A child dies every 2 min of pneumonia, diarrhoea in India

One child under the age of five years dies every two minutes in India due to pneumonia and diarrhoea. This is according to an international report of 15 high-burden countries for the two infections released last week. It was stated that India annually recorded the highest number of deaths of children under five by pneumonia and diarrhoea in the entire world at 2,96, 279. This translates to 811 children dying of preventable infections each day or 33 children dying every hour.

The 2016 Pneumonia and Diarrhoea Progress Report is released by International Vaccine Access Centre (IVAC) of John Hopkins Bloomberg School of Public Health in US. Whenever a child develops pneumonia or diarrhoea, it is essential to give immediate care and treatment. Only 77% of all suspected children were taken to appropriate health care provider in India while only 12.5% recieved antibiotics, state estimates in the report.

“A single hospitalization for rotavirus diarrhea can be financially catastrophic for some families close to the poverty line. In India, a hospitalization can cost the equivalent of more than three weeks’ salary,” the report said.

The report raises questions on quality of care provided by health workers and points out disparity in use of antibiotics. “Antibiotic overuse is prevalent in many parts of India, it remains clear that particularly in areas where the disease burden is greatest, children often do not receive the appropriate antibiotic,” it says.  

For treating diarrhoea, the best treatment is giving Oral Rehydration Solution (ORS) and zinc supplements. Shockingly, a mere 0.3% of all affected children recieved zinc supplement syrup while 34% were administered ORS in India. Of all babies only 65% are exclusively breast-fed by their mothers. Breast-feeding reduces the risk of the baby catching these infections.

The report stated that India is under-performing in immunization coverage for diarrhoea and pneumonia. “India is a large country, you cannot introduce the dosages in the whole country over night. Rotavirus vaccine has just been introduced in four states as of now, while Pneumococcal Conjugate Vaccine is planned to be introduced by 2017,” said Dr Pradeep Haldar, Deputy Commissioner (Immunization), Union Health Ministry.

“Fifteen years after PCV’s first introduction globally in 2000 (the United States was first to implement the vaccine), five of the highest pneumonia burden countries (India, Indonesia, Chad, China, and Somalia) are still not using the vaccine in their routine immunization programs,” points out the report.

Dr Haldar says that cost-effectiveness of the vaccine is an issue. In private sector, three doses of PCV cost Rs 15,000. “We will be supported by Global Alliance for Vaccines and Immunization initially and then acquire vaccines under Government of India’s programme at subsidized costs,” he said.

The report says that availibility of oxygen therapy, amoxicillin antibiotics, ORS and zinc supplements can go a long way in curtailing preventable child deaths. “Prevention through immunization alone is not enough. Access to appropriate treatment in adequate health facilities staffed by well-trained health care workers is critical to saving lives,” it says.

A SAD STATE

72% of the global burden of pneumonia and diarrhea child deaths occur in just 15 countries, even though they are home to only 55% of the world’s under-5 population

Of all affected children in India, only 77% were taken to appropriate health care, 12.5% recieved antibiotics, 34% recieved ORS and only 65% exclusive breast feeding, which are necessary to prevent these deaths

Largest number of under-5 pneumonia and diarrhoea deaths:

India  2,96,279
Nigeria  2,10,219
Pakistan  1,03,444