Acute respiratory infections in children

ACUTE RESPIRATORY INFECTIONS IN CHILDREN Basic facts • Acute Respiratory Infections (ARIs) are a major cause of mortality and morbidity in emergencies. • About 20% of all deaths in children under 5years are due to Acute Lower Respiratory Infections (ALRIs - pneumonia, bronchiolitis and bronchitis); 90% of these deaths are due to pneumonia. Early recognition and prompt treatment of pneumonia islife saving. • Causative organisms may be bacterial (most commonly Streptococcus pneumoniae and Haemophilus influenzae) or viral. However, it is not possible to differentiate between bacterial andviral ARIs based on clinical signs or radiology. • Low birth weight, malnourished and non-breastfed children and those living in overcrowded conditions are at higher risk of getting pneumonia. Thesechildren are also at a higher risk of death from pneumonia. Case management of ARI in children 2 month to 5 years • Assessment, classification and treatment of ARI are summarized on the attached charts.All children presenting with cough or difficult breathing should be assessed according to these charts. • All children should also be assessed for signs of severe malnutrition - visible severe wastingand oedema of both feet. Children with any of these signs must be referred to a hospital as they are at a very high risk of death from pneumonia. • Children with danger signs should be referred to ahospital after a single dose of IM chloramphenicol. In situations where referral is not possible, twice daily injections of IM chloramphenicol should be continued for 5 days, followed by oral antibiotictherapy for another 5 days. • Children with severe pneumonia should be referred to a hospital for treatment with IM ampicillin/penicillin. In situations where referral is not possible, these childrencan be treated with oral amoxicillin given thrice daily for 7 days. Oral amoxicillin has recently been shown to be effective in treatment of severe pneumonia. • Children with non-severe pneumonia...