Voice Of Children

Muhammad QasimTuesday, November 12, 2013 
From Print Edition

Rawalpindi

Every 30 seconds, a child somewhere in the world, dies of pneumonia, making it number one global cause of childhood mortality. In Pakistan, an estimated seven million cases of pneumonia occur every year and out of these, as many as 92,000 children die before their fifth birthday due to the infection. At least 85 out of 1,000 children die under the age of five in Pakistan and it is alarming that most of these deaths are unfortunately due to vaccine preventable diseases including pneumonia.

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.

Children whose immune systems are compromised are at higher risk of developing pneumonia. Infants and children below two years of age are at higher risk of contracting pneumonia as their immune systems are still developing, said Head of Community Medicine at CMH Lahore Medical College Professor Dr. Muhammad Ashraf Chaudhry while talking to ‘The News’ in connection with World Pneumonia Day being observed on November 12 (today). He said that World Pneumonia Day is observed to raise awareness of pneumonia as a public health issue and help prevent millions of avoidable deaths from the infection that occur each year. “The theme of this year is: “Innovation” highlighting innovative solutions to end childhood pneumonia while at the same time emphasising that there are existing simple interventions that need to reach the most vulnerable children.”

Dr. Ashraf said that pneumonia is preventable and treatable with host of proven interventions, including exclusive breastfeeding infants in their first six months of life, ensuring an environment free of indoor air pollution and promoting frequent hand washing, immunising against leading causes, and ensuring access to medical care and antibiotics when cases do emerge. He said that appropriately treating underlying causes such as malnutrition, and exclusively breast-feeding children for the first six months of their life can decrease the risk of pneumonia.

He believes that a child’s immune system may be weakened by malnutrition or under nourishment, especially in infants who are not exclusively breastfed for the first six months of their life.

He said that more than 50 per cent children under five years of age are malnourished in Pakistan. 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, a coal, living in crowded homes and parental smoking also increase a child’s susceptibility to pneumonia, he said.

He pointed out that alarmingly Pakistan has the lowest breastfeeding rates in South Asia, 37 per cent. He added 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, lower chest wall in drawing; very severely ill infants may be unable to feed or drink and may also experience convulsions, he explained.

Talking of remedies, he said 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 percent.” Dr. Ashraf added that immunising against pneumococcus, measles and whooping cough is the most effective way to prevent pneumonia. Parents should not be hesitant about taking their children to the nearest health facility for the administration of vaccines that are available free of cost.

To a query, he said that by managing cases of pneumonia in children with antibiotics at community level, pneumonia-related child deaths can be reduced by 70 percent. Lady Health Workers can be trained to assess signs of pneumonia, determine appropriate treatment and guide parents, administer antibiotics and provide home care. They can also refer sick children to a health facility if complications arise, said Dr. Ashraf.

He added that government should also utilize Lady Health Workers to educate mothers to recognize the signs and symptoms of pneumonia. It must also prioritise routine immunisation coverage. When children suffering from pneumonia can be treated promptly and effectively with antibiotics, their chances of survival increase significantly, he said.

He, however, added that overuse of antibiotics should be prevented in order to curb microbial resistance and children with upper respiratory infections mainly cough and colds should not be prescribed unnecessary antibiotics. He suggested that indiscriminate use of cough medicines should be reduced.

Pneumonia control and other child health interventions must be accelerated to meet Millennium Development Goal 4 that is reducing under-five mortality by two-thirds by 2015, concluded Dr. Ashraf.