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We commemorate World pneumonia Day on the 12th of November annually, a reminder that pneumonia remains a preventable and curable disease.

Image of drug-resistant klebsiella pneumoniae. © NIAID

Despite substantial progress over recent decades, much remains to be done. WHO estimates that pneumonia affects approximately 450 million people per year globally. In 2019, Pneumonia claimed the lives of 740 180 children under the age of 5, accounting for 14% of all deaths of children under five years old globally. Reducing childhood pneumonia mortality in many parts of sub-Saharan Africa remains a major challenge due to limited access to healthcare services, inadequate vaccination coverage, and the high prevalence of underlying conditions such as malnutrition and HIV. Additionally, environmental factors like air pollution and poor living conditions exacerbate the risk of pneumonia in children.

Data from the Kenya health Information System indicate a substantial increase in cases over the last year from 477,186 cases in 2020/2021 to 793,864 cases in 2022/2023 particularly in Mandera, Samburu, Narok, Isiolo, Marsabit, Tana River, and Wajir counties. Factors such as poor nutrition and seasonal flooding are significant contributors to this trend.

What exactly is pneumonia and what causes it?

Pneumonia is an inflammation of the lung tissue (respiratory bronchioles and alveoli), where exchange of oxygen occurs.

It is mostly caused by microorganisms that enter the lower respiratory system causing infection. Viruses and bacteria are the most common causes. However, it can also be caused by TB, fungi, and parasites. Pneumonia can also result from inhaling substances that irritate the lungs.

How is pneumonia transmitted?

Pneumonia can be spread in several ways. The viruses and bacteria that are commonly found in a child’s nose or throat, can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. More research is required on the different pathogens causing pneumonia and the ways they are transmitted, as this is of critical importance for treatment and prevention.

Who is at a greatest risk of contracting pneumonia?

The risk of disease is greatest in children less than 5 years old and adults older than 75 years. This is believed to be due to their reduced immunity. Other risk factors include, smoking, air pollution, upper respiratory tract infections, chronic diseases – lung disease, diabetes, heart disease, cancer, malnutrition, HIV/AIDS, prolonged bed rest among others. Pneumonia also occurs more in low to middle income countries as opposed to high income countries, where healthcare infrastructure is lacking, and people are least able to afford the treatment.

What preventive measures can be taken against pneumonia?

Immunization against Hib, pneumococcus, measles and whooping cough (pertussis) has proved to be a highly effective way to prevent pneumonia. Adequate nutrition is also key to improving children’s natural defenses, starting with exclusive breastfeeding for the first 6 months of life. In addition to being effective in preventing pneumonia, it also helps to reduce the length of the illness if a child does become ill.

Addressing environmental factors such as indoor air pollution (smoking, use of firewood, for example) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia. In children infected with HIV, the antibiotic cotrimoxazole is given daily to decrease the risk of contracting pneumonia.

What are the classic signs and symptoms of pneumonia and how is it diagnosed?

In case of an infection, the symptoms of pneumonia will include fever, cough, chills, sweating, shortness of breath, fast breathing, chest pain, fatigue, reduced appetite, headache, low oxygen in blood and the lips turning blue. Diagnosis is made by taking a good history of the symptoms and signs and performing a physical examination. Sometimes the doctors require a chest Xray and take sputum to know the cause of the pneumonia. Blood tests like culture and CT scan of the chest are at times done in special occasions.

When one is diagnosed with Pneumonia what are the treatment options available?

Treatment usually involves a dose of antibiotics over about 3 to 5 days. Other supportive treatment includes giving of oxygen, nutritional support, and prevention of dehydration by giving of fluids or putting a tube to pass food directly to the stomach.

The Sustainable Development Goal targets for SDG 3.2.1 – reducing child mortality – ending preventable diarrhoea and pneumonia-related deaths is now an urgent priority. In light of this, WHO and UNICEF have developed an integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD) aims to accelerate pneumonia control with a combination of interventions to protect, prevent, and treat pneumonia in children. KWTRP works in partnership with the MoH to end deaths from Pneumonia in children. Pneumonia can be prevented by simple proven solutions, every breath counts, let us join hands to end child pneumonia!

Read the full story on the KWTRP website