Pneumonia: The forgotten child killer

Thursday 9 May 2019

By Florence Dzame- Communications and Campaigns Manager

At the Lodwar County and Referral Hospital (LCRH) in Northern Kenya, Emanman, 8, and his siblings are receiving treatment in the in-patient ward. It is a hot day and a dusty breeze hits the open window into the ward that they share with other patients. His siblings Achuka, 2, and Alice who is 4 months old have all been diagnosed with pneumonia.

Emanman, his mother Lokwami and other siblings at the pediatric ward at LCRH. Nina Raingold / Save the Children.

Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.

The disease is a leading cause of mortality among children under the age of five years globally, according to a 2018 World Health Organisation (WHO) and UNICEF Report Child Health Epidemiology Reference Group. In Kenya, a study revealed that it is the second leading cause of death among children under the age of five years and 1 in 4 children die of it in this age group.

“Pneumonia can be prevented by immunization, adequate nutrition, and by addressing environmental factors such as encouraging good hygiene in crowded homes,” said Linda Misiko Save the Children Child Health Technical Advisor

Pneumonia deaths usually occur when the immune system is weakened by malnutrition or insufficient breastfeeding and unable to fight the infection according to a report dubbed “Pneumonia-the forgotten killer”.

A pharmacist holds some amoxicillin at the dispensing window of the pharmacy, Lodwar County Hospital, Turkana region, Kenya. Amoxicillin is used to help treat pneumonia at the hospital. Nina Raingold / Save the Children

Timely diagnosis and appropriate treatment is critical to reduce deaths caused by pneumonia. Vaccines can prevent a large portion of pneumonia cases. A global immunization report, shows that the percentage of Kenyan children routinely vaccinated against the illness is increasing, reaching 84 percent by 2018. Amoxicillin dispersible tablets are the recommended treatment for non-severe pneumonia. A pulse oximeter is required to diagnose those severe cases that have low oxygen levels. The small device fits over a child’s finger to detect hypoxemia by measuring the percentage of oxygen saturation in the blood. Once diagnosed, oxygen therapy is essential. 

Emanman, aged 8 years, at Lodwar County hospital, Turkana region, Kenya. Nina Raingold / Save the Children.

In Turkana County inaccessibility to health facilities makes it challenging for children to receive timely diagnosis and treatment for pneumonia. It is on average 30-40 kilometers to the nearest health facility.

“Children who are lucky enough to get to the pediatric ward often have long distances to travel to get to the hospital and their families may not have the means or the funds to do so,” said Robert Lochuch, Save the Children Technical Officer Health and Nutrition.

“Usually children respond well to the antibiotics within a couple of days. The paediatric ward at LCRH sees a high volume of cases of children suffering with pneumonia. In the surrounding rural areas 6 to 7 out of every 10 children contracts severe pneumonia,” said John Ngasike Clinical Officer in charge at LCRH

Kenya has made strides to incorporate the treatment of pneumonia to the country’s healthcare system. In 2017, the Ministry of Health adopted Amoxicillin as a first-line treatment, per the WHO recommendations.

Save the Children in partnership with the Ministry of Health and Turkana County Government is implementing various interventions to manage pneumonia in children. Since nutrition is a contributor for pneumonia, a pilot project is integrating Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) treatment into the Intergrated Community Case Management (iCCM). iCCM is an intervention of using a community approach where Community Health Volunteers are trained to identify, treat and refer cases of pneumonia, diarrhea, malaria and malnutrition for children under 5 years.