Simple Measures to Decrease Child Pneumonia Deaths

Implementing measures to improve nutrition, indoor air pollution, immunization coverage and the management of pneumonia cases could be cost-effective and significantly reduce child mortality from pneumonia, according to a study led by the Johns Hopkins Bloomberg School of Public Health.

Researchers found that these strategies combined could reduce total child mortality by 17 percent and could reduce pneumonia deaths by more than 90 percent. Pneumonia is a leading cause of death of infants in many developing countries, resulting in 2.2 million deaths each year. The study is published in the June 2009 issue of the Bulletin of the World Health Organization.

The study, conducted in collaboration with the World Health Organization (WHO) and other public health schools, assessed economic aspects of existing child interventions and identified the most efficient pneumonia control strategies. Programs to promote better community-based treatment of pneumonia, promotion of exclusive breastfeeding, zinc supplementation and vaccination for Hib and S. pneumoniae were found to be the most cost-effective interventions. The burning of solid fuels like wood, for cooking and heating, was found to contribute at least 20 percent to the burden of childhood pneumonia.

“The interventions we examined already exist, but are not fully implemented in the developing world. In addition, implementation of these interventions do not require a great deal of new infrastructure to carry out,” said Louis Niessen, MD, PhD, lead author of the study and associate professor in the Bloomberg School’s Department of International Health. “Fully funding and implementing these interventions could bring us a big step closer towards reaching the U.N. Millennium Development Goals.”

“The next step is to assess how donors and countries currently deliver these interventions and want to progress in the coming years,” said Majid Ezzati, PhD, co-investigator of the study and associate professor at the Harvard School of Public Health.

“Comparative impact assessment of child pneumonia interventions” was written by Louis Niessen, Anne ten Hove, Henk Hilderink, Martin Weber, Kim Mulholland and Majid Ezzati. The research was supported by grants from the Netherlands Environmental Assessment Agency, the WHO and the United Nations Children’s Fund.

Source: Johns Hopkins Bloomberg School of Public Health, June 1, 2009

Comments

  1. quiact says

    Pneumonia is an inflammation and consolidation of lung tissue to due to an infectious agent, such as a bacteria, or virus. Most pneumonia cases are usually acquired in a community setting .

    Bacterial pneumonia occurs more often due to bacteria called S. Pneumo. About half of all people infected with this bacteria show no overt symptoms.

    Also, in comparison with viral pneumonia, bacterial pneumonia has a shorter duration and is also more severe in the damage the bacteria can do to the patient. If left untreated, pneumonia can lead to the critical diseases of meningitis or sepsis, if not death. In fact, pneumonia was the number one cause of death in the United States before the advent of antibiotics.

    Approximately 2 million, if not more, people acquire pneumonia every year. 40 to 60 thousand people die due to pneumonia every year, and pneumonia is the most common infectious cause of death that exists. More men get pneumonia than women.

    About 20 percent of CAP cases are viral rather than bacterial. So most of the time, an antibiotic will be needed for the pneumonia patient. Also, about 10 million doctor visits are due to CAP and the symptoms from the disease.

    Pneumonia acquired while a patient is in a medical institution for another medical reason is called nosocomial pneumonia. Often, the symptoms are more severe, as the patient usually has another serious medical issue that is being treated in the medical facility as they acquire this type of pneumonia.

    If this type of pneumonia is acquired at such a location, it usually happens after the first 48 hours of a patient being in such a facility. Also, the microbe that causes nosocomial pneumonia is usually S. Aureus, according to others.

    However, frequently the cause of pneumonia is by resistant bacteria that are difficult to kill, as they are shielded from adaptation, these bacteria, from the many existing antibiotics historically used as therapy for patients invaded by bacteria. Such bacteria, as MRSA or VRE, are most resistant to most antibiotics.
    Treatment for nosocomial pneumonia usually requires a longer period to restore the health of a patient with this diagnosis. About 25 percent of ICU patients without pneumonia acquire nosocomial pneumonia while there for another medical issue.

    Symptoms for the typical pneumonia patient may be a fever, a high heart rate, a productive cough, and inflamed lungs noted on an X-ray. A sputum sample is usually obtained from the suspected patient in order to determine what is causing the pneumonia.

    If it is bacterial, antibiotic therapy is initiated for a certain length of time to cure the infection. At the same time, the health care provider should rule out lung cancer or tuberculosis as the provider is assessing the patient. Chest X-Rays usually are taken to rule out such diseases.

    Patients who are suspected or are diagnosed with community acquired pneumonia (CAP) are often started an antibiotic regimen from what is called the macrolide class of antibiotics. Macrolides have been proven to shorten the length of time the disease exists in the patient who has pneumonia.

    How serious CAP is with a patient can be determined by what is called a risk stratification point system- which lists various symptoms and conditions that may be present in the suspected patient who may have pneumonia.

    Points are assigned to these symptoms, and the severity of them regarding the disease of pneumonia. If the point number exceeds 90 points, the pneumonia patient is admitted to a hospital for more aggressive treatment and evaluation. About a third of all patients with community acquired pneumonia require hospitalization.

    Elderly patients usually experience this type of severity with their CAP illness, as well as those people with compromised immune systems for whatever reason. Also, primary care physicians diagnose and treat typical pneumonia in the United States. In the United States, about 2 million or more people acquire pneumonia, and over 4 thousand people die from this disease every year.

    Worldwide, about 2 million children less than 5 years of age die every year due to pneumonia. Two pneumonia vaccinations are available presently. It has recently been proven that the polysaccharide pneumonia vaccine is not useful in preventing pneumonia. However, the conjugate pneumonia vaccine has been shown to prevent the disease, according to recent studies.

    The effective vaccine has experienced greater worldwide access recently to prevent what may be a very deadly disease without prevention and treatment, as it is believed to protect well over 50 percent of people who receive this vaccination from pneumonia.

    http://www.lungusa.org

    Dan Abshear

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