E-Kantipur

JUN 06 -

Pneumonia is one of the most common childhood illnesses and a leading cause for hospital admission among children. It is also a major contributor to childhood mortality. While the condition can affect children of any age, infants and smaller children are more vulnerable.

Babies can be born with pneumonia if infected in the mother’s womb, or they may get the disease soon after birth due to infection around the time of labour and delivery. Injectable antibiotics are needed to treat newborns and small infants (below 2 months of age) with pneumonia becauseit can develop into a systemic disease if the infection spreads into the blood stream. Beyond this age group, pneumonia can be effectively treated with oral medications unless the child is very sick. If the child is breathing fast, not eating well, vomiting oral medications, and is not able to maintain oxygen in blood (manifested as bluish discoloration of the nails and lips), hospital admission becomes necessary. Timely and appropriate antibiotic treatment—along with other supportive measures like temperature control, fluid and nutritional support—help most children suffering from pneumonia make a quick and complete recovery. Once fully recovered, these children will not have an increased risk of getting pneumonia later in life. However, if the disease is severe, or if treatment is delayed, some children can develop complications such as sepsis, collection of pus at the covering layers of the lungs, or other long and short-term problems that may even result in death. There exists a common misconception that pneumonia is caused by cold weather or exposure to a chilly environment. Of course, some viral infections such as the common cold are certainly more prevalent in the winter and these infections can sometimes predispose children to pneumonia. Furthermore, factors like overcrowding, poorly ventilated rooms and smoke from indoor heating systems during cold weather can add up to the risk of pneumonia. But the fact remains that pneumonia is caused by viruses and bacteria, not the weather.  

The bacteria responsible for childhood pneumonia are found residing in the back of the nose and throat (nasopharynx) of many healthy children. It has been discovered in several studies that the carriage of bacteria in the nasopharynx of children has a direct bearing on the disease burden. Overcrowding and poor ventilation then help in transmitting these bacteria to other children and spreading the disease. In terms of prevention, vaccines against some pneumonia-causing bacteria in children have been developed, and are readily available. To counter one of the most common pneumonia-causing bacteria in children under 5 years of age, a vaccine known as Hib vaccine is available. This vaccine has been incorporated into the government’s vaccination schedule and is given together with the DPT vaccine at one and a half, two and a half and three and a half months of age. Another vaccine against pneumonia known as Pneumococal vaccine—widely used in the west—is available in Nepal, but only in some private facilities. It is also too expensive for the general population. Furthermore, the currently available Pneomococcal vaccine is not very effective in fighting the disease-causing strains of the bacteria in our population.

Problems such as the incomplete immunisation of our children against pneumonia, poor environmental conditions favouring the spread of the disease, malnutrition that makes children vulnerable to the condition, the unavailability of proper health care facilities—not to mention irrational treatment—paint a somewhat gloomy picture. However, we all have roles to play and as long as there are some vaccines and other preventive measures along with various modes of treatment, there is always hope.

Shrestha is the Chair of Paediatrics at Patan Hospital and a Professor of Paediatrics at the Patan Academy of Health Sciences

Posted on: 2011-06-06 10:21

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