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How to spot pneumonia

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pneumonia (disease or medical condition)

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Global Health Issue
Here's the problem

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Pneumonia claims the lives of the world's most vulnerable children

Pneumonia remains the leading infectious cause of death among children under five, killing 2,500 children a day. Pneumonia accounted for 15 per cent of all under-five deaths and killed 920,000 children in 2015. Most of its victims were less than 2 years old.

Mortality due to childhood pneumonia is strongly linked to poverty-related factors such as undernutrition, lack of safe water and sanitation, indoor air pollution and inadequate access to health care. An integrative approach is urgently needed to tackle this important public health issue.

Around half of childhood pneumonia deaths are associated with air pollution. The effects of indoor air pollution kill more children globally than outdoor air pollution. At the same time, around 2 billion children 0-17 years of age live in areas where outdoor air pollution exceeds international guideline limits.

The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) sets forth an integrated framework of key interventions proven to effectively protect children's health, prevent disease and appropriately treat children who do fall ill with diarrhoea and pneumonia.

Protective interventions provide the foundations for keeping children healthy and free of disease

Exclusive breastfeeding for the first 6 months of life (without additional foods or liquids, including water) protects infants from disease and guarantees them a food source that is safe, clean, accessible and perfectly tailored to their needs. Nearly half of all diarrhoea episodes and one-third of all respiratory infections could be prevented with increased breastfeeding in low- and middle-income countries.

Adequate complementary feeding and continued breastfeeding: good nutrition supports strong immune systems and provides protection from disease. From 6 months to 2 years of age, adequate complementary feeding - providing children with adequate quantities of safe, nutritious and age-appropriate foods alongside continued breastfeeding - can reduce child deaths, including those due to pneumonia and diarrhoea.

Vitamin A supplementation: high-dose vitamin A supplementation helps maintain strong immune systems and can reduce all-cause mortality by 24 per cent and cases of diarrhea by 15 per cent. Children between the ages of 6-59 months should be protected with 2 high-dose supplements of vitamin A every year in countries with high under-five mortality or where vitamin A deficiency is a public health problem.

Preventative interventions help stop disease transmission and prevent children from becoming ill

Immunization: The Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCV) are effective in preventing the two most common bacterial causes of childhood pneumonia and the rotavirus vaccine provides protection against one of the most common causes of childhood diarrhoea-related death.
The use of vaccines against measles and pertussis in national immunization programmes substantially reduces pneumonia illness and death in children.

B. Percentage of surviving infants who received the third dose of PCV vaccine

Safe drinking water, sanitation and hygiene: Almost 60 per cent of deaths due to diarrhoea worldwide are attributable to unsafe drinking water and poor hygiene and sanitation. Hand washing with soap alone can cut the risk of diarrhoea by at least 40 per cent and significantly lower the risk of respiratory infections. Clean home environments and good hygiene are important for preventing the spread of both pneumonia and diarrhoea. Safe drinking water and proper disposal of human waste, including child faeces, are vital to stopping the spread of diarrhoeal disease among children and adults.

Reduced household air pollution: More than 40 per cent of the world's population rely on solid fuels (wood, coal, animal dung and crop waste) to cook and heat their homes, exposing children to household air pollution and almost doubling their risk of pneumonia. Improved household air quality can reduce cases of severe pneumonia while also preventing burns, saving time and reducing fuel costs. The use of chimney stoves can cut household air pollution by half, reducing severe pneumonia by almost 30 per cent.

HIV prevention: Preventing HIV and treating HIV infections with antiretroviral drugs helps maintain the immune system and reduce the risk of contracting pneumonia. Co-trimoxazole prophylaxis provides further pneumonia-related protection for HIV-infected and exposed children and can reduce AIDS deaths by 33 per cent.

Treatment interventions - when timely and appropriate can cure children from pneumonia and ensure survival

Saving children from pneumonia requires urgent action and recognizing danger signs - including fast and difficult breathing and a cough - is the first step. The treatment for most types of serious pneumonia is usually antibiotics, which typically cost less than 50 cents for a full treatment. However, not all children with symptoms of pneumonia should receive antibiotics: According to the WHO and UNICEF Integrated Management of Childhood Illness guidelines, only those cases classified by a health worker as pneumonia should be treated with antibiotics. Moreover, not all children classified as such have true pneumonia. That said, in settings without adequate diagnostic tools, the WHO/UNICEF guidelines provide a common standard by which health workers can assess and classify bacterial pneumonia illnesses requiring antibiotic treatment. Although it cannot be assumed that all children with symptoms have bacterial pneumonia and should receive antibiotics, the data indicate a big gap between the rich and the poor in treatment of symptoms of pneumonia: The poorest children in the poorest countries are least likely to receive treatment when ill. This gap is particularly wide in sub-Saharan Africa and South Asia.

