Acute Respiratory Infections (ARI) In Children

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CLINICAL DESCRIPTION

Most ARI are mild, self-limiting viral infections. The Malawi ARI Control Program emphasizes standard case management as its main strategy.

This includes:

  • Early diagnosis
  • Appropriate drug use
  • Timely referral
  • Advice on suitable home care

TREATMENT

  • Refer to ARI Control Program Guidelines, MOHP 1998 for more information
  • Refer to the WHO's Management of the Child with Cough or Difficult Breathing for a summary of patient assessment, classification of illness and treatment instructions

Note ARI Case Management

  • Refer all cases for severe disease/pneumonia to hospital for admission after initial IM doses of recommended antibiotics
  • Treat all pneumonia cases as out-patients with
  • Cotrimoxazole or Amoxicillin
  • Do not use cough syrup - they have no role to play in ARI management

Home care of children with ARI

Advise guardian to:

  • Watch out for these danger signs (which may indicate pneumonia) and return quickly to the health facility if any occur:
    • Difficulty breathing
    • Fast breathing
    • Child cannot drink
    • Child becomes more ill
  • Feed the child
    • Continue feeding the child during illness
    • Increase feeding after illness
    • Clear blocked nose if interfering with feeding
  • Increase fluids
    • If > 6 months old, offer the child extra fluids to drink, Increase breastfeeding
  • Soothe throat and relieve cough
    • Give sips of water or other (preferably warm) fluids
  • Treat fever
    • Give Paracetamol in the recommended dose every 6 hours until the high fever stops
    • Increase fluids (see above)
    • Do not overdress or overwrap the child i.e., keep the child lightly dressed
  • Complete prescribed treatment
    • Complete this even if the child becomes better
  • Return for follow-up assessment after 2 days if child is being treated for pneumonia.