02 November 2009
By Nirmala M Nagaraj
Bangalore, India
Annually across the world, two million children under five years of age die of pneumonia. In fact, it contributes to almost 20% of childhood mortality cases, more than AIDS, measles and malaria combined, according to data published by World Health Organisation in the Lancet Journal in September.
In India, the main culprit is malnourishment – 47% of the paediatric population suffers from low immune systems. “Lack of good nutrition, polluted air and poor hygiene are the main causes of pneumonia. Premature babies are at higher risk, so by improving maternal nutrition, low–birth premature babies can be prevented and by tackling malnourishment, improving immune system and controlling air pollution, pneumonia can be prevented. Better access to antibiotics can control mortality due to the disease,” said Dr H Paramesh, national president for respiratory disease chapter of the Indian Academy of Paediatrics.
Environmental factors have increased a child’s susceptibility to pneumonia, especially among those living in crowded homes, exposed to indoor air pollution caused by using biomass fuels for cooking and parental smoking habits. Due to this, India accounts for almost 40% of worldwide childhood pneumonia cases, and among children who survive Hib meningitis, about 30% suffer from major disabilities.
A vaccine appears to keep it at bay, but costs a lot. Despite this, in two African countries, Rwanda and the Gambia, pneumococcal vaccine is introduced in the routine immunisation schedule. Immunisation against HIV, pneumococcus, measles and whooping cough (pertussis) can prevent pneumonia.
Says Dr Paramesh: “The pneumococcal vaccine can prevent infection from only one particular bacterial germ, and three doses of this vaccine cost more than Rs 10,000. So, apart from being expensive, the vaccine doesn’t assure complete protection from all types of pneumonia. Even in the African countries, where the vaccine has been introduced in routine immunisation programme, there have been regular instances of pneumonia outbreak due to viral, fungal and other types of bacterial germs.”
However, according to the Indian Academy of Paediatrics, pneumonia can be treated with antibiotics, but unfortunately, less than 20% of children with pneumonia receive antibiotics.
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