Taking children to a health care provider quickly can save their lives, yet, worldwide, only about two-thirds of children receive the necessary help and care when pneumonia symptoms arise. In sub-Saharan Africa, where most pneumonia deaths occur, less than 50 per cent of children with pneumonia symptoms are taken for care. As data from population-based survey data indicate, there has not been major progress in careseeking behavior for pneumonia symptoms since 2000.

Percentage of children with symptoms of pneumonia taken for care to a health provider, by wealth quintile and region, 2015

Percentage of children with symptoms of pneumonia taken for care to a health provider, by residence and region, 2015

UNICEF, One is too many: Ending child deaths from pneumonia and diarrhea, UNICEF, New York, 2016.

UNICEF, Clean the air for children, UNICEF, New York, 2016

UNICEF, Committing to Child Survival: A promise renewed - Progress report 2015, UNICEF, New York, 2015

United Nations Inter-agency Group for Child Mortality Estimation (IGME), Levels and Trends in Child Mortality: Report 2015, WHO and UNICEF, New York, 2015

Ending Preventable Child Deaths from Pneumonia and Diarrhoea by 2025: The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD), WHO, Geneva, 2013.

UNICEF, Pneumonia and Diarrhoea: Tackling the deadliest diseases for the world's poorest children, UNICEF, New York, 2012.

WHO and UNICEF, Global Action Plan for the Prevention and Control of Pneumonia (GAPP): Report of an informal consultation, WHO, Geneva, 2008.

WHO and UNICEF, Integrated Management of Childhood Illness, WHO, Geneva, 2008.

UNICEF and WHO, Pneumonia: The forgotten killer of children, UNICEF, New York, 2006.

Peer-reviewed Publications

Liu, Li , et al. (2015), 'Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis', Lancet, 385, 430-40.

Campbell, H., et al., 'Measuring Coverage in MNCH: Challenges in monitoring the proportion of young children with pneumonia who receive antibiotic treatment', in PLOS Medicine: published 7 May 2013, info:doi/10.1371/journal.pmed.1001421 (see: PLOS Collection: Measuring Coverage in Maternal, Newborn, and Child Health).

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Pneumonia claims the lives of the world's most vulnerable children Pneumonia remains the leading infectious cause of death among children under five, killing 2,500 children a day. Pneumonia accounted for 15 per cent of all under-five deaths and killed 920,000 children in 2015. Most of its victims were less than 2 years old.

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17 children a hour die under the age of five die

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'A chance at life' - Tackling child mortality in Madhya Pradesh, India

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In the Indian State of Madhya Pradesh, the 'storm' of poverty, food insecurity and malnutrition leads to an alarming number of child deaths. UNICEF correspondent Priyanka Pruthi reports on efforts to tackle child mortality in the state For more information, visit: http://www.unicef.org/infobycountry/india_67695.html

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Video explanation of what Pneumonia is.

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pneumonia (disease or medical condition)

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An animation for healthcare instructions for Rural India.

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India's Leading in the world with highest child mortality rates

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India's Leading in the world with highest child mortality rates

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Staff Reporter

The country has 44 million cases while China reported 18 million, says report

NEW DELHI: India tops the list of 15 countries that account for three-quarters of childhood pneumonia cases worldwide.

World over, pneumonia kills more children than any other illness AIDS, malaria and measles combined states a report `Pneumonia the forgotten killer of children,' brought out by the United Nations Children's Fund (UNICEF) and World Health Organisation (WHO).

According to the report, India, with 44 million pneumonia cases, China with 18 million cases and Nigeria and Pakistan with seven million cases top the chart.

Respiratory infections

The disease causes acute infections in any part of the respiratory system from the middle ear to the nose to the lungs. Acute respiratory infection is also a serious problem in India, accounting for 14.3 per cent deaths during infancy and 15.9 per cent deaths among children aged between 1-5 years in India, claim studies undertaken by experts.

