Irony: Preventable pneumonia is biggest killer of children under 5

Pneumonia can be prevented. It can be treated using first-line cheap and easily available antibiotics. Despite being preventable and curable, it continues to be the lead cause of morbidity and mortality for children below the age of five years. “Pneumonia is a serious disorder affecting children even in their very early stages of life. The tragedy is that it is preventable. So, the top priority is to prevent it and, if it develops, then to provide timely treatment,” said Professor (Dr) Gourdas Choudhuri, Head, Department of Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow. Prof Gourdas Choudhuri is a noted public health expert too.

HEALTH AND TREATMENT LITERACY
“Pneumonia occurs due to overcrowding in small homes with poor ventilation. The problem is further aggravated if one or both of the parents smoke. Passive smoking makes children more prone to chest and pulmonary infections. The other important aspect in preventing pneumonia is about hygiene - cleanliness and hand washing will prevent the germs from spreading. So, a general sense of hygiene should be there at all times. The other issue is of pollution - the fumes and dust in the air which children breathe. These particles will aggravate the bacteria and the virus if they are around. There is a need for a lot of awareness in mothers about their child picking up pneumonia at an early stage. Chest infections in children are bound to happen. But if a child has high or persistent coughing, a doctor should be sought so that antibiotics can be given timely. Timely access to medical care is crucial. In the early stages of the disease oral antibiotics work. But once the child becomes very sick, much more intensive care is required - like hospitalisation, stronger and more expensive injectible antibiotics among others. So, proper awareness of the disease is an important issue in increasing the survival rate of children” said Prof Choudhuri.

“Pneumonia is a serious infection of the lungs and can be caused by several germs. The role of vaccines in preventing the disease cannot be overlooked.  However, a vaccine may work well against some of these but not all. So it is difficult to have a complete vaccine for full protection.Some vaccines, like the Hib vaccine, are good and a must, which can be given routinely. The pneumococcal vaccine is another good vaccine. But the issue is whether the strains causing the disease, which are present in the community, are the same as those present in the vaccine, otherwise the vaccine will not work, and the money spent will not get the protection one is expecting. Pneumococcus, one of the germs that cause pneumonia in children, has many strains. The vaccine, which is currently available, has strains that are found chiefly in the western world, and its profile does not match with the strains found in our country. So a routine immunization with one vaccine may not work”, explained Prof Choudhuri.

“There is co-infection and co morbidity in pneumonia. Children suffering from some respiratory problem like asthma/chronic bronchitis; children whose spleens have been removed; children with a depressed immune system; malnourished children; and children more prone to pneumococcal infections - are more vulnerable to pneumonia.”

OBESE CHILDREN ARE ALSO MALNOURISHED
“Lifestyle disorders play a crucial role in upping the risk to pneumonia. Obese children are also malnourished and so have a compromised immune system. So it is important to ensure that children keep an ideal body weight and use the sports field and/or do plenty of exercise to keep their lungs healthy. One of the most preventable factors is passive smoking. It does not directly cause pneumonia, but makes the child more vulnerable to it. Smoking does nobody any good, and fathers especially need to be made aware to be more responsible towards their children’s health”, said Prof Choudhuri.

Shobha Shukla - CNS
(The author is the Managing Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: http://www.citizen-news.org/)

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