Eliminating and preventing Pneumonia in Children

Pneumonia accounts for 15% of all deaths of children under 5 years old, killing an estimated 922,000 children of below 5years in 2015. (WHO).

Pneumonia can be caused by viruses, bacteria or fungi.

Pneumonia can be prevented by immunization, adequate nutrition and by addressing environmental factors.

Pneumonia caused by bacteria can be treated with antibiotics, but only 1/3 of children with pneumonia receive the antibiotics they need.

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

Pneumonia is the single largest infectious cause of death in children worldwide. Pneumonia affects children and families everywhere but is most prevalent in South Asia and Sub-Saharan Africa.

Children can be protected from Pneumonia, It can be prevented with simple interventions, and treated with low-cost, low-tech medications and care.

Causes  

Pneumonia is caused by a number of infectious agents including viruses, bacteria and fungi. The most common are:

.Streptococcus pneumoniae -the most common cause of bacterial pneumonia in children.

.Haemophilus influenzae type b (Hib)-the second most common cause of pneumonia.   

.Respiratory syncytial virus is the most common viral cause of pneumonia in infants infected with HIV, Pneumocystis jiroveci is one of the commonest causes of Pneumonia, responsible for at least ¼ of all Pneumonia deaths in HIV-infected infants.

Transmission

Pneumonia can be spread through: I. Viruses and bacteria commonly found in a child’s nose or throat, if they are inhaled can infect the lungs.

They may also spread via air-borne droplets from a cough or sneeze.

Pneumonia may spread through blood, especially during and shortly after birth.

Presenting features

In children less than 5 years, who have cough and/or difficult breathing, with or without fever, Pneumonia is diagnosed by the presence of either fast breathing or  lower chest wall in drawing where their chest moves in or retracts during inhalation, in a healthy person the chest expands during inhalation. Wheezing is more common in viral infections.

Very severely ill infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions.

Risk factors

While most healthy children can fight the infection with their natural defenses, children whose immune systems are compromised are at higher risk of developing pneumonia. Immunity may be weakened by malnutrition or undernourishment, especially in infants who are not exclusively breast fed.

Pre-existing illnesses, such as symptomatic HIV infections and measles, also increases a child’s risk of contracting pneumonia.

Environmental factors also increase a child’s susceptibility o pneumonia. E.g. I. indoor air pollution caused by cooking and heating with biomass. ii. living in crowded homes. iii. Parental smoking

Treatment

Pneumonia should be treated with antibiotics.

The antibiotic of choice is amoxicillin dispersible tablets according to WHO. Most cases of pneumonia require oral antibiotics.

DAMOXEN produced by DAILY NEED Industries Ltd is the only indigenous Nigerian brand. It comes in 125mg and 250mg.

Prevention

Preventing Pneumonia in Children is an essential component of a strategy to reduce child mortality. Immunization against Hib, pneumococcus, measles and whooping cough (pertusis) is the most effective way to prevent pneumonia.

Adequate nutrition is key to improving child’s natural defences, starting with exclusive breastfeeding for first six months.

Encouraging good hygiene in homes especially crowded homes also reduces number of children who fall ill with pneumonia.

In children infected with HIV, the antibiotic is given daily to decrease risk of contacting pneumonia.