Polmonite. Uccide 700,000 bambini all’anno. Eppure vaccino e cura costano quasi nulla.

Giuseppe Sandro Mela.

2022-11-20.

La polmonite uccide 700,000 bambini ogni anno, eppure è curabile con due pastiglie ed esiste il vaccino. Il tutto per pochi centesimi di dollari americani.

Il problema consiste nella precisa volontà di sterminio.

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                         La polmonite uccide più bambini di qualsiasi altra malattia infettiva. Molte persone associano la polmonite agli anziani, ma in realtà è il più grande killer infettivo dei bambini in tutto il mondo. Ogni anno miete più di 700,000 vittime tra i bambini di età inferiore ai 5 anni, tra cui oltre 153,000 neonati, particolarmente vulnerabili all’infezione. È imperdonabile che migliaia di bambini non possano accedere ai servizi e ai trattamenti sanitari essenziali che possono prevenire la polmonite e salvare loro la vita.

                         La polmonite è un’infezione respiratoria acuta dei polmoni. Non ha un’unica causa: può svilupparsi a causa di batteri, virus o funghi presenti nell’aria. Quando un bambino è infetto, i suoi polmoni si riempiono di liquido e diventa difficile respirare. I bambini il cui sistema immunitario è immaturo (ad esempio i neonati) o indebolito, ad esempio dalla denutrizione o da malattie come l’HIV, sono più vulnerabili alla polmonite.

                         Il trattamento della polmonite dipende dal tipo di polmonite. Nei Paesi in via di sviluppo, un gran numero di casi di polmonite è causato da batteri e può essere trattato con antibiotici a basso costo. Tuttavia, solo un terzo dei bambini affetti da polmonite riceve gli antibiotici di cui ha bisogno perché non ha accesso a un’assistenza sanitaria di qualità. Altre cause di polmonite sono virus o micobatteri (ad esempio quelli che causano la tubercolosi) che richiedono altri trattamenti.

                         La polmonite causata da batteri è facilmente prevenibile con i vaccini. Tuttavia, oltre il 50% dei bambini di tutto il mondo non è completamente protetto dal vaccino principale per la prevenzione della polmonite: il vaccino contro lo pneumococco (PCV). È in fase di sviluppo un nuovo vaccino per una delle principali cause virali di polmonite.

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«Pneumonia kills more children than any other infectious disease. Many people associate pneumonia with the elderly, but it is actually the biggest infectious killer of children worldwide. Every year, it claims the lives of more than 700,000 children under the age of 5, including over 153,000 newborns, who are particularly vulnerable to infection. It is inexcusable that thousands of children are unable to access the essential health services and treatments, which can prevent pneumonia and save their lives.»

«Pneumonia is an acute respiratory infection of the lungs. It doesn’t have one single cause – it can develop from either bacteria, viruses or fungi in the air. When a child is infected, their lungs are filled with fluid and it becomes difficult to breathe. Children whose immune systems are immature (i.e. newborns) or weakened – such as by undernourishment, or diseases like HIV – are more vulnerable to pneumonia»

«The treatment for pneumonia depends on the type of pneumonia. In developing countries, a large number of pneumonia cases is caused by bacteria and can be treated with low cost antibiotics. Yet only one third of children with pneumonia receive the antibiotics they need because they lack access to quality health care. Other causes of pneumonia are viruses or mycobacteria (e.g. those causing tuberculosis) requiring other treatments»

«Pneumonia caused by bacteria is easily preventable with vaccines. However, more than 50 per cent of children around the world are not fully protected with the primary vaccine to prevent pneumonia – the Pneumococcal (PCV) vaccine. A new vaccine for one of the main viral causes of pneumonia is under development»

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Giornata mondiale contro la polmonite: ogni 45 secondi muore un bambino sotto i cinque anni.

In occasione della giornata mondiale contro la polmonite, l’UNICEF ricorda che ogni 45 secondi muore almeno un bambino sotto i cinque anni a causa della polmonite, ovvero oltre 700.000 bambini ogni anno. La polmonite rimane la malattia infettiva che provoca il maggiore numero di morti tra i bambini, pur essendo ampiamente prevenibile e curabile.

Si stima che nel 2019 oltre 7 milioni di bambini di età inferiore ai cinque anni che vivevano in Paesi a basso e medio reddito siano stati ricoverati in ospedale con una polmonite che ha causato bassi livelli di ossigeno nel sangue e che ha richiesto un trattamento urgente con ossigeno per farli sopravvivere.

