CHAMPIONING THE FIGHT TO STOP PNEUMONIA 

BY FAGBENRO WINIFRED OLAJUMOKE  

REVIEWED BY DR OLUSINA AJIDAHUN (the_bearded_dr_sina)

Pneumonia remains the leading cause of death, particularly among children under five of age and adults of 65 and above. Infecting about 450 million people a year with 2.5 million deaths globally including 502,000 children, this calls for action to combat this disease and break down barriers slowing down effective prevention, diagnosis and treatment. 

OVERVIEW OF PNEUMONIA

Pneumonia is an infection that causes inflammation of the air sacs of one or both lungs. The affected lung(s) have their air sacs or alveoli filled with pus or fluid.

Pneumonia is caused by bacterial, viral, or fungi infections.

1. Bacterial pneumonia: Pneumonia caused by bacteria are more common and severe than viral pneumonia. The most common cause of bacterial pneumonia is Streptococcus pneumoniae. Another important bacterial cause of pneumonia is, Mycoplasma pneumoniae , a bacterium can cause a milder type of pneumonia called walking/ atypical pneumonia which is mostly present as a chest cold but may also present as pneumonia. Symptom onset is typically gradual and can include fever, cough, and a sore throat.
2. Viral pneumonia: They usually occur due to other viral respiratory infections, e.g. cold and influenza, and are most common in children under 5. It also increases the risk of also getting bacterial pneumonia.
3. Fungi pneumonia: Caused by Cryptocccus, Pneumocystis jirovecii and Coccidioides.

People with weakened immune systems are at most risk of getting pneumonia.

https://images.app.goo.gl/JqMu86pAM3cVtYDBA

STAGES OF PNEUMONI

1. Congestion stage: occurs within 24 hours of infection. The lungs may look red from increased blood flow and swelling of the lung tissue.
2. Red hepatization: 48 to 72 hours later, the affected lung becomes more dry,
   granular and airless. Red and white blood cells, bacteria and cellular debris can clogs
   the lung airways. This stage lasts for about 2 to 4 days.
3. Grey hepatization: The lungs looks grey or yellow in color due to a breakdown
   of fibrin, hemosiderin and red blood cells. Macrophages start to form.
4. Resolution: This is the recovery stage and occurs on day 8 to 10. The
   macrophages present help to clear white blood cells and leftover debris while fluids
   and products from cell destruction are being reabsorbed as the alveoli and air ways
   return to normal lung function.

SYMPTOMS

1. Cough with green, yellow or bloody phlegm or pus.
2. Fever.
3. Chest pain.
4. Shortness of breath.
5. Fatigue.
6. Loss of appetite.

RISK FACTORS

1. Age: Children under five and people of 65 years and above have a higher risk of
   pneumonia.
2. Weakened immune system: People with a weak immune system due to pregnancy,
   HIV or other infections at a risk of getting pneumonia.
3. Medical conditions: People with preexisting and chronic health problems such as
   asthma, liver disease, cystic fibrosis.
4. Exposure to irritants: Being regularly exposed to lung irritants such as toxic fumes,
   dust can increase your chances of getting pneumonia.
5. Smoking makes it difficult for the body to get rid of mucus in the airway,
   increasing the risk of pneumonia.
6. Recently suffering from cold or influenza.

COMPLICATIONS
Pneumonia if left untreated can cause other problems for the patient. Its complications
are more common in young children, the elderly and those with pre-existing health
issues, some of these complications include:

1. Pericarditis: An inflammation of the pericardium surrounding the heart.
2. Endobronchial obstruction: Blockage of the airway.
3. Lung abscess: Pus-filled holes in the lungs.
4. Sepsis: The infection enters the bloodstream and spreads to other organs.

HOW TO PROTECT YOURSELF AND OTHERS FROM PNEUMONIA
Some types of pneumonia (bacterial and viral pneumonia) are contagious and spread
through droplets. One can avoided being infected with pneumonia and passing it to
others by following these steps:

1. Getting vaccinated against pneumonia and the flu
2. Avoid smoking and secondhand smoke
3. Stick to your treatment plan for any health conditions you currently have
4. Cleaning and disinfecting surfaces that have been touched a lot
5. Coughing or sneezing into your elbow or tissue
6. Regular hand washing
7. Avoid close contact with infected individuals
8. Visit a doctor if you notice any of the symptoms mentioned above.

THE FIGHT AGAINST PNEUMONIA IN NIGERIA
Nigeria has one of the highest child mortality rates from pneumonia globally which an
average of 2,000 pediatric deaths daily. It caused 19% of child deaths in 2018 and
was the biggest killer of children under 5 in 2017. Fortunately, there has been a
decline in pneumonia cases thanks to countless efforts from the health organizations
in the nation and beyond.:

1. WHO and UNICEF integrated Global action plan for Pneumonia and Diarrhea
   (GAPPD) in 2013 which aims to accelerate pneumonia control with actions to
   a) Protect children from pneumonia, including promoting exclusive
   breastfeeding and adequate complementary feeding;
   b) Prevent pneumonia with vaccinations, hand washing with soap, reducing
   household air pollution, HIV prevention and cotrimoxazole prophylaxis for
   HIV-infected and exposed children;
   c) Treat pneumonia focusing on making sure that every sick child has access to
   the right kind of care and can get the antibiotics and oxygen they need to get
   well.
2. The introduction of the Pneumococcal Conjugate Vaccine into the national
   immunization program to prevent pneumococcal infections with the support of the
   Gavi, the Vaccine alliance in December 2014. As of 2022, Nigeria has achieved
   60% coverage with the final dose of the PCV vaccine
3. The EBCC supported the Nigerian Federal Ministry of Health (FMoH) to develop a
   pneumonia control strategy between January 2019 and 2020. Coalition members
   including USAID, the Nigerian offices of Dalberg, Save the Children, UNICEF,
   and the Clinton Health Access Initiative (CHAI) joined forces to support the
   process.

Even with the various programs and collaborations done to combat pneumonia, there
are still some setbacks affecting its effectiveness. Many regions in Nigeria,
particularly rural and conflict-affected areas, have limited healthcare facilities and a
shortage of trained healthcare workers, resulting in delayed or ineffective pneumonia
treatment. Moreover, the scarcity of essential resources, such as antibiotics and
oxygen, lack of strong coordination of a well funded push against pneumonia and lack
of timely data on pneumonia intervention coverage slow down any form of progress.
More can be done to ensure that preventive and treatment methods reach all parts of
the country to achieve a pneumonia-free nation.

REFERENCES

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