Primary Health Care LEC 12: Acute Respiratory Infection

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Questions and Answers

Which of the following best describes acute respiratory infections (ARI)?

Infections limited to the upper respiratory tract.

Infections that only manifest through high fever.

Infections affecting various sites of the respiratory tract. (correct)

Infections solely caused by bacterial pathogens.

Which infection is classified as an upper respiratory tract infection?

Common cold (coryza) (correct)

Pneumonia

Croup

Bronchitis

What is the primary causative agent of acute respiratory infections in children in developed countries?

Fungi

Bacteria

Viruses (correct)

Parasites

In which scenario would a bacterial infection be considered a more significant factor in ARI?

In developing countries with limited healthcare access. Signup and view all the answers

Which of the following illnesses is considered a lower respiratory tract infection?

Laryngitis Signup and view all the answers

What symptom might suggest a child has a respiratory infection affecting multiple sites?

Cough coupled with shortness of breath Signup and view all the answers

Which of the following best represents a common manifestation of upper respiratory tract infections?

Catarrh Signup and view all the answers

Why is it challenging to classify respiratory infections based solely on symptoms?

Infections can occur at multiple sites simultaneously. Signup and view all the answers

What percentage of deaths in children under 5 years of age are caused by ARIs in developing countries?

20-30% Signup and view all the answers

What is the main burden of ARI cases on health establishments?

Outpatient and inpatient visits Signup and view all the answers

Which of the following risk factors is associated with a higher mortality rate due to pneumonia in infants?

Low birth weight Signup and view all the answers

Which factor increases the incidence of pneumonia by more than 5 times?

Artificial feeding Signup and view all the answers

What is the primary age group affected by ARI deaths in Iraq?

Infants under 1 year Signup and view all the answers

What is a significant effect of Vitamin A deficiency on children's health?

Higher incidence of pneumonia Signup and view all the answers

Which of the following is NOT a risk factor for ARI according to the information provided?

Regular exercise Signup and view all the answers

How many episodes of ARI is a child under 5 years likely to experience annually?

4-6 episodes Signup and view all the answers

What are the most common micro-organisms that cause pneumonia in children in developing countries?

Streptococcus Pneumoniae and Haemophilus influenzae Signup and view all the answers

Which step is NOT part of the clinical management of a child with ARI?

Parental education on nutrition Signup and view all the answers

What effect has the clinical management of ARI cases had on the mortality rate in children?

Reduced mortality rate by 25% to 67% Signup and view all the answers

Which statement about the use of antibiotics for ARI cases is correct?

Use of antibiotics decreased to 8.6% Signup and view all the answers

What is a key role of mothers in the management of ARI in children?

Recognizing dangerous signs of pneumonia Signup and view all the answers

What has been the impact of educating mothers on ARI control?

Improved household care for children with ARI Signup and view all the answers

What is one of the major benefits of the ARI programme in terms of hospital referrals?

Decrease in referrals from 14% to 2.1% Signup and view all the answers

What environmental factor is linked to increased cases of ARI in children?

Exposure to air pollution from household smoking Signup and view all the answers

Study Notes

Acute Respiratory Infection (ARI) in Children Under Five

ARI encompasses infections in any part of the respiratory tract, from the nose and ears to the lungs.
Symptoms include fever, cough, dyspnea, sore throat, and others.
Classification of ARI can be based on infection site, pathogen type, or symptoms.

Classification of ARI

According to Site of Infection

Upper Respiratory Tract Infections: Common cold, pharyngitis, tonsillitis, otitis media.
Acute Lower Respiratory Tract Infections: Include croup, laryngitis, bronchitis, bronchiolitis, pneumonia.
Measles, whooping cough, and diphtheria are also classified as ARI.

According to Pathogenic Agent

Viruses: Primary cause of respiratory infections, especially in children.
Bacteria: Less common in developed countries but significant in severe cases in developing nations.
Other Pathogens: Include gram-negative enteric bacteria and Group A streptococcus.

According to Clinical Manifestation

Symptoms can overlap, complicating diagnosis.
WHO simplified classification aids clinical management:
- Cough with shortness of breath.
- Ear problems.
- Pharyngitis.

Size of the Problem

Global Impact

ARIs cause 3-4 million deaths annually in children under 5, about 20-30% of total child mortality.
Most deaths (95%) occur in developing countries; 2/3 are in infants under one year.
Children under five experience 4-6 ARI episodes annually.
ARIs account for 30-50% of outpatient visits and 10-30% of hospital cases.

Local Impact in Iraq

ARIs cause 22% of child deaths under five.
80% of these deaths occur in infants aged below 1 year.
ARIs lead to 36% of outpatient visits and 35% of inpatient cases.

Risk Factors for ARI

Low Birth Weight: Increased risk of pneumonia mortality by 3-8 times.
Malnutrition: Heightens pneumonia incidence in children.
Artificial Feeding: Increases pneumonia incidence over fivefold.
Vitamin A Deficiency: Impairs respiratory tract immunity.
Overcrowding: Elevates infection rates and mortality.
Smoke & Air Pollution: Indoor air pollution exacerbates respiratory issues.
Exposure to Cold: Particularly risky for infants under two months.
Lack of Immunization: Increases susceptibility to infections.
Age: Younger children are more prone to ARIs.

Safe Clinical Management

Symptoms indicative of ARI include cough/shortness of breath, ear issues, and pharyngitis.
Management involves:
- Assessment of the child’s condition.
- Classification of the illness.
- Treatment based on classification.

Common Micro-organisms and Treatment

Main pathogens causing pneumonia in developing countries are Streptococcus pneumonia and Haemophilus influenza.
Proper management includes correct drug use and referrals to hospitals when necessary.

Successful Management Outcomes

Implementation of ARI management programs has led to:
- 25%-67% reduction in mortality rates.
- Decrease in hospital referrals for ARI from 14% to 2.1%.
- Reduction in antibiotic usage from 59.9% to 8.6%.
- Cost savings due to use of effective, low-cost antibiotics and reduced unnecessary tests.

Role of Maternal Education

Mothers play a crucial role in managing ARI in children.
Education helps in recognizing dangerous signs, allowing timely treatment and preventing complications.

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Description

This quiz focuses on Acute Respiratory Infection (ARI) in children under five years. It covers the definition, signs, symptoms, and implications of ARI. Perfect for students in primary health care looking to enhance their understanding of respiratory issues in young children.