BANGLADESH: New vaccine could stem child pneumonia deaths

13 May 2009 12:23:57 GMT

DHAKA, 13 May 2009 (IRIN) - High levels of pneumonia continue to be reported among children in Dhaka, but a new vaccine introduced earlier this year could significantly improve the situation.

Pneumonia is responsible for 23 percent of infant deaths and 26 percent of deaths among children aged 1-5 countrywide, government statistics show.

According to the International Centre for Diarrhoeal Diseases and Research, Bangladesh (ICDDR,B), [see: http://www.icddrb.org/] a sprawling health complex and hospital in Dhaka, pneumonia is the leading cause of childhood mortality in Bangladesh.

An estimated 55,000 children under five die annually due to pneumonia, ICDDR,B reported.

Up to 60 percent of children currently being admitted to ICDDR,B for diarrhoeal diseases, also have pneumonia and bronchial infections, officials told IRIN.

About 900 diarrhoea patients are admitted each day. Half of them are children under five - and it is not only this one hospital reporting such cases.

"Over the past week, children with pulmonary diseases, common colds and influenza have increased in the hospital," Mohammad Darul Islam, a doctor at Bangladesh Institute of Child Health (BICH), told IRIN. Some 40-50 child pneumonia cases were being admitted to the BICH hospital each day, he said.

Not unusual?

However, according to Shahadat Hossain, head of the longer stay unit at ICDDR,B, the increase in pneumonia patients was not unusual.

Summer heat, combined with dampness as a result of occasional rainfall was an ideal environment for various influenza and cold microbes to multiply at this time of year, he said, adding that most pneumonia cases seen at ICDDR,B were viral in origin.

According to the Department of Environment (DoE), Dhaka is one of the most polluted cities in the world, with the extremely high levels of airborne particulate matter, [see: http://www.irinnews.org/Report.aspx?ReportId=83772] a major bronchial irritant.

Hossain also told IRIN different types of bronchial infection, influenza and other seasonal childhood infections can cause pneumonia through secondary infection.

Lack of awareness

Compounding problems is the lack of awareness amongst parents, who often mistake the early stages of pneumonia for a common cold, only seeking treatment when things deteriorate.

According to the UN Children's Fund (UNICEF), only 30 percent of under five children with suspected pneumonia are taken to an appropriate health care provider.

"Continuous sweating caused by the sweltering heat… causes children to catch cold. This cold, if untreated, may progress into pneumonia," Azad Choudhury, a leading child care specialist, told IRIN.

The fact that mothers are usually unable to detect the early stages of pneumonia, coupled with the already weakened immune system of many children due to malnourishment, makes pneumonia a leading child killer, he said.

Pneumonia-causing agents

The primary pneumonia-causing agent in Bangladesh is the pneumococcus bacteria, Choudhury said, which was readily treatable with penicillin and proper health care.

Meanwhile, haemophilus influenzae type b (Hib), a bacteria responsible for severe pneumonia, meningitis and other invasive diseases almost exclusively in children aged under five, according to the World Health Organization (WHO), remains a source of concern.

Transmitted through the respiratory tract from infected to susceptible individuals, WHO identifies Hib as a major contributor to childhood death.

Hib can result in both pneumonia and meningitis, leaving 15-35 percent of survivors with permanent disabilities such as mental retardation or deafness [see: http://www.who.int/mediacentre/factsheets/fs294/en/index.html].

Vaccine

Earlier this year, Bangladesh introduced the so-called pentavalent combination vaccine (or the DPT-Hib), a combination vaccine for five childhood diseases, including diphtheria, tetanus, pertussis, hepatitis B and Hib.

The vaccine could prevent about one third of life-threatening cases of bacterial pneumonia and up to 80 percent of probable bacterial meningitis cases in Bangladesh.

Now part of the country's routine immunisation programme, the vaccine will be given to about four million children a year.

Since about 25 percent of deaths among under fives are caused by pneumonia, the vaccine is expected to save 20,000 lives a year, the ICDDR,B says.

The Global Alliance for Vaccine and Immunization will spend more than US$95 million procuring more than 27 million doses of the vaccine in 2009 and 2010 [see: http://www.unicef.org/infobycountry/bangladesh_48001.html].