Ongoing battle with pneumonia

Pneumonia is an infection of one or both lungs. It can be caused by fungi, bacteria, or viruses. The condition is the single largest cause of deaths among children under the age of five. 

Dr R Somasekar, Professor of Paediatrics and the president, Indian Academy of Paediatrics, Chennai City Branch, points to some of the common causes. “These include low birth weight and poor hand hygiene and incomplete vaccination,” he adds. 

According to a report published in the Indian Journal of Community Medicine, substantial evidence indicates that ‘common risk factors leading to the development of pneumonia are non-exclusive breast feeding for first 6 months and lack of measles immunisation, indoor air pollution and overcrowding. Interventions targeted on most of these risk factors to reduce pneumonia and associated mortality can be effective only in the long-term as they are intimately related to poverty and social-cultural factors.’ 

He adds that with the latest alarm over increasing air pollution that is being cited as one of the risk factors for many conditions, including stroke and cancer, the emphasis is more on the indoor aspect of air pollution. 

However, he adds that brighter side of the issue is the efforts taken on the war footing by the Central Government. He says, “Thanks to the PM for The Swachh Bharat movement, and his plan to provide free cooking gas to all, thereby minimising air pollution from firewood.”

He adds that there is also need for a mass movement towards taking pledge to control indoor and outdoor pollution and to implement regulatory acts by the Government. 

It has been estimated that in India incidence of pneumonia among under-fives is 0.37 episodes/year, resulting in 43 million new cases. Of all pneumonia cases, 7-13% are severe enough to require hospitalisation. Pneumonia causes an estimated 408,000 deaths among under-fives contributing to 19% of child mortality in India.

While the pneumococcal vaccines that have found to be effective in addressing pneumonia burden, there are concerns about the affordability. 

Dr D Vijayasekaran, paediatric pulmonologist says, “There are vaccines available for Rs 1,400—even these are expensive for many,” he says, adding that though they may not ensure 100 per cent protection, the vaccine helps bring down numbers drastically.” 

The vaccination programme includes pneumonia vaccines, but it is treated as optional in some parts of the country, points out Dr Madhuri Prabu, neonatal-paediatrician, Motherhood. “It is ideal when the vaccine is administered in the 6th, 10th and 14th week, followed by a booster. This should be followed in the 15th month and just before the child goes to school. It has been seen that the vaccination programme has helped reduce the huge numbers. But this has to be implemented more effectively for a favourable result,” she says. However, an overall approach must be maintained for a favourable impact, says Dr Somasekar. “Pneumonia once diagnosed must be treated with appropriate antibiotics for an adequate period of time and with other supportive measures like nutritional support, continuum of breast feeding, availability of Oxygen and supplementation with zinc,” he says.