Every Breath Counts

A child dies of pneumonia every 45 seconds. Pneumonia is the world’s biggest infectious killer of adults and children. According to the World Health Organization (WHO), pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake. The WHO adds, pneumonia is the single largest infectious cause of death in children worldwide. Pneumonia killed 740 180 children under the age of 5 in 2019, accounting for 14% of all deaths of children under 5 years old but 22% of all deaths in children aged 1 to 5 years. Pneumonia affects children and families everywhere, but deaths are highest in southern Asia and sub-Saharan Africa. Children can be protected from pneumonia, it can be prevented with simple interventions, and it can be treated with low-cost, low-tech medication and care. Since 2009, World Pneumonia Day is observed on November 12 annually. The day is set aside to raise awareness regarding the impact of pneumonia and to advocate for global action to protect against, help prevent and effectively treat this deadly disease. Transmission Pneumonia can be spread in several ways. The viruses and bacteria that are commonly found in a child's nose or throat can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. More research needs to be done on the different pathogens causing pneumonia and the ways they are transmitted, as this is of critical importance for treatment and prevention. Presenting features The presenting features of viral and bacterial pneumonia are similar. However, the symptoms of viral pneumonia may be more numerous than the symptoms of bacterial pneumonia. In children under 5 years of age who have cough and/or difficult breathing, with or without fever, pneumonia is diagnosed by the presence of either fast breathing or lower chest wall indrawing where their chest moves in or retracts during inhalation (in a healthy person, the chest expands during inhalation). Wheezing is more common in viral infections. Very severely ill infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions. Risk factors While most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. A child's immune system may be weakened by malnutrition or undernourishment, especially in infants who are not exclusively breastfed. Pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child's risk of contracting pneumonia.

Global Increase in Respiratory Diseases There has been an increase in respiratory diseases globally. Respiratory syncytial virus (RSV) cases are on the rise nationally. In fact, Johns Hopkins All Children’s Hospital saw 350-plus cases in September and October combined. While RSV is typically seen in the winter months, viral seasons seem to have shifted around likely due to COVID-19. Minister of Health and Wellness Dr Christopher Tufton has indicated that Jamaica is recording an abnormally high number of hospital admissions of children with respiratory illnesses. Dr. Tufton said that this has resulted in overcrowding at the Bustamante Hospital for Children in Kingston and the Spanish Town Hospital in St Catherine. “Whereas the Bustamante Hospital for Children would usually admit four SARI cases per week at this time of year, in the last few weeks, they have admitted approximately 13 children each week,” he said, noting that the figure represents an exponential increase. What is RSV? RSV is a virus affecting the lungs, respiratory system and breathing. It is highly contagious and spreads through droplets or contaminated surfaces. It can be particularly serious in newborns, those with asthma, lung issues and children under 5 years old. A doctor will typically conduct a nasal swab test to determine if your child is positive for RSV, but it’s important to look for symptoms, including: congested and or runny nose, sore throat, cough and or shortness of breath, headache and fever. While most cases of RSV can be treated at home with regular cold medicine, some cases can be serious and develop into bronchiolitis or pneumonia. If your child has any of the above-mentioned symptoms you should contact your pediatrician immediately or take him/her to the nearest medical facility. The website pneumonia.org states that pneumonia is a disease of poverty. They argue that it is the poorest and marginalized children who are most at risk. The organization theorizes that such children are likely to be malnourished and experience bad sanitation and indoor air pollution, and are the least likely to be vaccinated, correctly diagnosed and treated. Many governments have not adequately invested in their health systems. Additionally, the COVID-19 pandemic has exposed the gaps in the health care systems of many societies. Unfortunately, decades of underinvestment in preventing, diagnosing and treating pneumonia has left most countries with health systems that do not have the right equipment or the trained health care workers to effectively diagnose and treat respiratory infections. The poorest parents are often left to pay for care they cannot afford, or the clinics serving them lack essential medicines (including medical oxygen) diagnostic equipment and trained health workers. The sustained lack of investment has also left vast populations unaware of the dangers of pneumonia, how to recognize the signs and where to seek appropriate healthcare. COVID-19 has alerted governments to the dangers of respiratory infections like pneumonia, and to the need to build strong health systems so they can effectively diagnose and treat these conditions, with a key focus on vulnerable populations. Many countries across Africa, Asia and Latin America that are struggling with heavy burdens of COVID-19 and child pneumonia deaths will need effective strategies to fight both. Treatment Pneumonia should be treated with antibiotics. The antibiotic of choice for first line treatment is amoxicillin dispersible tablets. Most cases of pneumonia require oral antibiotics, which are often prescribed at a health centre. These cases can also be diagnosed and treated with inexpensive oral antibiotics at the community level by trained community health workers. Hospitalization is recommended only for severe cases of pneumonia. Effective diagnosis and treatment of pneumonia is critical to improve child survival. Unless the international community takes urgent action now to reduce pneumonia deaths million more children and adults will die from pneumonia within the next decade. In order to meet the United Nations Sustainable Development Goal targets for SDG 3.2.1 the international community needs to re-evaluate where we are and what is required in order to reduce child mortality. Alarmingly, by 2030 pneumonia will kill another 6 million children unless the international community takes decisive action now. As the international community observes World Pneumonia Day we need to hold our officials accountable to ensure that the necessary investments are made in the health care systems both in terms of human and financial resources. In the words of Margaret Chan, countries should remain on high alert for unusual outbreaks of influenza-like illness and severe #pneumonia. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #Stoppneumonia #EveryBreathCounts #WorldPneumoniaDay #SustainableDevelopmentGoals #RSV