Ari Control Programme

NATIONAL ACUTE RESPIRATORY
INFECTION CONTROL
PROGRAMME
INTRODUCTION
• Infections of the respiratory tract are perhaps the most common
human ailment
• They are a substantial cause of morbidity & mortality in children
• National ARI control programme was launched as a pilot project in
25 selected districts in India during the year 1990
• The programme was integrated as one of the components with
CSSM in 1992 & later with RCH
Objectives of ARI control programme
• To reduce mortality and morbidity due to ARI-pneumonia

among under fives.
• To avoid delay in getting treatment for those cases of ARI
requiring hospitalization.
• To reduce no. of cases needing hospital admission
What is ARI?
ARI may causes inflammation of the respiratory tract anywhere
from nose to alveoli with combination of signs and symptoms.
It is classified as:
• Acute Upper Respiratory Infections (AURI)
• Acute Lower Respiratory Infections (ALRI)

AURI- includes ALRI:- includes
• Epiglottitis
• Common
• Laryngitis
cold
• Laryngotracheitis
• Pharyngitis
• Bronchitis
and • Bronchiolitis
• Otitis media • Pneumonia.
Problem Statement (Globally)
• Every year ARI in young children is responsible for an estimated 3.9
million deaths worldwide
• About 90% of ARI deaths are due to pneumonia
• Pneumonia kills more children than other disease (more than AIDS,
Malaria & Measles combined)
• More than 1.1 million under 5 year of age children die from
pneumonia each year
• Accounting for almost 17% under-five deaths world wide
In India
• Pneumonia accounts for 14% of all deaths of children under 5
year of age & killing 740180 children in 2019.
• 207 people died in Delhi because of acute respiratory
infections in 2016
• Kerala had the highest number of cases —
58,57,820, followed by West Bengal with 43,77,093 cases
Factors influencing the incidence of respiratory
tract infections
• Poor nutritional status
• Poor socio-economic status.
• Parental smoking
• Parasitic infection.
• Breastfeeding & Early weaning.
• Immunization
Strategies
• Ensure standard Care management of pneumonia in children under 5 years
by training medical and other health personal.
• Train peripheral health staff to Recognize & treat cases of pneumonia.
• Promote timely referral of sever pneumonia by the peripheral health staff
• Improve maternal knowledge about home management of cough, cold &
recognition of early danger signs for seeking appropriate Core.
• Promote immunization, exclusive breast feeding in the first 4-6 months,
proper weaning & vitamin A administration
Clinical assessment
History to be collected:
• H/O fever
• Age of the child
• Child is excessively
• Since how long the child is
drowsy/difficult to wake
coughing
• Irregular breathing
• Young infant stopped feeding
well (less than 2 months) • Convulsions
• The child is able to drink (2 • The child turning blue
months to 5 years)
Physical examination
1. Count the breaths in one minute:-
• Fast breathing depend upon the age of the child
• It should be seen for 1 full minute looking at the abdominal movement
or lower chest when the child is calm

Age Fast breathing
Less than 2months 60 breaths /minute or more
2months to 1 year 50 breaths/minute or more
1 to 5 years 40 breaths/minute or more

2. Look for chest indrawing:-
• The child has chest indrawing if the
lower chest wall goes in when the child

breathes in
• It occurs when the effort required to
breathe in, is much greater than normal

3. Look and listen forstridor:-
• Stridor makes a harsh noise when the child breaths IN
• It occurs when there is narrowing of the larynx,
trachea or epiglottis which interferes with air entering

the lungs
• This condition is called croup
4. Look for wheeze:-
• Wheezing is soft whistling noise or show sign of breathing
out is difficult
• It is caused by narrowing of air passage in lung
• Breathing out phase takes longer than normal effort
• Previous history of wheezing taken from mother

5. Check for severe malnutrition:-
• Case fatality rates are higher in these children
• These children need careful evaluation and
management for pneumonia

6. Other Signs:-
• Abnormally sleepy or difficult to wake
• Feel for fever or lower body temperature
• Cyanosis
• Spo2<92%
Classification of illness
1. Child aged 2 months – 5 years:
a) Very severe disease
b) Severe pneumonia
c) Pneumonia
d) No pneumonia
2. Infants less than 2 months:

a) Very severe pneumonia
b) Severe pneumonia
c) No pneumonia
Management of AURI
• DO NOT require treatment with antibiotics
• Causative agents are viruses
• Symptomatic treatment and care at home

TREATMENT OF PNEUMONIA AT HEALTH
CENTER
• Cotrimoxazole is the drug of choice for the treatment of
pneumonia
• Studies carried out in India have confirmed the efficacy of the
drug to be similar to ampicillin and procaine penicillin
• Cure rate is upto 95%
• It is less expensive with few side-effects
Prevention ofARI
Prevention of ARI
• Improved living conditions
• Better nutrition
• Reduction of smoke pollution indoors
• Better Maternal Child Health care
• Immunization
• Health promotional activities

Immunization
• Measles vaccine
• HIB vaccine
• Pneumococcal vaccine
ROLE OF NURSE
• Cotrimoxazole should not be given to premature babies & cases of neonatal
jaundice
• In small children the tablet should be crushed & mixed with milk or other
fluid
• Advice the mother to give correct doses
• Adequate feeding to be advised
• Mother should be advised to keep young infants warm
• DPT and measles vaccination at appropriate age
• Hand washing before feeding & touching the baby

Ari Control Programme

Uploaded by

Copyright:

Available Formats

Ari Control Programme

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Ari Control Programme

Uploaded by

Copyright:

Available Formats

NATIONAL ACUTE RESPIRATORY

• To reduce mortality and morbidity due to ARI-pneumonia

• Acute Lower Respiratory Infections (ALRI)

well (less than 2 months) • Convulsions

• The child is able to drink (2 • The child turning blue

• It should be seen for 1 full minute looking at the abdominal movement

or lower chest when the child is calm

Less than 2months 60 breaths /minute or more

2months to 1 year 50 breaths/minute or more

1 to 5 years 40 breaths/minute or more

• The child has chest indrawing if the

lower chest wall goes in when the child

breathe in, is much greater than normal

• Stridor makes a harsh noise when the child breaths IN

• It occurs when there is narrowing of the larynx,

trachea or epiglottis which interferes with air entering

• Wheezing is soft whistling noise or show sign of breathing

• Breathing out phase takes longer than normal effort

• Previous history of wheezing taken from mother

• Case fatality rates are higher in these children

• These children need careful evaluation and

management for pneumonia

• Abnormally sleepy or difficult to wake

• Feel for fever or lower body temperature

2. Infants less than 2 months:

• DO NOT require treatment with antibiotics

• Causative agents are viruses

• Symptomatic treatment and care at home

• Reduction of smoke pollution indoors

• Better Maternal Child Health care

• Health promotional activities

You might also like