Professional Documents
Culture Documents
Acute Respiratory Infections
Acute Respiratory Infections
Infections (ARI)
Prepared by-
Dr. Sunil M. Sagare
Specific learning objectives(SLOs)
Fever
Cough
Sore throat
Running nose
Difficulty in breathing &
Ear problems
Classification
UPPER RESPIRATORY LOWER RESPIRATORY
TRACT INFECTION. TRACT INFECTION.(LRTI)
(URTI)
e.g. e.g.
Common cold Epiglottitis
Pharyngitis Laryngitis,
Otitis media Laryngotracheitis
Bronchitis, Bronchiolitis
Pneumonia
PROBLEM STATEMENT
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PROBLEM STATEMENT CoNTD….
In World -
Deaths- 3.9 millions
90% of ARI deaths - due to pneumonia (Usually bacterial)
< 5 yrs Children - 5 episodes of ARI/child/year
In India -
Deaths - 9.87 lakhs (WHO estimates)
(9.69 lakhs due to ALRI & 10,000 due to AURI & 9000 due to
Otitis Media)
DALYs lost was 25.5 million
13 % inpatient deaths - due to ARI in pediatric wards
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Epidemiological DETERMINANTS
A. AGENT FACTORS
Bacteria
Bordetella Pertussis
Cornybacterium diphtheria,
H. Influenzae
Klebsiella pneumoniae
Strptococcus pneumoniae
Viruses
Adenovirus-endemic type (1,2,5) & epidemic type (3,4,7)
Enterovirus- ECHO & Coxsackie
Influenza A,B,C, & Parainfluenza 1,2,3
Corona virus, Rhinovirus
Respiratory syncytial virus
Measles
Other agents.
Chlamydia type B (Psittacosis)
Coxiella burnetti (Q fever)
Mycoplasma Pneumoniae
Severity of illness is determined by whether or not
secondary bacterial infection occurs(LRTI)
B. Host factors
Age
Young infants & malnourished children - Higher morbidity &
mortality rates
Children < 3 yrs affected more often & more severely
Adult women experience more illness than men.
C. Risk Factors
Overcrowding
Poor nutrition
LBW
Intense indoor smoke pollution
Level of industrialization and socioeconomic development
Low socioeconomic conditions
Maternal cigarette smoking
Preschool children attending day care canters
MODE OF TRANSMISSION
Direct
Droplet infection
Droplet nuclei
PORTAL OF ENTRY
Respiratory tract
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CONTROL OF ARI
Improving primary medical care services
Clinical assessment
Chest indrawing
Stridor
Wheeze
wake.
Wt-Less than
expected
Absent - Response to
hypoxia
or absent
Cyanosis: +/-
Classification of illness
1. No pneumonia 1. No Pneumonia
2. Severe Pneumonia 2. Pneumonia
3. Very severe pneumonia 3. Severe pneumonia
1. No pneumonia
Cough or cold
No fast breathing
No chest indrawing
2. Pneumonia
Cough or cold
Fast breathing
No Chest indrawing
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2. Severe pneumonia
Chest indrawing
Fast breathing - May/may not present
Nasal flaring
Grunting (Short snorting sound)
Cyanosis
1. No pneumonia
Cough or cold
No chest indrawing or fast breathing
2. Severe pneumonia
Severe chest indrawing or fast breathing
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Treatment
A) Children aged 2 months – 5 yrs
1. No Pneumonia
Symptomatic treatment
Treat wheezing
2. Severe pneumonia-
Refer urgently to hospital
Keep young infant warm
Give first dose of antibiotic
a) Inj. Benzyl Penicillin-50,000IU/Kg/Dose-12hrly (<7 days),6hrly
(7days-2months) OR
b) Inj. Ampicillin -50 mg /Kg/dose-12hrly,8hrly OR
c) Inj.Gentamycin-2.5 mg/Kg/dose-12hrly,8hrly
3. Very severe pneumonia-
Refer urgently to specialized hospital
Keep young infant warm
Give first dose of antibiotic
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OTHER PREVENTIVE MEASURES
Improved living conditions
Better nutrition