Pneumonia continues to be the biggest killer of under 5 children in the world today. The global burden of childhood pneumonia mortality led WHO in early eighties to develop pneumonia control strategies for developing countries having limited resources and inadequate health infrastructures. Case management was identified as one of the major components of pneumonia control strategy. Simple clinical signs which could be recognised by healthcare providers having little or no formal medical education were identified and then used for classification of varying severity of pneumonia within the settings where there was limited or no access to technology. These guidelines classified children 2 to 59 months of age with respiratory symptoms into four broad categories. Children with only cough and cold who did not have fast breathing were classified as “no pneumonia” and were sent home with no antibiotics. Children who had fast breathing only were classified as “non-severe pneumonia” and were sent home with an oral antibiotic for 5 days. Children who had lower chest in drawing with or without fast breathing were classified as “severe pneumonia” and were referred to a nearby health facility for treatment with injectible penicillin. Children who had any of the general danger signs were classified as “very severe pneumonia/disease” and were given the first dose of oral antibiotic and then immediately referred to a health facility for further evaluation and treatment with parenteral antibiotics. These guidelines have shown to reduce pneumonia mortality significantly in developing communities when they have been implemented effectively. READ MORE

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