WHO IMCI training video - Case study 1

Summary

Jenny, a 15-month-old girl, was brought to the clinic with diarrhea. After assessing her general condition, breathing, and signs of dehydration, it was concluded that she has pneumonia due to fast breathing and diarrhea without dehydration. Despite visible severe malnutrition, with signs of wasting and palapala, she does not have fever, ear problems, or severe dehydration. Jenny's condition was classified as pneumonia, diarrhea with no dehydration, and severe malnutrition, emphasizing the need for treatment of her malnutrition and pneumonia.

Takeaways

• 😀 Jenny is 15 months old, weighs 6 kg, and has a normal temperature of 37°C.
• 😀 Jenny was brought to the clinic due to diarrhea, but her general condition does not indicate any danger signs (no lethargy, vomiting, or convulsions).
• 😀 Jenny has been coughing for 5 days. Her breathing rate is 42 breaths per minute, which is considered fast for her age.
• 😀 Jenny does not have chest in-drawing or stridor, which indicates her pneumonia is not severe.
• 😀 Based on her fast breathing, Jenny is classified as having pneumonia.
• 😀 Jenny’s diarrhea has lasted for 2 days and does not contain blood, which reduces the risk of severe infection.
• 😀 Jenny’s general condition does not show signs of dehydration (no sunken eyes, she drank eagerly when offered water, and her skin elasticity returned immediately).
• 😀 Jenny's diarrhea is classified as ‘diarrhea with no dehydration’ due to the absence of severe dehydration signs.
• 😀 Jenny does not have fever or ear problems, which further simplifies her diagnosis.
• 😀 Jenny shows visible severe wasting (severe malnutrition), some palapala (paleness), and is classified as very low weight for age.
• 😀 Jenny’s final classification includes pneumonia, diarrhea with no dehydration, and severe malnutrition.

Q & A

What general danger signs were assessed for Jenny?

The general danger signs assessed for Jenny were lethargy, unconsciousness, ability to drink, vomiting, and convulsions. Jenny did not exhibit any of these danger signs, so she was not classified as having general danger signs.

What was the main symptom assessed related to Jenny’s cough?

The main symptom assessed for Jenny was cough. Jenny had a cough for 5 days, and her breathing was counted at 42 breaths per minute, which indicated fast breathing. No chest in-drawing or stridor was observed.

How was Jenny’s breathing assessed and what was the result?

Jenny’s breathing was assessed by counting the number of breaths in one minute, which was found to be 42 breaths per minute. Since Jenny is 15 months old, this indicated fast breathing, which led to a classification of pneumonia.

What findings indicated Jenny had no dehydration despite having diarrhea?

Jenny’s eyes were not sunken, she drank eagerly and appeared thirsty, and her skin returned to its normal state immediately after being pinched, showing no signs of severe dehydration. Thus, she was classified as having diarrhea with no dehydration.

How did Jenny’s diarrhea and stool condition impact her classification?

Jenny’s diarrhea lasted for 2 days and there was no blood in her stool. These findings, along with the absence of dehydration symptoms, classified her condition as diarrhea with no dehydration.

What was the conclusion regarding Jenny’s malnutrition and anemia?

Jenny was found to have visible severe wasting and some palapala (pale palms), but no edema of both feet. These signs, along with her very low weight for age, classified her as having severe malnutrition.

How does Jenny’s classification of pneumonia relate to her symptoms?

Jenny was classified as having pneumonia due to her fast breathing and prolonged cough, though she did not show signs of severe pneumonia or very severe disease. The presence of fast breathing placed her in the pneumonia category.

Why was Jenny not classified as having persistent diarrhea?

Jenny was not classified as having persistent diarrhea because her diarrhea lasted for less than 14 days, and there were no other signs such as blood in the stool or severe dehydration.

What factors contributed to Jenny being classified under severe malnutrition?

Jenny’s visible severe wasting and low weight for age, along with some palapala, led to her classification as having severe malnutrition. These signs were identified as part of her assessment for malnutrition and anemia.

What would the classification of Jenny’s condition be, based on the full assessment?

Based on the full assessment, Jenny was classified as having pneumonia, diarrhea with no dehydration, and severe malnutrition. These classifications were based on her symptoms, weight, and the presence of severe malnutrition signs.