ESCALATING PNEUMONIA RELATED CHILD MORTALITY: AN EMERGING GLOBAL HEALTH CONCERN

BY:

AGHEDO, OJORE GODDAY

Pneumonia is preventable with vaccines and treatable too in most cases with antiboiotics, and the World Pneumonia Day was established in 2009, to be commemorated on November 12^th, each year. However, it remains one of the world’s leading cause of mortality in children of below 5 years. According to World Health Organization (2019), 15% of all death of children under 5 years of age is caused by pneumonia, killing 808,694 children in 2017 alone. It is simply an acute pulmonary infection (that is, infection of the respiratory system), which makes breathing difficult and painful, due to insufficient oxygen uptake and invasion of the alveoli by pus and fluid. South Asia and sub-Sahara Africa have highest prevalence of pneumonia.

KNOWN CAUSES AND TRANSMISSION ROUTES

The causative agents of pneumonia include: viruses, bacteria, fungi and parasites. Pneumonia causing bacteria include: Streptococcus pneumoniae, Haemophilus influenzae, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila. In children living with HIV (CLHIV), Pneumocystis jiroveci is the common cause of pneumonia related deaths. Generally, bacteria and viruses inhabiting the throats and nose of children can cause pneumonia if inhaled by the children. Nevertheless, it can be transmitted by air-borne droplets from a cough or sneeze, as well as through blood contacts during or/and shortly after birth. This means that children can get infected even before birth and must be treated as immediate as possible, but unfortunately, many children do not get to receive proper and early treatment, accounting for high mortality rate in children under 5 years of age. More researches on the transmission routes of pneumonia is necessary, to ensure adequate preventive measures are in place, or early diagnosis and prompt treatment.  

SIGNS AND SYMPTOMS

Symptoms of pneumonia can come sudden or develop slowing over few days. For instance, in pneumonia caused by the flu virus, symptoms manifest within 18 to 72 hours while that caused by respiratory syncytial virus (RSV) manifest in 4 to 6 days. The commonest symptom of pneumonia is cough, which can be either dry or phlegm containing.  Difficulty in breathing, fever, the presence of tachycardia (that is fast breathing), retraction of the chest during inhalation and even wheezing are other possible presenting symptoms. In very severely ill infants, difficulty in feeding (loss of appetite), fatigue, unconsciousness, hypothermia and convulsions may be experienced.

RISK FACTORS

Healthy children with optimal immune system can easily fight off pneunomia naturally. However, weakened or compromised immunity, malnutrition or undernourishment (especially for children undergoing other feeding plans different from exclusive breast feeding), other preexisting opportunistic infections/illnesses like Measles or Tuberculosis or HIV, and environmental factors such as indoor air pollution (from cooking with biomass fuels), overcrowded homes and parental smoking, are major risk factors of pneumonia in children.

PREVENTIVE MEASURES

The 2030 ambition of ending preventable child deaths, is fast coming under threat of non-fulfillment, unless pneumonia amongst other diseases is consciously prevented.

1.    Immunization or vaccination against Haemophilus influenzae type-b (Hib), pneumococcus, measles and whooping cough is reputed as the most effective way to prevent pneumonia.

2.    Sufficient and acceptable feeding practices and proper nourishment will help boost the immune system. For instance, exclusive breastfeeding for the first 6 months of life, is highly recommended for the nourishment and protection of every child.

3.    Completely eradicating indoor air pollution by avoiding cooking with dungs and woods in the rooms where children stay, is high advised.

4.    Avoiding to raise children in overcrowded homes and practicing extremely good hygiene, is very helpful.

5.    Children who are infected with HIV should be placed on daily antibiotic (cotrimoxazole).

CONCLUSION

Pneumonia is a leading global health killer infection, which despite being preventable and treatable kills thousands of children below 5 years annually. This can be an indication of either neglect or inadequate attention paid to it by key global health stakeholders. With renewed commitment and concerted efforts by all relevant stakeholders, especially in Asia and sub-Sahara Africa, the goal of ending preventable child deaths by 2030 is achievable. Children have the right to life. Let’s stop pneumonia from taking more lives of the children.

#ProtecttChildrenfrompneumonia

#Preventpneumoniawithvaccines

#Treatpneumonia

©Aghedo, Ojore Godday (AMIIM, HRMA)