch from the Red Cross War Memorial Children’s Hospital, weighs in.

Tune into Newzroom Afrika, DSTV channel 405, for more details.

Position Statement: Ambulatory care for children with COVID‐19

Position Statement: Ambulatory care for children with COVID‐19

Summary:

This document has been prepared by the South African Paediatric Association (SAPA) to assist primary  health care workers, general practitioners, and paediatricians in the ambulatory / out-patient / home-based care of children with SARS-CoV-2 infection.

Important considerations  Children with mild COVID-19 can be safely managed in isolation at home. Children with moderate or  severe  COVID-19  require  hospitalisation;  clinical  signs  include:  tachypnoea,  lower  chest  wall  indrawing, <92% oxygen saturation in room air, restlessness, difficulty in completed feeds or speaking  sentences. Not specific to COVID-19, the integrated management of childhood illness general danger  signs for children under 5 years are:

  • inability to drink or breastfeed
  • vomiting without retaining any fluids
  • lethargy or unconsciousness
  • convulsions

In addition, heath care workers need to be mindful of the presence of dehydration, persistent fever  and WHO signs of multisystem inflammatory syndrome in children (MIS-C)*.

There is limited evidence for the use of medication in the management of ambulatory COVID-19 in  children. The following proposed medications have been suggested based on expert opinion and or  extrapolated from adult studies. In general, the ambulatory/home-based management of children  is largely supportive with close monitoring for signs of deterioration.

There is currently no convincing data supporting the use of vitamin A, vitamin C, vitamin D, thiamine, nicotinic acid, zinc, selenium, inhaled steroids or short acting β‐agonist, lopinavir/ritonavir, hydroxychloroquine, azithromycin, ivermectin, cough mixtures or any other medication in children with COVID‐19; their routine use for this indication is consequently discouraged.

Corticosteroids, anticoagulation, antiviral or monoclonal antibody treatment for COVID‐19 or MIS‐C may be used in hospitalised children but are not indicated as part of ambulatory care. The care of people with SARS‐CoV‐2 infection is an area of active research and these recommendations will be updated as required.

SAPA’s Position

This document represents the view of the South African Paediatric Association, a professional society representing paediatricians in the public and private sector in South Africa. The document is supported by the Paediatric Management Group.

*https://www.nicd.ac.za/wp‐content/uploads/2020/09/MIS_C‐Case‐Def_09‐Sept‐2020.pdf

SAPA on ENCA

SAPA on ENCA

The ACDP and some doctors are challenging efforts to vaccinate children aged between 12 and 17 against COVID-19.

Dr Despina Demopoulos is questioned if parents should have any concerns about the jab.

View the full interview below:

Position statement: COVID-19 Vaccination of Pregnant and Breastfeeding Women

Position statement: COVID-19 Vaccination of Pregnant and Breastfeeding Women

The South African Paediatric Association (SAPA) remains committed to promoting the wellbeing of all children and their mothers.

Background

It has been brought to the attention of SAPA that some pregnant and breastfeeding women are being advised by public and private sector healthcare workers, including general practitioners, obstetricians and paediatricians to decline or delay COVID-19 vaccination.

The National Department of Health has issued a circular recommending all pregnant and breastfeeding women be offered the vaccination1 and SAPA supports these recommendations.

Evidence

  • COVID-19 during pregnancy increases the risk of preterm birth and other adverse obstetric outcomes.
  • Pregnant women and those in the early postnatal period are at substantially higher risk for severe COVID-19, including dying.
  • The available evidence supports the safety, immunogenicity, and efficacy of all currently available COVID-19 vaccines in both pregnant and breastfeeding women.
  • The vaccine has up to 96% effectiveness against documented infection in pregnant women2
  • Additional benefits of vaccination include the transfer of SARS-CoV-2 antibodies to the infant transplacentally and in breast milk this is likely to provide significant benefit to the infant.
  • Other vaccines, including tetanus, influenza and pertussis vaccines, are already part of recommended routine ante- and post-natal care as they have been shown to be safe and effective for both mother and infant.3
  • As yet, it is considered unlikely, that unidentified rare adverse effects of COVID-19 vaccination in pregnant and breastfeeding women will develop. However, ongoing safety monitoring will ensure these can be detected.

Recommendation

COVID-19 vaccination should be offered to all eligible women during any stage of pregnancy, and during lactation.

This position paper represents the view of the South African Paediatric Association, a professional society representing paediatricians in the public and private sector in South Africa. The position is supported by the Paediatric Management Group, the South African Academy of Family Physicians and the South African Society of Obstetricians and Gynaecologists.

References

  1. Updated Circular: Vaccination of Pregnant and Breastfeeding Women, NDoH, 29 August 2021 https://sacoronavirus.co.za/2021/08/30/updated-circular-vaccination-of-pregnant-and- breastfeeding-women/
  2. Dagan, N., Barda, N., Biron-Shental, T. et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat Med 27, 1693-1695 (2021). https://doi.org/10.1038/s41591-021-01490-8
  3. Zamparini, J, Murray, L, Saggers, R T, Wise, A J, & Lombaard, H. (2021). Considerations for COVID-19 vaccination in pregnancy. South African Medical Journal 2021;111(6):544-549.

SAPA Scientific committee

Despina Demopoulos
Ziyaad Dangor
Mignon McCulloch
Haroon Saloojee
Gary Reubenson
Neil McKerrow