Nicholas Comninellis

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What’s The Neonatal Dose For Quinine? – Angola Day 19

Angola Neonate

 

This is a question very few, if any, neonatologist ever faces in wealthier communities. Today I met this mother and her three-week old infant, who stopped nursing yesterday. Malaria is so very common here, even in the dry season, that the standard thick smear blood test is part of the work up of anyone with a fever – even a neonate. His blood smear demonstrated the parasites, and I went scrambling to find the proper infant dose of IV quinine. It’s not in any of our pediatrics or infectious disease text books, certainly not in Epocrates – that fancy medical info program I carry in my PDA. Alas, I finally found the dose in Handbook of Medical Care In Developing Countries. But this was only the beginning of the obstacles. Our pharmacy only has adult IV sets, and the wards have no infusion pumps, and no means for cardiac monitoring… Gotta love these challenges!

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