FEVER

IDENTIFY THE PICTURE

GIVEN

MENINGITIS

MALARIA

DECIDE THE MALARIA RISK

To classify and treat children with fever, you must
know the malaria risk in your area.
There is a high malaria risk in areas where more
than 5% of the fever cases in children are due to
malaria.
There is a low malaria risk in areas where 5% or
less of the fever cases in children are due to
malaria.
There is no malaria risk in areas where no
transmission of malaria occurs.

MEASELS

DENGUE

Fatima is 18 months old. She weighs 11.5 kg. Her temperature is 37.5
C. The health worker asked, What are the childs problems? The mother
said Fatima has been coughing for 6 days, and she is having trouble
breathing.
This is the initial visit for this illness. The health worker checked Fatima for
general danger signs. The mother said that Fatima is able to drink. She has
not been vomiting. She has not had convulsions during this illness. The
health worker asked, Does Fatima seem unusually sleepy? The mother said,
Yes. The health worker clapped his hands. He asked the mother to shake
the child. Fatima opened her eyes, but did not look around. The health worker
talked to Fatima, but she did not watch his face. She stared blankly and
appeared not to notice what was going on around her. The health worker
asked the mother to lift Fatimas shirt. He then counted the number of
breaths the child took in a minute. He counted 41 breaths per minute. The
health worker did not see any chest indrawing. He did not hear stridor. The
health worker asked, Does the child have diarrhoea? The mother said, Yes,
for 3 days. There was no blood in the stool. Fatimas eyes looked sunken.
The health worker asked, Do you notice anything different about Fatimas
eyes? The mother said, Yes. He gave the mother some clean water in a
cup and asked her to offer it to Fatima. When offered the cup, Fatima would
not drink. When pinched, the skin of Fatimas abdomen went back slowly.
Because Fatimas temperature is 37.5 C and she feels hot, the health worker
assessed Fatima further for signs related to fever. The mother said Fatimas
fever began 2 days ago. It is the dry season, and the risk of malaria is low.
CASE 1:

REFERENCE
1. K. Park. Integrated Management of Neonatal and
Childhood Illness (IMNCI). Textbook of Preventive and
Social Medicine 22nd Edition 2013; 7: 423-424.
2. K. Park. Integrated Management of Childhood Illness
(IMCI). Textbook of Preventive and Social Medicine 22 nd
Edition 2013; 10: 532-533.
3. K. Park. Annexure A. Textbook of Preventive and Social
Medicine 22nd Edition 2013; 10: 552-559.
4. WHO. Integrated Management of Childhood Illness. Chart
Booklet March 2014.
5. WHO, UNICEF, CAH. Integrated Management of Childhood
Illness. Handbook 2005.

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