Acute Respiratory infections in children 2024.pptx

We are going to see about IVAS

1. U niversídade Católica de Moçambique Departamento de Medicina-FCS  Acute Respiratory Infections in Emergency Situations 4 o ano Agosto/2024 Akú Júnior Macuácua Médico GP Mestrando Medicina Tropical

2. Classification: A s to the severity Mild Moderate Severe Region of the affected tract Upper respiratory tract infections  lower respiratory tract infections Acute Respiratory Infections (ARIs)

3. General Terms : Epidemic: ‘upon people’ (large number of cases in a certain community) Endemic: ‘amongst people’ (regulary found among particular group) Pandemic: ‘all people’ (in a country / in the world) Outbreak: sudden start of something unpleasant (an outbreak can lead to an epi- or pandemic of a communicable disease)

4. Epidemiology- Refugee and migrant health 2022 More than 1 billion people are on the move globally , about 1 in 8 of the global population . Of this total: 281 million people are international migrants , and 84 million are forcibly displaced : 48 million are internally displaced 26.6 million are refugees 4.4 million are asylum seekers Among the forcibly displaced , 35 million are children and 1 million were born into refugee life .

5. The number of people on the move is expected to grow due to: Poverty/ poor Lack of security Lack of access to basic services Conflict Environmental degradation and Disasters. Epidemiology- Refugee and migrant health 2022

6. The top 10 causes of deaths Worldwide- 2021 Citation : The World Bank . World Bank Country and Lending Groups . https :// datahelpdesk.worldbank.org / knowledgebase / articles /906519-world-bank-country-and-lending-groups The top 10 causes of death accounted for: 39 million deaths, or 57% of the total 68 million deaths worldwide .

7. Fonte: The World Bank . World Bank Country and Lending Groups . https :// datahelpdesk.worldbank.org / knowledgebase / articles /906519-world-bank-country-and-lending-groups

8. Leading causes of death by income group Fonte: The World Bank . World Bank Country and Lending Groups . https :// datahelpdesk.worldbank.org / knowledgebase / articles /906519-world-bank-country-and-lending-groups

9.  UNHCR’s programme in Mozambique Fonte:  UNHCR Mozambique Operational Data Portal | Protection Cluster – Mozambique | Global Focus | Twitter | Facebook UNHCR Mozambique End of Year Report 2022 OPERATIONAL UPDATE August 2023

10. Acute Respiratory Infections (ARIs) Major cause of morbidity and mortality throughout the world 25-30% of deaths in children < 5yrs in developing countries 90% due to Pneumonia Complications from measles, whooping cough and diphtheria 15-25% of all ARI Acute respiratory infections (ARI) have received far less attention in humanitarian relief policies and programmes , despite being the largest baseline contributor to disability-adjusted life-years (DALYs) lost.

11. RSV = respiratory syncytial virus; HAdV = human adenovirus ; PIFV = parainfluenza virus; hMPV = human metapneumovirus Respiratory pathogens  Citation : Riccò , M.; Corrado , S.; Bottazzoli , M.; Marchesi , F.; Gili , R.; Bianchi, F.P.; Frisicale , E.M.; Guicciardi , S.; Fiacchini , D.; Tafuri , S. RSV Infection in Refugees and Asylum Seekers : A Systematic Review and Meta- Analysis . Epidemiologia 2024, 5, 221–249. https :// doi.org /10.3390/epidemiologia5020016

12. Risk Factors for the Spread Group of Risk Low birth weight Malnutrition Poor breast-feeding practices Specific nutritional deficiencies Risk Factors Indoor Air pollution Urban air pollution Overcrowding

13. Modes of transmission Personal contact Droplet transmission [viruses and (myco-) bacteria] through: Coughing Sneezing Direct contact with contaminated material (some viruses)

