Prevention and control of childhood pneumonia

This month’s WHO Bulletin, led by the Global Action Plan for the Prevention and Control of Pneumonia (GAPP), focuses on the prevention and control of childhood pneumonia. It highlights research on the many aspects that drive this deadly disease and the progress now being made – progress that is a priority if Millennium Development Goal 4 to reduce child mortality is to be achieved.

Why this attention on childhood pneumonia? It is the leading killer of children worldwide with more than two million children under the age of five dying of the disease each year. The highest rates and greatest burden of pneumonia occurs in Africa and Asia and special attention must be paid to these regions. Children with compromised immune systems, such as those who are undernourished, of low birth-weight or are HIV positive, are at greater risk. Environmental factors including overcrowding in homes and exposure to indoor air pollution can also make children more susceptible. Pneumonia places a huge burden on families and health systems and effective interventions (prevention and case management) are essential to address it.

Proven preventive measures, many of which are addressed in the special issue of the Bulletin include immunisation, promotion of exclusive breast feeding during the first few months of life, zinc supplementation, control of indoor air pollution, prevention of mother to child HIV transmission and pneumonia prophylaxis in high HIV prevalent areas.

Two interventions have been proven effective – vaccination and case management, but these measures alone are unlikely to completely prevent childhood pneumonia and key challenges remain. Prompt treatment with effective antibiotics can save lives, but to ensure that this is implemented successfully, health workers need to be properly trained to diagnose and treat pneumonia and families must seek care without delay. The Bulletin reports successes such as community-based management in Nepal, which doubled the number of children treated, and ongoing research ranging from the impact of delayed care-seeking in Uganda to the implementation of an oxygen concentrator system in Malawi.

If the scientific community, the public and policy-makers act now, millions of needless deaths around the world can be prevented. It is imperative that we work together to adopt, fund and implement measures preventing deadly childhood pneumonia from striking the world’s most vulnerable.

(Source: GAVI’s PneumoADIP: May 2008)