Coping with pneumonia in children

Globally, pneumonia is the leading cause of death for children under the age of five. The World Health Organisation (WHO) estimates that more than 160 million children around the world develop pneumonia each year, out of which 20 million are hospitalised and two million die.Often, this illness begins after an upper respiratory tract infection (an infection of the nose and throat), with symptoms starting after two or three days of a cold or sore throat before moving to the lungs. Dr. Ekanem Ekure, Associate Professor in the department of Paediatrics, University of Lagos and Honorary Consultant, Lagos University Teaching Hospital talked about how to handle pneumonia in children with GERALDINE AKUTU.

What gives rise to pneumonia in children?
PNEUMONIA is an inflammation of the lung tissue by a bacteria, virus, or fungi and chemicals. It can affect one or both lungs or a segment of the lung. It can be fatal, when severe. However, mild cases do occur.

What may increase a child’s risk for pneumonia?
Poor hygiene, prematurity/low birth weight babies, malnutrition, immunosuppression from HIV infection, diabetics mellitus, lack of immunisation, overcrowding, children not exclusively breast fed, children attending Day Care, passive smoking—children always around smokers, children in homes, where they use kerosene stove and charcoal. Others are chronic health problems, such as sickle cell anaemia, congenital heart disease, chronic lung disease and chronic kidney disease.

What are the signs and symptoms parents should look out for?
Cough, chest pain, stuffy nose, fast breathing, refusal of feeds, vomiting, fever, breathlessness—mouth breathing, reduced activity and bluish discoloration of the lips in severe cases.

How is it diagnosed?
The child’s healthcare provider will have to diagnose pneumonia by his examination. The medical expert will test the child’s oxygen levels, using a pulse oximetre. Clinically, by the presence of fever, difficulty with breathing, fast heart rate, fast breathing, bluish discoloration of the lips in severe cases. Radiographically – Chest X-Ray with changes in keeping with pneumonia —opacities, which may be patchy or uniform, and in complicated cases, fluid or abnormally located air in the lungs. Laboratory test can be done in severe cases to find the cause of the pneumonia.

Is it contagious?
Depending on its cause. Contagious causes include pneumonia from tuberculosis or viruses.

How is it treated?
By use of antibiotics and use of oxygen in severe cases, while in complicated cases, surgical intervention, such as draining of abnormally located air, fluid or pus from the lungs should be done on the patient. Treatment can be done at home, but if the pneumonia is severe, the healthcare provider may want your child to stay in the hospital for proper monitoring and treatment.

How can it be prevented?
By giving children immunization, such as BCG, measles, diphtheria, pertussis, Hib, and pneumococcal conjugate vaccines. These are free and available in the National Programme of Immunisation for Nigeria- (BCG, Pentavalent vaccine, Pneumococcal conjugate vaccine, and Measles vaccine). Good ventilation in houses, proper hygiene, avoiding overcrowding, good nutrition, reduce indoor pollution from kerosene stove use, fumes, charcoal use and cigarette smoking.

Are there home remedies for pneumonia?
Soothing effects— breast feeding, plenty fluid intake, use of honey in older children (above two years). If the child condition doesn’t get better, it is advisable to take him/her to the hospital for proper examination and treatment.