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Childhood pneumonia mortality—a permanent global emergency

2007; Elsevier BV; Volume: 370; Issue: 9583 Linguagem: Inglês

10.1016/s0140-6736(07)61130-1

1474-547X

Kim Mulholland,

Influenza Virus Research Studies

Worldwide, pneumonia is the dominant cause of death in children. The widely accepted estimate that the condition causes close to 2 million child deaths every year is based on data from many sources, and is probably conservative. It also omits about 1 million neonatal deaths that are believed to be due to sepsis or pneumonia. Since the early 1980s, international agencies and national governments have struggled to reduce the death toll from childhood pneumonia with programmes based on early recognition and treatment at the level of the community or the primary-care health facility. Initially this approach took the form of national acute respiratory infection programmes, which since the mid 1990s have been incorporated into the strategy known as Integrated Management of Childhood Illness (IMCI). 1 Tulloch J Integrated approach to child health in developing countries. Lancet. 1999; 354: 16-20 Summary Full Text Full Text PDF Scopus (170) Google Scholar Opinions vary as to the effectiveness of this approach, which has been promoted strongly by WHO with variable support from UNICEF and other agencies. Since 2000, the prospect of pneumonia prevention by vaccination has become a reality with the increasing availability of vaccines against Haemophilus influenzae type b (Hib) and the prospect of suitable pneumococcal conjugate vaccines being available in the near future. Results of a recently completed intervention study from Guatemala have supported what several previous observational studies suggested—that reduction in household smoke exposure protects young children from pneumonia. 2 Smith KR Bruce N Weber MW et al. Impact of a chimney wood stove on risk of pneumonia in children aged less than 18 months in rural Guatemala: results from a randomized controlled trial. Symposium MS3 at the ISEE/ISEA Annual Conference, Paris, September 2006. Epidemiology. 2006; 17: S45 Crossref Google Scholar The role of malnutrition as the dominant risk factor for pneumonia suggests that strategies to improve the nutrition of young children will prevent pneumonia, yet this has never been proven in the field.