Childhood pneumonia - progress and challenges

Simple item page
dc.contributor.authorZar, Heather J
dc.contributor.authorMadhi, Shabir A
dc.date.accessioned2016-02-01T10:00:20Z
dc.date.available2016-02-01T10:00:20Z
dc.date.issued2006
dc.date.updated2016-01-22T13:26:19Z
dc.description.abstractRemarkable progress has been made in the development of antimicrobial therapy, effective vaccines and pneumonia management guidelines in the past 50 years. However, pneumonia is currently the leading cause of death in children younger than 5 years in developing countries, accounting for approximately 20% of childhood deaths. This article reviews changes in the epidemiology, management and prevention of childhood pneumonia in developing countries, specifically in Africa and South Africa, and addresses future challenges. MAIN FINDINGS: The HIV epidemic has sharply increased the incidence, severity of, and mortality due to, childhood pneumonia. Bacterial infection remains a major cause of pneumonia mortality. Additional pathogens such as Pneumocystis jirovecii and Gram-negative bacteria are found in HIV-infected children, associated with a high mortality. Mycobacterium tuberculosis is an important cause of acute pneumonia in both HIV-infected and uninfected children. Use of case management guidelines can substantially reduce neonatal, infant and under-5 mortality and pneumonia-specific mortality. General preventive interventions including micronutrient supplementation with zinc and vitamin A, and immunisations can substantially reduce the burden of childhood pneumonia. Despite a lower efficacy in HIV-infected children, vaccination protects against disease in a significant proportion of children. In South Africa, new advances over the past 50 years have included greater access to primary health care for children, the use of Integrated Management of Childhood Illness guidelines in primary care, development of guidelines for diagnosis and management of childhood pneumonia and adoption of an expanded immunisation programme that includes coverage for Haemophilus influenzae type b. The pneumococcal conjugate vaccine recently licensed in South Africa also has the potential to significantly reduce the burden of childhood pneumonia. Recent roll-out of the national antiretroviral programme can reduce the incidence and severity of HIV-associated pneumonia through the prevention of HIV infection, use of cotrimoxazole prophylaxis and treatment with antiretrovirals. CONCLUSION: Available, effective interventions for prevention and treatment of childhood pneumonia exist; the challenge is to achieve widespread implementation and high coverage rates in developing countries. Greater access to newer vaccines and to antiretroviral therapy and co-trimoxazole prophylaxis in HIV-infected children is necessary to further reduce the burden of childhood pneumonia and the discrepancies in global child lung health.en_ZA
dc.identifierhttp://dx.doi.org/10.7196/SAMJ.1269
dc.identifier.apacitationZar, H. J., & Madhi, S. A. (2006). Childhood pneumonia - progress and challenges. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/16627en_ZA
dc.identifier.chicagocitationZar, Heather J, and Shabir A Madhi "Childhood pneumonia - progress and challenges." <i>South African Medical Journal</i> (2006) http://hdl.handle.net/11427/16627en_ZA
dc.identifier.citationZar, H. J., & Madhi, S. A. (2006). Childhood pneumonia-progress and challenges. South African Medical Journal, 96(9), 890-899.en_ZA
dc.identifier.issn0256-9574en_ZA
dc.identifier.ris TY - Journal Article AU - Zar, Heather J AU - Madhi, Shabir A AB - Remarkable progress has been made in the development of antimicrobial therapy, effective vaccines and pneumonia management guidelines in the past 50 years. However, pneumonia is currently the leading cause of death in children younger than 5 years in developing countries, accounting for approximately 20% of childhood deaths. This article reviews changes in the epidemiology, management and prevention of childhood pneumonia in developing countries, specifically in Africa and South Africa, and addresses future challenges. MAIN FINDINGS: The HIV epidemic has sharply increased the incidence, severity of, and mortality due to, childhood pneumonia. Bacterial infection remains a major cause of pneumonia mortality. Additional pathogens such as Pneumocystis jirovecii and Gram-negative bacteria are found in HIV-infected children, associated with a high mortality. Mycobacterium tuberculosis is an important cause of acute pneumonia in both HIV-infected and uninfected children. Use of case management guidelines can substantially reduce neonatal, infant and under-5 mortality and pneumonia-specific mortality. General preventive interventions including micronutrient supplementation with zinc and vitamin A, and immunisations can substantially reduce the burden of childhood pneumonia. Despite a lower efficacy in HIV-infected children, vaccination protects against disease in a significant proportion of children. In South Africa, new advances over the past 50 years have included greater access to primary health care for children, the use of Integrated Management of Childhood Illness guidelines in primary care, development of guidelines for diagnosis and management of childhood pneumonia and adoption of an expanded immunisation programme that includes coverage for Haemophilus influenzae type b. The pneumococcal conjugate vaccine recently licensed in South Africa also has the potential to significantly reduce the burden of childhood pneumonia. Recent roll-out of the national antiretroviral programme can reduce the incidence and severity of HIV-associated pneumonia through the prevention of HIV infection, use of cotrimoxazole prophylaxis and treatment with antiretrovirals. CONCLUSION: Available, effective interventions for prevention and treatment of childhood pneumonia exist; the challenge is to achieve widespread implementation and high coverage rates in developing countries. Greater access to newer vaccines and to antiretroviral therapy and co-trimoxazole prophylaxis in HIV-infected children is necessary to further reduce the burden of childhood pneumonia and the discrepancies in global child lung health. DA - 2006 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 SM - 0256-9574 T1 - Childhood pneumonia - progress and challenges TI - Childhood pneumonia - progress and challenges UR - http://hdl.handle.net/11427/16627 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16627
dc.identifier.vancouvercitationZar HJ, Madhi SA. Childhood pneumonia - progress and challenges. South African Medical Journal. 2006; http://hdl.handle.net/11427/16627.en_ZA
dc.languageengen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.publisher.departmentDivision of Paediatric Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journalen_ZA
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleChildhood pneumonia - progress and challengesen_ZA
dc.typeJournal Articleen_ZA
uct.subject.keywordspneumoniaen_ZA
uct.subject.keywordschildhooden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Zar_Childhood_pneumonia_2006.pdf
Size:
203.71 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles