Write the criteria for diagnosing pneumonia in children according to the 'Acute Respiratory Infection (ARI) Control Programme' (WHO). Write the treatment strategies of different types of pneumonia according to the ARI Control Programme.
The World Health Organization’s Acute Respiratory Infection (ARI) Control Programme emphasizes clinical diagnosis of childhood pneumonia. A child is considered to have pneumonia when cough or breathing difficulty is accompanied by fast breathing, defined as a respiratory rate of at least 60 breaths per minute in infants under two months, 50 in those aged two to eleven months, or 40 in children aged one to five years. Chest indrawing, where the lower chest wall moves inward during inspiration, also indicates pneumonia. Severe pneumonia is diagnosed when these features are present along with danger signs such as inability to feed, persistent vomiting, convulsions, lethargy, or stridor at rest. Very severe disease is recognized by central cyanosis or oxygen saturation below 90 percent. Management depends on severity: mild cases are treated with oral amoxicillin; severe pneumonia requires hospital care, injectable antibiotics, oxygen if hypoxic, and supportive measures. Very severe cases demand urgent hospitalization, immediate parenteral therapy, and close monitoring.
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