12 News FEATURE people DAILY / Thursday, November 12, 2020 Thursday, November 12, 2020 / people DAILY News
people DAILY / Thursday, November 12, 2020
world Pneumonia Day
Children gasp for
air as pneumonia
takes a deadly toll
While the world observes
Pneumonia Day, there is a
call to action to enhance
systems and prevention
measures to eliminate the
disease that causes 15 per
cent of under-five deaths
by Evelyn Makena
@evemake_g
Dusk was quickly approaching, but anti-
biotics had done little to ease the strained
breathing of Emily Awour’s infant daughter.
Inside their home in the densely popu-
lated Kosovo area in Kiambiyu slums, Nai-
robi Awour tried to comfort her restless
child. It had been a week since her daugh-
ter; one among her nine-month old triplets
had been diagnosed with pneumonia at a
local hospital.
“She was given medication and begun
recuperating. But after a week, the com-
plications intensified,” says Awour. When
Awour’s husband came home from work
that evening, he rushed the child to a hos-
pital in Buruburu, but she succumbed
while being attended to. Barely a month
after the unfortunate events that unfolded
towards the end of October this year, the
27-year-old mother of four believes her
daughter’s life could have been saved if the
diagnosis was made earlier.
At the time of their birth, Emily’s daugh-
ter, the smallest among the three, weighed
only 1.3kg while the other two boys
weighed 2kg and 1.9 kg.
“She had chest complications and would
breathe with a grunting sound. She was put
in a nursery and we stayed at the hospital
for two months,” remembers Awour.
Even after being discharged, the breath-
ing difficulties persisted. For nine months,
Awour visited different facilities and got
medication to treat the child’s chest com-
plications without really testing her to
identify the root cause. At nine months,
the little girl was weak, her neck and legs
unstable compared to her brothers.
Fatal disease
Pneumonia is one of the fatal infectious
diseases killing 2.5 million people in 2019,
among them 627,000 children. In Kenya, 15
per cent of child deaths in 2018 were due to
pneumonia and in 2017, it was the second
biggest killer among children under five.
Caused by viruses, bacteria or fungi,
pneumonia is an acute infection that af-
fects the lungs and respiratory system. The
infection, which causes a patient’s lungs to
fill with fluid, making it difficult to breathe,
is a common cause of death in children un-
der five in Africa. Non completion of im-
munisation is one among the main causes
of pneumonia on the continent, according
to Dr Benard Langat, Programme Direc-
tor, HIV, TB, Malaria and NCDs at Amref
Health Africa. The World Health Organisa-
tion (WHO) has identified immunisation
against Haemophilus influenza, pneumo-
coccus, measles and whooping cough as
one of the most effective ways to prevent
Thursday, November 12, 2020 / people DAILY
Facts about pneumonia
1.24 million
under-5 deaths caused by pneumonia
and diarrhoea deaths in 2017 globally
Emily Awuor pneumonia.
holds two of her “Other causes include, poor water
surviving triplets. sanitation and hygiene practices as well
PD/evelyn Makena as environmental factors such as indoor
pollution as a result of cooking and heat-
ing in homes with firewood or kerosene,
overcrowding, especially in informal settle-
ments and smoking,” says Langat.
Dr Catherine Kanari, Clinical Business
Lead, Amref Health Africa, adds that gen-
eral community awareness on tackling
environmental factors such as indoor pol-
lution can reduce the number of children
that fall ill from pneumonia.
“Additionally, appropriate health seek-
ing behaviours once symptoms are expe-
rienced and completion of treatment es-
pecially for bacterial pneumonia to avoid
antibacterial resistance is important in
fighting the disease,” she says.
Adequate nutrition, starting with exclu-
sive breastfeeding for the first six months
of a child’s life and appropriate weaning
improve immunity to fight infections such
as pneumonia.
Timely diagnosis and appropriate treat-
ment are important to reduce deaths
among children with pneumonia. In 2017,
Kenya adopted the use of amoxicillin dis-
persible tablets as a first line treatment for
non-severe pneumonia in accordance with
WHO guidelines. The dispersible tablets
are effective as they do not require refrig-
Nd u ku eration, dissolves in water and assures ac-
curate dosage, according to information on
Ministry of Health’s website.
Use of the tablet, Catherine notes, has
At first I
greatly reduced mortality caused by pneu-
monia in children.
thought it is Symptoms of the disease include fever,
coughing, headache, shallow breathing,
just ordi- sharp chest pain, fatigue, loss of appetite,
sweating and shaking chills. Experts say
nary cold the ongoing global Covid-19 pandemic
could increase pneumonia deaths. Stop
Source: WHO, Fighting for Breath in Kenya report, Pneumonia & Diarrhea Progress Report 2020 Graphic: Michael Mosota
News FEATURE 13
world Pneumonia Day
Lack of investment fuels the disease
by Nduta Waweru
@Nduta__
A doctor checks breathing of
a young patient. courtesy
gies into the health system once the pan-
demic reduces.
