Prevention and Control of Childhood Pneumonia
Bulletin of the World Health Organization, 1 May 2008

This month’s WHO Bulletin, led by the Global Action Plan for the Prevention and Control of Pneumonia (GAPP), focuses on the prevention and control of childhood pneumonia. It highlights research on the many aspects that drive this deadly disease and the progress now being made – progress that is a priority if Millennium Development Goal 4 to reduce child mortality is to be achieved.

Why this attention on childhood pneumonia? It is the leading killer of children worldwide with more than two million children under the age of five dying of the disease each year. The highest rates and greatest burden of pneumonia occur in Africa and Asia and special attention must be paid to these regions. Children with compromised immune systems, such as those who are undernourished, of low birth-weight or are HIV positive, are at greater risk. Environmental factors including overcrowding in homes and exposure to indoor air pollution can also make children more susceptible. Pneumonia places a huge burden on families and health systems and effective interventions (prevention and case management) are essential to address it.

Proven preventive measures, many of which are addressed in the special issue of the Bulletin include immunization, promotion of exclusive breast feeding during the first few months of life, zinc supplementation, control of indoor air pollution, prevention of mother to child HIV transmission and pneumonia prophylaxis in high HIV prevalent areas.

Two interventions have been proven effective - vaccination and case management, but these measures alone are unlikely to completely prevent childhood pneumonia and key challenges remain. Prompt treatment with effective antibiotics can save lives, but to ensure that this is implemented successfully, health workers need to be properly trained to diagnose and treat pneumonia and families must seek care without delay. The Bulletin reports successes such as community-based management in Nepal, which doubled the number of children treated, and ongoing research ranging from the impact of delayed care-seeking in Uganda to the implementation of an oxygen concentrator system in Malawi.

If the scientific community, the public and policy-makers act now, millions of needless deaths around the world can be prevented. It is imperative that we work together to adopt, fund and implement measures preventing deadly childhood pneumonia from striking the world’s most vulnerable.

From the Bulletin of the WHO Special Issue

EDITORIALS

A global action plan for the prevention and control of pneumonia
- Brian Greenwood

Can the burden of pneumonia among HIV-infected children be reduced?
- Prakash Mohan Jeena

NEWS

HIV drives children’s pneumonia in sub-Saharan Africa

Controversial funding mechanism to fight pneumonia

Cuba’s primary health care revolution: 30 years on

An interview with Tabish Hazir: Pneumonia: No. 1 killer of Pakistan’s children.

RESEARCH

Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study
- Karin Källander et al.

LESSONS FROM THE FIELD

From research to national expansion: 20 years’ experience of community-based management of childhood pneumonia in Nepal - P Dawson et al.

Implementation of an oxygen concentrator system in district hospital paediatric wards throughout Malawi
- Penny Enarson et al.

PUBLIC HEALTH REVIEWS

Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings
- Stephen M Graham et al.

Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions
- Daniel E Roth et al.

Vaccines to prevent pneumonia and improve child survival
- Shabir A Madhi et al.

Safety profile of pneumococcal conjugate vaccines: systematic review of pre- and post-licensure data
- Frank DeStefano et al.

Community case management of pneumonia: at a tipping point?
- David R Marsh et al.

Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: a systematic review and meta-analysis
- Mukesh Dherani et al.

Equity and child-survival strategies
- EK Mulholland et al.

Epidemiology and etiology of childhood pneumonia
- Igor Rudan et al.