Pneumonia is an acute respiratory infection that affects the lungs. According to the World Health Organisation, it is the single largest cause of death in children worldwide and every year kills an estimated 1.4 million children under five years. This is more than AIDS, malaria, and tuberculosis combined.
Pneumonia is caused by various bacteria, viruses, and fungi and is transmitted through airborne droplets from a cough or a sneeze. These causative agents are commonly found in the nose and throat. Pneumonia can also be spread through blood, especially during, or shortly after birth.
Infection then leads to inflammation of the lung air sacs and airways, mucus secretion, partial obstruction of airways, and reduced air exchange.
In children, the typical symptoms of pneumonia include rapid or difficulty breathing, cough, fever, chills, loss of appetite, and wheezing in a few.
Severe pneumonia may lead to chest indrawing, loss of consciousness, and convulsions.
Risk factors that may increase a child’s likelihood of contracting pneumonia include malnutrition, HIV, and measles. Other environmental factors include indoor air pollution (from charcoal smoke and stoves), living in crowded homes, and if you smoke at home.
Diagnosis of pneumonia in children is mainly clinical, based on the signs and symptoms that a child may present with. More sensitive signs include increased respiratory rate, lower chest indrawing, and cough.
Chest X-rays are mainly done to confirm the areas of the lungs that are affected to rule out other causes of symptoms, especially when there is no improvement after adequate treatment.
Sputum tests rule out other diseases such as tuberculosis and pick out the causative agents of pneumonia.
Pneumonia can be treated with antibiotics. Painkillers and fluids to rehydrate the child may also be necessary. The prognosis is excellent with adequate and timely treatment.
Antibiotics must be administered by a qualified health professional. In many cases, management is at home, and symptoms can disappear in less than a week. Hospitalisation is necessary for severe pneumonia as well as in children who are less than two months old.
Recurrent pneumonia or pneumonia that does not seem to respond to treatment may be due to the following:
Obstruction by a foreign body, which is common in crawling children.
Aspiration (breathing in) of foods.
Tuberculosis can be prevented through immunisation. Vaccines against the different causes of pneumonia are readily available in private hospitals as well as government facilities.
Adequate nutrition is important and so is exclusive breastfeeding in the first six months of life to build natural immunity.
Environmental factors should be addressed as much as possible, especially avoiding wood smoke around children, and improving ventilation at home.
Children with HIV must receive daily cotrimoxazole (septrin) to reduce the risk of contracting pneumonia.