Esistono vaccini efficaci per prevenire la polmonite, ma milioni di bambini non possono accedere a questo vaccino salvavita. Le interruzioni dei sistemi di vaccinazione dovute alla pandemia hanno portato al peggior arretramento dei tassi di vaccinazione da tre decenni a questa parte. A livello globale, 25 milioni di bambini non possono usufruire dei vaccini più elementari. Metà dei bambini nel mondo non è protetta dal vaccino salvavita contro lo pneumococco (PCV).

Quasi un terzo (30%) di tutti i decessi per polmonite sono causati dall’inquinamento atmosferico, il principale fattore di rischio di morte per polmonite in tutte le fasce d’età. Nei bambini di età superiore ai cinque anni e inferiore ai 20, questo numero sale a oltre il 40%.

L’inquinamento atmosferico aumenta notevolmente il rischio di malattie come la polmonite. La siccità e la crisi climatica riducono l’accesso all’acqua sicura, a una buona alimentazione e ai servizi sanitari necessari per prevenire e curare la polmonite, creando condizioni di pericolo per i bambini.

La malnutrizione acuta grave, inoltre, contribuisce a più della metà delle morti infantili, comprese quelle per polmonite. Un bambino malnutrito ha già le difese immunitarie indebolite e le vaccinazioni mancate possono far sì che malattie infantili comuni come la polmonite diventino rapidamente letali.

Il miglioramento del lavaggio delle mani con il sapone potrebbe ridurre i decessi per polmonite del 50%, dimostrando l’impatto potenziale di garantire a tutti l’accesso ad acqua pulita e sapone. Questo aspetto è fondamentale soprattutto nei luoghi che devono affrontare l’impatto delle emergenze climatiche e delle crisi umanitarie.

Lo stress combinato del COVID-19, dei cambiamenti climatici, dei conflitti e del costo globale della vita hanno un impatto negativo sulla salute dei bambini e sulla lotta alla polmonite. Anche prima della pandemia, i progressi per porre fine alle morti dei bambini prevenibili erano in fase di stallo. È necessario agire rapidamente per garantire che nessun bambino muoia di polmonite e di altre malattie prevenibili o curabili.

L’UNICEF chiede ai governi di porre fine alle morti prevenibili di bambini per polmonite, attraverso un accesso equo alla vaccinazione, prevenzione e cura della malnutrizione acuta e assistenza sanitaria primaria di qualità per tutti i bambini.

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Childhood pneumonia: Everything you need to know.

Pneumonia kills more children than any other infectious disease.

Many people associate pneumonia with the elderly, but it is actually the biggest infectious killer of children worldwide. Every year, it claims the lives of more than 700,000 children under the age of 5, including over 153,000 newborns, who are particularly vulnerable to infection. 

It is inexcusable that thousands of children are unable to access the essential health services and treatments, which can prevent pneumonia and save their lives.  

                         What causes pneumonia?

Pneumonia is an acute respiratory infection of the lungs. It doesn’t have one single cause – it can develop from either bacteria, viruses or fungi in the air. When a child is infected, their lungs are filled with fluid and it becomes difficult to breathe. Children whose immune systems are immature (i.e. newborns) or weakened – such as by undernourishment, or diseases like HIV – are more vulnerable to pneumonia.

                       What are the symptoms of pneumonia?

As pneumonia is an infection of the lungs, the most common symptoms are coughing, trouble breathing and fever. Children with pneumonia usually experience fast breathing, or their lower chest may draw in or retract when they inhale (in a healthy person, the chest expands during inhalation).

                         Is pneumonia contagious?

Pneumonia is contagious and can be spread through airborne particles (a cough or sneeze). It can also be spread through other fluids, like blood during childbirth, or from contaminated surfaces.

                         How is pneumonia diagnosed in children?

Health workers can diagnose pneumonia through a physical exam, including checking for abnormal breathing patterns and listening to the child’s lungs. Sometimes they may use chest x-rays or blood tests for diagnosis.

In countries without strong health care systems (i.e. few doctors, lack of access to chest x-rays and laboratories), health workers often rely on diagnosing pneumonia by counting the number of breaths the child takes per minute. For instance, a 5 month old child who takes 50 breaths per minute would be breathing too fast, and could have pneumonia. The number of breaths for ‘fast breathing’ depends on the child’s age – younger children normally have higher rates of breathing than older children.

