Childhood Pneumonia: A Hidden Pandemic

By Dr. Anil Gupta

Apr 28, 2023

According to various reports, every year, pneumonia claims the lives of more than seven lakh children under the age of five. This figure includes one lakh fifty thousand infants who succumb to this condition. At least one child dies of pneumonia after every forty-five seconds. The most critical fact here is almost all these deaths are preventable. In this world where all of us have become the harbinger of equality, thousands of children are devoid of essential healthcare services that can save their lives.

Let us unfold each layer of childhood pneumonia.

What is Pneumonia?

Pneumonia is an acute infection of the respiratory system and majorly involves the lungs. It can be due to bacteria, viruses, or fungi. When a child develops pneumonia, fluids or pus build-up occurs in the lungs, making it difficult for them to breathe.

Who are vulnerable to pneumonia?

The following groups of children are susceptible to pneumonia:

Children with immature immune systems (newborns)
Children with a weakened immune system, such as the undernourished children
Children with immunocompromised diseases like HIV, Malnourished children

What are the most common symptoms of pneumonia in the child?

Since pneumonia is an infection of the lungs, most symptoms are related to inflammation and breathing.

Some common manifestations of pneumonia are:

Coughing
Troubled breathing
Fever
Fast breathing
Retracting of lower chest during inhalation

Note: In a healthy child, the lungs expand during inhalation

Can pneumonia spread from one child to another?

Pneumonia is definitely a contagious disease. It can spread through aerosols of coughing or sneezing. It can also spread through fluids, such as sputum or blood. Some children may have pneumonia after contacting contaminated surfaces.

How do doctors diagnose pneumonia in children?

Your doctor can diagnose pneumonia through:

Physical examination
Evaluation of abnormalities in breathing patterns
Chest auscultation for abnormal sounds from the child's lungs
Chest x-rays
Blood tests

The diagnosis protocol depends on the healthcare infrastructure present in a country. If you are in a country with limited healthcare facilities, few doctors, lack of laboratory and radiological diagnostic services, your doctor may diagnose pneumonia just by counting the breathing rates and listening to the lung sounds.

What are the different treatment modalities for pneumonia?

The treatment for pneumonia infection depends on the age and the type of pneumonia. In developing countries, most pneumonia cases are due to bacterial infections that a doctor can manage with low-cost antibiotics. Still, according to some reports, only one-third of pneumonic children receive the necessary antibiotics due to a lack of quality healthcare facilities.

Is oxygen an asset in treating pneumonia?

Oxygen is essential and life-saving for children and infants with severe pneumonia. The reason is simple. Pneumonia causes fluid build-up and inflammation in the lungs. Thus the amount of oxygen entering the bloodstream significantly decreases.

According to various estimates, more than seven million people below five years are admitted to the hospital due to pneumonia every year in developing countries and need oxygen therapy. But this oxygen therapy is not accessible to all. In economically underdeveloped countries with weak healthcare infrastructure, oxygen therapy is available only at the levels of super specialty care. The recent pandemic has further worsened the situation. Sometimes a child may not respond to oxygen therapy only, may require ventilator support for survival.

Can I prevent my child from getting pneumonia?

Pneumonia is preventable. Some of the preventive measures are:

Adequate nutrition
Reduced exposure to air pollution. Air pollution can make your lungs more susceptible to infection.
Good hygiene practices. According to various studies, regular hand washing with soaps, as per the recommendations, can decrease the risk of pneumonia by fifty percent.

Is there a vaccine for pneumonia?

Yes, the vaccines are there. In fact, the vaccine gives strong protection against bacterial pneumonia. But only fifty percent of children globally have access to the pneumococcal vaccine, the primary vaccine to prevent pneumococcal infection. Scientists are also working on developing a vaccine effective against viral pneumonia.

Are the deaths of children due to pneumonia are same everywhere?

The child mortality rates due to pneumonia are maximum in African and Asian countries, including:

Democratic Republic of Congo
Ethiopia
India
Nigeria
Pakistan

These five countries together account for more than fifty percent of pneumonia-related deaths among children under five years.

Is air pollution a contributing factor to pneumonia?

Exposure to air pollution can make your child susceptible to all respiratory infections, and pneumonia is one of them. According to a survey, air pollution is one of the principal causes of one-third of all pneumonia-related deaths. With the growth of urbanization, especially in countries with high pneumonia burdens, the risk is high. Not only outdoor pollution, but indoor air pollution (due to coal or wood as fuels) also poses a health risk. Indoor pollution contributes to more than sixty percent of pollution-related pneumonia deaths in children.

The role of malnutrition in pneumonia-related deaths in children.

Wasting or malnutrition is the leading cause of pneumonia-related deaths in children. Wasting is a life-threatening form of malnutrition. In a malnourished child, the immune system is weak, making them vulnerable to infections like pneumonia. Wasting most commonly impacts children under two years of age and is prevalent in children in the lowermost economic strata.

Conclusion

Pneumonia is a predominant cause of child mortality ( death )globally. Most of these deaths are preventable. The fight against pneumonia is not a battle of an individual. As a society, we need collaborative and swift action to combat this deadly disease.

Government and healthcare institutions should work on framing policies that can intercept pneumonia at any stage (before the beginning of the disease to the point where the disease has reached its peak).

The steps can be:

Reduce risk factors of pneumonia
Strengthen children's immune systems
Increase accessibility to good-quality healthcare, including diagnostics and treatment facilities

Prevention of pneumonia in newborns is possible by: