USING INTERGRATED APPROACH, DISCUSS INTERVENTION FOR REDUCTION OF BOTH CHILDHOOD

PNEUMONIA AND DIARRHOEA

Pneumonia is an acute lower respiratory tract infection that causes 19% of mortality in the under 5 age
group whereas diarrhea refers to the passage of increased amounts and frequency of loose stools or
what the mother perceives as diarrhea that cause about 14% of under 5 mortality.

Pneumonia risk factors include the following contact with a person with upper respiratory tract
infection, exposure to indoor smoking, immunosuppression, exposure to hydrocarbons, overcrowding
whereas the risk factors for diarrhea constitutes the following poor sanitation and hygiene, early
weaning and incorrect weaning methods, prematurity, history of antibiotics.

As a result of high mortality that can be attributed to both pneumonia and diarrhea a Global Action Plan
for Pneumonia and Diarrhea was developed so as minimize the effects and mortality from these
diseases. It constitutes three components of protection, prevention as well as treatment of these
disease that cause high mortality rates.

As from the above risk factors for pneumonia and diarrhea it can be seen that low cost highly effective
interventions can be done and they would severely reduce the mortality due to these disease .In terms
of protection there should be promotion breastfeeding according to the WHO ten steps so that there is
increase in the number of exclusively breastfed for six months and continuum up to 24 months with
mixed adequate feeds as per each age group as this boost immunity and fight against the disease .For
those who go for alternative feeds they should be encouraged to meet the availability, feasibility
,affordability ,sustainability and safety criteria so that the child will benefit without endangering to risk
them to get diarrhea. The should be provision of adequate and clean safe water as well as appropriate
shelter so as to reduce overcrowding.

As for the prevention most of the burden of the disease come from vaccine preventable disease either
from viral or bacterial infections , hence the need to promote vaccination at public health scale for
disease such as tuberculosis ,diphtheria ,pertussis ,pneumococcal ,Hemophilus influenza type b ,
measles that can cause pneumonia or rotavirus that causes winter diarrhea .There is also need for the
upscaling to prevent mother to child transmission of HIV so that we reduce immunosuppression either
by exposure or infection .Also their mothers should be educated to know danger signs of these disease
so that they are quick to look for help such as fast breathing ,labored breathing for pneumonia and signs
of dehydration for diarrhea and other illness .

As for the treatment they should be managed according Integrated Management of Neonates and
Children Illness. The pneumonia has got to classified according to the WHO guidelines into Severe ,
pneumonia and no pneumonia whereas diarrhea into severe , some and no dehydration and managed
accordingly .Pneumonia should managed according to presentation but generally should receive oxygen
support , get antibiotics as one of the reasons attributed to the mortality was the lack of antibiotics in
the management .As for diarrheal depending on the presentation generally they should receive fluids as
oral rehydration salts , zinc supplements as they reduce the frequency , the severity as well as
recurrence of the diarrhea and the baby should continue being fed . For diarrhea antibiotics are not
routinely recommended but should be given for bloody diarrhea and as well when their risk of sepsis.
vitamin A supplementation should be given as per schedule of the road to health care. Deworming
should also be done with albendazole if there is need or suspicion and mothers should be counselled on
when to return, mitigate the potential risk factors.

Also information should be disseminated through the health information systems so that it can be used
to make decision as well as assess the effectiveness of failure of the measures thus so far being done