Pneumonia has been cited as a leading cause of death among children below the age of 5 and experts say in this day and age this shouldn’€™t be happening. It is caused by a bacterial infection which, in turn, causes a number of other infections known as pneumococcal diseases.

Pneumonia is a lung infection that can severely affect one’€™s breathing and is more common in children. Professor Shabir Madhi, of Wits University, says children in developing countries are at a higher risk of developing pneumonia due to a number of factors.

‘€œPneumococcal disease is much more common in developing countries like Africa. Forty-five percent of all children that die of pneumococcal disease die in Africa. The reason why children in Africa die and the reason why they are more susceptible to developing it is them living in overcrowded settings, them having limited access to getting treatment or antibiotics at the correct time, them being exposed to pollution such as in-door pollution or even parents smoking. These are some of the predisposing factors that can cause a child to develop pneumonia’€, Professor Madhi says.

He adds that pneumonia ranks the highest amongst diseases caused by pneumococcal bacteria.

‘€œPneumococcal disease causes children to develop brain infections such as meningitis, lung infections like pneumonia and infections in the ears. The reason why children develop pneumococcal disease is, firstly, children under the age of two… they’€™ve got a very immature immune system and that on its own predisposes children from developing pneumonia. But, any child that may have any other underlying reason why the immune system might be weak will also develop pneumococcal disease. For example, children who are malnourished, HIV-positive, children that have any problems with the lung ‘€“ will be more prone to getting it’€, he says.

There are a number of ways to protect children from getting pneumonia and other pneumococcal illness, but, Madhi stresses the importance of getting children vaccinated.

‘€œChildren need to be breast-fed exclusively for the first six months. People need to minimise the exposure of children to pollutants, so parents shouldn’€™t be smoking near children. But, the intervention most likely to heed the greatest deal of benefit in the shortest space of time is vaccination. What is available to us now is a vaccine that targets the most important strains of pneumococcal (diseases), which is the pneumococcal conjugate vaccine. This vaccine prevents children from getting pneumococcal disease, from developing pneumonia and meningitis. In fact, what we know is that by vaccinating children from very poor settings such as rural settings you can prevent 16% of those children from dying’€, says Madhi.

However, pneumonia is not a threat to children alone, even adults are at risk. At Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, pulmonologist, Professor Guy Richards, says the contributing factor to the development of pneumonia in adults is HIV/AIDS.  

‘€œBecause of the fact that people are immune compromised or may be immune compromised with HIV; they become more susceptible to these infections. Therefore, the largest numbers of people we see being admitted with pneumonia have HIV and AIDS. They are immune compromised’€, says Professor Richards.

He says at Charlotte Maxeke, they see up to 20 cases of pneumonia a day, the majority of who are HIV-positive and don’€™t know it. Consequently, they get very ill with pneumonia without having sought the medication for the primary cause of illness, being HIV.

‘€œThe vast majority of people who were admitted to this hospital who have pneumonia and are HIV-positive and have AIDS are not on ARVs, and that’€™s why they’€™re still so susceptible. As a consequence, there are often people who might leave any form of therapy late.  In other words, they have not sought help for the primary disorder, which is the HIV/AIDS often, and then they will often present late with pneumonia’€, says Richards.

He says other reasons that can cause people to present themselves late are that they come from areas where there is poor transport services, poverty is high and there is no money for transport, they go to a state hospital where they have to wait in long queues, and are often too sick to wait, so they go home.