Infection can cause the lungs to fill with pus and fluid, making breathing and oxygen consumption difficult. And while anyone can get pneumonia, children with weakened immune systems or underlying diseases are more susceptible. Therefore, pneumonia kills more than a million children each year around the world.
There have been some critical advances in prevention and treatment of the disease. These include vaccines, antibiotics and supplementary oxygen supplies. In 2009, South Africa became the first African country to include the pneumococcal clutch vaccine in its routine infant immune program. By 2012, 81% of infants 1 year old received three doses of the vaccine.
South Africa has also reduced the burden of her pneumonia through the mass onslaught of anti-retroviral therapy and AIDS prevention of a mother-to-child transmission program. This made a difference because children born to infected HIV mothers have a significantly increased risk of pneumonia and disease and death.
But a lot of work remains. In 2016 influenza and pneumonia were the second leading cause of death among children under the age of five in South Africa. That is why we at the National Institute of Infectious Diseases in the country follow key areas related to the cause and effects of pneumonia.
There is reason to be optimistic: the number of current advances in development will most likely strengthen our artillery in the fight against pneumonia. Some are complex and expensive, such as developing more effective vaccines. But there are also many tools that do not involve costly and complicated medical interventions such as providing proper nutrition, clean air and water.
There is an argument to get back on basics in an attempt to deal with pneumonia. The answer to stopping the death of children from preventative diseases may simply be at the base as reducing poverty and inequality.
As with any other disease, the data is critical when it comes to understanding, and ultimately, controlling pneumonia. At the Institute, we check what pneumonia and pneumonia varieties are rotating at any given time. We also focus on population groups at risk of infection and death (as in children) and monitor the impact of existing vaccines on the disease.
All data help to detect increases in disease. This helps us prepare quick reactions and work towards the containment in the event of an eruption occur.
The information we collect can also help those who are trying to develop new vaccines for pneumonia and improve current immunological schedules. For example, immunization of women in the third trimester of their pregnancy to provide protection to their babies in the first months of their life when they are most vulnerable.
In addition, candidates for vaccines against one of the viruses responsible for a significant portion of childhood pneumonia – respiratory and respiratory virus (RSV) – are in the late stages of development.
Further progress is being made to improve pneumonia diagnosis. These include improved radiological methods, point-of-care tests which are used or near-patient treatment to speed up diagnosis, and the use of host biomarkers to examine the type of immune response a person develops to identify the cause of the infection.
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back to basics
We know that malnutrition, domestic air pollution, poverty, poor hygiene and sanitation significantly increase a child's risk of infection and death.
In South Africa, some 30.3 million people live below the poverty line in 2015. Two-thirds of the children under the age of 18 lived in poverty.
It is essential to provide children with basic human needs like adequate nutrition, access to clean water and air, equal access to vaccines and basic health.
The costs of improving children's living conditions must be assessed against the high costs associated with the clinical management of childhood pneumonia. The residual burden of pneumonia can be reduced by prioritizing the child's health through simple interventions. These include improving living conditions and accessibility to affordable drugs, vaccines and treatment.
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Nicole Walter, chief medical scientist, National Institute of Infectious Diseases
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