Acute Respiratory infection (ARI)

and Control of Diarrhoeal

Diseases(CDD)
Dr. Abdulkareem A. Mahmood
Professor of Community Medicine
 Integrated Management of Children illness
(IMNCI)
• Is a WHO/UNICEF program implemented in
developing countries in 1997 to reduce
mortality and morbidity from major diseases
mainly Diarrhoea, ARI ,Measles , Malnutrition
and Malaria which account for 70% of
children death in these countries.
 Objectives of IMNCI
• To reduce mortality and morbidity of children
under five years of age especially of the five
diseases.
• To promote health and growth development
of children.
• To improve health system
• To improve skills of health care providers
through training .
 ARI
• Acute respiratory infections (ARI) are the
second leading cause of global illnesses
resulting in over 4 million deaths annually.
Evidence suggests that respiratory syncytial
virus and influenza are associated with the
majority of episodes of ARI, especially in
children and the elderly.
 ARI
• ARI is one of the major causes of mortality
among under five population, it contributes to
19% deaths in age group beyond neonatal
period.
• Every child suffers 4 to 6 episodes of acute
respiratory infections in one year.
• This includes common cold cough and
pneumonia. See ARI guidelines .
• ARI caused by viruses or Bacterial agents .
 Management of ARI
• If child is having cold cough and fever but
respiratory rate is normal and there is no
evidence of chest recession then child can be
managed at home with paracetamol for fever.
• Give plenty of fluids, keep child warm, and
give him normal diet.Home remedies like
honey,‫زنجبيل‬ginger can be given.
 Management of ARI
• If child is having cold cough, fever, respiratory
rate is increased as well as there is evidence
of chest recession along with color change on
tongue and lips to blue then child is suffering
from severe pneumonia. Take the child to the
nearest hospital because child needs
admission and injections for antibiotics.
 Control of Diarrhoeal Diseases(CDD)

• Diarrhoea is defined as passage of watery

stool up to three or more loose tools per day
with or without blood.
• An average child suffers from 1.7 episodes of
diarrhea per year.
• In order to control Diarrheal diseases MOH of
Iraq has adopted the WHO guidelines on
Diarrhea management.
 Management of Diarrheal Diseases
• Iraq introduced the low osmolarity Oral
Rehydration Solution (ORS), as recommended
by WHO for the management of diarrhea.
• • Zinc has been approved as an adjunct to ORS
for the management of diarrhea. Addition of
Zinc would result in reduction of the number
and severity of episodes and the duration of
diarrhea.
 :Management

• 1. Give plenty of home based fluids to the child during episode of diarrhoea : such
as :
• • Rice water
• • Soup
• • Tea
• • Water
• • ORS
• • Fruit Juices
• 2. ORS preparation steps:
• • Wash your hands with soap.
• • Take a litre of clean drinking water in a clean container.
• • Take a packet of ORS and add all its contents in the water.
• • Stir thoroughly so that the powder is completely mixed.
• • Cover the vessel.
 Management (cont..)
Consult nearest health centre in case :
• • Increase frequency of diarrhoea and
vomiting
• • Child not taking anything orally
• • Child is not active
• • Child is having features of dehydration
(irritable, lethargic, dry tongue, delayed skin
turgor)
During diarrhoea do not stop giving food to the child
 NKS
TH A