New plan in war against pneumonia

Streptococcus pneumoniae, or pneumococcus, is a gram-positive bacteria responsible for many types of pneumococcal infections. The Ministry of Health will change the treatment regimen of pneumonia from Amoxicillin syrup to soluble tablets in a bid to reduce deaths in children caused by the disease. PHOTO | FOTOSEARCH

What you need to know:

  • The revision of the guidelines took place early this year, but health workers are yet to be sensitised.
  • According to a 2017 report by Save the Children, antibiotic treatment is often lacking in hospitals apart from late recognition of the disease.

  • The report stated that slightly over 60 per cent of hospitals often have the recommended Amoxicillin available.

The Ministry of Health will change the treatment regimen of pneumonia from Amoxicillin syrup to soluble tablets in a bid to reduce deaths in children caused by the disease.

In 2017, pneumonia killed 21,584 people according to data from the Ministry of Health, a number that the ministry has attributed to healthcare workers inability to diagnose, poor health seeking behaviour and poverty.

REFRIGERATION

Dr Warfa Oman, head of new born, child and adolescent health at the ministry, said that the syrup bottles could break and required refrigeration to maintain their potency.

He added: “But the tablets are sweeter, once dissolved for the baby to drink, as compared to the syrups that they would spit.”

The revision of the guidelines took place early this year, but health workers are yet to be sensitised.

52 DEATHS

Pneumonia is an infection of the lungs characterised by pus and fluid filling the lungs which causes pain when one breathes. Every 20 seconds, a child dies of pneumonia globally and more than half of those deaths occur in sub-Sahara Africa.

Dr Oman said that pneumonia contributes the highest number of under-five mortality, which stands at 52 deaths per 1,000 live births.

RESPONSE

He added that the ministry’s failure to recognise the swiftness with which the disease claims lives has led to a lethargic response to controlling it.

Nyanza — Kisii, Kisumu, Homa Bay, Migori and Nyamira counties — accounts for the largest number of under-five deaths according to the 2014 Kenya Demographic Health Survey standing at 82 deaths per 1,000 deaths as compared to 42 in central.

PAEDIATRICIAN

Dr Oman took special notice of Turkana, West Pokot, Marsabit, Kilifi and Mandera counties where there are unacceptably high numbers of Pneumonia deaths. These counties have many children that are under nourished, and lack immunity boosting vitamins such as Vitamin A. With a frail immunity, the children die in less than 48 hours after the onset of fast breathing.

According to Dr David Githanga, a paediatrician and public health specialist, the tell-tale signs of pneumonia are fever and fast breathing; a quick diagnosis that the WHO has reported to be often missed by healthcare workers.

RECOMMENDED

According to a 2017 report by Save the Children, antibiotic treatment is often lacking in hospitals apart from late recognition of the disease. The report stated that slightly over 60 per cent of hospitals often have the recommended Amoxicillin available.

Even if the medication was made available, the gaps in health system in Kenya continue to place children on pneumonia’s path.

VULNERABLE

On the vaccine, Unicef public health specialist Peter Okoth said “the vaccines we give prevent mostly against bacterial pneumonia, not the virus ones.”

More than half of Kenyan households still use firewood and studies have shown that fine particles and toxic gases in the smoke inflame children’s lungs which makes them twice as vulnerable to pneumonia risk.

CHALLENGING

Dr Okoth stressed that tackling pneumonia is more challenging because it is a chain since “the mothers delay in seeking care, but even when they do, there is the question of whether they will find the services in the health facility and whether at home or in the hospital, the baby succumbs."

While the government is changing its guidelines for the first time since 2012, the current protocol certified by WHO has been faulted for locking out certain groups of sick children out of hospital care, where they are at risk of death.

GUIDELINES

Kemri-Wellcome Trust’s Dr Ambrose Agweyu analysed data of 16,031 children with pneumonia in 14 county hospitals before the new guidelines were rolled out. Five per cent (832) died, and one in every four that died (39 per cent), had in-drawing of the lower chest, and would therefore have been classified as “not severe” in these new guidelines.