PREVALENCE OF PNEUMONIA IN CHILDREN 0-5 YEARS IN FEDERAL TEACHING HOSPITAL, ABAKALIKI

PREVALENCE OF PNEUMONIA IN CHILDREN 0-5 YEARS IN FEDERAL TEACHING HOSPITAL, ABAKALIKI

CHAPTER ONE

 INTRODUCTION

1.1 Background to the Study

Pneumonia is an acute infection, caused mainly by the pneumococcal species of bacteria and it affects the upper respiratory system. The lungs are made up of small sacs (alveoli) which fill with air when a healthy individual breathes. However, when a person develops pneumonia, the alveoli are filled with pus and fluid, making breathing painful and restricts the intake of oxygen (WHO, 2016). Worldwide, acute lower respiratory tract infections (ALRTI) in young children are one of the chief causes of deaths in childhood (Fiave, 2014). Pneumonia killed over 920 000 children below 60 months of age globally in 2015, which amounts to 16% of children who are less than five years old and have died. This disease affects children and families everywhere, but is most prevalent in South Asia and sub-Saharan Africa.

In children, pneumonia can be prevented through optimal breastfeeding, immunization, adequate complementary feeding, reducing household air pollution and with cost effective treatment (WHO, 2016). In 2015, close to 3 million deaths out of about 6 million deaths in children below five years was in neonates with the leading causes being complications from preterm delivery, pneumonia, and intrapartum-linked episodes consecutively (Liu et al., 2016). The maximum number of deaths caused by pneumonia (81%) happen in the initial 24 months of life (Madhi, Bamford, & Ngcobo, 2014) Vaccine-preventable pneumonia is most often caused by Streptococcus pneumonia (related to 18.3% of cases).

Morbidity and mortality from childhood pneumonia are decreasing, nonetheless, action is required  to accelerate its reduction globally and at country level (Walker et al., 2013). Early diagnosis and treatment of the disease can prevent substantial morbidity and mortality, but are often challenging in resource-poor settings (Acácio et al., 2015). The epidemiology of childhood pneumonia is due to risk factors such as under-nutrition, substandard breastfeeding, and zinc deficit (Walker et al., 2013). One study reported  that polluted air from meal preparation using biomass fuel, smoking by parents and overcrowding are risk factors of pneumonia (Karki, Fitzpatrick, & Shrestha, 2014).

Since pneumonia is a major contributor to infant mortality, preventing of infection in children is a very crucial part of strategies adopted to decrease childhood deaths and the most effective way is through vaccinations against Hib, pneumococcus, pertussis and measles (WHO, 2016). However, adequate diet is crucial in building immunity in children which begins with exclusive breastfeeding for the initial 6 months of childhood. Moreover, breastfeeding aids in reducing the duration of infection (WHO, 2016). Furthermore, promoting good hygiene in crowded homes and combating environmental factors such as household air pollution (with the provision of clean and affordable indoor stoves, for example) also reduces the number of children who develop pneumonia (WHO, 2016). Contact with an infected upper respiratory tract of a person and delay in seeking treatment are also risk factors associated with severe pneumonia (Onyango, Kikuvi, Amukoye, &Omolo, 2012).

Death from pneumonia is associated with intensity of infection, crowding, malnutrition, abject poverty, as well as insufficient immunizations, and areas where access to healthcare is poor. Thus, poor and hungry children, and living in areas that are difficult to reach suffer most. Suggesting a relationship between pneumonia mortality risk and inequity in access to healthcare (Adegbola, 2012).

1.2 Problem Statement

Pneumonia is one of the main public health issues in children below age five (Karki et al.,

2014). It is also a public health problem in the tropics (Rurangwa&Rujeni, 2016). Pneumonia accounts for nearly a million deaths per year in infants (Adegbola, 2012). About fifty percent of global deaths owing to pneumonia in children below age five occur in Africa. The estimated proportion of deaths in children less than 5 years in sub-Saharan Africa accredited to pneumonia is between 17 and 26% (Onyango et al., 2012). Although there was a reduction in main causes of infections in sub-Saharan Africa between the year 2000 to 2015, pneumonia, diarrhoea and counterparts are still key and must be the main target for improving child survival (Liu et al., 2016). Moreover, it has been found to cause more deaths annually than HIV, malaria, and measles combined with majority of these deaths occurring in developing countries and mortality attributed to pneumonia appears to be on the rising (Acácio et al., 2015).

Nations are counselled to prioritize child survival policy and programs in the sustainable development growth (SDG) era according to its related cause of child mortality (Liu et al., 2016). By 2030, SDG target for child mortality aims to end preventable deaths of under-5 mortality to at least as low as 25 per 1,000 live births (WHO, 2017). Lui and colleagues (2016) stated that continued and enhanced efforts to scale up life-saving interventions that have been proven are desirable in the achievement of SDG childsurvival target.

According to Tette and colleagues (2016), pneumonia is the third leading cause of child mortality in under-fives (18.4%) in Nigeria and is on the rise. Distinct risk factors that have been recognized in children below 5 years are malnutrition and diarrhoeal diseases

(Ashraf, Hamidul Huque, Kenah, Agboatwalla, & Luby, 2013). This is currently 60 per 1000 live births in Nigeria (NDHS, 2014). Understanding the determinants of diseases like pneumonia in the Nigerian paediatric population is very crucial (Tette, Neizer, Nyarko, Sifah, Nartey, et al., 2016). In Nigeria, there is little information on the relationship existing between nutritional status and pneumococcal infection in children under five.

1.3 Research Questions

  • What is the prevalence of pneumonia at the Federal Teaching Hospital, Abakaliki?
  • What are the risk factors of pneumonia in children below age five?
  • Are there nutritional factors that affect children under five with pneumonia?
  • Does poor nutritional status affect children under five with pneumonia?
  • Is there an association between nutritional status and pneumonia in children under five?

 

1.5 Justification

This research has particularly been necessitated, as there is little data on the relationship between nutritional status and pneumonia in children under five. As the number of children below 5 years with pneumonia keep increasing, compromised nutritional status will exacerbate its occurrence leading to more deaths from pneumonia in children under five, thus, child mortality rate would increase. This study will assess the association between nutritional status and pneumonia in children below 5 years. Data obtained from this study will add to existing knowledge and also help develop health policies in prevention and treatment of pneumonia in children under five in Nigeria.

 

 

1.6 Objectives

1.6.1 General Objective

To examine the relationship between pneumonia and nutritional status in children under five at Federal Teaching Hospital, Abakaliki, Ebonyi State

1.6.2 Specific Objectives

  1. To determine socio-demographic factors associated with pneumonia among children under five at Federal Teaching Hospital, Abakaliki, Ebonyi State.

 

  1. To examine the relationship between nutritional status and pneumonia in children under five at Federal Teaching Hospital, Abakaliki, Ebonyi State.

 

  1. To determine other factors associated with pneumonia among children under five at Federal Teaching Hospital, Abakaliki, Ebonyi State.

 

PREVALENCE OF PNEUMONIA IN CHILDREN 0-5 YEARS IN FEDERAL TEACHING HOSPITAL, ABAKALIKI

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