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Johns Hopkins Bloomberg School of Public Health

Pneumonia Solutions: Prevention & Treatment

Pneumonia is the number one killer of children worldwide, and many people have no idea

It kills 1.5 million children each year. That’s 5,500 child deaths per day. Or one child death every 15 seconds.

Despite these sobering statistics, there is good news: solutions exist to prevent and treat pneumonia, and to ultimately save young lives.

In fact, implementing pneumonia prevention and treatment interventions worldwide could save one million lives each year and alleviate untold suffering. It would also significantly reduce the burden of families and communities that must cope with pneumonia-related illnesses and deaths.

To achieve this, pneumonia prevention and control must be a high priority for governments, scientists and other stakeholders. Policy changes are needed to ensure that adequate funding and infrastructure is available to deliver these solutions to people most in need, particularly those living in developing countries. And we must continue to educate parents, caregivers and providers to recognize the signs and symptoms of pneumonia and to use vaccines to prevent pneumonia before it occurs.

These efforts are critical to achieving Millennium Development Goal #4 - a pledge by the world’s governments to reduce child mortality by two-thirds by 2015.

Pneumonia prevention and treatment is possible, and can save millions of lives

There are many effective existing tools to prevent and treat childhood pneumonia deaths:

  • Protection: Ensuring that children have adequate nutrition, including exclusive breastfeeding during the first six months of life, can help protect them from pneumonia. Reducing environmental risk factors, such as overcrowding in homes, exposure to tobacco smoke and indoor air pollution are also important protective measures.
  • Prevention: The use of vaccines against pneumococcus, Hib and other diseases can help prevent pneumonia before it occurs.
  • Treatment: Early diagnosis of pneumonia to ensure that children receive early and appropriate medical care is critical. Proper treatment with antibiotics that typically cost less than one dollar per day can be life-saving.

Pneumonia treatment is an ongoing challenge; that is why preventing pneumonia before it occurs is key

The treatment for pneumonia is a prompt, appropriate course of antibiotics. These antibiotics often cost less than one dollar per day. The antibiotics cotrimoxazole and amoxicillin (ie. “first-line” drugs) are usually effective against common pneumonia-causing bacteria, and are often used to treat children in developing countries.

The type of antibiotic, as well as the route of administration (e.g. oral or intravenous), and the duration of treatment depend on several factors, including the age of the patient, the severity of the pneumonia and local patterns of antimicrobial resistance . For example, infants under two months of age with pneumonia are at risk of severe illness and death, and require treatment with intravenous antibiotics in a hospital setting. In areas where antibiotic resistance rates are high, first-line drugs may be less effective against pneumonia, requiring providers to use alternative drugs. In some settings, such as where there are large numbers of high-risk persons who are undernourished or HIV-positive, providers must adapt their treatment strategies to include drugs that are effective against PCP.

Antibiotic resistance is an increasing concern

Antibiotics can be life-saving in cases of bacterial pneumonia, but they do not help fight viral pneumonia. It can be difficult for providers to distinguish between viral and bacterial pneumonia without sophisticated, expensive testing. Giving antibiotics unnecessarily to treat viral pneumonia can contribute to the emergence of antibiotic resistance.

Many children do not receive appropriate treatment

  • The first step in getting children appropriate therapy for pneumonia is for caregivers to recognize the danger signs of pneumonia. However, one study showed that only about one in five caregivers recognized that difficult or fast breathing is a reason to seek medical care immediately.
  • The second step is for caregivers to seek appropriate medical care from providers that can correctly diagnose and treat pneumonia. Surveys indicate that only about half of children under age five in developing countries are taken to an appropriate provider when pneumnia is suspected.
  • The third step is for healthcare providers to administer antibiotics. Ultimately, only approximately one in five children with pneumonia receives a potentially life-saving antibiotic.

Treatment can be costly for families and communities

In addition to the heavy emotional toll of illness, pneumonia can cause serious financial difficulties for families and communities, contributing to the cycle of poverty. The costs of illness include:

  • Direct medical costs of illness (e.g. hospital costs, medical personnel time, diagnostics and medications)
  • Non-medical direct costs (e.g. transportation to healthcare facilities, food while hospitalized)
  • Productivity costs (e.g. lost work time for family members who must care for ill children)