Pneumonia is a preventable and treatable disease that kills 1.6 million each year, around 1.4 million of which are children aged under five. This makes pneumonia the number one killer of children under five, claiming more young lives than AIDS, malaria, and measles combined and accounting for one fifth of all children’s deaths in Pakistan.
This was stated by World Health Organisation (WHO) representatives on Thursday. Addressing a press conference, WHO officials told the media that recently WHO, in collaboration with Lady Health Workers (LHWs), had conducted a study in Haripur, Khyber Pakhtunkhwa, which showed that pneumonia could be easily controlled and treated at home. “The result of the study shows that children with severe pneumonia who were treated by LHWs at home with simple, oral antibiotics were more likely to recover than children who were referred to a health facility, as previously recommended by WHO,” said Dr Shamim Qazi.
WHO Department of Maternal, Newborn, Child and Adolescent Health Pneumonia Expert and co-author of the Lancet paper Dr Shamim Qazi said, “Pneumonia kills more children than any other illness, but it is amongst the most solvable problems in global health. The results of this study show that community health workers can identify and treat most children with pneumonia at home with simple antibiotics.
“The study has found that LHWs are able to identify and treat children with severe pneumonia at home, avoiding the need to go to hospital. If this is confirmed in other settings, we can make treatment much more accessible for families, help governments make the most of limited resources, and save more children’s lives,” Dr Shamim added.
Currently, WHO recommends that children with non-severe pneumonia be treated at home, but that those with severe pneumonia be given a single dose of antibiotic medicine and sent for treatment to a facility. However, referral to a facility poses problems for many families who cannot afford to pay to get to hospital, or to pay for the services once they get there.
Severe pneumonia is when a child with a cough also has chest in-drawing, i.e. the chest moves in as the child inhales; whereas in a healthy child the chest expands during inhalation.
The study compared the impact of treating severe pneumonia at home versus referral to a health facility (clinic or hospital). It was found that 18% of children who were referred to a health facility had treatment failure, while this rate was only half that (9%) among those who were treated at home.
Treatment failure was classified as when a child was unable to drink; had convulsions; vomited after eating or drinking; was abnormally sleepy; still had a fever and lower chest in-drawing after several days of treatment; needed to switch to a different antibiotic; or died.
LHWs are trained and receive ongoing supervision and basic supplies from the government of Pakistan. They attend to about 150-200 families in their homes every month, providing health education to the families about maternal and child health and treating common diseases like diarrhoea and respiratory infections. They also identify danger signs for some diseases like pneumonia and suspected cholera and refer them to the nearest health facilities. A new milestone has been cleared and now the LHWs are treating pneumonia at home.
“If children with severe pneumonia can be effectively managed at home, this would reduce delays in starting treatment and cut costs for families and the health system,” said WHO Representative for Pakistan Dr Guido Sabatinelli. World Pneumonia Day (12 November) is to be marked by various events across the world including Pakistan to raise awareness of pneumonia as a public health issue and help prevent the millions of avoidable child deaths from pneumonia that occur each year. It is organised by the Global Coalition against Child Pneumonia, a network of international, government, non-governmental and community-based organisations, research and academic institutions, foundations, and individuals that was created in 2009 to bring much-needed attention to pneumonia among donors, policy makers, health care professionals, and the general public.
This year’s World Pneumonia Day theme is “I am the face of pneumonia.” This theme strives to connect the personal, human stories that illustrate pneumonia’s direct impact.
Most people are unaware of pneumonia’s overwhelming death toll and because of this pneumonia has been overshadowed as a priority on the global health agenda, and rarely receives coverage in the news media.
There are effective vaccines against the two most common causes of deadly pneumonia, Haemophilus Influenzae type B and Streptococcus Pneumoniae. A course of antibiotics which costs less than US$ 1 is capable of curing the disease if it is started early enough.
The Global Action Plan for the Prevention and Control of Pneumonia (GAPP) released by the WHO and UNICEF on World Pneumonia Day, 2009, finds that 1 million children’s lives could be saved every year if prevention and treatment interventions for pneumonia were widely introduced in the world’s poorest countries.
The United Nations Millennium Development Goals (MDGs) are eight international development goals that 192 United Nations member states and at least 23 international organisations have agreed to achieve by the year 2015.
The fourth of these goals is to reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.
Because pneumonia causes such a large number of under five deaths (almost 20%), in order to achieve MDG 4, the world must play an active part to reduce pneumonia deaths.
