Pneumonia number one illness in babies

DESPITE an excellent immunisation programme, pneumonia still stalks far too many children in South Africa.

This is the finding of the Drakenstein Child Health Study, which is tracking 1 000 motherchild pairs in the Paarl area of the Western Cape over several years.

Pneumonia is the number one killer of children under five, claiming around one million lives a year worldwide, and the burden is disproportionately high in Africa.

The key lesson from the study, said lead University of Cape Town researcher Professor Heather Zar, is that despite vaccines, low prevalence of HIV in children and good access to care, pneumonia remains a “major cause of childhood illness”.

She said: “We found that pneumonia remains a major cause of illness (incidence 0.27 episodes per child per year) and hospitalisation, particularly in the first six months of life, despite excellent immunisation coverage.”

To combat pneumonia, SA was the first country on the continent to immunise babies against Streptococcus pneumoniae. The vaccine was introduced for infants at six weeks and 10 weeks in 2009, and replaced with an improved one in 2011.

The study says it is not only high exposure to pathogens that fuel the situation; it is also factors such as “smoke exposure, lack of breast-feeding, prematurity, low birth weight, low socio-economic status, crowded living conditions or HIV infection”.

Mncedisi Twala, head of the Abemi Grassroots Movement in Cape Town, says overcrowding is a major concern. “Adults get sick but there are so many in shack or house that the virus moves quickly from one family member to another.”

Parents also “struggle to find the R20 needed for transport to health centres, and when they do get there and get medication for their kids, they come home to the same conditions as before”.

According to the World Health Organisation, “indoor air pollution caused by cooking and heating with wood” is also a major factor.

And when immune systems are compromised by malnutrition or undernourishment, children cannot easily fight off pneumonia.

Zar and her team say novel strategies are needed, and one under discussion involves immunising pregnant women in the third trimester.