Pneumonia is still the number one killer of Bangladesh’s children under-five years of age, but experts say prevention needs a 'multi-system approach’ since most of the health facilities are not ready to deal with this lung problem.
But there are low-cost solutions that can make a difference, experts of the Research for Decision Makers (RDM) Activity of icddr,b and Data for Impact (D4I) said while interacting with the members of the Bangladesh Health Reporters’ Forum (BHRF) on Wednesday ahead of the World Pneumonia Day on Thursday. The USAID supported the event.
Presenting the latest facts and figures, the experts said that pneumonia is not a single entity; it is a combination of various health complications.
“It is important to identify the causes of pneumonia, strengthen our health system and invest in low cost local solutions to prevent pneumonia and pneumonia related deaths among children aging below 5 years,” said an icddr,b statement.
Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, according to the WHO, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.
Bangladesh has made significant progress in reducing child mortality and advancing the health sector in the past two decades. Despite that, about 24,300 children die from pneumonia in Bangladesh every year, making 18 percent of the children dying before completing 5 years of their age.
The Bangladesh Demographic and Health Survey (BDHS) 2017 found that only 42percent children aged less than 5 years with signs of lung infection were taken to a hospital/health facility and only 34percent had received an antibiotic.
According to the Bangladesh Health Facility Survey (BHFS) 2017, 45percent of the pneumonia-related deaths are occurring at health facilities, which strongly indicate the lack of readiness of the health facilities to provide appropriate treatment for childhood pneumonia.
Dr. Ahmed Ehsanur Rahman, Associate Scientist, at icddr,b informed that according to BDHS, only 5 percent health facilities of Bangladesh have the necessary preparedness to provide proper treatment to pneumonia.
The survey also found that not even half of the health facilities had oxyegn concentrator. Other oxygen sources were not available in one-third of the health facilities.
A basic tool like pulse oximetry to measure oxygen saturation was available only in one-third of the district hospitals.
Though health seeking behaviour is still not developed among parents, without strengthening the systems, the children being brought to health centres cannot be provided with effective and timely treatment.
Prof. Dr. Md. Ruhul Amin, Paediatric Pulmonologist; Prof. Dr. Samir Kumar Saha, Executive Director, Child Health Research Foundation (CHRF); Dr. Mohammad Jobayer Chisti, Senior Scientist, Hospitals, Nutrition and Clinical Sciences Division and Dr. Shams El Arifeen, Chief of Party, RDM Activity and Senior Director, Maternal and Child Health Division of icddr,b attended the session as technical experts and exchanged their views with journalists on ways to prevent these unfortunate deaths.
Prof. Dr. Ruhul Amin said that 18 percent of the children dying before completing 5 years of age are dying from pneumonia.
Still sensitivity around this disease is low. He stressed on ensuring nutrition of children by exclusive breastfeeding, complementary feeding; looking into the environmental factors such as pollution and timely treatment of children with respiratory distress can prevent pneumonia and pneumonia-related deaths.
Prof. Dr. Samir Kumar Saha identified that it is crucial to know the total number of children being affected by pneumonia every year, not only the death rate. For 50 percent of the pneumonia cases, causes are still unknown.
Without this information, in the long run, pneumonia cannot be prevented. He stressed on combining efforts to strengthen the health systems so that parents bring their children to seek treatment.
Dr. Mohammad Jobayer Chisti focused on having pulse oximetry devices in hospitals and investing on low cost local innovations. He brought the example of a shampoo bottle made low cost bubble CPAP machine that reduced death by 75 percent during trial. He also stressed on focusing on malnutrition as malnutrition causes 15 times more death among pneumonia affected children.
President of Bangladesh Health Reporters’ Forum Toufiq Maruf also attended the session.