Day of Pneumonia – the leading child killer

LAHORE – Like other parts of the globe, World Pneumonia Day will be observed across the country including Lahore tomorrow to raise awareness about necessary precautions to fight against number one killer of children under five.

Seminars, workshops and walks will be arranged both at the government and private level to raise awareness about pneumonia and measures to avoid children falling prey to the preventable disease.

Pneumonia accounts for 92,000 deaths of children under-five in Pakistan annually, making it the leading killer of children, said health experts at a press briefing at a local hotel yesterday to mark upcoming World Pneumonia Day.

“Globally, Pneumonia is one of the biggest killers of children causing 16% deaths under five and accounting for more than 920,000 death. It is alarming that Pakistan is among top five countries which account for 99% of childhood pneumonia cases,” said Dr Tahir Masood, President Pakistan Paediatric Association (PPA).

“Pneumonia is a form of acute respiratory infection that affects the lungs. When an individual has pneumonia, the alveoli (small sacs in lungs which fill with air when a healthy person breathes) are filled with pus and fluid, which makes breathing painful and limits oxygen intake,” he added.

“Children under five with severe cases of pneumonia may struggle to breathe, with their chests moving in or retracting during inhalation (known as chest indrawing). Young infants may suffer convulsions, unconsciousness, hypothermia, lethargy and feeding problem,” Dr Tahir added.

“Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. The most common causes of pneumonia amongst children include: Streptococcus pneumoniae and Haemophilus influenzae type b (Hib).”

Dr Tayyaba Khawar Butt, Professor of Paediatrics, SIMS, said: “Preventing children from developing pneumonia in the first place is critical to reducing its death toll.” Fortunately Pneumococcal conjugate vaccine (pneumonia vaccine) was introduced in Pakistan’s EPI program in October, 2012, and this achievement made Pakistan to become the first South Asian country to include PCV in its national immunisation program, she added.

She regretted that despite all efforts vaccination coverage was not optimistic and a lot need to be done to increase the coverage. Parents need to be educated about getting their children vaccinated as immunisation was a proven tool for controlling and eliminating life-threatening infectious diseases.

She added that vaccines were important to fight pneumonia. “Vaccines against pneumococcus, Hib, pertussis, and measles can prevent a significant portion of pneumonia cases from ever occurring,” Dr Tayyaba concluded.

Speaking at the World Pneumonia Day briefing at the Committee Room of the Directorate General Health Services, DG Health Dr Mukhtar Hussain Syed highlighted some of the steps taken by the government to protect, prevent and treat pneumonia in the province.

Director Expanded Program on Immunisation Dr Munir Ahmed, Health Specialist UNICEF Dr Mushtaq Ahmed Rana, Pakistan Paediatrics Association representative and experts from WHO and EPI Program were also present.

“Pneumonia can be prevented by immunisation, adequate nutrition, and by addressing environmental factors,” the DG Health said.

According to him, a child survival group of technical experts has been formed to chalk out workable strategy. “In Punjab a new initiative to provide medical commodities for children suffering with Pneumonia and Diarrhoea has been initiated in the year 2016. The plan is being pilot tested in five districts with support from UNICEF-Bill and Melinda Gates Foundation,” he added.

The Punjab Expanded Program on Immunisation has introduced pneumonia vaccine as part of routine immunisation in 2012. The latest coverage survey reports suggest immunisation coverage above 86%. EPI EPI Director Dr Munir Ahmed said, “Punjab was able to increase routine immunisation progress from 64% (Penta-III) to 86% as per Neilsen Survey.”

By effective use of technology, the vaccinator attendance has improved from mid 50s to 97% as of last month, he added.

Unicef Health Specialist Dr Mushtaq Ahmed Rana said that the recommendations of the Global Action Plan were being implemented through a project initially piloted in five districts. As part of the plan, necessary guidelines and training material was being updated.

In order to facilitate the provision of antibiotics, dispersible tablets were being introduced in place of syrup.

Also, the WHO and UNICEF have developed an integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD) that aims to accelerate pneumonia control with a combination of interventions to protect, prevent, and treat pneumonia in children. The GAPPD was signed by Pakistan in 2013.