Stop The Child From Turning Blue: Fight Pneumonia



By Shobha Shukla, CNS
November 12, 2010
The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI). She is supported by the Stop TB Partnership to write from the 41st Union World Conference on Lung Health, Berlin, Germany (11-15 November 2010). Email: shobha@citizen-news.org, website: www.citizen-news.org

The second World Pneumonia Day is being held on November 12, 2010. World Pneumonia Day was launched in 2009 by a broad coalition of public and non profit organizations, the Global Coalition Against Child Pneumonia, to mobilize efforts to fight a neglected disease. This day seeks to bring focus on pneumonia as a public health issue and to prevent the millions of avoidable deaths that occur each year.

Pneumonia is an infection of the lungs, filling them with fluid. It causes cough and fever and can make breathing difficult. It is the leading cause of death among children under 5 years of age worldwide, killing 1.6 million of them every year . This means that one child dies from pneumonia every 20 seconds. Pneumonia alone accounts for 20% of all paediatric deaths around the world. By contrast, 732,000 children die from malaria and 200,000 from HIV/AIDS each year.

Most children (about 98%) who die of pneumonia live in developing countries. 43 million cases of pneumonia occur every year in India.

Dr Nils Billo, Executive Director of The Union, feels that "better management of the problem, with low cost prevention and treatment strategies, is the key to its solution. Governments need to be convinced to invest in vaccination and treatment which is available. An integrated approach, especially at the peripheral level, can be a great help."

The death rate from pneumonia is 215 times higher in low-income countries than in high-income countries. And yet, we can protect from pneumonia. Exclusive breastfeeding during the first six months of life is an easy way to help protect children from pneumonia and many other diseases. Other strategies, like good nutrition and reducing indoor air pollution from cook stoves and tobacco smoke also help. Vaccines are a safe and effective tool for preventing pneumonia before it occurs. But once it occurs,the treatment for most types of serious pneumonia is usually antibiotics.

India did establish a program for case management of pneumonia with anti microbial agents in 1990. This has had some effect on child mortality, bringing it down from 116 deaths, in 1990 to 69 deaths in 2008, per 1000 children under the age of 5 years. But the magnitude of problem continues. Immunization coverage is still low at 44% of all children below the age of 5 years. The coverage is lower in urban slum and rural areas. Researchers estimate that even if 87% of Indian households (especially in rural areas) could gain access to clean stoves, 240,000 fewer children under age 5 would die from acute respiratory infections.

Pneumonia, along with influenza, and respiratory syncytial virus (RSV), forms a disease group commonly known as Acute respiratory infections (ARIs), group that, are responsible for 4.25 million deaths each year, according to the first-ever Acute Respiratory Infections Atlas, launched during the 41st Union World Conference on Lung Health, Berlin, Germany (11-15 November 2010) by World Lung Foundation. Out of these, one million deaths occur in India alone, which is about one quarter of the world total. The death toll from ARIs among Indians is more than all deaths from HIV/AIDS, malaria and tuberculosis combined.

The main drivers of ARIs (as also of tuberculosis) are malnutrition (one billion people around the world are malnourished), indoor and outdoor air pollution, overcrowding/cramped living conditions, and tobacco use.

In an exclusive interview given to CNS (Citizen News Service) at the launch of this Atlas, Dr Neil Schluger, author of this Atlas said that "there were basically three problem areas in controlling ARIs, especially in the developing countries --- awareness of the disease, proper distribution of vaccines, and developing newer treatments. According to him, “Parents should be able to recognize the symptoms of the disease understand when the child is sick and seek treatment before it is too late. Then there should be support from government and donor organizations to ensure availability and distribution of the vaccines and antibiotics. As of now only about two and a half percent of the donor funds are used for acute respiratory infections. Pharmaceutical companies will have to be encouraged to more invest in research.”

Dr Schluger thinks that it would be worthwhile to involve schools in this fight against ARIs, especially for vaccination programs, as well as to help identify the symptoms in school going kids at an early stage.

Pneumonia has been neglected for too long, perhaps because it affects children and old people more than others – who are unable to draw attention of the authorities and compel them to take appropriate action. It is time for others to come out and speak on behalf of them. We need to make a lot of noise to draw the attention of the authorities towards this neglected disease.

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Posted on: November 12, 2010 05:21 PM IST