Predicting the potential impact of scaling up four pneumonia interventions on under-five pneumonia mortality

A prospective analysis has revealed that scaling up pneumonia interventions could have a significant impact on under-five mortality rates in low- and middle-income countries.

Background

Pneumonia remains the leading cause of mortality in under-five children outside the neonatal period. Progress has slowed down in the last decade, necessitating increased efforts to scale up effective pneumonia interventions.

Methods

We used the Lives Saved Tool (LiST), a modelling software for child mortality in low- and middle-income settings, to prospectively analyse the potential impact of upscaling pneumonia interventions in Bangladesh, Chad, and Ethiopia from 2023 to 2030. We included Haemophilus influenzae type B (Hib) vaccination, pneumococcal conjugate vaccine (PCV), oral antibiotics, pulse oximetry and oxygen as pneumonia interventions in our analysis. Outcomes of interest were the number
of pneumonia deaths averted, the proportion of deaths averted by intervention, and changes in the under-five mortality rate.

Findings

We found that 19,775 lives of children under-five could be saved in Bangladesh, 76,470 in Chad, and 97,343 in Ethiopia by scaling intervention coverages to ≥90 percent by 2030. Our estimated reductions in pneumonia deaths among children under five range from 44.61 percent
to 57.91 percent in the respective countries. Increased coverage of oral antibiotics, pulse oximetry, and oxygen show similar effects in all three countries, averting between 18.80 percent and 23.65 percent of expected pneumonia deaths. Scaling-up PCV has a prominent effect, especially in Chad, where it could avert 14.04 percent of expected pneumonia deaths. Under-five mortality could be reduced by 1.42 per 1000 live births in Bangladesh, 22.52 per 1000 live births in Chad, and 5.48 per 1000 live births in Ethiopia.

Conclusions

This analysis shows the high impact of upscaling pneumonia interventions. The lack of data regarding coverage indicators is a barrier for further research, policy and implementation, all requiring increased attention.

Published in the Journal of Global Health

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Citation: Journal of Global Health, 2024; 14: 04001.

Country: Bangladesh | Chad | Ethiopia

Keywords: Child survival | Pneumonia | Research