“The pulse oximeters provided for
Experts have decried the lack of fund- Covid-19 should eventually be available
ing and specific government strategy for at all primary healthcare centres and the
addressing respiratory infection includ- oxygen concentrators, Continuous Posi-
ing pneumonia in most low and middle- tive Airway Pressure and Bilevel Positive
income countries. Airway Pressure machines and ventilators
This, they say, exposes the population should find their way to the general, ma-
to increased risk of the disease, especially ternal and paediatric wards of hospitals.
since health systems do not have the right Pneumonia prevention, diagnosis and
equipment or trained healthcare workers Co-ordinator, Every Breath Counts Coali- treatment should be an item in national
to effectively diagnose and treat respira- tion in a press statement marking World health budgets, along with vaccines.
tory infections, or to install and maintain Pneumonia Day. Global health donors will need to ac-
respiratory care equipment. Covid-19 has exposed the glaring gaps tivate multilateral health agencies they
“This sustained lack of investment in such situation, and at the same time fund to help low and middle-income
has left vast populations unaware of the
dangers of pneumonia, how to recognise
created conditions to address them. Ef-
forts by countries to develop plans, are
countries fill gaps in pneumonia control,
where needed,” she said, calling for a
signs and where to seek appropriate educating communities and equipping change in government and donor posi-
healthcare. Globally, almost one in three
children with suspected pneumonia is
health centres to control the virus, some-
thing that has helped in the reducing
tion on pneumonia, and prioritise the
deadly disease.
not taken for care, and many more are ex- respiratory diseases and deaths among “The next decade is critical. Countries
posed to pneumonia due to low vaccina-
tion coverage, high rates of malnutrition
children.
Greenslade said governments should
should emerge from the pandemic with
specific national strategies to control
Experts
Pneumonia, an initiative by International and air pollution,” said Leith Greenslade, integrate these technologies and strate- pneumonia,” she advised.
Vaccine Access Centre, IVAC estimates that
Covid-19 could add 1.9 million to the death take
808,694
toll this year. Disruptions to health care ser-
vices during the pandemic are estimated to
cause an additional 2.3 child deaths, 35 per
estimated children died in 2017 cent from pneumonia and sepsis.
globally due to pneumonia Lang’at notes that both pneumonia and
Covid-19 bear a close connection. Both dis-
eases affect the lungs and can lead to death.
25%
While pneumonia is caused by viruses,
15%
bacteria and fungi, Covid-19 is caused by
SARS-Cov 2 virus. Pneumonia is one of D r L a n g’ at
percentage of all the complications of Covid-19 and is dif-
infectious deaths Pneumonia ficult to treat. Bacterial pneumonia can be Still,
caused by pneu- accounts for 15 per treated with antibiotics while Covid-19 has a lot re-
monia cent of all under
five children
no approved treatment, but requires sup- mains to
portive care.
deaths “Viral pneumonias are hard to treat,
be done to
therefore pose complications in man- achieve this
agement. These infections are better ap- ambitious
goal. We
39sec 1.9 million
proached by prevention, which means
developing and administering vaccines,” have come
he adds. a long way,
interval in which a child COVID-19 could add 1.9 million but we still
under 5 dies of pneumonia to the death toll this year Health services
Covid-19 continues to complicate the
need to do
treatment of pneumonia, through delay in more in
diagnosis as the attention of health services communi-
ties
Pneumonia attracts just 6% of international has shifted to respond to the outbreak.
development assistance for infectious diseases and Avoiding health facilities due to Covid-19
stigma may lead to avoidable complica-
3% of infectious disease research spending
tions and loss of life according to Catherine.
Winfred Nduku, 30 has been a victim of
15
delayed pneumonia diagnosis during the
Angola, Bangladesh, Chad, China, Côte Covid-19 pandemic.
D’ivoire, DRC, Ethiopia India, Indonesia, Mali, For four months, Nduku who washes
high burden Niger, Nigeria, Pakistan, Somalia and Tanzania
clothes to earn a living had been experienc-
countries with 70% ing a sharp pain on her ribs and frequent
of all under 5 shaking chills.
deaths “At first I thought it is just ordinary cold
since my work involves touching cold wa- D r Ka ra n i
ter for prolonged periods,” she says.
Every time she went to hospital and ex- Ap-
plained her symptoms, she would be given propriate
painkillers. But, as time went, she was get- health
ting weaker, becoming easily fatigued and seeking
lost appetite. Its only two weeks ago that behaviours
Nduku underwent a test that showed that
she had pneumonia. Nduku who is still un-
once symp-
toms are
der medication says she is already feeling
better. experienced
Kenya is striving towards the goal of end- and com-
pletion of
41%
ing childhood deaths caused by pneumo-
6 in 1,000 live births 6%
nia by 2025 in line with the Global Action treatment,
of Plan for Prevention and Control of Pneu- especially
child pneumonia under five mortality rate due to pneumonia in monia and Diarrhoea (GAPPD) launched
deaths in Kenya
annual reduction for bacterial
2018 in Kenya. rate of pneumonia by WHO and Unicef in 2009. Under the
in 2017, were plan, the country has embedded some of pneumonia
in Kenya between
caused by
2000-2018. Under the recommended action plans for these to avoid an-
child wasting,
this rate Kenya two diseases including advocacy for exclu- tibacterial
35% by indoor
pollution, 16%
is expected to
achieve GAPPD by
sive breastfeeding and standardised pneu-
monia diagnosis protocols and treatments.
resistance is
important
by prematurity.
2029 “Still, a lot remains to be done to achieve
this ambitious goal. We have come a long
way, but we still need to do more in com-
munities,” says Langat.