Kids dying of treatable conditions: Unicef
CHILDHOOD pneumonia and diarrhoea, two conditions that should ordinarily be treated and cured, are killing two million children under the age of five each year.
Nine out of 10 deaths are occurring in sub-Saharan Africa and South Asia where poverty levels are high.
According to a report released on Friday by the UN Children’s Fund (Unicef), pneumonia and diarrhoea are the leading killers of children under five years of age in spite of the fact that there are a cost-effective interventions to curb these illnesses.
Far fewer children are dying today from these conditions than 20 years ago. In 1990, 12 million child deaths were recorded, compared to 7.6 million in 2010.
This reduction is mainly as a result of the rapid expansion of public health and nutrition interventions such as immunisation, breastfeeding and safe drinking water. However, the use of low-cost, curative interventions against pneumonia and diarrhoea remains low, particularly among the most vulnerable communities.
In South Africa, the under-five mortality rate was 57 in 1 000 live births in 2010, translating to about 58 000 children dying in that one year.
A Medical Research Council review of vital registration data from various sources reveals in 2007 the majority of registered child deaths in South Africa was babies (76 percent), with 22 percent of these deaths occurring in the first month of life.
Of the 61 335 under-five deaths registered in 2007, diarrhoea accounted for 21 percent of deaths and lower respiratory infections for 16 percent.
Public health experts agree that South Africa needs to focus on pneumonia and diarrhoea.
Dr Tanya Doherty and Professor David Sanders of the University of Western Cape point out that, with the decreased mother-to-child HIV transmission (3.5 percent transmission from HIV-positive women at tests carried out in 2010), HIV’s contribution to child mortality is decreasing.
“However, even among deaths due to HIV, the terminal events leading to death are usually diarrhoea- or pneumonia-related.
“South Africa has one of the lowest rates of exclusive breastfeeding in the world (1.5 percent among children aged four to six months) yet high coverage of exclusive breastfeeding could result in the largest reduction in under-five mortality due to these illnesses,” say Doherty and Sanders.
They add that community health workers need to manage cases of diarrhoea by supplying oral rehydration solutions and giving antibiotics for pneumonia.
“Community treatment for pneumonia is being implemented in 18 subSaharan African countries. This could be added to the scope of the outreach teams being scaled up across South Africa and would have a substantial impact on reducing deaths from these illnesses,” they say.
The Unicef report says deaths from pneumonia and diarrhoea were largely preventable through optimal breastfeeding practices and adequate nutrition, vaccinations, hand washing with soap, safe drinking water and basic sanitation, among other measures.
In the next three years, more than two million child deaths from pneumonia and diarrhoea could be averted across the 75 countries with the highest mortality burden if national coverage of key pneumonia and diarrhoea interventions were raised to the level in the richest 20 percent of households in each country.
New vaccines against major causes of pneumonia and diarrhoea are available, but vulnerable children are not being reached.
Exclusive breastfeeding during the first six months of life is one of the most cost-effective interventions and greatly reduces the risk of a baby dying of pneumonia or diarrhoea. Less than 40 percent of children under six months of age in developing countries is exclusively breastfed.
Nearly 90 percent of deaths from diarrhoea worldwide has been attributed to unsafe water, inadequate sanitation and poor hygiene.
Despite attaining the UN’s Millennium Development Goal of improved drinking water sources, 783 million people worldwide do not have access to this supply, while 2.5 billion do not use an improved sanitation facility.
Hand washing with water and soap is among the most cost-effective health interventions to reduce the incidence of childhood pneumonia and diarrhoea.
Timely recognition of key pneumonia symptoms by caregivers followed by seeking care and antibiotic treatment for bacterial pneumonia is lifesaving. In spite of an increase in seeking care for children, appropriate treatment remains low with less than a third of children with suspected pneumonia receiving antibiotics.
At risk of dying from dehydration, children with diarrhoea require early and appropriate fluid replacement as the main intervention to prevent death.
Yet few children with diarrhoea in developing countries receive appropriate treatment with oral rehydration therapy and continued feeding.
Even fewer receive solutions made of oral rehydration salts with no real progress on this front in the past decade.
In South Africa, less than half (40 percent) of children has access to oral rehydration therapy but in rural areas, this is only 32 percent.
Poor nutrition is an important underlying risk that often interacts with infections.
A malaria infection may interact with other illnesses to increase susceptibility or severity of pneumonia or diarrhoea, while HIV places a child at high risk of either condition. – Health-e News Service