As recent studies have shown, pneumonia has replaced malaria as the highest killer of children in Nigeria. Martins Ifijeh writes on the need for government, stakeholders and health bodies to step up preventive measure and management of the killer disease
While child death is increasing in most regions of the world, even in some developing countries, the same cannot be said of Nigeria, which prides itself as the giant of Africa and the economic hub of the continent. Rather, the prevalence rates of child deaths due to various diseases has continued to soar, with malaria known to top the chart for several years as the highest killer of children in the country.
Just as the country is still battling with reducing malaria scourge, especially among women and children, who are the most hit, pneumonia, one of Nigeria’s most misunderstood diseases is now killing children more than malaria in the country if the recent report by the International Vaccines Access Centre (IVAC) is anything to go by.
The report shows that in 2015, about 17 per cent of deaths and 10 per cent of deaths of all under-five deaths were caused by pneumonia and diarrhoea, respectively, suggesting that malaria is now second placed among child killer diseases in the country.
With most Nigerians believing that pneumonia is caused by exposure to cold weather, food and water, thereby ignorantly warning their children not to take cold drinks or water to avoid contracting the disease, experts say this may be a major part of a larger picture fueling the increased prevalence of the disease in the country.
Available statistics show that pneumonia kills a staggering 1.6 million people globally every year with children under age five bearing the brunt of the crisis, especially in underdeveloped and developing countries.
According to the World HealthOrganisation, pneumonia is preventable and treatable. But WHO said that every 20 seconds, a child somewhere in the world dies of pneumonia, making it the number one infectious killer of children across the globe, especially in Africa where even malaria is known to be the commonest of diseases.
Africa has been known to be badly hit by the pneumonia scourge compared to other continents. Again, according to reports, Nigeria is taking the lead in incidence rate on the continent.
Available statistics also show that an estimated 6.7 million cases of childhood pneumonia is recorded in Nigeria every year with about 200, 000 children under the age of five dying from the preventable disease annually. In essence, every one hour, 20 children die from pneumonia in Nigeria.
According to reports, among five children in Nigeria that die of childhood killer diseases,two are killed by pneumonia.
Now, experts are calling on stakeholders and the governments at local, state and national levels to scale up awareness of the disease, just as it is currently doing for malaria, polio andHIV/AIDS. They are also calling on Nigerians to put measures in place to prevent the disease from taking away their loved ones.
The Project Head, Perfect Health Initiative, Dr. Omons Okumale said most people do not know about pneumonia and how it can be prevented. Adding that the lack of awareness was responsible for its prevalence, especially in children whose immunity is not as strong as that of adults.
“Pneumonia is a severe disease, because the body gets oxygen through the lungs and once the brain does not get oxygen in three minutes, death occurs.That is why it is a very fatal disease,” Okumale explained.
He said though pneumonia was more prevalent in the western world, “it is not the most common cause of death for them, because they know how to deal with their issues, they have preventive measures in place to tackle it unlike us here where it is a growing concern.”
On why children are more prone to the disease, Okumale said they were more prone to it because their immune system was very low. “Apart from children, other people also at high risk of the disease are the immune compromised people. I mean persons with Human Immuno Virus (HIV) and those on drugs like corticosteroids. Also prone to it is the elderly because at their age their immunity is low,” he said.
According to him, pneumonia happens because of infections caused by bacteria, fungi, viruses, and other types of germs. He added: “Chemical causes should not be left out also. Assuming one mistakenly drinks kerosine, a quantity of it could go into the lungs causing chemical pneumonia.
“The cause of pneumonia determines the treatment. Before treatment, one must first do a diagnosis to know which of the germs is the remote cause, so that the physician can know exactly which medication to use.”
What are the symptoms of pneumonia and how do they manifest? He said the most common symptom includes cough, fever and shortness of breath. “God gave everyone cough as a defense mechanism to push out foreign bodies from the respiratory tract. Also, shortness of breathe is understandable because since there is infection in the alveoli, there definitely will be difficulty in exchanging gases with the blood, vice versa,” he said.
To compensate for the inadequate oxygen to the blood, he said the lung breathes faster and shorter so as to make up for the fact that each breathing during pneumonia does not deliver enough oxygen to the blood. “There could be loss of appetite as well as weakness. Even when the person eats, there is not enough oxygen to metabolise the food, hence the body becomes weak. There could sometime be chest pain,” he explained further.
Can cold weather cause pneumonia? Okumale said pneumonia was caused by germs against the misconception about cold weather which most people make reference to. “If it was due to cold, all the children in cold regions abroad would have contracted it by now. When this bacteria or virus gets into the body either through the mouth or other openings in the body, it goes to the gut and contaminates the blood and goes into the respiratory apparatus to cause problem there. That is pneumonia.
“People must understand that the most viable way pneumonia is transmitted is through germs contracted under poor sanitation and hygiene.It is not prevented or treated by wearing clothes that cover every part of the body or being in a warm environment,” he said. He said children exposed to cigarette smoke, those who do not participate in routine pneumonia programmes and those exposed to smoke from charcoal or firewood are more at risk of the disease.
He, however said the myth about cold being a causal effect may not be totally discarded, as the assumption could have an element of fact, adding that the germs causing the disease thrives more in cold weather, but noted that because the disease thrives more in cold environment does not mean cold is the source of the disease.
“That is why it is a very common disease abroad. Even at that, it is not the most common cause of death over there because they sure know how to take care of themselves. They have vaccines against it. The reason people are still dying of malaria today is because it is an African problem. If it was the advanced countries’ problem, they would have developed vaccines against it.Warm environment is a little bit not conducive for pneumonia virus to thrive,” he added.
Harping on the causal agents, he noted that there were different bacteria or viruses responsible for pneumonia, hence the need to identify which kind of germ causes a particular pneumonia before treatment can be initiated for the patient.
“There are anti-bacterial drugs for the pneumonia caused by bacteria, which usually is administered over a long period of time. But with the new drugs developed, the medication might last just few days. If the pneumonia is severe and the person is having fast and short breathe, it is necessary to put the person on oxygen as a temporary measure before treating for pneumonia itself.
For a Consultant Paediatrician, Dr. Odom Ebizimo, most Nigerians do not know that there are vaccines available to immunise them against pneumonia, stressing that it is necessary they take advantage of it and prevent undue illnesses and death in the country.
According to him, awareness is the major factor that can reduce the high number of deaths due to childhood pneumonia. “In advance countries, there are a lot of vaccines for various respiratory infections and their citizens know about them. So it’s easy to access such facilities unlike here in Nigeria where most people may not be aware. The prevalence of pneumonia is not as high in western countries compared to ours.
“Recently, Nigerian government added two new respiratory vaccines to the one they give to children at six weeks or 10 weeks. Even on individual basis, these vaccines can be sourced from private hospitals, but they will be of course more expensive. Pneumonia is preventable in Nigeria if vaccines are taken,” he noted.
Ebizimo who said clean environment has a major role to play in the prevention of pneumonia painted a scenario where over 10 people sleep in one room,especially in cities like Lagos, and then questioned why pneumonia would not thrive in such an environment.
“Government has been doing a lot in creating awareness for Nigerians to immunise themselves against diseases like polio, measles, tuberculosis and a host of others. But more awareness should be created especially forpneumonia.
“Nigerians should be encouraged to immunise themselves against pneumonia. People should also live in a well ventilated place. Offices and other closed rooms should be well ventilated as well,” he added.