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Acuterespiratoryinfections(ARI)areamajorcauseof
morbidityandmortalityinyoungchildrenworldwide.
Nearly4millionchildrendieeveryyearduetoARI.
ARIaccountsfor3040%ofthehospitalvisitsbychildrenin
officepractice.
ofrespiratoryinfectionsperyear.
Incidenceofacutelowerrespiratory
infections(pneumonia)isveryhighindeveloping
countries.
ARIcompriseinfectioninanypartoftherespiratory
system(upperorlower)lastinglessthan30days
(forotitismedialess,than2weeks).
B.WHOclassification/Clinicalclassification
Identifyingthefewchildrenhavingpneumoniaamong
themanychildrenwithARI
AIClassifiedbasedonthesiteofinfection
AcuteUpperRespiratoryInfections(AURI)
AcuteLowerRespiratoryInfections(ALRI)
Nasopharyngitis
Tonsillitis
Sinusitisand
Otitismedia.
Epiglottitis,
Laryngitis,
LaryngoTracheobronchitis
Bronchitis
Bronchiolitisand
Pneumonia
Nopneumonia:Coughorcold
Pneumonia
Severepneumonia
Veryseverepneumonia
Bacteria Viruses
Strep.Pneumoniae RSV
Staph.Aureus Adenovirus
H.Influenzae Influenzae
Parainfluenza
Measles
Malnutrition
Lowbirthweight
Notbreastfed
VitaminAdeficiency
Indoorairpollution
Lowsocioeconomicstatus
Poorhygiene
Missingvaccines
Primarilybydirectcontactwithdischargesfrom
respiratorymucousmembranesofinfectedpersons
Bytheairborneroute,probablybydroplets
Byindirectcontactwitharticlesfreshlysoiledwith
thedischargesofinfectedpersons.
AssessClassifyIdentifytreatment
AntibioticsPenicillin,Ampicillin,Cotrimoxazole
Supportivecare
Oxygen
Multiplicityofagents
Periodicantigenchangesespeciallyamongviruses
Immunizationagainstvirusesmaynotoffereffective
resistanceagainstinfectionofthesurfacemucosaofthe
respiratorytract.
Airbornespreadoftheinfection.
Lackofspecifictreatment.
TherapidchangeintheclinicalpictureofachildwithARI
1Improvesocioeconomiccondition.
2Healtheducation.
3Decreaseovercrowding.
4Improvenutrition.
5Promotebreastfeeding.
6Avoidexposuretoindoor1airpollution
Immunizationagainstmeasles,pertussis,diphtheria
andtuberculosis
Pneumococcalvaccineandinfluenzavaccinehowever
botharenotwidelyused
widelyused.
Individualizedtreatmentguidelinespercountry
Trainingandsupervisionof1stlevelhealthworkers
Changingfamilybehaviorregardingcareofthesick
Availabilityandeffectivenessofessentialdrugs.
AssessClassifyTreatment
AsARIbeingasignificantproblem,Govthaslaunched
anationwideARIcontrolprogram:
Itsmainobjectivesare:
Earlydiagnosisandtreatmentofpneumonia
Itsprincipalstrategiesare:
Prevention
Casefindingandmanagement
Bewareofseriousconditionslikemeasles,mumpsand
diphtheriawhichmaybeginasnasopharyngitis.
Bloodstainednasaldischargeespeciallyunilateral,may
indicateconditionslikediphtheriaorforeignbody(old)and
henceneedsENTevaluation.
Sinusitis,serousotitismediaoracutelowerrespiratory
infectionsarecommoncomplicationsfollowing
nasopharyngitis.
Clinicallyviralpharyngotonsillitismaybedifficultto
differentiatefrombacterialpharyngotonsillitis.