Early recognition and management of childhood pneumonia

Pneumonia is the leading cause of death among children under 5 years of age worldwide. One child dies from pneumonia every 20 seconds.  That means 4,300 young lives are lost every day. “Pneumonia is a common respiratory infection in children and an important cause of morbidity and mortality, even in new born infants. 98% of children who die of pneumonia live in developing countries” said Professor (Dr) PK Misra, luminary paediatrician, who is the former Principal of India’s prestigious King George’s Medical College (KGMC, now known as Chhatrapati Shahuji Maharaj Medical University) and also the former Head of the Paediatrics Department at KGMC.

Added Prof (Dr) PK Misra: “Pneumonia is an infection of the lungs, filling them with fluid. It causes cough and fever and can make breathing difficult. Severe pneumonia can be deadly. In developing countries, children under 5 years of age are at risk, especially in the poorest communities. Tobacco smoke and other indoor air pollution increase susceptibility to pneumonia. Some children and adults are at greater risk because they have other infections, such as HIV. Children who are poorly nourished can also have weakened immune systems, putting them at higher risk of contracting pneumonia.”

Prof (Dr) PK Misra further explains that "globally, bacteria such as Hib and pneumococcus are estimated to cause more than 50% of pneumonia deaths in children under 5 years of age. Viruses and fungi can also cause pneumonia infections. In resource-poor settings, pneumonia can be diagnosed by the symptoms it causes, including cough, fever and difficulty or fast breathing. Chest X-rays and laboratory tests can also diagnose pneumonia, but these tools are often unavailable in developing countries, especially in remote rural communities, making it more difficult to diagnose and treat pneumonia."
“Some pneumonia can often be prevented with vaccines against Hib and pneumococcus. Measles and pertussis (whooping cough) infections can result in pneumonia complications, so vaccinating against these childhood diseases can prevent some pneumonia cases. Inexpensive antibiotics can effectively treat pneumonia at the community level. Early recognition and early management are very important. If pneumonia cannot be managed at the health centre, then early referral to a better health centre can become life saving at times. But all cases don’t need highest level of medical care. Pneumonia can be effectively managed (depending upon the condition) by providing home-based care. Early recognition of signs by family members, or by those who look after the child, that a child needs medical attention  without delay at an appropriate health centre, are crucial. Aseptic and clean environment should be maintained to raise the child and those who are caring for the child should wash their hands properly, wash clothes properly, and keep the umbilicus clean and not put anything there which can infect the child through umbilicus” said Prof (Dr) PK Misra.

Shobha Shukla and Bobby Ramakant – CNS