14. What is the situation in a Refugee Camp?

15. What is the situation in a Refugee Camp? Community prone for outbreaks of communicable diseases Crowding of survivors of disaster in temporary accommodation Little facilities for personal hygiene Stress, affected by disaster Fatigue Malnutrition Absence of regular Public health programmes Vaccination, HIV/tb-care

16. What is the situation in a Refugee Camp? Among the leading causes of death Little data about morbidity and about specific pathogens little data about morbidity and about specific pathogens

17. What is the situation in a Refugee Camp? Principal Risk Factors for ARI : Malnutrition Vitamin A deficiency Chilling in infants Overcrowding Indoor pollution (bad ventilation, use of solid fuels) Decreased coverage of Expanded Programmer of Immunization (EPI) interventions

18. What is the situation in a Refugee Camp? Psychological stress Exhaustion Increased frequency of low birth weight and prematurity Lack of or delay in diagnosis and treatment due to insecurity and breakdown in health services

19. What is the situation in a Refugee Camp ? Surveillance Clinical case definition Prevention Improving nutritional status Administering supplements of vitamin A Reducing Overcrowding and reducing chilling I mnunization : measles, diphtheria, whooping cough Haemophilus influenza and Streptococcus pneumoniae Isolation

20. What kind of respiratory infections Diphtheria Measles Pertussis Influenza Tuberculosis Opportunistic infections (HIV endemic areas)

21. Measles I s a highly infectious viral disease Etiology: Morbillivirus ( P aramyxovirus family ) Transmission: C oughing S neezing Close personal contact D irect contact (with infected nasal or throat secretions) Especially in non- vaccinated Other features The virus remains active and contagious in the air or on infected surfaces for up to 2 hours . It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts Incubation period: 7 to 14 days Prevention: Routine measles vaccination for children M ass immunization campaigns

22. Influenza (flu) I s an acute viral respiratory disease Etiology: Orthomyxoviridae family T ypes : influenza A, B ( epidemic disease ) and C N atural reservoir : aquatic birds Classification: S easonal influenza Pandemic influenza ( A/H1N1 , A/H2N2 and A/H3N2 ) Transmission: R espiratory droplets C ontact Incubation period: 2 to 5 days Prevention: Vaccination L ess crowding, isolation, handwashing N euraminidase inhibitors C omplications : P neumonia (viral, strepto - and staphylococcal) Characterized by: F ever H eadache Myalgia Sore throat Cough

23. Diphtheria Is bacteria infections Etiology: Corynebacterium diphtheriae Exotoxin Transmission: Droplets & direct contact Especially in non-(re-) vaccinated Incubation period: 5 day Clinical presentation: Both children and adults can be affected Membranous nasopharyngitis (coalescing pseudo-membrane) Obstructive laryngotracheitis Fever, sore throat, malaise Cervical lymphadenopathy Complication: Damage of myocardial and nervous tissues

24. Prevention: Vaccination Boosters Less crowding Treatment: Anti-toxin (horse serum) Macrolides : Erythromycin Penicillin

25. Pertussis Is bacteria infections Etiology: Bordetella pertussis (coccobacilli, gram-) Transmission: Respiratory droplet nuclei from patients and carriers Incubation period: 7 to 14 days (3 weeks) Complications: Pneumonia Encephalopathy Especially in non-vaccinated & non-exposed communities Clinical presentation: Rhinorrhoea Fever - catarrhal phase Paroxysms of coughing Whooping cough

26. Prevention Vaccination less crowding Isolation Handwashing Macrolides Feed Rehydration

27. Is Bacteria infections Etiology: Mycobacterium tuberculosis Transmission: Aerosol droplets Classification: Clinical : Pulmonary and extrapulmonary tuberculosis Treatment : sensitive and MDR Clinical presentation FESTA Opportunity refugee camp: low immunity! Different from HIV-related form: More contagious Newly acquired infections may happen too Treatment: Isolation therapy Tuberculosis

28. Akú Júnior Macuácua Médico GP Mestrando Medicina Tropical Thank you