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Published On: Wed, Nov 20th, 2019

Towards addressing Nigeria’s childhood pneumonia mortality

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By Tobias Lengnan Dapam

The United Nations Children’s Fund ( UNICEF), said Nigeria contribute to the highest number of global pneumonia child deaths.
It said Nigerian children made up the highest number of those who died, with an estimated 162,000 deaths in 2018 – 443 deaths per day, or 18 every hour.
“In Nigeria, 19% of child deaths were due to pneumonia in 2018, and it was the biggest killer of children under-five in 2017.”
UNICEF in a statement issued recently by Oluwatosin Akingbulu
Communication, Advocacy and Partnerships added that pneumonia claimed the lives of more than 800,000 children under the age of five last year globally, with one child every 39 seconds, according to a new analysis.
“Pneumonia is a deadly disease and takes so many children’s lives – even though this is mostly preventable. And yet, this killer disease has been largely forgotten on the global and national health agendas. We can and must change this,” said Pernille Ironside, Acting UNICEF Representative in Nigeria.
The statement said the biggest risk factors for child pneumonia deaths in Nigeria are malnutrition, indoor air pollution from use of solid fuels, and outdoor air pollution.
“Most global child pneumonia deaths occurred among children under the age of two, and almost 153,000 within the first month of life.
“Sounding the alarm about this forgotten epidemic, six leading health and children’s organisations today launched an appeal for global action.
“In January, the group will host world leaders at the Global Forum on Childhood Pneumonia in Spain.
“Pneumonia is caused by bacteria, viruses or fungi, and leaves children fighting for breath as their lungs fill with pus and fluid.”
UNICEF said more children under the age of five died from the disease in 2018 than from any other, adding that 437,000 children under five died due to diarrhoea and 272,000 to malaria.
“Just five countries were responsible for more than half of child pneumonia deaths: Nigeria (162,000), India (127,000), Pakistan (58,000), the Democratic Republic of Congo (40,000) and Ethiopia (32,000).
“Children with immune systems weakened by other infections like HIV or by malnutrition, and those living in areas with high levels of air pollution and unsafe water, are at far greater risk.”
The statement said the disease can be prevented with vaccines, and easily treated with low-cost antibiotics if properly diagnosed.
“But tens of millions of children are still going unvaccinated – and one in three with symptoms do not receive essential medical care.
“Children with severe cases of pneumonia may also require oxygen treatment, which is rarely available in the poorest countries to the children who need it.
“Funding available to tackle pneumonia lags far behind other diseases. Only 3% of current global infectious disease research spending is allocated to pneumonia, despite the disease causing 15% of deaths in children under the age of five.
“Increased investment is critical to the fight against this disease,” said Pernille Ironside. “Only through cost-effective protective, preventative and treatment interventions delivered to where children are – including especially the most vulnerable and hardest-to-reach – will we be able to save hundreds of thousands of lives in Nigeria.”
UNICEF further called on Governments in the worst-affected countries to develop and implement Pneumonia Control Strategies to reduce child pneumonia deaths; and to improve access to primary health care as part of a wider strategy for universal health coverage.
“Richer countries, international donors and private sector companies should boost immunisation coverage by reducing the cost of key vaccines and ensuring the successful replenishment of Gavi, the Vaccine Alliance; and to increase funding for research and innovation to tackle pneumonia.”
On his part, Dr Abel Kanji, a Pulmonologist called for an end to preventable pneumonia deaths, ensuring equitable access to interventions for prevention and control of pneumonia.
Kanji, who spoke recently during the commemoration of World Pneumonia Day, said to end the preventable burden of childhood pneumonia and deaths there was a need for the government to raise continuous awareness about pneumonia, the leading killer of young children.
Kanji appealed to the government to strengthen, accelerate and sustain interventions to prevent and treat pneumonia.
He said that the government should focus on equitable access to, and delivery of comprehensive pneumonia prevention and control programmes.
He again advised that the government should design specific strategies to reach the “hard-to reach” populations to improve their accessibility to available interventions.
The Pulmonologist called on experts to conduct research to develop innovative strategies to reduce the burden of pneumonia in the country.
“Together, with the government we can end preventable deaths from pneumonia,” he said.
Kanji said that every minute, children under five die from pneumonia, representing 16 per cent of childhood deaths globally.
He said that eighty per cent of deaths were in children under two years old. “Almost all deaths were in low and middle-income countries.”
Kanji said that pneumonia was also a common cause of death or illness in the elderly, being the single most common cause of death from infectious disease.
He said that pneumonia was largely preventable, good nutrition including exclusive breastfeeding for the first four to six months of life and adequate complementary foods protection. could protect children from pneumonia.
“Comprehensive immunisation including vaccines against the common germs that cause pneumonia such as pneumococcus, measles, Haemophilus Influenzae b, pertussis whooping cough, diphtheria and influenza should be available to all children to prevent pneumonia.
“Avoiding tobacco smoke exposure and reducing exposure to indoor air pollution reduces the risk of pneumonia in children.
“Prevention of mother-to-child transmission of HIV, early use of antiretroviral therapy in HIV-infected children, and cotrimoxazole prophylaxis for HIV-infected and exposed children, can reduce the burden of childhood pneumonia.
Kanji said that pneumonia was largely treatable with timely access to appropriate management including antibiotics, referral to hospital and oxygen when needed, were critical for children who become ill from pneumonia.
“Many children continue to die from pneumonia, largely due to lack of comprehensive, holistic implementation of the package of interventions for pneumonia prevention and treatment,” he said.

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