Fighting Pneumonia: Issues and Challenges


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Fighting Pneumonia: Issues and Challenges

  1. 1. Defeating Pneumonia:Overcoming the Challenges
  2. 2. Why pneumonia ?• one of the biggest killers diseases in the 20th century• 2.4 million deaths annually• Child mortality
  3. 3. Why Pneumonia
  4. 4. Enough efforts ? WHO & UNICEF campaigns Sub-Sahara countries and pneumonia
  5. 5. Causes of pneumoniabacterial, viral and fungalPneumonia and ARISpreading infection waysMechanism of the disease
  6. 6. SymptomsGeneral symptomsDecisive symptomsChest X-ray and blood test
  7. 7. Vulnerability enhancing factors
  8. 8. DemographicsAge Children under 5 Immune system Breastfeeding: GAPP TargetGender?Source: WHO; “Pneumonia, the forgotten killer of children”
  9. 9. Response through GAPPSource: WHO: “Global Action Plan for Prevention and Control of Pneumonia” 2009
  10. 10. Context 1Indoor smoke pollution 50% of mortality Cognitive impairment, COPD, lung cancer, inflammations and immune system GAPP Target
  11. 11. Response through GAPPSource: WHO: “Global Action Plan for Prevention and Control of Pneumonia” 2009
  12. 12. Context 2Disasters and crises Rise of mortality: 17 % to 30 % Shelter Hygiene Overcrowding Nutrition Access to healthcare Clustering
  13. 13. HIV/AIDS and pneumoniaIneffective immunesystemGlobally 90% in low income countries Antiretroviral therapy coverageDifferent strategy Pneumocystis Jirovecii Standard vaccinations ineffective
  14. 14. Antiretroviral Therapy Coverage Low- and middle income countries v/art/atlas.html
  15. 15. Response through GAPPSource: WHO: “Global Action Plan for Prevention and Control of Pneumonia” 2009
  16. 16. Progress to reduce vulnerabilitySource: IVAC “Pneumonia Progress Report” 2012
  17. 17. Obstacles for low income countriesNo/late introduction new pneumococcalconjugate vaccines in low incomecountriesLow required capacity for nationalimmunization programmesToo little breastfeeding Time, pain, exhaustion, traditions, advice medical staff,socio-economic status.Access to healthcare and antibiotics Education parents Diagnosis and referral “Lady Health Workers” Pakistan
  18. 18. PneumoniaPrevention, Treatment and Rehabilitation
  19. 19. Framework of Pneumonia Control (UNICEF, 2006)
  20. 20. Controlling PneumoniaVaccination, which includes the use of vaccines againstStreptococcus Pneumonia and Haemophilus Influenza type b.Case management in the community, health centers andthe hospitalsExclusive breast feeding for the first six months of lifeImprovement in nutrition and prevention of low birthweightControl of indoor air pollution and promotion of ahealthy environmentPrevention and management of HIV infection
  21. 21. Source: WHO/UNICEF, 2006 Community Based Case Management of PneumoniaSigns Classify As TreatmentFast Breathing Refer Urgently to Hospital for Injectable Antibiotics and Oxygen if NeededLow Chest Wall Withdrawal Severe pneumonia Give First Dose of Appropriate AntibioticsStridor in Calm Child Prescribe Appropriate AntibioticsFast Breathing Non Severe pneumonia Advise Mother on Other Supportive Measures and When to Return on a Follow Up VisitNon Fast Breathing Other Respiratory Disease Advise Mother on Other Supportive Measures and When to Return on a Follow Up VisitWhat is Fast BreathingIf the Child is2 Months to 12 Months Old 50 Breathes or More Per Minute12 Months to 5 Years Old 40 Breathes of More Per Minute
  22. 22. TreatmentPrompt identificationFull course of antibiotics (bacterial): dangerous if givenwithout proper diagnosis
  23. 23. Pneumonia Prevention: Challenges Lack of resources (46% sub sahara, 39 % south asia, 36% LDCs) Access formal medical services Training of community level volunteers Creating a barrierfree environment
  24. 24. Socioeconomic Factors:Opportunities and Liabilities Mexico Kenya Nicaragua
  25. 25. Mexico: Socioeconomic Liabilities (I) Pneumonia caused by H1N1 Pandemic and Post-Pandemic Group Socio-economic Status (SES)
  26. 26. Mexico: Socioeconomic Liabilities (I) Socio-economic Status (SES) Basic necessities, medical care, insurance Access to information Health Care Seeking Behaviour
  27. 27. Kenya: Socioeconomic Liabilities (II)Symptoms of Pneumonia IgnoredTraditional Equipment
  28. 28. CCM in Nicaragua:Socioeconomic OpportunitiesCommunity Case Management36% Reduction in Mortality in Children 0-4Integral part of Nicaragua’s Maternal and Child HealthStrategyProactive and Reactive Measures
  29. 29. CCM in Nicaragua: Socioeconomic OpportunitiesStep 1: Find Step 4: EmpowerStep 2: Train Step 5: VisitStep 3: Educate
  30. 30. Policy RecommendationsGAPP: Cost ImplicationsPneumonia under the National ImmunizationPlanNational Campaign on exclusive breast feedingIntegrated Child Disease Management Plan at theNational LevelPromotion of Community Case ManagementEquitable distribution of resourcesMass Awareness Program
  31. 31. Thank You!!!!! “Pneumonia can be prevented and cured.... We must scale-up proven solutions and ensure they reach every child in need." UN SG Ban Ki-moon•Lars Faber•Mohammad Moursy•Shakeb Nabi•Tim Carpenter