                         What is the treatment for pneumonia?

The treatment for pneumonia depends on the type of pneumonia. In developing countries, a large number of pneumonia cases is caused by bacteria and can be treated with low cost antibiotics. Yet only one third of children with pneumonia receive the antibiotics they need because they lack access to quality health care. Other causes of pneumonia are viruses or mycobacteria (e.g. those causing tuberculosis) requiring other treatments. Tuberculosis in particular often remains un-diagnosed.

                         What role can oxygen play in treating pneumonia?  

Oxygen is an essential and life-saving treatment for children and newborns suffering from severe pneumonia. That’s because the inflammation of their lungs prevents enough oxygen from entering their bloodstream.  

                         Can pneumonia be prevented?

Pneumonia can be prevented in the first place by increasing protective measures, such as adequate nutrition, and by reducing risk factors like air pollution (which makes the lungs more vulnerable to infection) and using good hygiene practices. Studies have shown that improved handwashing with soap reduces the risk of pneumonia by up to 50 per cent by lowering exposure to bacteria.

Studies show that improved handwashing with soap reduces the risk of pneumonia by up to 50% 

                         Is there a pneumonia vaccine?

Pneumonia caused by bacteria is easily preventable with vaccines. However, more than 50 per cent of children around the world are not fully protected with the primary vaccine to prevent pneumonia – the Pneumococcal (PCV) vaccine. A new vaccine for one of the main viral causes of pneumonia is under development. 

                         Where are the most children dying from pneumonia?

The countries with the largest number of child pneumonia deaths are concentrated in sub-Saharan Africa and Asia, including Democratic Republic of Congo, Ethiopia, India, Nigeria and Pakistan. Together, these five countries account for more than half of all deaths due to pneumonia among children under five.

Child deaths from pneumonia are concentrated in the world’s poorest countries. Within these countries, it is the most deprived and marginalized children who suffer the most. They often have limited or no access to basic health services and are more likely to suffer from other health threats like malnutrition, infectious diseases and polluted air. They often live in fragile or humanitarian settings, where often risk factors increase and health systems break down.

                         How does air pollution factor into pneumonia?

Air pollution can significantly increase the risk of respiratory infection, including pneumonia. Almost a third of all pneumonia deaths are attributable to air pollution.  

The climate crisis is a child rights crisis and poses a serious threat to children’s health and well-being.

Outdoor air pollution is a risk to children, especially with growing rates of urbanization in high-burden pneumonia countries. But indoor air pollution – generated by unclean fuels for cooking and heating – poses a greater global threat. Indoor pollution contributes to 62 per cent of air pollution-related child pneumonia deaths.

                         How big a factor is wasting in pneumonia related deaths?   

Wasting is the leading risk factor for deaths from pneumonia among children. It’s the most visible and life-threatening form of malnutrition. When a child is too thin and their immune systems are weak, they’re far more vulnerable to diseases like pneumonia. Wasting tends to occur very early in life and disproportionately impacts children under 2 years of age. It’s essential that we invest in nutrition services to prevent children from dying from pneumonia. 

                         What is needed to stop pneumonia? 

Swift action is required to ensure that no child dies from pneumonia and other preventable or treatable diseases.  

That response requires reducing risk factors, protecting children’s immune system and ensuring access to good-quality health care, free at the point of use, with well trained and equipped health workers to all children.

Preventing pneumonia is possible if newborns and young children are breastfed early, vaccinated, have access to clean water, good nutrition, and limited exposure to air pollution. 

It’s imperative that we strengthen and prioritize routine immunization, scaling up access to the PCV vaccine, to ensure every child is protected from pneumonia 

And steps need to be taken to improve basic oxygen access and use, so no child is left fighting for breath. 

It’s also crucial that we tackle the issue of wasting by investing in the prevention and treatment of severe acute malnutrition. That will help to accelerate a reduction of child deaths from pneumonia.  

Treating pneumonia also requires health workers to be within easy reach of families, and to have the right training, medicines and diagnostic tools. 

Both prevention and treatment require strong primary health care as well as engaged and empowered communities. But globally, only 68 per cent of children with pneumonia symptoms are taken to a health care provider.

At least one child dies from pneumonia every 45 seconds. Urgent action is needed now to end these preventable deaths. Health workers who are trained and equipped to support both prevention and treatment of pneumonia can change the course of the disease and help keep every child alive.

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