Stronger health systems necessary to address pneumonia- a major killer of children under 5

Citizen News Service - CNS
Despite being preventable and treatable, it is unacceptable that Pneumonia continues to be a leading infectious killer for children under five years globally. Dr Ajay Mishra, Senior Director and Head of Paediatrics, Nelson Hospital in Lucknow, said in a webinar (recording, podcast) that "while pneumonia in children is preventable and treatable, it still remains the number one killer of children below the age of 5 years, killing 760,000 children aged 1-59 months in 2015.

With 35 million pneumonia episodes per year India tops the 15 high pneumonia burden countries. More than 90% of all pneumonia deaths occur in developing countries out of which 50% occur in India." Dr Ajay Mishra added: "Risk factors for childhood pneumonia include poor immunisation coverage; low birth weight, malnutrition, not exclusively breast feeding the infant for first 6 months; Vitamin A and zinc deficiency; indoor air pollution (from tobacco smoke for example), and poor access to health services are known. There is no excuse not to avert every preventable pneumonia death."

Shobha Shukla, former senior faculty of Loreto Convent and senior advisor to Vote For Health campaign of Asha Parivar said that Indian government along with other governments have committed to achieve Sustainable Development Goals (SDGs) by 2030 one of which is to end preventable deaths in children. But are we on track to meet this and other SDGs that include addressing malnutrition, universal health coverage, tobacco control, infant and maternal mortality, etc?
Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. According to Dr Steve Graham, senior child health expert with the International Union Against Tuberculosis and Lung Disease (The Union), 45% of childhood pneumonia is bacterial while 40% is caused by virus. The most common cause of bacterial pneumonia in children is Streptococcus pneumoniae  followed by Haemophilus influenzae type b (Hib). In HIV-infected infants, Pneumocystis jiroveci is a common cause of pneumonia.

Dr Mishra advised implementing 100% coverage of Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCV), measles and other vaccines to prevent pneumonia. “We must scale up life saving interventions and have better data collection to inform decision makers at country level. Public private partnership should be utilised to implement the global action plan GAPPD. Parents’ education and community awareness programmes must be organised for preventing the risk factors and recognising symptoms of pneumonia for early diagnosis. Limited supply of oxygen or timely access to neonatal intensive care units is often a challenge and must be dealt with.” We call upon the UP government to strengthen its health system, down to the primary healthcare level, to ensure that no child dies of  a preventable and treatable disease like pneumonia.

Citizen News Service - CNS   
December 17, 2016