By Dr. Zubair Abdulahi
All over the world, there is no single infectious entity responsible for more deaths of children than Pneumonia. Every year, around 800,000 children die from it – more deaths in one year than deaths from AIDS and Malaria combined, which is analogous to 1200 jumbo plane crashes every year.
Every minute, 2 children die from Pneumonia. According to the Centre for Diseases and Control, Pneumonia was the biggest cause of death in Nigeria in 2018.
It is also the 4th most common cause of death in all age groups, globally according to the World Health Organisation. This year, the viral pneumonia – coronavirus, has led to more excess deaths than ever recorded in modern times.
What Is Pneumonia?
Pneumonia is a complex infectious disease that affects the lungs. The alveoli are small sacs in the lungs which fill up with air when we breathe and are necessary for air exchange. In pneumonia, they are filled with pus and fluids. This limits oxygen intake and makes breathing difficult and painful. Pneumonia causes cough, fever, chills and difficulty in breathing in affected persons which may be mild or serious enough to lead to death.
Pneumonia is responsible for around 100 million infections yearly and nearly a million deaths. Children under five are the most affected group because their immune system is not fully developed and cannot adequately respond to the microorganisms that cause pneumonia. It is also a common cause of death in the elderly.
What causes pneumonia?
Pneumonia is usually caused by a pneumococcal infection caused by a bacterium called Streptococcus Pneumoniae but may be caused by other bacteria as well as viruses, and fungi. Pneumonia may also be caused by breathing in vomit or foreign objects such as chemicals or a peanut. This is commonest in children, hospitalised patients who are being fed in bed and industrial workers.
Pneumonia is also commonest in areas with poor sanitation, overcrowding, poverty, no access to safe water and healthcare. Underweight children, poorly breastfed children, children living with parents or carers who smoke, and children with congenital diseases like cleft palate or congenital heart diseases are most at risk. The viruses and bacteria that cause pneumonia are typically present in the nose or throat and can infect the lungs when inhaled. These viruses are spread when one sneeze, coughs or speaks loudly in an enclosed area. The droplets may also be deposited on surfaces such as door handles and mobiles phone which may then infect other people who come in contact with it.
What are the symptoms of Pneumonia?
The symptoms of Pneumonia may be mild, only causing mild discomfort or severe enough to require hospitalisation or even lead to death. This mostly depends on the age of the affected person, the organism causing the Pneumonia, and one’s overall health status. It may affect just one lung (called lobar pneumonia) or cause patches within both lungs (called bronchopneumonia).
The following are the signs and symptoms you may experience if you have Pneumonia. They tend to develop over a couple of days, progressively worsening if treatment is not sought.
• Cough with green, yellow or bloody mucus or dry cough
• Fast and/or shallow breathing
• Rapid heartbeat
• Fever, chills and excessive sweating
• Chest pain which is worsened by coughing
• Low energy, appetite and fatigue
• Nausea and vomiting
• Joint and muscle aches
• Confusion, especially in the elderly
Generally, bacterial pneumonia is often more serious than viral pneumonia. Pneumonia is particularly worse in the following people:
• Children under five,
• Malnourished children,
• Adults over the age of 65,
• People with underlying health conditions like diabetes,
• People who smoke,
• People with a weakened immune system, and
• People on steroid therapy or cancer treatment.
How is a diagnosis of Pneumonia made?
A doctor can diagnose pneumonia by asking a few questions, examining you and ordering a few tests which may include blood tests, blood culture, pulse oximetry, sputum tests and imaging tests like X-rays and CT scans.
How is Pneumonia treated?
In mild cases, pneumonia may be treated on an outpatient basis. In this case, you are encouraged to drink plenty of fluids, get adequate rest and use prescribed medications (typically antibiotics if a bacterial cause is suspected). Recovery occurs in a matter of days but in some instances can take weeks. When severe, pneumonia is treated in hospitals. This is to prevent complications such as sepsis, lung abscess, kidney failure, and respiratory failure.
How can Pneumonia be prevented?
Vaccines have been developed against the two of the most common bacterial causes of Pneumonia (Haemophilus influenzae type B and Streptococcus Pneumoniae) and the most common viral form of Pneumonia, Orthomyxoviridae. The pentavalent vaccine that prevents against diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B is available for children in Nigeria as part of the immunization schedule.
Preventing pneumonia also involves:
• Practising good hygiene such as covering one’s mouth with your elbow or with a disposable napkin when sneezing or coughing
• Handwashing also helps curtail the spread of the microorganisms responsible for the spread of pneumonia
• Wear a face mask and practice social distancing
• Endeavour to quit smoking and limit exposure to second-hand smoking
• Cut down on alcohol intake
• Eat healthily to help your body’s natural defence against infections.