Published:  12:51 AM, 12 November 2019

Pneumonia: Still a threat to the U-5 children in Bangladesh!

Pneumonia: Still a threat to the U-5 children in Bangladesh!
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 is filled with pus and fluid, which makes breathing painful and limits oxygen intake.  The most common bacterial type that causes pneumonia is Streptococcus pneumonia. It can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems. Pneumonia is the single largest infectious cause of death in children worldwide. It is also a leading cause of death among the children in Bangladesh. It is a threat to the newborn baby in Bangladesh. Most of the newborn baby are affected by Pneumonia after their birth in our country.According to ICDDR,B (International Centre for Diarrhoeal Disease Research)in Bangladesh, pneumonia is responsible for around 28% of the deaths of children under five years of age.Around 50,000 children die of pneumonia every year. And an estimated 80,000 children under five years of age are admitted to hospital with virus-associated acute respiratory illness each year; the total number of infections is likely to be much higher.

CAUSES OF PNEUMONIA

Predominantly Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. Such as Streptococcus pneumonia - the most common cause of bacterial pneumonia in children, Haemophilusinfluenzae type b (Hib) - the second most common cause of bacterial pneumonia and respiratory syncytial virus is the most common viral cause of pneumonia.

RISK FACTORS

While most healthy children can fight the infection with their natural defenses, 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. The following environmental factors also increase a child's susceptibility to pneumonia such as  indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung), living in crowded homes, parental smoking.

HOW CAN IT BE TRANSMITTED?

Pneumonia can be spread in a number of 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.

WHY ARE CHILDREN VULNERABLE?

Unlike healthy children with many natural defenses to protect them against the invasion of pathogens in the lungs, the unhealthy children with a compromised immune system has weak defenses.Children who suffer from malnutrion, particularly inadequate zinc intake and lack of exclusive breastfeeding have a higher risk of developing pneumonia.Other risk factors include being born premature, having asthma or genetic disorder such as sickle-cell disease,having heart defects such as Ventricular Septal Defect (VSD), Atrial Septal Defect (ASD) or Patent Ductus Arteriosus (PDA). Several environmental factors such as overcrowding homes and exposure to parental smoke increases a child's susceptibility to pneumonia and its complications.

SYMPTOMS OF PNEUMONIA

Symptoms may be a bit different for each child. They may also depend on what is causing the pneumonia. Bacterial pneumonia may have the following symptoms like cough that produces mucus, cough pain, vomiting or diarrhea, loss of appetite, tiredness (fatigue), fever. On the other hand, viral pneumonia symptoms include chills, fast or hard breathing, headache and fussiness.

WHAT COMPLICATIONS MAY ARISE FROM PNEUMONIA?

PLEURAL EFFUSION

When fluid accumulates between the pleura and the chest wall due to the large amount of fluid already present in the lungs.As a result of the Pneumonia, a pleural effusion may develop which could lead to the collapse of the lungs if not treated appropriately.

EMPYEMA

Pus may be present in the lungs due to the infection.Thus pockets of pus may develop in the cavity between the pleura and the chest wall, or in the lung itself which is otherwise known as empyema

LUNG ABSCESS

A lung abscess develops when the infection has destroyed lung tissue and a cavity filled with pus is formed.

BACTEREMIA

This occurs when the infection is no longer contained within the lungs and moves into the bloodstream, thus the blood is infected.

SEPTICEMIA

When bacteremia occurs septicemia can follow, as this is an infection that is spread throughout the body.The infected blood is the best way for the infection to manifest in other parts of the body.

MENINGITIS

The infection may spread to the meninges that cover the brain and spinal cord, leading to meningitis.

ENDOCARDITIS OR PERICARDITIS

As blood is also circulated through the heart muscles and the pericardium, the risk of developing an infection there is very high if bacteremia is present.

PREVENTION

The WHO and UNICEF integrated Global action plan for pneumonia and diarrhoea (GAPPD) aims to accelerate pneumonia control with a combination of interventions to protect, prevent, and treat pneumonia in children with actions to:
#    Protect children from pneumonia including promoting exclusive breastfeeding and adequate complementary feeding;
#    Prevent pneumonia with vaccinations, hand washing with soap, reducing household air pollution, HIV prevention and cotrimoxazole prophylaxis for HIV-infected and exposed children;
#    Treat pneumonia focusing on making sure that every sick child has access to the right kind of care either from a community-based health worker, or in a health facility if the disease is severe and can get the antibiotics and oxygen they need to get well;

SOME GUIDELINES FOR PNEUMONIA IN CHILDREN

#   Washing your hands before eating, before handling food, after using the restroom, and after being outside. If soap is not available, use an alcohol-based hand sanitizer.
#    Avoiding being around people who are sick. Ask them to visit when they are feeling better.
#    Not touching or sharing objects that are shared with others. Germs can be transferred from object to you if you touch your nose or mouth without washing or sanitizing your hands first.
#    Eating a healthy diet, exercise,
and get enough rest. Healthy habits keep your immune system strong.
#    Getting treated for any other infections or health conditions you may have. These conditions could weaken your immune system, which could increase your chance of infections.
#   Avoiding excessive consumption of alcohol.
Prevention is more effective than cure so it is high time to take necessary initiatives for the prevention of Pneumonia. It will protect our future generation as well as save medical costing for the treatment of pneumonia. More emphasize should be given on vaccination from the early life of a child. Save children, shape future world.


The writer is a MS student, Department of Applied Nutrition and Food Technology at Islamic University, Bangladesh. E-mail: billalanftiu@gmail.com

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