By Naomi Sharang,
In spite of several factors that contribute to the affliction of pneumonia, medical experts insist that no single intervention can effectively prevent, treat and control it.
The experts, however, agree that five simple but effective interventions, if properly implemented, will reduce the incidence of the disease which is responsible for almost one-fifth of all child deaths around the world.
The Partnership for Maternal, New-born and Child Health says that these interventions include exclusive breastfeeding of children for six months and sustained breastfeeding, complemented by intake of nutritious solid foods, up to the age of two years.
“The interventions also comprise vaccination against whooping cough, measles, Haemophilus influenzae type b (Hib) and pneumococcus; provision of safe drinking water, sanitation and hand washing facilities.
“Others are improved cooking stoves to reduce indoor air pollution; improved treatment, including provision of amoxicillin dispersible tablets and oxygen.”
The International Medical Corps defines pneumonia as an acute respiratory infection that causes alveoli, the small sacs in the lungs, to be filled with puss and fluid, making it difficult and painful to inhale oxygen and exhale carbon dioxide.
It says pneumonia can be caused by bacteria, viruses or fungi, the most common of which is Streptococcus Pneumoniae, a bacterium.
“Among the children living with HIV, Pneumocystis jirveci is the most common opportunistic infection and it accounts for at least 25 per cent of deaths in HIV-positive infants,’’ it says.
In the same vein, Dr Rilwanu Mohammed, Executive Secretary, FCT Primary Health Care Board, describes pneumonia as a lung infection that is caused by chemical, bacterial and viral infections.
He says that pneumonia is one of the childhood killer diseases which can be provoked by excessive cold and living in rooms which are not properly ventilated.
“Other risk factors of pneumonia include measles, whooping cough and herpes,” he adds.
Mohammed says that the disease also affects adults, adding, however, that children are more prone to catching pneumonia.
According to the executive secretary, personal hygiene is crucial to efforts to prevent pneumonia, underscoring the need for people to also have good ventilation in their apartments.
“Mothers should not neglect children having persistent cough, as this could be a symptom of pneumonia.
“Another preventive measure entails the adoption of child survival strategy; this includes girl-child education.
“When a girl-child is well educated, she will be able to take care of her husband and children in future,” he says.
While underscoring the importance of immunisation in the war against pneumonia, Mohammed says that Pneumococcal Conjugate Vaccine is now readily available in the country’s health institutions for the prevention of the disease.
He, however, calls on the three tiers of government to put in extra efforts in the fight against pneumonia.
Shedding more light on the disease burden, the World Health Organisation (WHO) says pneumonia is the leading cause of death among under-five children, killing more children than AIDS, malaria and tuberculosis combined.
Sharing similar sentiments, the United Nations Children’s Fund (UNICEF) recalls that in 2013 alone, more than 900,000 children died from this preventable and treatable illness, accounting for 15 per cent of under-five child mortality worldwide, of which two per cent are new-borns.
“Ninety-nine per cent of these deaths are in developing countries, where access to health care facilities and treatment is out of reach for many children,’’ it says.
Dr Mickey Chopra, Head of UNICEF’s Global Health Programmes, says that pneumonia is still a very dangerous disease.
“Poverty is the biggest risk factor of pneumonia and that means our efforts need to reach every child, no matter how marginalised.
“This is because deaths from pneumonia are highest in poor rural communities,” he adds.
Chopra, nonetheless, says that household air pollution is a major cause of pneumonia, adding that children from households that rely on solid fuels such as wood, dung or charcoal for cooking or heating are, therefore, at high risk.
“Overcrowded homes also contribute to higher pneumonia levels,” he says.
“In addition, poor children are less likely to be immunised against measles and whooping cough which are also among major causes of pneumonia; so, strategies must target low-income communities,” he adds.
Chopra says that although the number of deaths from pneumonia is declining, with nearly 1,000,000 deaths a year, there is no room for complacency.
“The more we focus on the causes and the known solutions, the faster we will bring this childhood scourge under control.
“We can’t have the reductions in child mortality which we envisage without a concentrated, direct attack on the biggest enemy that children face.
“Governments have to take the threat of pneumonia seriously and provide adequate vaccines, diagnostic services, treatment and health care, especially among the poorest, or this scourge will continue to rob the world of its children at the rate of almost 3,400 per day.
`This is unacceptable,” he adds.
Chopra insists that a failure to tackle pneumonia is a double failure, saying: “Not only are we allowing a treatable and preventable disease to wipe out over a million children a year; we are also leaving to its mercy the very people who need help the most — the poorest of the poor.”
Nevertheless, the UNICEF director maintains that closing the treatment gaps between the poor and the affluent is crucial to efforts to reduce preventable deaths from pneumonia.
As part of efforts to tackle the scourge of pneumonia, Wellbeing Foundation Africa underscores the need to step up communications on behavioural change at the grassroots.
“For the people to adequately understand pneumonia prevention and care, it is necessary for them to understand the disease and its reach,’’ it says.
Wellbeing Foundation Africa, a foremost maternal, new-born and child health empowerment organisation in Africa, recalls that in 2013, Nigeria occupied the second position in the top 15 high-burden countries with pneumonia deaths of under-five children.
“This implies that additional efforts are required to combat the disease in Nigeria and in the developing world at large.
“Alongside the Federal Ministry of Health, the Wellbeing Foundation Africa is working to control childhood pneumonia by facilitating the delivery of an integrated package of interventions to protect children; prevent and treat the disease,’’ the foundation says.
Meanwhile, the WHO has set aside Nov. 12 as World Pneumonia Day every year in order to raise public awareness of pneumonia, promote prevention and treatment of the disease, while generating action to fight the illness.
All the same, health experts say that significant declines in child deaths from pneumonia substantiate claims that the designed strategies aimed at defeating the disease are working.
They, however, call on innovators to work on improved and more easily affordable respiratory rate timers to facilitate the timely recognition and management of pneumonia.
“Besides, there is the need to scale up the availability of inexpensive medicines such as the antibiotic, amoxicillin, so as to expand the people’s access to medication, particularly in remote neighbourhoods,’’ they add. (NANFeatures)