Pre­vent­ing Pneu­mo­nia Death sin Nige­ria

De­spite the avail­abil­ity of ef­fec­tive drugs, pneu­mo­nia still kills at least 20 Nige­rian chil­dren ev­ery hour while 6.7 mil­lion cases are recorded yearly. Martins Ifi­jeh writes on the need for gov­ern­ment, stake­hold­ers and health bod­ies to step up pre­ven­tive

THISDAY - - HEALTH & LIFESTYLE -

Just as Nige­ria is still bat­tling with re­duc­ing malaria dis­ease, es­pe­cially among women and chil­dren, who are the most hit, pneu­mo­nia, one of Nige­ria’s most mis­un­der­stood dis­eases is now killing chil­dren more than malaria in the coun­try, if the re­cent re­port by the In­ter­na­tional Vac­cines Ac­cess Cen­tre (IVAC) is any­thing to go by. The re­port shows that in 2015, about 17 per cent and 10 per cent of all un­der-five deaths were caused by pneu­mo­nia and di­ar­rhoea re­spec­tively, sug­gest­ing that malaria is now third placed among child killer dis­eases in the coun­try.

This is even as a coali­tion of civil so­ci­ety or­gan­i­sa­tions un­der the aegis of Phar­ma­ceu­ti­cal So­ci­ety of Nige­ria Part­ner­ship for Ad­vo­cacy in Child andFam­ily Health (PSN-PACFaH) also raised the alarm that more chil­dren were now dy­ing in the coun­try due to pneu­mo­nia and di­ar­rhea.

With most Nige­ri­ans be­liev­ing that pneu­mo­nia is caused by ex­po­sure to cold weather, food and wa­ter, thereby ig­no­rantly warn­ing their chil­dren not to take cold drinks or wa­ter to avoid con­tract­ing the dis­ease, ex­perts say this may be a ma­jor part of a larger pic­ture fu­el­ing the in­creased preva­lence of un­der-five deaths in the coun­try.

Avail­able statistics show that pneu­mo­nia kills a stag­ger­ing 1.6 mil­lion peo­ple glob­ally ev­ery year with chil­dren un­der age five bear­ing the brunt of the cri­sis, es­pe­cially in un­der­de­vel­oped and de­vel­op­ing coun­tries.

Ac­cord­ing to the World Health Or­gan­i­sa­tion, even though pneu­mo­nia is pre­ventable and treat­able, a child some­where in the world still dies of pneu­mo­nia ev­ery 20 sec­onds, mak­ing it the num­ber one in­fec­tious killer of chil­dren across the globe, es­pe­cially in Africa where even malaria is known to be the com­mon­est of dis­eases.

Africa has been known to be badly hit by the pneu­mo­nia dis­ease com­pared to other con­ti­nents. Again, ac­cord­ing to re­ports, Nige­ria is tak­ing the lead in in­ci­dence rate in Africa.

Avail­able statistics from the United Na­tions Ed­u­ca­tion Fund (UNICEF) also show that an es­ti­mated 6.7 mil­lion cases of child­hood pneu­mo­nia is recorded in Nige­ria ev­ery year with about 200,000 chil­dren un­der-five deaths an­nu­ally. In essence, ev­ery one hour, 20 chil­dren die from pneu­mo­nia in Nige­ria.

Ac­cord­ing to re­ports, among five chil­dren in Nige­ria that die of child­hood killer dis­eases, two are killed by pneu­mo­nia.

Ex­perts are how­ever call­ing on stake­hold­ers and the gov­ern­ments at lo­cal, state and na­tional lev­els to scale up aware­ness of the dis­ease, just as it is cur­rently do­ing for malaria, po­lio and HIV/AIDS. They are also call­ing on Nige­ri­ans to put mea­sures in place to pre­vent the dis­ease from tak­ing away their loved ones.

The Project Head, Per­fect Health Ini­tia­tive, Dr. Omons Oku­male said most peo­ple do not know about pneu­mo­nia and how it can be pre­vented. Adding that the lack of aware­ness was ma­jorly re­spon­si­ble for its preva­lence, es­pe­cially in chil­dren whose im­mu­nity is not as strong as that of adults.

“Pneu­mo­nia is a se­vere dis­ease, be­cause the body gets oxy­gen through the lungs and once the brain does not get oxy­gen in three min­utes, death oc­curs.That is why it is a very fa­tal dis­ease,” Oku­male ex­plained.

He said though pneu­mo­nia was more preva­lent in the west­ern world. “It is not the most com­mon cause of death for them, be­cause they know how to deal with their issues, they have pre­ven­tive mea­sures in place to tackle it un­like us here where it is a grow­ing con­cern.”

On why chil­dren are more prone to the dis­ease, Oku­male said it was be­cause their im­mune sys­tem is very low. “Apart from chil­dren, oth­ers also at high risk are the im­mune com­pro­mised peo­ple. I mean per­sons with Hu­man Im­muno Virus (HIV) and those on drugs like cor­ti­cos­teroids. Also prone to it is the el­derly be­cause at their age their im­mu­nity is low,” he said.

He said pneu­mo­nia hap­pens be­cause of in­fec­tions caused by bac­te­ria, fungi, viruses, and other types of germs. “Chem­i­cal causes should not be left out also. As­sum­ing one mis­tak­enly drinks kero­sine, a quan­tity of it could go into the lungs caus­ing chem­i­cal pneu­mo­nia.

“The cause of pneu­mo­nia de­ter­mines the treat­ment. Be­fore treat­ment, one must first do a di­ag­no­sis to know which of the germs is the re­mote cause, so that the physi­cian can know ex­actly which med­i­ca­tion to use.”

