Pneumonia still a major cause of mortality in Indian children

Pneumonia still a major cause of mortality in Indian children

Many children lack access to the Pneumococcal Conjugate Vaccine

New Delhi, 30 November 2017: About 20 children die every hour due to pneumonia in India, reveal recent statistics. Despite efforts being made toward universal immunization, more than 25 million children in India were not immunized with Pneumococcal Conjugate Vaccine (PCV) in 2016.Pneumonia claims more lives in children around the world than any other infectious disease. A majority of those who die are from low and middle-income countries. If this continues, the disease is likely to claim 22,587 lives 2030.

Pneumonia is an acute respiratory infection which affects the lungs. It causes difficulty in breathing and limits oxygen intake. It can be caused by bacteria, fungi or viruses and is a contagious disease.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Pneumonia in India in children under five is caused by malnutrition, low birth weight, non-exclusive breastfeeding, lack of measles immunization, indoor air pollution and overcrowding. When the germs reach the lungs, the lungs become inflamed and fill up with fluid. This causes breathing difficulties, which makes it difficult for enough oxygen to enter the bloodstream. The body's cells can't function as they normally would, and infection can't be flushed from the body. If untreated, the infection may continue to spread, leading to death. Certain children whose immune defenses or lungs are weakened by other illnesses, such as cystic fibrosis, abnormalities in the immune system or cancer (as well as by the chemotherapy used to treat cancer), may be more likely to develop pneumonia. Children whose airways or lungs are abnormal in other ways may have a higher risk.”

Pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. Children can lose their appetite and seem less energetic than normal. Babies and toddlers may seem pale and limp, and cry more than usual.

Adding further, Dr Aggarwal, said, “Pneumonia can be treated with antibiotics. A large majority of the cases can be tackled at home itself. Hospitalization is recommended only in very severe cases. Pneumonia is not contagious, but the upper respiratory viruses and bacteria that lead to it are. It is a good idea to keep kids away from anyone with stuffy or runny nose, sore throat, cough, or respiratory infection in general”.

Here are some tips to prevent pneumonia in children.

• Breastfeed regularly as it is a great way to boost immunity.
• Wash hands frequently with alcohol based sanitizer every time you blow your nose, use bathroom and before eating and preparation of food.
• Children younger than 5 should be vaccinated against pneumococcal pneumonia a common form of bacterial pneumonia.
• Keep children away from people suffering from colds, flu or other respiratory infections. This greatly increases their risk of catching an infection.

Adequate care to the mother and newborn can prevent infant mortality

Adequate care to the mother and newborn can prevent infant mortality

Quality care for small and sick newborns around the time of birth may help prevent about 80% of newborn deaths

New Delhi, 19 November 2017: About 70 of every 1000 newborn babies in India die during the first year of life. The first 4 weeks of life or the neonatal period are the most crucial for a newborn as two-thirds of all newborn deaths occur during the first week of life. In India, the period from 15^th to 21^st November is marked as the New Born Care Week with the aim of generating awareness and suggesting measures to improve the health of new born and increase child survival rates.

Infections, lack of oxygen to fetus in the womb and new born baby, premature deliveries, delivery complications, and birth defects are some of the factors that can cause newborn deaths. As per the IMA, it is important to raise awareness about the need for adequate and exclusive care for the expectant mother before delivery; and for both the mother and the new born after delivery to improve the chances of survival.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “There is a need for skilled care during birth and postnatal checkups, both of which are essential for the well-being of the mother and the newborn. A newborn requires thermal and cord care, and immediate breastfeeding. The postnatal period is the time following delivery until six weeks after birth, and health checks during this time – especially the first two days after delivery – are absolutely essential. Postnatal care can help in checking for and averting any danger signs such as insufficient feeding, fast breathing (a breathing rate of more than 60 per minute), severe chest in drawing, lethargy, fever, low body temperature, or jaundice. This is also the time when mothers are advised on how to identify and respond to these symptoms, as well as the benefits of exclusive breastfeeding and immunization.”

