Killer in disguise

Indian and International experts in child health have urged to take immediate steps to control and prevent pneumonia morbidity and morality...

Written by EXPRESS FEATURES SERVICE | Published: April 8, 2009 2:08 am

Pneumonia is a leading killer of children under five years and vaccination can prevent death of 100,000 children in India,say experts

Indian and International experts in child health have urged to take immediate steps to control and prevent pneumonia morbidity and morality,which they say is the leading cause of death among children under-five years of age in India and other developing countries.

“India leads the world in under-five mortality,with 20 lakh children dying every year,” says Dr Jagdish Dhekne on the occasion of the Pune Pneumococcal Disease Conference. “Of these,four lakh deaths are due to pneumonia,” he adds.

The conference is jointly hosted by Asian Strategic Alliance for Pneumococcal disease prevention-India chapter (ASAP-India) and Indian Academy of Pediatrics (IAP). Around 125 pediatricians from Pune and around are participating in the event.

Pneumonia is inflammation of the lungs. The bacterium Streptococcus pneumoniae or pneumococcus is the leading cause of pneumonia right from infancy to adulthood. Streptococcus pneumoniae can also cause other serious infections such as bacteremia (blood infection),meningitis (infection of the coverings of brain and spinal cord),sinusitis (infection of the sinuses) and otitis media (middle ear infection). “This group of diseases is collectively called pneumococcal disease,which besides acute illness and sufferings can also lead to long term sequelae like brain damage,paralysis,learning disabilities,speech delays and at times death,” says Dr Nitin Shah,chairperson,ASAP-India and president ,Indian Academy of Pediatrics 2006.

“Half of all severe cases of pneumonia and pneumonia deaths are caused by pneumococcus and almost 40 per cent of these deaths,that is,nearly one lakh under-five deaths are preventable by use of pneumococcal conjugate vaccine in the National Immunization Programme,” says Dr Y K Amdekar.

Dr Shishir Modak,says,“Pneumonia is the forgotten killer of children. It kills more children than any other illness – more than AIDS,malaria and measles combined – according to UNICEF data,” he adds.

The speakers and participants were unanimous about the pivotal role of pneumococcal conjugate vaccine (PCV) in preventing pneumococcal disease in infants and children younger than 24 months. It also helps to protect older children up to nine years. Successful childhood national immunization programme with PCV has shown significant benefits passed on to even unvaccinated people of all ages due to the herd immunity against IPD and pneumonia.

As a next step,both ASAP-India and IAP have recommended use of PCV on one to one basis as per the IAP immunisation schedule. They also agreed to represent to the Ministry of Health to include PCV in the National Immunisation Programme. At present,PCV-7 is the only vaccine available to prevent pneumococcal diseases. Extended valent vaccines are expected in the near future.

The World Health Organisation (WHO) has identified the inclusion of PCV in national immunisation programmes as a priority,particularly in countries where the mortality rate of children under five years old is more than 50 per 1,000 live births,or where more than 50,000 children die annually. India is an ideal candidate for inclusion of PCV in the national immunisation programme,as with under-five mortality of 75 and annual death burden of more than 200,000 under the age of five years,it meets with both the above criteria.

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