Acute Respiratory Infections

Acute respiratory infections (ARI), especially pneumonia, are responsible for about one-fifth of deaths among children under age 5. Worldwide, respiratory infections cause 30 to 40 percent of pediatric visits to health facilities. Standard case management of ARI, including appropriate recognition and proper use of simple and cheap antibiotics, could avert 30 to 60 per cent of ARI-related child deaths. Such treatment is not available, however, to many children in developing countries.

USAID is committed to combating this major cause of child mortality through the continuing development and introduction of effective technologies and approaches. As part of this effort, USAID supports the expansion of the Integrated Management of Childhood Illness approach, which combines prevention and treatment interventions for ARI, diarrhea, malaria, malnutrition, and measles, at the community and household levels.

learn more about USAID's Integrated Management of Childhood Illness (IMCI).

Achieving a major impact on ARI-related mortality requires timely recognition of ARI and its symptoms by mothers and other caregivers, as well as improved access to care. Comprehensive immunization coverage against Haemophilus influenzae type b, measles, and diphtheria, pertussis, and tetanus is also important for preventing ARI deaths in children.

Current USAID programs and research activities focus on:

• Prevention of ARI through improved nutrition and breastfeeding, immunizations, and reduced indoor air pollution
• Early recognition of ARI and improved home management by caregivers
• Appropriate illness management by health workers in the community and at primary health facilities
• Rapid referral of the most serious ARI cases

Several USAID-supported programs also promote increasing the availability of effective antibiotics.

USAID's Key Achievements in the Prevention and Treatment of Acute Respiratory Infections:

• In a project covering 21 districts in Nepal, community health volunteers identified more than 125,000 children with pneumonia and treated them with antibiotics. USAID supports the training of the volunteers. USAID assistance in Nepal over the past 15 years has contributed to a 42 percent decline in under-five mortality.
• USAID supports research to identify improved treatment strategies for pneumonia. A recent eight-country study demonstrated that severe childhood pneumonia can be treated with oral amoxycillin instead of injectable penicillin at less cost and with fewer risks. The findings will be incorporated into World Health Organization guidelines.
• USAID supports efforts to improve health worker performance in treating major childhood illnesses in Ouémé Province in southeastern Benin. Health facility surveys have found that six months after receiving training in Integrated Management of Childhood Illness, 73 percent of workers were correctly treating children with pneumonia, up from 28 percent.