Proven high-impact interventions and quality care for small and sick newborns around the time of birth may help in preventing about 80% of newborn deaths. Proper and timely vaccinations are very important.

Adding further, Dr Aggarwal, said, “India has seen a significant decline of 8% in the number of infant deaths this year compared to that in the year 2016. This has largely been the result of countrywide efforts to expand health services coverage, including reproductive, maternal and newborn health services. However, there is a still a long way to go in terms of expanding the reach of such efforts into the remote areas and ensuring access to postnatal healthcare to mothers and newborns there.”

The following points are a must to remember after childbirth.

·   Wash your hands with soap or use a hand sanitizer before handling the baby.

·   Be careful to support the baby's head and neck.

·   Start breastfeeding within an hour of birth.

·   Ensure that the baby is exclusively breastfed for the first 6 months.

·   Child should be fed on demand or at least 8 times in 24 hours.

·   Avoid feeding honey, water or things other than breast milk in lieu of a ritual as it can be a source of infection to a baby.

·   Give the baby a sponge bath until the umbilical cord falls off and the navel heals completely (1-4 weeks).

·   Kangaroo Mother Care especially for low birth weight infants, wherein the baby is held in a special way stuck with the chest to provide skin to skin contact with the mother along with exclusive and frequent breastfeeding

Ozone-related premature mortality highest in India

Ozone-related premature mortality highest in India Air pollution has been under spotlight for quite some time now. Air quality in Delhi, in particular, has often been in the ‘poor’ or ‘very poor’ category since Diwali last year. Environmental pollution adds to the global burden of disease, both morbidity and mortality. High air pollution levels have been implicated in many diseases including respiratory disease, diabetes and heart disease. Air Quality Index (AQI) takes into account eight air pollutants: PM10, PM2.5, nitrogen dioxide (NO2), sulphur dioxide (SO2), Ozone (O3), Lead (Pb), Ammonia (NH3), carbon monoxide (CO). There are six AQI categories: Good (0-50), Satisfactory (51-100), Moderately polluted (101–200), Poor (201–300), Very Poor (301–400) and Severe (401-500). A new report ‘State of Global Air 2017’ released by the Health Effects Institute (HEI) and Institute for Health Metrics and Evaluation (IHME) last week states that 92% of the world’s population lives in areas with unhealthy air. All told, long-term exposure to fine particulate matter-- the most significant element of air pollution-- contributed to 4.2 million premature deaths and to a loss of 103 million healthy years of life in 2015, making air pollution the 5th highest cause of death among all health risks, including smoking, diet, and high blood pressure. As per the report, India along with China accounted for more than half of the total global attributable deaths. This report also highlighted ozone-related mortality. Globally there was a 60% increase in ozone-attributable deaths, with a striking 67% of this increase occurring in India. An estimated 2.54 lakh deaths were attributable to exposure to ozone and its impact on chronic lung disease. India recorded the highest number of premature deaths due to ozone pollution (107,800), its toll 13 times higher than Bangladesh (7900) and 21 times higher than Pakistan (5000). This report quantified air pollution using two main pollutants: PM2.5 and ozone. Surface or ground ozone is harmful, unlike the ozone layer high up in the atmosphere, which acts as a shield and protects from harmful UV rays. Ground ozone is formed by the reaction of pollutants in the vehicular and industrial emissions with sunlight. Nitrogen oxides (NOx) and volatile organic compounds (VOC) are the ozone precursors. Traffic emissions constitute more than 50% of the ozone precursors. While this report defined ozone-related deaths in numbers, it did not clarify as to how these deaths were confirmed to be due to ozone. Also, paradoxically, the levels of ozone are higher in rural areas compared to urban areas. This is because the levels of NOx are lower in rural areas. Cities have a higher NOx levels due to traffic, which neutralize ozone and keep it in or near permissible limits. Levels of PM2.5 are higher in cities. Ozone is associated with respiratory disease independent of exposure to PM2.5. Dr KK Aggarwal National President IMA and HCFI