Control of Acute Respiratory Infections (ARI)
The global strategy to control ARI, particularly pneumonia, centers on the Integrated Management of Childhood Illness (IMCI) approach, focusing on early identification and standardized treatment to reduce morbidity and mortality.
1. WHO Clinical Classification & Management
| Classification | Clinical Sign | Management |
|---|---|---|
| No Pneumonia | Cough/cold only | Home care (fluids, soothing) |
| Pneumonia | Fast breathing | Oral Antibiotics (Amoxicillin) |
| Severe Pneumonia | Chest indrawing or danger signs | Hospitalization + IV Antibiotics |
2. Program Components
- Case Management: Standardizing treatment at the primary health care level using simple clinical signs to categorize illness.
- Immunization: Promoting high coverage for Hib (Haemophilus influenzae type b), PCV (Pneumococcal conjugate vaccine), and Measles to prevent secondary pneumonia.
- Nutritional Support: Addressing malnutrition and promoting exclusive breastfeeding for the first 6 months to improve immune resistance.
- Environmental Control: Reducing indoor air pollution (e.g., cleaner cooking fuels) to decrease chronic respiratory stress.
NEET PG Hint: Remember the IMCI criteria for “Fast Breathing”: ≥ 60/min for < 2 months; ≥ 50/min for 2–11 months; and ≥ 40/min for 1–5 years. Also, note that Amoxicillin is the preferred first-line antibiotic for outpatient management of non-severe pneumonia due to its better safety and efficacy profile compared to older drugs like cotrimoxazole.