It is estimated that more than 150 million cases of pneumonia occur every year among children under five in developing countries, accounting for more than 95 per cent of all new cases worldwide.

Between 11 million and 20 million children with pneumonia will require hospitalisation, and more than two million will die from the disease, the report warns.

Stating that the incidence of pneumonia among children decreases with age, the report says that South Asia and sub-Saharan Africa bear the burden of more than half of the total number of pneumonia episodes worldwide among children under five.

The Unicef/WHO report states that effective interventions can save over a million lives.

"Preventing children from developing pneumonia in the first place is essential for reducing child deaths. Key prevention measures include promoting adequate nutrition [including breast feeding and zinc intake], raising immunisation rates and reducing air pollution."

Recent research also suggests that hand washing may help reduce the incidence of pneumonia. "Prompt treatment of pneumonia with a full course of appropriate antibiotic is life-saving," the report notes.

The UNICEF and the WHO have published guidelines to diagnose and treat pneumonia in community settings in developing world.

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Staff Reporter The country has 44 million cases while China reported 18 million, says report NEW DELHI: India tops the list of 15 countries that account for three-quarters of childhood pneumonia cases worldwide.

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Here's a solution.

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Looking out over India from the north-west Himalayas, Mandi was the perfect setting for an historic day for public health last week, whose consequences will reach across the whole country. Our town in hilly Himachal Pradesh witnessed the launch of the pneumococcal vaccine as part of India's Universal Immunization Programme, which will protect children against pneumococcal diseases such as pneumonia and meningitis. This momentous step will save lives and address India's burden of pneumonia, which is one of the world's highest.
Photo: formal dress at the launch ceremony last week.
The vaccine is being launched in a phased manner across India, covering Himachal Pradesh, parts of Bihar and Uttar Pradesh in its first phase, before expanding to Madhya Pradesh and Rajasthan next year and eventually the entire country. With this shot, the government program strengthens its effort to reduce vaccine preventable deaths among young children. In India, pneumonia is a ruthless killer of more children under five years of age than any other infectious disease. The pentavalent vaccine, which is already part of the immunization programme, protects against pneumonia caused by Haemophilus influenza type b (Hib) . With the introduction of pneumococcal vaccine, we should see a decline in the number of child deaths from pneumococcal pneumonia.

The launch event saw many distinguished individuals join nurses and health workers to sign a pledge to ensure every child receives the new vaccine. Among them were Jagat Prakash Nadda, Union Minister for Health and Family Welfare, Vandana Gurnani, Joint Secretary for Reproductive & Child Health, Ministry of Health and Family Welfare, and Kaul Singh Thakur, Himachal Pradesh Health Minister.

Speaking at the event, the Union Health Minister said that the launch of pneumococcal vaccine was in line with the Prime Minister's commitment to saving child lives. He emphasized the importance of preventive measures to preserve health, not just stop disease. The vaccine will not only prevent child deaths, but reduce the number of children being hospitalized due to pneumonia, reducing the economic burden on the families, he added. Heralding the vaccine as a tool for creating equity, the health minister said that the vaccine will be accessible for free to those who needed it the most. The Himachal Pradesh Health Minister, Kaul Singh Thakur welcomed the vaccine introduction in the state, and spoke about how it would help improve the child health indictors in the state, which already were among the best in the country.
Photo: Health minister JP Nadda at the launch.
The launch of the pneumococcal vaccine follows the introduction of three new vaccines: inactivated poliovirus vaccine (IPV), rotavirus vaccine (RVV), and measles-rubella (MR) vaccine into the immunization programme in the last year alone. India's vaccine programme will now provide vaccines against 12 life threatening diseases, free of cost, to 26 million children annually. It is a small step in protection against pneumonia, a giant leap towards child health.

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A shot at tackling childhood pneumonia in India

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Dr. Mangla Sood, State Immunization Officer, Himachal Pradesh Looking out over India from the north-west Himalayas, Mandi was the perfect setting for an historic day for public health last week, whose consequences will reach across the whole country. Our town in hilly Himachal Pradesh witnessed the

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Weekend Express: Pneumonia is the leading cause of death in children

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Why Are American Health Care Costs So High?