Fighting pneumonia, the number one killer of children

Francis Okoye, CNS Correspondent, Nigeria
[First published in nigeriapoliticsmagazine.com ]
Medical and media experts gathered recently in a webinar hosted by Citizen News Service to deliberate on how to address the world’s deadliest childhood infection: pneumonia. According to the Global coalition against childhood pneumonia (GCACP), pneumonia is the most deadly infectious illness for children under age 5 worldwide. Even though from 2000 to 2015,the annual death toll from childhood pneumonia decreased from 1.7 million deaths annually to 920,000 in 2015, approximately 2,5000 children still die from pneumonia every day.

This amounts to 16 % of all child deaths. Over 90% of these deaths occur in South Asia and sub Saharan Africa. The experts who gave talks on pneumonia in children included Dr Steve Graham, Professor of International Child Health, University of Melbourne, Australia and a senior expert with the International Union Against Tuberculosis and Lung Disease (The Union), Audrey M Battu, Director, Essential Medicines, Clinton Health Access Initiative (CHAI), Dr Ajay Mishra, Director and Head of Paediatrics, Nelson Hosipital India, Dr Kate O'Brien, Executive Director and Professor, International Vaccine Access Centre (IVAC), Johns Hopkins Bloomberg School of Public Health

Causes of pneumonia

Pneumonia has a number of bacterial, viral and fungal causes. The illness can be caused by bacteria and viruses already present in the body, or it can be transmitted from an infected person through droplets in the air following a cough or sneeze or through blood, such as during childbirth.
During an infection,the lungs alveoli-small sacs that inflate with air when a person breaths-fill with pus and fluid. Breathing becomes laboured and difficult, limiting oxygen intake. Other symptoms include retraction rather than expansion of the chest during inhalation, fever, sweating and chills, cough which may produce phlegm, and fatigue.

Fighting pneumonia

Pneumonia is both preventable and curable.This year, GCACP put forward three holistic ways to prevent pneumonia from taking so many young lives:-

(i) Protect: Encourage exclusive breast feeding through the first 6 months of  an infant’s life, which helps a child’s immune system naturally defend itself. In addition,adequate nutrition and vitamin A supplements help ensure a healthy immune system. Affordable and effective interventions like vaccines, antibiotics, hand washing and breast feeding have proven track records and immediate impacts. Indoor household pollution caused by tobacco smoke and biomass fuels must be avoided at all costs.

(ii) Prevent: Providing immunization against haemophilus influenza type b, pneumoccus, measles and whopping cough is an effective means of preventing pneumonia.The GCACP estimates that increased vaccine coverage in the world’s 73 poorest countries could avoid 2.9 million deaths and 52 million cases of infection attributed to the disease. Economically such a move would save $51 billion dollars in health costs and productivity.

(iii) Treat: WHO recommends amoxicillin dispersible tablets, costing about USD 0.21-0.42 per treatment, as the first line treatment for children. Health workers can use a pulse oximeter to assess the level of oxygen in the blood and provide life saving therapy. In Ethiopia, they have a national oxygen and pulse oximetry road map ,and other developing countries should introduce it to fight pneumonia.

Improving access to health services, along with other cost effective strategies, such as integrated case management, are essential to controlling the disease. Only 60% of care givers seek out adequate care for suspected pneumonia cases, and only one third of pneumonia cases are addressed with the proper antibiotics treatment. Parent education programmes should be oraganised to ensure that parents know how to prevent, protect and seek treatment for pneumonia. Strategic and effective programmes should be mapped out to educate communities on pneumonia. Community health workers should be trained in the care, prevention and treatment of pneumonia. Government and CSOs should put up programmes and policies to encourage exclusive breast feeding during the first 6 months of an infant’s life. Appropriate healthcare should be in place at all levels of health institutions with adequate training on pneumonia. The use of antibiotics for treatment, as well as vaccines for prevention, should be well explained and efforts made to ensure that genuine ones are readily available and at affordable rates for low income countries. So there need to be policies that support adjust early care seeking and referrals, accurate diagnosis and improved treatment of pneumonia.

Francis Okoye, Citizen News Service - CNS
December 26, 2016

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