Pneumonia, an acute respiratory infection affecting the lungs, is the leading infectious cause of death in children worldwide. In 2019, it accounted for 14% of deaths in children under 5, making it a significant global health concern. Deaths are most prevalent in southern Asia and sub-Saharan Africa. Simple interventions and low-cost treatments can prevent and manage pneumonia, offering hope for affected children and families.

Key Facts:

• Pneumonia is responsible for 14% of deaths in children under 5, claiming the lives of 740,180 children in 2019.
• It can be caused by viruses, bacteria, or fungi.
• Prevention is possible through immunization, proper nutrition, and addressing environmental factors.
• Antibiotics effectively treat bacterial pneumonia, but only one-third of affected children receive the necessary treatment.

Causes:

• Streptococcus pneumoniae is the primary bacterial cause, while Haemophilus influenzae type b (Hib) follows closely.
• Respiratory syncytial virus is the predominant viral cause.
• In HIV-infected infants, Pneumocystis jiroveci is a major contributor to pneumonia deaths.

Transmission:

• Pneumonia can spread through inhalation of viruses and bacteria from the nose or throat.
• Airborne droplets from coughs or sneezes also contribute to transmission.
• Blood transmission, particularly during and after birth, is another possible route.

Presenting Features:

• Similar symptoms in viral and bacterial pneumonia, but viral cases may exhibit more symptoms.
• Diagnosis in children under 5 involves observing fast breathing or chest wall indrawing during inhalation.
• Wheezing is more common in viral infections.
• Severe cases may lead to feeding difficulties, unconsciousness, hypothermia, and convulsions.

Risk Factors:

• Weakened immune systems due to malnutrition, lack of exclusive breastfeeding, symptomatic HIV infections, and measles.
• Environmental factors such as indoor air pollution, crowded living conditions, and parental smoking.

Treatment:

• Antibiotics, particularly amoxicillin dispersible tablets, are the first-line treatment.
• Most cases can be managed with oral antibiotics prescribed at health centers.
• Hospitalization is reserved for severe pneumonia cases.

Prevention:

• Immunization against Hib, pneumococcus, measles, and whooping cough is crucial.
• Adequate nutrition, especially exclusive breastfeeding for the first 6 months, enhances natural defenses.
• Addressing environmental factors like indoor air pollution and promoting hygiene in crowded homes reduces pneumonia risk.
• HIV-infected children may receive daily cotrimoxazole to lower pneumonia risk.

Global Initiatives:

• Countries like Bangladesh, India, Kenya, Uganda, and Zambia have comprehensive plans for pneumonia and diarrhea control.
• Integrating pneumonia-specific actions into national child health and survival strategies is a widespread approach.

Urgency and Goals:

• Effective diagnosis and treatment of pneumonia are critical for achieving Sustainable Development Goal targets.
• Ending preventable pneumonia-related deaths is an urgent priority to reduce child mortality (SDG 3.2.1).