2. z
The oral drugs, intramuscular drugs and other treatments
presented in the IMCI charts are recommended for first-level
health facilities.
First-line drugs were chosen because they are effective, easy
to give and inexpensive.
second-line drug is only given if a first-line drug is not
available, or if the child's illness does not respond to the first-line
drug.
3. z
ORAL ANTIBIOTICS
Give the first-line oral antibiotic if it is available. It has been
chosen because it is effective, easy to give and inexpensive.
4. Recommended first-line and second-line
antibiotics may need to be changed based on
resistance data. You should give the second-line
antibiotic only if:
o the first-line antibiotic is not available,
o the child's illness does not respond to the
first-line antibiotic, or
the first line antibiotic is cotrimoxazole and an HIV
exposed or infected child is already on
cotrimoxazole prophylaxis
5. z
Some children have more than one illness that requires
antibiotic treatment, so single antibiotic is given to treat several
illness.
Sometimes more than one antibiotic must be given to treat the
illnesses. Eg, An antibiotic to treat pneumonia may not be
effective against dysentery, so a child may need to be given two
antibiotics.
6. z
RAPID ACTING BRONCHODILATOR
A bronchodilator is a drug that helps some children with a
wheeze to breathe easier by relaxing the muscles in the bronchi
walls so that the bronchi open up. Bronchodilators act rapidly
when given by injection or inhaled as a vapour. This is why they
are called "rapid acting". Salbutamol is the most common and
effective bronchodilator.
7. z
Give inhaled salbutamol for trial before
classifying cough or difficulty breathing
All children presenting with a wheeze and either fast breathing
or chest in drawing should get a trial with a rapid acting
bronchodilator, given up to three times 15-20 minutes apart,
before their cough or difficulty breathing is classified. If chest in
drawing or fast breathing disappears, then antibiotic treatment is
not needed.
8. z
Give inhaled salbutamol for home
treatment
Children with wheezing should continue getting 2 puffs of
inhaled bronchodilator three times daily for 5 days. In settings
where an inhaler is not available, oral salbutamol may be the
second choice.
9. z
PARACETAMOL FOR HIGH FEVER
(>38.5°C) OR PAIN
Paracetamol lowers fever and reduces pain.
If a child has a high fever, regardless of the classification, give
one dose of paracetamol in clinic.
If the child has ear pain, give the mother enough paracetamol for
1 day, that is, 4 doses. Tell her to give one dose every 6 hours or
until the ear pain is gone.
10. z
VITAMIN A
One dose of vitamin A is given to all children every 6 months to
prevent serious illness any time after 6 months of age.
One extra dose of vitamin A is given to treat children with
measles or PERSISTENT DIARRHOEA if they have not
received a dose of vitamin A within the past month.
Vitamin A helps resist the measles virus infection in the eye as
well as in the layer of cells that line the lung, gut, mouth and
throat. It may also help the immune system to prevent other
infections. Corneal clouding, a sign of vitamin A deficiency, can
progress to blindness if vitamin A is not given.
11. z
Cont.
IRON
A child with some palmar pallor may
have anaemia. A child with anaemia
needs iron. Give syrup to the child
under 12 months of age. If the child
is aged 12 months or older, give iron
tablets. Give the mother enough iron
for 14 days. Tell her to give her child
one dose daily for the next 14 days.
Ask her to return for more iron in 14
days. Also tell her that the iron may
make the child's stools black.
MEBENDAZOLE
If hookworm or whipworm is a problem in
your area, give mebendazole as a single
dose in the clinic to each child that is 1 year
old or older and has not had a dose in the
previous 6 months.
Hookworm or whipworm infections contribute
to anaemia because of iron loss through
intestinal bleeding. These infections also
contribute to malnutrition.
Give 500 mg mebendazole as a single dose
in the clinic. Give either one 500 mg tablet or
five 100 mg tablets.
12. z
ARV PROPHYLAXIS FOR HIV EXPOSED
BREASTFEEDING CHILD
A young infant classified as HIV EXPOSED should be given
cotrimoxazole and nevirapine, based on the weight of the baby.
Nevirapine is given from birth or from the time HIV exposure is
recognised.