What are the symp­toms of pneu­mo­nia and how do they man­i­fest? He said the most com­mon symp­tom in­cludes cough, fever and short­ness of breath. “God gave every­one cough as a de­fense mech­a­nism to push out for­eign bod­ies from the res­pi­ra­tory tract. Also, short­ness of breathe is un­der­stand­able be­cause since there is in­fec­tion in the alve­oli, there def­i­nitely will be dif­fi­culty in ex­chang­ing gases with the blood, vice versa,” he said.

To com­pen­sate for the inad­e­quate oxy­gen to the blood, he said the lung breathes faster and shorter so as to make up for the fact that each breath­ing dur­ing pneu­mo­nia does not de­liver enough oxy­gen to the blood. “There could be loss of ap­petite as well as weak­ness. Even when the per­son eats, there is not enough oxy­gen to metabolise the food, hence the body be­comes weak. There could some­time be chest pain,” he added.

Can cold weather cause pneu­mo­nia? Oku­male said pneu­mo­nia was caused by germs against the mis­con­cep­tion about cold weather which most peo­ple make ref­er­ence to. “If it was due to cold, all the chil­dren in cold re­gions abroad would have con­tracted it by now. When this bac­te­ria or virus gets into the body ei­ther through the mouth or other open­ings in the body, it goes to the gut and con­tam­i­nates the blood and goes into the res­pi­ra­tory ap­pa­ra­tus to cause prob­lem there. That is pneu­mo­nia.

“Peo­ple should un­der­stand that the most vi­able way pneu­mo­nia is trans­mit­ted is through germs con­tracted un­der poor san­i­ta­tion and hy­giene.It is not pre­vented or treated by wear­ing clothes that cover ev­ery part of the body or be­ing in a warm en­vi­ron­ment,” he said.

He said chil­dren ex­posed to cig­a­rette smoke, those who do not par­tic­i­pate in rou­tine pneu­mo­nia pro­grammes and those ex­posed to smoke from char­coal or fire­wood are more at risk of the dis­ease.

He, how­ever said the myth about cold be­ing a causal ef­fect may not be to­tally dis­carded, as the as­sump­tion could have an el­e­ment of fact, adding that the germs caus­ing the dis­ease thrives more in cold weather, but noted that be­cause the dis­ease thrives more in cold en­vi­ron­ment does not mean cold is the source of the dis­ease.

“That is why it is a very com­mon dis­ease abroad. Even at that, it is not the most com­mon cause of death over there be­cause they sure know how to take care of them­selves. They have vac­cines against it. The rea­son peo­ple are still dy­ing of malaria to­day is be­cause it is an African prob­lem. If it was the ad­vanced coun­tries’ prob­lem, they would have de­vel­oped vac­cines against it.Warm en­vi­ron­ment is a little bit not con­ducive for pneu­mo­nia virus to thrive,” he added.

Harp­ing on the causal agents, he noted that there were dif­fer­ent bac­te­ria or viruses re­spon­si­ble for it, hence the need to iden­tify which kind of germ causes a par­tic­u­lar pneu­mo­nia be­fore treat­ment can be ini­ti­ated.

“There are anti-bac­te­rial drugs for the pneu­mo­nia caused by bac­te­ria, which usu­ally is ad­min­is­tered over a long pe­riod of time. But with the new drugs de­vel­oped, the med­i­ca­tion might last just few days. If the pneu­mo­nia is se­vere and the per­son is hav­ing fast and short breathe, it is nec­es­sary to put the per­son on oxy­gen as a tem­po­rary mea­sure be­fore treat­ment.

For a Con­sul­tant Pae­di­a­tri­cian, Dr. Odom Ebiz­imo, most Nige­ri­ans do not know there are vac­cines avail­able against pneu­mo­nia, stress­ing that it is nec­es­sary they take ad­van­tage of it and pre­vent un­due ill­nesses and death in the coun­try. Ac­cord­ing to him, aware­ness is the ma­jor fac­tor that can re­duce the high num­ber of deaths due to child­hood pneu­mo­nia.

“In ad­vance coun­tries, there are a lot of vac­cines for var­i­ous res­pi­ra­tory in­fec­tions and their cit­i­zens know about them. So it’s easy to ac­cess such fa­cil­i­ties un­like here in Nige­ria where most peo­ple may not be aware. The preva­lence of pneu­mo­nia is not as high in west­ern coun­tries com­pared to ours.

“Re­cently, Nige­rian Gov­ern­ment added two new res­pi­ra­tory vac­cines to the one they give to chil­dren at six weeks or 10 weeks. Even on in­di­vid­ual ba­sis, these vac­cines can be sourced from pri­vate hos­pi­tals, but they will be of course more ex­pen­sive. Pneu­mo­nia is pre­ventable in Nige­ria if vac­cines are taken,” he noted.

Ebiz­imo who said clean en­vi­ron­ment has a ma­jor role to play in the pre­ven­tion of pneu­mo­nia, painted a sce­nario where over 10 peo­ple sleep in one room, es­pe­cially in cities like La­gos, and then ques­tioned why pneu­mo­nia would not thrive in such an en­vi­ron­ment.

“Gov­ern­ment has been do­ing aware­ness for Nige­ri­ans to im­mu­nise them­selves against dis­eases like po­lio, measles and tu­ber­cu­lo­sis, but more aware­ness should be cre­ated es­pe­cially for pneu­mo­nia.

“Nige­ri­ans should be en­cour­aged to im­mu­nise them­selves against pneu­mo­nia. Peo­ple should also live in a well ven­ti­lated place. Of­fices and other closed rooms should be well ven­ti­lated as well,” he added.

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