Childhood pneumonia

Aarti Dhar, CNS Correspondent, India
(First published in TheIndiasaga.com)
According to the Global Coalition Against Childhood Pneumonia (GCACP), pneumonia is the most deadly infectious illness for children under 5 years of  age worldwide. Even as 2000 to 2015, the annual death toll from childhood pneumonia decreased from 1.7 million deaths in 2000 to 920,000 in 2015, approximately 2,500 children still die from pneumonia every day. This amounts to 16% of all child deaths.

Children all over the globe are affected by pneumonia, but a 2012 study found that low- and middle-income nations bear the largest burden: less than 1% of childhood deaths occur in developed countries and over 90% of deaths in children under-5 years of age occur in South Asia and sub-Saharan Africa. 50% of all pneumonia deaths occur in India. 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 lung's alveoli—small sacs that inflate with air when a person breathes—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 shaking chills; cough, which may produce phlegm; diarrhoea and vomiting; and fatigue.

Pneumonia is both preventable and curable. Encouraging exclusive breastfeeding in the first 6 months of life, which helps to develop a naturally strong immune system in a child, and adequate nutrition and vitamin A supplements help ensure a healthy immune system, says Dr Ajay Mishra, Director and Head of Paediatrics, Nelson Hospital, India. In addition, affordable and effective interventions like vaccines, antibiotics, and the simple act of hand-washing have proven track records and immediate impacts. As far as prevention is concerned, providing immunisation against Haemophilus influenzae type b (Hib), pneumococcus, measles and whooping cough, for example, 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 attributable to the disease. Economically, such a move would save $51 billion dollars in health costs and productivity losses.

More than half of childhood pneumonia deaths are caused, at least in part, by indoor household pollution, such as that caused by certain cook stoves. WHO recommends amoxicillin dispersible tablets as the only first line treatment for children under age 5 diagnosed with pneumonia, costing about USD 0.21-0.42 per treatment. Health workers can use a pulse oximeter to assess the level of oxygen in the blood and provide lifesaving oxygen therapy. Improving access to health services, along with other cost-effective health care strategies, such as integrated case management, are essential to controlling the disease. Only 60% of caregivers seek out adequate care for suspected pneumonia cases, and only one-third of pneumonia cases are addressed with proper antibiotic treatment.

Aarti Dhar, Citizen News Service - CNS
January 8, 2017

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