Like all the killer diseases ravaging children, mostly in the developing countries of Africa and Asia, pneumonia has emerged as a major cause of infant morbidity and mortality in Nigeria. A recent report has it that no fewer than 20 children under the age of five years die of the disease in the country every hour. Further research also reveals that, at the global level, Nigeria, with 7 million cases, is placed third among the 15 countries accounting for three quarters of the burden of childhood pneumonia cases. This is not only alarming but embarrassing.
Together with diarrhoea and malaria, pneumonia is the biggest threat to the survival of under-five children in the country. It is estimated that of every five deaths in Nigeria from childhood killer diseases, two are from pneumonia. This is a story that tugs at the heartstrings. What kind of a country is it that does not have feelings even for the innocent lives of those regarded as its future? The Nigerian government has failed to realise that the level of civilisation of a given society is measured partly by the kind of protection it offers to the weakest and the most vulnerable of its citizens.
The feeling of apathy towards the Nigerian authorities derives mainly from the fact that the disease that is causing so much havoc can be controlled; it is a disease that can be prevented and treated. Indeed, in countries that place premium on the welfare of children, the incidence has been reduced drastically. This is why both parents and the health authorities should be able to pull out all the stops to end the free rein of pneumonia and all the other childhood killer diseases that seem to define the Nigerian nationhood.
Pneumonia is defined by the World Health Organisation as “a form of acute respiratory infection that affects the lungs”, while, to the British Lung Foundation, it is simply “a type of chest infection”. The lungs, the main organs for breathing, are made up of little sacs called alveoli, which help in carrying the oxygen needed for human survival. But in an infected person, the sacs become filled with pus, instead of oxygen, which limits oxygen intake and makes breathing difficult.
The disease has been able to wreak so much havoc in Nigeria, especially in the rural areas, due to ignorance. Many believe that it is caused by cold weather; but the fact remains that it is an infectious disease caused by microorganisms. There are, in the main, three types of pneumonia, depending on the pathogen that is responsible for a particular case. Apart from the infection caused by bacteria, there are also those caused by virus and fungi, among other causes, which make the treatment slightly different.
However, the most common among children is bacterial, caused by Streptococcus pneumonia; followed by another bacterial pneumonia, caused by Haemophilus influenzae type B, also known as Hib. While the most common viral pneumonia is caused by respiratory syncytial virus, Pnuemocystis jiroveci has been identified as the most common cause of the disease in HIV-infected children and is responsible for at least a quarter of pneumonia deaths in HIV-infected infants, according to WHO.
Although children have emerged as the greatest victims of pneumonia, the disease is not limited to them. In fact, during the last presidential campaign in the United States, Hillary Clinton, one of the candidates, had to temporarily suspend her campaign because she went down with pneumonia. The difference, however, is that it is not as fatal in adults as it is in children whose immune systems are not yet well developed. It is believed that as children grow older, they are more likely to survive the disease. In the same vein, people of advanced age are susceptible, because their immune systems are gradually weakened by old age.
Symptoms of the disease include cough, which may be accompanied by fever. In children, the difficulty in breathing is noticed as the child tries to take in more oxygen by breathing faster to make up for the limited oxygen that is permitted by the infected alveoli. In very severe cases, the child may have difficulty eating, resulting in unconsciousness, convulsion and hypothermia (a considerable drop in body temperature).
The disease is spread through inhalation of the pathogens in airborne droplets after an infected person may have released them through coughing or sneezing. It is also believed that they are present in the nose and throat and if the air is not filtered could later infect the lungs. But it should be noted that living in crowded conditions and exposure to smoke predisposes people to pneumonia. Indoor air pollution through exposure to biomass fuel such as firewood during cooking is also an environmental risk factor. These risk factors should, therefore, be avoided.
As with many other diseases, preventing pneumonia is far more important that seeking cure. Adequate nutrition, which helps in keeping a high level of immunity, and sanitation are very important in its prevention. In children who are not yet six months old, exclusive breastfeeding is cardinal to keeping pneumonia at bay as the baby whose immune system is not yet well developed benefits from the mother’s immunity and can fight off the disease.
As with tuberculosis and other diseases, the presence of HIV worsens the case for people with pneumonia and increases the chances of infection for those not yet infected. But there are drugs, recommended by doctors that can be taken regularly to prevent pneumonia in an HIV-infected person.
According to UNICEF and WHO, people should be vaccinated to prevent infections. But, besides vaccination, a high level of hygiene is needed, especially the washing of hands with soap regularly. There is also the need for Nigeria to develop a functional national health plan as has been done by some other countries that will take care of pneumonia. The level of awareness should be increased so that people know what to do when confronted with cases of pneumonia.