World Pneumonia Day: Poor vaccination & lack of awareness make India pneumonia hotspot

Air pollution contributes 17.5 pc or nearly one in five pneumonia deaths among children under five worldwide (MIG Photos)

In 2019, India recorded over 2.5 million deaths due to pneumonia, with children under two accounting for most of the deaths and 153,000 deaths within the first month of life, says the United Nations Children’s Fund (UNICEF) in a report on the state of the deadly disease that is highly prevalent in India.

India ranked ahead of poorer neighbours like Pakistan or Bangladesh in terms of the pneumonia-related deaths in children and was behind only Nigeria in the world in terms of incidence and deaths of children due to pneumonia.

The disease is caused by bacteria or viruses and it is also a form of acute respiratory infection that leaves patients fighting for breath as their lungs get filled with fluids. Though most of the pneumonia cases are caused by bacterial infections, the disease is also caused by various viral infections and unless promptly treated, it causes serious inflammatory damage to the lungs. Children younger than 5 years and those aged above 65 years are the most vulnerable to and the worst affected by pneumonia.

“Children are more vulnerable to pneumonia due to the unawareness of the disease at the beginning stage and also a major problem is that people don’t take it seriously. The most common symptoms are coughing, difficulties in breathing and fever and children usually experience fast breathing while inhaling,” Dr Surya from Ariyalur, about 300 km southwest of Chennai, capital of Tamil Nadu, tells Media India Group.

Pneumonia affects children with weakened immune system and those who breathe highly polluted air or lack access to safe drinking water are most at risk. The rising air pollution across large parts of India has made the situation of pneumonia worse in India and nearly half of all deaths caused by pneumonia are associated with air pollution. Children with malnourishment conditions are also vulnerable to the deadly disease.

“Due to unawareness among parents and lack of immunity power pneumonia takes thousands of lives of children in India. Parents don’t take their child to the hospital. If every parent would start approaching the doctors, it is preventable at the beginning stage itself. Even when they come to us at an early stage of pneumonia, they themselves give a random reason for the fever. For example, when they come to us with their child who has high fever, they say that their kid is ill most probably as she played in the rain or due to environmental changes,” adds Dr Surya.

A report by the Institute of Health Metrics and Evaluation, a research institute based in Washington DC in the United States says that outdoor air pollution contributes 17.5 pc or nearly one in five pneumonia deaths among children under five worldwide.

Despite its rising incidence and the deadly impact, many patients or their family members still don’t take pneumonia seriously and this remains a major cause of morbidity in children as most parents remain unaware of the disease and its severity.

“At the starting stage, pneumonia can be cured by rich nutrition diet and homemade remedies or oral antibiotics. It is 99 pc preventable at the early stages but in the last stage it becomes difficult to deal with. Many people don’t go to hospital and they just think it’s a normal fever and cough. Also, due to poverty many people don’t get adequate health facilities,” explains Surya.

Prevention better & easier than cure

There are several low-cost treatments available for pneumonia including antibiotics, but pneumonia is also easily preventable with a three-dose vaccine that has long been available for children. Unfortunately, over 70 pc of children in India don’t receive the pneumococcal conjugate vaccine that has been approved by the Indian health ministry which also prepared a nationwide action plan to tackle pneumonia in 2017.

After seeing the raise of pneumonia deaths every year, Indian government also initiated Child Development Service programme, the National Health Mission and Village Health Sanitation and Nutrition Committee to reduce the burden of pneumonia. Pneumonia incidences can also be curbed by ensuring proper diet for children as well as by reducing exposure to high levels of air pollution or polluted water.

“Even though the government is taking steps to prevent this disease, but it can’t change the scenario until people understand the seriousness of the disease. It has a cost-effective, protective and preventive treatment, still pneumonia takes lives due to many reasons,” adds Dr. Surya.

But still tens of millions of children still await their vaccine doses, leading to calls by several public health experts who have asked for a nationwide expansion of the vaccine, instead of focusing on the so-called vulnerable parts of India as the disease is pretty much present everywhere in the country.