Case Definition

Clinical assessment

  • URI: Rhinorrhea, sneezing, coughing, low grade feverE
  • Sinusitis: Head congestion, facial pain, and purulent nasal discharge that progresses to productive cough, suspect bacterial infection if worsening after 7-14 daysE,F,
  • Pharyngitis: Sore throat, exudate, tonsil enlargement, feverE,F
  • Acute bronchitis: Productive cough, fever, rhonchiE, can persist up to 14 daysF,

Red Flags

Pneumonia: Fever, cough, tachypnea, chest painE with decreased air entry, wheezes, crackles, rhonchiF

  • Adults: Macrolide or doxycyclineE, F,, augmentin, respiratory fluoroquinoloneF, amoxicillinE
  • Peds: BactrimE
  • Nebulizer treatmentF
  • Ceftriaxone if severe (both adults and peds) E
  • Refer neonates to hospitalE

Management

General recommendations

URI: Symptomatic managementF, H, limit antibiotic useI,R , hygiene practices to reduce transmissionH

  • Encourage fluidsE,R, tea or hot water with honey (not for children <12mos) R
  • Saline nasal drops for infants (1/4 tsp salt, 1/4 tsp baking soda, 1 cup boiled and cooled water) and provide bulb syringesI.

Pharyngitis: Rapid strep or mono spot test if exudativeF

  • Antibiotics only if strep test positive or signs of bacterial infectionF,H

Pharmacologic management

  • Acetaminophen or NSAID for feverE, M, R
  • Decongestants9 , antihistamine cough syrupE, I, M, S
  • Sinusitis: AmoxicillinE, F
  • Pharyngitis: Amoxicillin or penicillin VKE, F, H,
  • Second line: MacrolideE, F, H,
  • Acute bronchitis: May add albuterol inhaler PRNF
  • Consider amoxicillin or macrolide x 7-10 daysK (Peds: TMP-SMX) E
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Organization A

Locations: Nicaragua
Trips per year: 4
Format of trips: Mobile medical clinics and standing clinics
Setting: Rural
Type of Organization: Secular

Organization B

Locations: Guatemala
Trips per year: Variable
Format of trips: Clinics
Setting: Rural
Type of Organization: Secular

Organization C

Locations: Haiti
Trips per year: Variable
Format of trips: Clinic
Setting: Urban
Type of Organization: Faith-based

Organization D

Locations: Dominican Republic
Trips per year: 3
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

Organization E

Locations: Haiti
Trips per year: 7
Format of trips: Not mentioned
Setting: Rural
Type of Organization: Secular

Organization F

Locations: Honduras, Ecuador, Belize, Guyana, Guatemala
Trips per year: 5
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Faith-based

Organization G

Locations: Ecuador, Guatemala, Dominican Republic
Trips per year: 100 (spread over 6 sites)
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Secular

Organization H

Locations: Ecuador
Trips per year: 3
Format of trips: Mobile brigades in schools/Clinics in health centers
Setting: Rural
Type of Organization: Secular

Organization I

Locations: Honduras
Trips per year: 1
Format of trips: Mobile brigades in 20 villages
Setting: Rural
Type of Organization: Faith-based

Organization J

Locations: Jamaica, Haiti
Trips per year: 4
Format of trips: Mobile brigades, Permanent clinics/hospital medicine
Setting: Rural and urban
Type of Organization: Secular

Organization K

Locations: Haiti
Trips per year: 4
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

Organization L

Locations: Guatemala, Nicaragua
Trips per year: 3
Format of trips: Mobile clinics
Setting: Rural
Type of Organization: Faith-based

Organization M

Locations: Nicaragua, Honduras
Trips per year: 51
Format of trips: Mobile brigades, Hospital-based
Setting: Rural
Type of Organization: Faith-based

Organization N

Locations: Guatemala
Trips per year: 12
Format of trips: Hospital
Setting: Rural
Type of Organization: Secular

Organization O

Locations: Honduras
Trips per year: Up to 50
Format of trips: Mobile brigades in school and churches
Setting: Rural
Type of Organization: Faith-based

Organization P

Locations: Haiti
Trips per year: Variable
Format of trips: Mobile brigades and clinics
Setting: Rural and urban
Type of Organization: Secular

Organization Q

Locations: Dominican Republic, Haiti
Trips per year: 12 to 15
Format of trips: Mobile brigades
Setting: Rural
Type of Organization: Secular

Organization R

Locations: Honduras, Nicaragua, Panama
Trips per year: Hundreds
Format of trips: Mobile brigades in community centre or school
Setting: Rural
Type of Organization: Secular

Organization S

Locations: Honduras
Trips per year: 4
Format of trips: Mobile brigades, Specialty hospital services
Setting: Rural
Type of Organization: Secular

Organization T

Locations: Haiti
Trips per year: Approximately 40
Format of trips: Mobile clinics in 14 villages and Standing clinic
Setting: Rural
Type of Organization: Faith-based