Weak vaccination programs, malnutrition termed major causes of pneumonia

KARACHI: Weak vaccination programmes and rampant malnutrition are two key causes for the high rates of childhood pneumonia in Pakistan. This was the expert consensus which emerged from a seminar held on World Pneumonia Day-Saving Children Together at the Aga Khan University Hospital(AKUH) on Wednesday.

Pneumonia remains one of the leading causes of under-five child mortality globally, responsible for one-fifth of all child deaths. Worse, three-quarters of children who die from pneumonia live in Africa and Southeast Asia, with Pakistan as one of the 15 countries including  Afghanistan, Angola, Bangladesh, China, Congo, Ethiopia, India, Indonesia, Kenya, Niger, Nigeria, Sudan, Tanzania and Uganda – where two-thirds of the cases of this infection occur.Tragically, all these deaths are preventable.

Just last year, the launch of WHO’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea and a special series in The Lancet, both with research contributed by the Aga Khan University, had called for an integrated approach to end deaths from pneumonia and diarrhoea.

Associate Professor, Department of Paediatrics & Child Health said Dr Syed Asad Ali said majority of pneumonia-related deaths in children are caused by two bacteria – Streptococcus pneumonia and Haemophilus influenza – which can be effectively targeted through vaccination. He said ‘vaccinate your child’ should be the public message sent by government campaigns and the medical community.

He said unfortunately, just half of children less than two years of age in Pakistan are vaccinated, with parents refusing inoculation and drop outs presenting a significant challenge.

Experts stressed the need for strong and complete programme of immunization, particularly at the community levels. They reinforced the World Health Organization’s independent Expert Review Group on Information and Accountability for Women’s and Children’s Health statement that “the political will and financial resources needed to protect the lives of children at risk of pneumonia falls well short of what is needed.”

The panel of experts reiterated that pneumonia is a preventable illness that can be managed when diagnosed early and treated promptly; delays in diagnosing the disease increase the risk of it becoming severe.

Professor, Department of Paediatrics & Child Health, Dr Gaffar Billoo said that children under five years of age remained at high risk of mortality in Pakistan owing to pre-disposing risk factors, including rampant malnutrition, indoor air pollution and a poor history of vaccination.

Dr Ali Faisal Saleem said severely malnourished children are nine times more likely to die from pneumonia than children of the same age group with adequate nutrition. He said malnutrition is rampant among children in Pakistan, with more than 50 per cent of children showing signs of severe to moderate malnutrition.

He said exclusive breast feeding for the first six months of a child’s life, followed by continued breastfeeding till the age of two complemented by nutritious solid food is essential to ward off many infections including pneumonia.

Access to safe drinking water and adoption of healthy hygiene practices including hand washing with soap are important protective strategies. Experts advocated the use of improved cooking stoves, proper ventilation within living quarters and reduced exposure to second hand cigarette smoke as measures that would go a long way in reducing indoor pollution and a child’s risk of developing respiratory disorders, including pneumonia.

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