Pneumonia is an acute respiratory infection of the lungs that, without treatment, kills quickly. Pneumonia can be caused by bacteria, viruses, fungi, or airborne irritants and it is the main cause of death in young children, who are particularly susceptible to the disease. In 2015 over 2.7 million people are estimated to have died from pneumonia and of these, 700,000 were children under the age of five (WHO). The bacterial pneumococcal pneumonia is the most common cause of death in all ages (1.5 million or 55 percent).
Pneunomia is most common in South Asia and sub-Saharan Africa where children may already be weakened by low birth weight, poor nutrition or other pre-existing diseases, which puts them at higher risk of infection. Environmental factors such as cooking using wood or dung or living in crowded conditions can also increase a child's susceptibility to pneumonia.
Treatment and prevention
There is considerable evidence to show that pneumonia can be diagnosed and treated successfully at the community level (relieving the burden on overstretched hospitals). This is because bacterial pneumonia can be treated with high dose oral antibiotics. We have been involved in scaling up diagnosis and treatment at community level through our community based primary health care and integrated community case management activities.
Dealing with environmental factors, increasing zinc intake and improving personal hygiene are proven preventative measures that have some role in reduction of deaths due to pneumonia, although these interventions are more commonly associated with the reduction of morbidity and mortality caused by diarrhoeal diseases.
A hindrance to rapid diagnosis and appropriate treatment is that children with pneumonia can exhibit a wide range of symptoms that also mimic malaria or can occur in association with a malaria infection (mixed infection), making it essential to treat both diseases. Malaria Consortium has been helping community health workers to address this particular problem and raising awareness of mixed infections among mothers and older children.
As noted above, a large number of deaths from pneumonia are caused by the pneumococcus bacterium for which there is also a very effective vaccine not widely available in lower income countries. Where deployed, this vaccine has the potential to save many lives, particularly as the pneumococcus is increasingly resistant to common antibiotics.
The World Health Organization together with UNICEF has developed The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD), which can be accessed here. The goal is to see a drop in deaths from diarrhoea to less than one per 1,000 live births and from pneumonia to fewer than three children per 1,000 live births by 2025.