Stop Pneumonia in children- every breath counts!

According to UNICEF, Pneumonia is the single largest infectious killer of children that claimed about 800,000 lives in 2018. More than 50% of these child pneumonia deaths occurred in just five countries- Nigeria (1,62,000), India (1,27,000), Pakistan (58,000), the Democratic Republic of Congo (40,000) and Ethiopia (32,000)

Fact Sheet- World Pneumonia Day’ 2019

•         Every minute, two children all over the world die from pneumonia.

•         80% of these deaths occur in children below two years of age.

•   Almost all of these deaths occur in low and middle-income countries.

• Although Pneumonia accounts for 15% of all childhood deaths below 5 years of age, it remains a neglected disease.

• Although breastfeeding is an important preventive strategy against childhood pneumonia, only 40% children less than six months old are exclusively breastfed.

• Although effective immunizations are available to prevent pneumonia, globally 170 million children in low and middle-income countries are not vaccinated against pneumonia.

The Forum of International Respiratory Societies (FIRS) has called for ending preventable pneumonia deaths by 2030.

What is Pneumonia?

Pneumonia is an acute respiratory infection that affects the lungs. The human lungs are made up of small sacs or pouches called alveoli, which fill with air when a healthy person breathes. When a person has pneumonia, the alveoli get filled with fluid and pus that makes breathing painful and limits the intake of oxygen.

  Causes- Pneumonia is caused by a number of micro-organisms like bacteria, viruses and fungi.

• According to W.H.O, the most common cause of bacterial pneumonia in children is Streptococcus Pneumoniae

•         Haemophilus influenzae type b (Hib) is the second most common cause of bacterial pneumonia.

• The most common viral cause of pneumonia is Respiratory Syncytial Virus (RSV).

• In infants infected with HIV, Pneumocystis jiroveci (a fungus that spreads through air) is the most common cause of pneumonia.

 The WHO fact sheet on pneumonia issues key facts and information on signs and symptoms, risk factors, treatment and prevention of this infectious disease.

Transmission- Pneumonia can spread in a number of ways.

•         The bacteria and viruses that are commonly present in a child's throat or nose can cause infection in the lungs if they are inhaled.

• These micro-organisms can also spread through air-borne droplets that are formed due to coughing or sneezing.

Signs & Symptoms:

• Children below 5 years of age have cough, fever, difficulty in breathing, fast breathing; stuffy nose, wheezing, less activity and loss of appetite.

• Infants, who are very severely ill, may be unable to feed or drink. They may also experience unconsciousness, convulsions and hypothermia (a medical condition in which the body temperature becomes very low)

Risk factors for Pneumonia: Children, whose immune system is weakened, are at a higher risk of developing pneumonia.

a) A child's immune system may be compromised by malnutrition and pre-existing illnesses such as measles and HIV infection.

b) Environmental factors such as parental smoking, living in crowded homes, indoor air pollution caused by cooking with biomass fuels (such as wood or dung) also increase a child's susceptibility to pneumonia.

c) According to data released by WHO in 2018, about 90% of people breathe air that is contaminated with pollutants. Air pollution is a major risk factor for childhood pneumonia.

Treatment:

According to W.H.O, early and correct diagnosis of pneumonia followed by treatment with antibiotics, referral to a hospital and oxygen treatment, when required can save many precious lives.

Prevention of Pneumonia-Some important steps for preventing pneumonia in children are:

a) Exclusive breastfeeding for the first 4-6 months of life, and sufficient complementary foods.

b) Vaccination against pneumonia, measles, Influenza, pertussis (whooping cough) and diphtheria.

c) Avoid exposure to tobacco smoke and reduce exposure to indoor air pollution.

d)  Early use of anti-retroviral treatment in HIV-infected children

e) Prophylaxis with cotrimoxazole for HIV-infected and exposed children, can reduce the burden of childhood pneumonia.

(Dr. Aarti Mishra is a Medical Communications Specialist based in Ludhiana)