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Johns Hopkins Bloomberg School of Public Health




Pneumonia is the leading killer of children worldwide

Each year, pneumonia kills more than 4 million people and causes illness in millions more around the world. In developed countries, pneumonia primarily affects elderly persons. However, half of pneumonia-related deaths worldwide actually occur among children under age five – most of whom live in developing countries. For every child that dies from pneumonia in developed countries, more than 2,000 children die from pneumonia in developing countries.

This is why controlling pneumonia is essential to achieving Millenium Development Goal (MDG) #4 - a pledge by the world’s governments to reduce child mortality by two-thirds by 2015.

Some children are at particularly high risk of pneumonia

There are several factors that can increase a child’s risk of acquiring pneumonia:

  • Children with compromised immune systems, such as undernourished children, low birthweight infants, infants who are not breastfed, and children suffering from other illnesses, including AIDS, malaria, and influenza
  • Environmental factors, including overcrowding in homes and exposure to tobacco smoke or indoor air pollution

Bacteria cause the most severe forms of pneumonia

Pneumonia, a severe infection that affects the lungs, can be caused by bacteria, viruses or fungi. Although most cases of pneumonia are caused by viruses, bacteria cause the most severe forms of pneumonia. Severe pneumonia is characterized by high fevers and difficulty breathing, and can be fatal. The bacteria Streptococcus pneumoniae, or pneumococcus, is the most common cause of severe pneumonia among children living in the developing world. Haemophilus influenzae type b (Hib) is another common bacterial cause of pneumonia.

Diagnosing and appropriately treating pneumonia is challenging

Pneumonia in children is diagnosed most often by clinical symptoms, which include fever, coughs, and fast or difficult breathing. Chest in-drawing, grunting, nasal flaring (in young infants), and stridor are signs of severe pneumonia. Healthcare providers should be trained to recognize the symptoms of pnemonia and, when indicated, promptly treat with antibiotics or refer for more advanced care.

However, the clinical symptoms of bacterial and viral pneumonia are similar, making it difficult for providers to distinguish between these two causes. This can make appropriate treatment of pneumonia difficult. While chest x-rays and laboratory tests can be helpful in confirming pneumonia and determining its cause, use of these tools is limited by cost and technical challenges in many areas of the world.

Further, parents and caregivers may be unable to recognize the danger signs of pneumonia, or may face barriers in accessing medical care for their children, such as cost and distance. This means that many children never have the chance to reach a trained healthcare provider and receive potentially life-saving treatment.

Despite the devastating toll of pneumonia and the challenges of diagnosing and treating this disease, there is good news: solutions exist to prevent and control pneumonia and to ultimately save young lives.