Sunday, November 11, 2012


Pneumonia number one killer of children

Pneumonia number one killer of children

Muhammad QasimSunday, November 11, 2012 
From Print Edition


Pneumonia being the leading cause of death in children kills an estimated 1.4 million children under the age of five every year worldwide. Every year, it accounts for 18 per cent of all deaths of children below five years of age, which is more than AIDS, malaria and tuberculosis combined. Out of these, 99 per cent of deaths occur in developing countries.

In Pakistan, more than 352,000 children die before their fifth birthday every year and almost one third of these deaths are due to pneumonia. If not all, at least 70 per cent of these deaths can be avoided with the help of in time management of the cases. There is a need to create awareness among public that pneumonia can easily be avoided through prevention and it is curable.

Professor and Head of Community Medicine at CMH Lahore Medical College Dr. Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ in connection with World Pneumonia Day, which is observed every year on November 12 around the globe. The theme of the day this year is: ‘Fight Pneumonia: Save a Child’.

He added that the day is observed with an aim to raise awareness of pneumonia as a public health issue and help prevent millions of avoidable deaths from pneumonia that occur each year. “World Pneumonia Day is an opportunity to remind our leaders that the lives of babies and children are too important to be discounted,” said Dr. Ashraf.

Pneumonia is a form of acute respiratory infection that affects the lungs. It is caused by viruses, bacteria or fungi (germs). The viruses and bacteria that are commonly found in a child’s nose or throat can infect the lungs if they are inhaled. They may also spread via air-borne drops from a cough or sneeze.

Studies reveal that children whose immune systems are compromised are at higher risk of developing pneumonia. A child’s immune system may be weakened by malnutrition or under nourishment, especially in infants who are not exclusively breastfed, said Dr. Ashraf.

He added that HIV infections and measles also increase child’s risk of contracting pneumonia. Environmental factors such as indoor air pollution caused by cooking fires and heating with biomass fuels (such as wood or dung), living in crowded homes and parental smoking also increase a child’s susceptibility to pneumonia, he said.

He believes that ignoring early signs of pneumonia can be death sentence. “The symptoms of pneumonia include rapid or fast breathing, cough, fever, chills, loss of appetite, wheezing, and lower chest wall in drawing while severely ill infants may be unable to feed or drink and may also experience convulsions.”

To a query, Dr. Ashraf said that the good news is that pneumonia is preventable and treatable with host of proven interventions including exclusive breastfeeding to infants in their six months of life, ensuring an environment free of indoor air pollution and promoting frequent hand washing (protection); immunizing against leading causes (prevention); and ensuring access to medical care and antibiotics when cases do emerge (treatment).

He added that limiting exposure to smoke from cigarettes or indoor cook stoves and fires can help limit the risk of pneumonia. Research has shown that hand washing with soap and water can reduce the number of pneumonia-related infections in children under the age of five by more than 50 per cent, he said.

He added that immunizing against Hib (Haemophilus influenzae type B vaccine), pneumococcus, measles and whooping cough is the most effective way to prevent pneumonia. “The government of Pakistan has recently included pneumococcal vaccine in Expanded Program on Immunization and all parents having infants below six weeks of age can now get their children immunized against pneumonia free of cost.”

Dr. Ashraf said that pneumonia can be treated with antibiotics but only 30 per cent of the children receive antibiotics when needed. “Pneumonia-related child deaths can be reduced by 70 per cent by managing cases of pneumonia in children with antibiotics at the community level.” He said that Lady Health Workers can be trained to assess signs of pneumonia, determine appropriate treatment and advice parents, administer antibiotics and provide home care. The LHWs can also refer sick children to a healthcare facility if complications arise.

He added that children suffering from pneumonia can be treated promptly and effectively with antibiotics, however, overuse of antibiotics should be avoided in order to curb microbial resistance and children with upper respiratory tract infections (mainly coughs and colds) should not be prescribed unnecessary antibiotics. Similarly indiscriminate use of cough medicines should also be reduced.

Prevention and proper treatment of pneumonia could avert one million deaths in children every year while with proper treatment alone, over 600,000 deaths could be avoided, concluded Dr. Ashraf.


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