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Pneumonia among Children in Developing Countries

Disease Listing | General Information | Technical Information | Additional Information

Clinical Features Pneumonia, an inflammation of the lung, is characterized by cough and fast, difficult breathing. Fever and muscle aches may occur.
Etiologic Agent Streptococcus pneumoniae and Haemophilus influenzae are the leading bacterial pathogens. Other bacteria (Staphylococcus aureus, and gram-negative pathogens) most often affect newborns and malnourished children. Respiratory viruses (RSV, influenza, parainfluenza, and adenovirus) can be identified in approximately a quarter of children with pneumonia but are much less likely to cause fatal infection than are the bacterial pathogens.
Incidence Approximately 5-10% of all children <5 years old in developing countries develop pneumonia each year.
Sequelae Each year, acute respiratory infections cause approximately 2 million deaths among children <5 years old and are the leading cause of death in this age group. About 1% of pneumonia cases result in sequelae (e.g., bronchiectasis), which increases the risk of recurrent infections.
Transmission Person-to-person transmission may occur by direct contact with infectious secretions. Most cases of pneumonia among children occur sporadically, not in outbreaks.
Risk Groups Infants (especially premature or low birth weight). Nearly 75% of pneumonia deaths occur among infants under 1 year old. Risk also increases with malnutrition, malaria, and suppressed immunity. The burden of pneumonia among children with HIV infection is high.
Surveillance No standard approach exists for surveillance in developing countries. Several protocols for measuring the burden of radiographic pneumonia in children are being evaluated.
Trends There has been some decrease in the number of pneumonia deaths over the last decade due to more widespread use of antibiotics. It is unknown if the rate of pneumonia among children in developing countries is changing; although the increasing prevalence of HIV infection in Africa has likely led to an increase in bacterial pneumonia there.
Challenges The impact of the HIV epidemic in Africa and Asia, spread of antibiotic resistance, use of case-management algorithm, widespread training of health workers, assuring antibiotic supply, and identifying strategies to promote global use of Hib conjugate vaccines.
Opportunities Conjugate vaccines for H. influenzae type B (available) and S. pneumoniae (licensed in the U.S. in 2000) offer the best opportunity to prevent morbidity and mortality. Increased use of case management and risk reduction also are important. Use of prophylactic antibiotics and antiretroviral medicines may decrease the incidence of HIV-infected children.
 
 
Date: October 13, 2005
Content source: National Center for Immunization and Respiratory Diseases: Division of Bacterial Diseases
 
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