Acute Respiratory Infections (ARI) in Children

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 breast- feeding
• 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.