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Acute Respiratory Infections.pptx
- 2. Infection of Respiratory tract may occur in which part?
- 3. So ARI may start in any part Nose Alveoli and ARI may spread to any part Nose Alveoli
- 4. Clinical Symptom depends on Site of Infection Site of Infection
- 5. Who are affected? Young Children (≤ 5 years) Older Children (> 5 years) Adult Elderly
- 6. 1980: World Health Organization (WHO) develop a pneumonia control strategy.
- 7. What’s Unique in this Strategy Simple signs are used to classify severities of pneumonia followed by appropriate case management.
- 8. Children with fast breathing Pneumonia Oral Antibiotics for 5 days @ home Children with chest indrawing ± fast breathing Severe Pneumonia Injectable Antibiotics @ nearest health centre Children with any danger sign Very Severe Disease Refer to higher centre
- 9. Integrated Management of Childhood Illness (IMCI) by WHO. Integrated Management of Neonatal and Childhood Illness (IMNCI) by India. (after modifying WHO version)
- 10. After 30 years: Revision of the pneumonia guidelines
- 11. The revisions include 1. Changing the recommendation for the first-line antibiotic 2. Re-defining the classification of pneumonia severity
- 12. New classification 1. Pneumonia with fast breathing and/or chest indrawing, which requires home therapy with oral amoxicillin. 2. Severe pneumonia, pneumonia with any general danger sign, which requires referral and injectable therapy.
- 13. Recommendation_1 • Children with fast breathing pneumonia with no chest indrawing or general danger sign should be treated with oral amoxicillin for 3 days.
- 14. Recommendation_2 • Children aged 2–59 months with chest indrawing pneumonia should be treated with oral amoxicillin
- 15. Recommendation_2 • Children aged 2–59 months with severe pneumonia should be treated with parenteral ampicillin (or penicillin) and gentamicin as a first-line treatment.
- 16. Recommendation_3 • Children aged 2–59 months with severe pneumonia should be treated with parenteral ampicillin (or penicillin) and gentamicin as a first-line treatment. Ceftriaxone should be used as a second-line treatment in children with severe pneumonia having failed on the first-line treatment.
- 17. General danger signs of seriously ill young infant Seriously ill Difficulty in feeding Reduced movements Fever / low body temperature
- 18. Sign of severe illness Not feeding well Severe Chest indrawing Convulsions Fast breathing Fever/low body temperature Less/no movements
- 19. Chest indrawing : Yes / No Source: https://www.who.int/maternal_child_adolescent/child/imci/training-video/en/
- 20. Chest indrawing : Yes / No Source: https://www.who.int/maternal_child_adolescent/child/imci/training-video/en/
- 21. Chest indrawing : Yes / No Source: https://www.who.int/maternal_child_adolescent/child/imci/training-video/en/
Notes de l'éditeur
- suitable for countries with limited resources and constrained health systems
- These pneumonia classification and management guidelines had been developed based on evidence generated in the 1970s and early 1980s, and were incorporated into the original version of Integrated Management of Childhood Illness (IMCI). In the intervening time, new evidence has emerged which prompted the development of revised guidelines
- Programmes should recognize the importance of these revisions, which will result in a substantially lower need for referral, and in better treatment outcomes. Local adaptations may be required, particularly the arrangements to include amoxicillin as the first-line therapy; facility-level
- The revisions include changing the recommendation for the first-line antibiotic and re-defining the classification of pneumonia severity. The data show that oral amoxicillin is preferable to oral cotrimoxazole for the treatment of “fast breathing pneumonia” and is equivalent to injectable penicillin/ampicillin in cases of “chest indrawing pneumonia”. Hence, in a programmatic context, the distinction between previously defined “pneumonia” (fast breathing) and “severe pneumonia”
- Ceftriaxone should be used as a second-line treatment in children with severe pneumonia having failed on the first-line treatment.