Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which are filled with air. When an individual has pneumonia, the alveoli get filled with pus and fluid, which makes breathing painful and limits oxygen intake. The common symptoms of pneumonia are rapid or difficult breathing, cough, fever, chills, loss of appetite and wheezing in case of very severe pneumonia. When it becomes critical, children may experience in-drawing of chest, hypothermia and convulsions.
Pneumonia can be treated with antibiotics, but less than 20% of children with pneumonia receive the antibiotics they need. Although the WHO guidelines advise health workers to provide oral antibiotics for cases of non-severe pneumonia and to refer severe cases to hospitals for treatment with antibiotics by injection, many children with severe pneumonia either die before they reach a hospital, or are so sick by the time they arrive that nothing more can be done to save them. Hence, WHO, and UNICEF have initiated a Global Action Plan for Prevention and Control of Pneumonia (GAPP) in the context of child survival strategy which identifies priority activities that need to be conducted to reduce pneumonia mortality.
Very severe pneumonia in children under five requires treatment with injectible antibiotics in a hospital. The case management strategy for very severe pneumonia, which includes treatment with injectible chloramphenicol followed by oral chloramphenicol, has successfully decreased child deaths from pneumonia. WHO recommends the treatment at the level of primary health workers, and for them the guidelines are just to recognize it by increased respiratory rate and administer some basic antibiotics and if required then refer the child to a hospital.
Dr. Vijaya Mohan (Consultant Pediatrician, Vivekananda Polyclinic and Institute of Medical Sciences) says," We can diagnose pneumonia by physical and clinical findings and also by examining blood or X-ray. Even if the facilities are not available then by simply examining the child one can detect pneumonia. Antibiotics administered in the treatment of pneumonia, actually depend on the organism which is causing pneumonia. Penicillins, cephalosporins are usually suggested. But in the field WHO recommends Cotrimoxazole, Chloramphenicol."
Shikha Srivastava - CNS