Acute respiratory infections (ARIs) are classified as upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The upper respiratory tract consists of the airways from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and the middle ear.
2. What is ARI?
Acute respiratory infection is an infection that may
interfere with normal breathing. It can affect just your
upper respiratory system, which starts at your sinuses
and ends at your vocal cords, or just your lower
respiratory system, which starts at your vocal cords
and ends at your lungs.
5. Symptoms of ARI
Congestion, either in the nasal sinuses or lungs.
Runny nose.
Cough.
Sore throat.
Body aches.
Fatigue.
6.
7.
8.
9. Mode of Transmission
Airborne droplets spread when the sick person
coughs or sneezes, and inhaled into the lungs
(breathed in) by a susceptible person
10. Control of ARI
Improving the primary medical care services and
developing better methods for early detection ,
treatment and prevention of acute respiratory
infection is the best way to control ARI .
Mortality rate due to pneumonia is reduced if treated
correctly.
Education of mothers about pneumonia because
compliance with treatment and seeking proper care
when child suffers determine outcome of the disease.
11. Management of ARI
WHO recommendation for management of ARI
a. Clinical assessment
b. Physical examination
12. Clinical Assessment
History taking and management are very important .
Note :
1)age
2)feeding habits
3)fever
4)convulsions
5)irregular breathing
6)history of treatment during the illness
7)activity
15. Cont..
Malnutrition :
If malnutrition is present its high risk and case
fatality rates are higher .
In severely malnourished:
1) Children with pneumonia, fast breathing and chest
indrawing may not be evident
2) Impaired or absent response to hypoxia and a weak
or absent cough reflex
3) Careful evaluation and management
17. Prevention Of ARI
Breastfeeding infants exclusively (no other food or
drinks, not even water) for the first six months breast
milk has excellent nutritional value and it contains the
mother’s antibodies which help to protect the infant
from infection.
Avoiding irritation of the respiratory tract by indoor
air pollution, such as smoke from cooking fires; avoid
the use of dried cow dung as fuel for indoor fires.
18. Immunization
• Immunization also increases control, by reducing the
reservoir of infection in the community and
increasing the level of herd immunity.
a. Measles vaccine
b. HIB vaccine
c. Pneumococcal vaccine
d. Pcv-7
19. Measles Vaccine
Pneumonia is a serious complication of measles
Reducing the incidence of measles helps reduce death
from pneumonia
Live attenuated vaccine Freeze dried product 0.5ml
dose subcutaneously also effective intramuscularly
Schedule : 9th month
20. HIB vaccine
Haemophilus influenza B most important cause of
death due to meningitis and pneumonia in developing
countries
Available for more than a decade Expensive Included
in the IAP immunization schedule combined
preparation with DPT and poliomyelitis
Three or four doses are given depending on type of
vaccine Schedule: 6 ,10, 14 weeks booster dose 12-18
months Vaccine is not offered to children more than
24 months
21. Pneumococcal vaccine
ppv23: polysaccharide non conjugate vaccine
containing capsular antigen of 23 serotypes against
this infection
Children under two years and immunocompromised
do not respond well to this vaccine
Select groups –sickle cell disease ,chronic heart
disease , DM, organ transplants etc
Dose -0.5ml
Administration – intramuscular in the deltoid
22. PCV 7 vaccine
Pneumococcal conjugate vaccine is a new vaccine
suitable for infants and toddlers
It is included in the IAP immunization schedule
Induces a t- cell dependent immune response
Prevents pneumococcal pneumonia and meningitis
moderately effective against otitis media
Dose- 6,10,14 weeks ,booster after 12 months OR
2, 4,6 months and booster after 12 months
Administration-intramuscular
23. WHO RESPONSE
In 2003, WHO's Division of Child and Adolescent
Health convened a meeting to review data and
evidence from recent ARI case-management studies
and to suggest the following revisions to case-
management guidelines and future research priorities:
Improve the specificity of clinical diagnostic criteria.
Reassess WHO's current recommended criteria for
detecting and managing treatment failure, given the
high rates of therapy failure.