Pneumonia is an illness that presents with lung inflammation. Its causal organisms are specifically bacteria and viruses (Sousa et al., 2013). Of these, the most significant pathogens are Haemophilus influenzae type b (Hib), Streptococcus pneumoniae , and respiratory syncytial virus (Honkinen et al., 2012). Additionally, toxins accumulating in the lungs from smoking or other forms of exposure also cause lung inflammation and consequently lead to pneumonia. From statistics obtained world over, this condition has been established to be the major cause of children deaths with over eighteen percent of all childhood deaths attributed to it (Rudan et al., 2015).
Most of the deaths resulting from pneumonia are specifically attributed to Streptococcus pneumoniae which takes advantage of relatively weaker immune systems such as in children below five years and adults aged above sixty five years. Additionally, people suffering from chronic diseases such as HIV, heart diseases or liver conditions are at a high risk of infection. On infecting the human body, the invasive infection occurs when the bacteria finds its way into the blood stream or other body fluids such as pleural fluid, joint fluid, cerebrospinal fluid and pericardial fluid where it lodges itself causing pneumococcal sepsis (Torres et al., 2014 ). The non-invasive infection occurs as a result of the pathogen lodging in the nasopharynx from where it spreads throughout the respiratory system causing bronchitis, sinusitis and /or otitis media. Between the two types of infection, the invasive is the most significant in causing deaths among children and the elderly (Honkinen et al., 2012). Despite being preventable and curable, hesitations in identifying the infection and seeking medical care and also failing to immunize all children provide a loophole for development of complications and subsequent deaths (Williams et al., 2015). Notably, most of these deaths especially children mortalities occur at their highest rates in the poorest countries (Hazir, 2013).
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Major predisposing factors for pneumonia infection are; weak immune systems arising from presence of chronic diseases in the body such as HIV, malnutrition and under nutrition particularly in children as well as aggravating illnesses such as measles (Capelastegui et al., 2012). The other important predisposing factor is environmental conditions such as air pollution in the living space through use of firewood, animal dung or other fuels that significantly pollute air in the living space. This is without forgetting the negative implications of indoor parental smoking. Notably, healthy individuals with strong immune systems encounter the pathogens that cause pneumonia but they don’t get infected since it is easily dealt with by a strong immune system.
Once an individual is infected, a wide range of symptoms present with their severity and extent dependent on the cause of the infection and age of the infected person (Capelastegui et al., 2012). If the cause of the infection is an organism such as bacterial or virus, the symptoms present are more or less the same although they may be more numerous and severe in viral pneumonia (Sousa et al., 2013). Symptoms that are commonly manifested in pneumonia are fever, difficult and painful breathing as well as coughing. These manifestations are more conspicuous in children aged below five years where; indrawing of the lower chest, nostrils appear flared with every breath and grunting on exhalation and wheezing appear. In cases of severity, the child may find it impossible to feed or drink. Unconsciousness may also be experienced together with convulsions and hypothermia.
To successfully treat pneumonia, proper diagnosis is needed. Physicians require thorough tests to identify the infection and determine the causal organism. In situations where such facilities don’t exist, physicians read the clinical signs and symptoms presented by the patient to come up with diagnosis. On successfully diagnosing the patient, the physician embarks on administering antibiotics to the patient (Bhutta et al., 2013). The drug administration regimen is guided by the drug’s efficacy in the given setting, that is, the level of resistance to drugs by the bacteria observed in the setting. In addition, the risk factors that predisposed the patient are considered for instance HIV positive and /or malnourished children.
In prevention and control of pneumonia, major intervention measures have been put in place. These include; vaccination against the causal organisms specifically Haemophilus influenzae type b (Hib), and Streptococcus pneumoniae , vaccination against other infections that aggravate pneumonia such as pertussis and measles, good practices of feeding infants such as exclusive breastfeeding for six months and appropriate complementary feeding thereafter to boost immunity and enhance the respiratory muscles and zinc supplementation (Bhutta et al., 2013). For children infected with HIV, cotrimoxazole antibiotic is administered daily as a way of reducing the likelihood of them contracting pneumonia (Torres et al., 2014). Other predisposing factors that need to be checked and addressed include; the environmental factors which can be controlled. For instance, household air pollution from using biomass fuels can be addressed through provision of alternatives such as clean and affordable stoves for indoor use. Additionally, proper hygiene practices in homes are a probable way of reducing incidences of pneumonia among children in the household (Hazir, 2013).
In conclusion, pneumonia is a disease of high public health concern. It mainly hits at the elderly and children below five years due to their relatively weaker immune system. People living with HIV are also at a high risk of contracting the infection due to the weakened immune system. Despite there being measures of combating and treating Pneumonia, it still remains a threat to life as evidenced by the huge number of deaths.
References;
Bhutta, Z. A., Das, J. K., Walker, N., Rizvi, A., Campbell, H., Rudan, I., & Black, R. E. (2013). Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost?. The Lancet , 381(9875), 1417-1429.
Capelastegui, A., España, P. P., Bilbao, A., Gamazo, J., Medel, F., Salgado, J., ... & Altube, L. (2012). Etiology of community-acquired pneumonia in a population-based study: link between etiology and patients characteristics, process-of-care, clinical evolution and outcomes. BMC infectious diseases , 12(1), 1.
Hazir, T. (2013). Severe Pneumonia Can be Safely Treated at Home: Revisions in WHO/UNICEF Integrated Management of Childhood Illnesses (IMCI) Pneumonia Management Guidelines. Journal of Research and Development , 2013.
Honkinen, M., Lahti, E., Österback, R., Ruuskanen, O., & Waris, M. (2012). Viruses and bacteria in sputum samples of children with community ‐ acquired pneumonia. Clinical Microbiology and Infection, 18(3), 300-307.
Rudan, I., O'Brien, K. L., Nair, H., Liu, L., Theodoratou, E., Qazi, S., ... & Child Health Epidemiology Reference Group. (2015). Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries.
Sousa, D., Justo, I., Dominguez, A., Manzur, A., Izquierdo, C., Ruiz, L., ... & Llinares, P. (2013). Community ‐ acquired pneumonia in immunocompromised older patients: incidence, causative organisms and outcome. Clinical Microbiology and Infection , 19(2), 187-192.
Torres, A., Blasi, F., Peetermans, W. E., Viegi, G., & Welte, T. (2014). The aetiology and antibiotic management of community-acquired pneumonia in adults in Europe: a literature review. European Journal of Clinical Microbiology & Infectious Diseases, 33(7), 1065-1079.
Williams, D. J., Edwards, K. M., Self, W. H., Zhu, Y., Ampofo, K., Pavia, A. T., ... & Bramley, A. M. (2015). Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines. Pediatrics , 136(1), 44-52.
