Treatment and Prevention

PHAHD is a serious illness with a high rate of mortality in infants in Tibet. The mortality rate in the 50s of the 20th century was as high as 50%. In the 60s it was 15-23%, in the 70s it was 4.2-15% [22, 39]. In fact, the mortality rate from ISMS has declined nearly 40% over the last 50 years, due to strengthening prevention among infants. At present, however, with the mortality rate id usually at about 5% of patients with ISMS in Qinghai-Tibet, this serious disease cannot be forgotten.

Remaining at altitude and local therapy led to disastrous results, because the failing heart simply does not respond to treatment at altitude. Administration of oxygen and treatment with cardiotonics, diuretics, corti-coids and antibiotics might buy time and provide temporary relief, but there is no alternative to rapid descent.

To avoid the disease, it is common practice for Han mothers to descend to their lowland homes to give birth and then entrust their child to the care of elderly relatives, because the Han mother must return to altitude and work. The child is then not brought to high altitude until is it over a year old or more. If some Han mothers must to give birth at high altitude for economic or personal reasons, the newborns should be under the care of the hospital. Establishing an oxygen enrichment room for infants is extremely necessary in Tibet. Nutritional supplements such as carbohydrates, proteins, iron and vitamins are necessary both for pregnant women and for infants. Prevention of respiratory infections is more important in children at high altitude.

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