With November 12 being observed as World Pneumonia Day and National Health Day in Indonesia, the commemoration should serve as a reminder for us that other diseases, such as pneumonia, too pose a threat to the health of children and also cause death.
The commemoration of National Health Day this year bears the main theme of "Sehat Negeriku, Tumbuh Indonesiaku," which means a healthy country creates a growing country. It means that all elements in Indonesia should watch out for their health in order to ensure a better quality of living.
However, until now, pneumonia remains one of the main causes of death among children under five years of age. The United Nations Children's Fund (UNICEF) stated that pneumonia had annually claimed the lives of more than 800 thousand children under the age of five. Most of these deaths were reported in South Asia, Sub-Saharan Africa, and Southeast Asia.
Data from the Health Ministry in 2019 recorded 153,987 cases of pneumonia in infants aged less than one year and 314,455 cases of children in the age bracket of one to five years. The number of child deaths due to pneumonia reached 550. Indonesia is ranked 7th in the world as the country with the highest burden of pneumonia globally.
Pediatric consultant for respiratory ailments, Prof. Dr Cissy Kartasasmita, Sp. A(K), M,Sc, explained that pneumonia is a severe infectious inflammatory disease that attacks the lungs. The infection makes the lung tissue inflamed and disrupts oxygen delivery in the body that can cause death among children.
Early symptoms of pneumonia are difficult to tell apart from other respiratory illness, such as cough, fever, and shortness of breath. However, rapid breathing is a typical symptom of pneumonia.
The rapid breathing rate can be above 60 breaths per minute for infants under two months, above 50 breaths per minute in children aged two months to less than 12 months, and above 40 times per minute for children aged one to five years.
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In addition to rapid breathing, the other symptom to watch out for is the deep chest pull when the child breathes. These symptoms usually appear in severe pneumonia.
“Parents must be aware if their child has cough and/or is experiencing breathing difficulties, such as rapid breathing. We recommend to immediately get the kid’s health checked by a doctor, " Professor Kartasasmita noted.
She later explained that pneumonia can be caused by infection from bacteria, viruses, and fungi gaining entry into the lungs. Pneumonia may infect infants with low birth weight, infants not consuming breast milk (ASI) for six months, infants not receiving basic immunizations, infants with malnutrition, infants exposed to indoor pollution, such as cigarette smoke, and infants who live in remote locations or in too densely populated areas.
Prevention through vaccination
Results of the pneumonia research showed that 70 percent of the pneumonia cases were caused by bacterial infections. The bacteria that most often causes severe cases in pneumonia are Streptococcus pneumoniae (pneumococci) and Haemophilus influenza type b (Hib).
Pneumonia can be treated with antibiotics and continuous treatment. However, pneumonia can be prevented through vaccination. Vaccines that can prevent pneumonia in infants are DPT, measles, Hib, and pneumococcus.
The first three vaccines mentioned above have been included in the basic complimentary vaccination program by the Indonesian government for the public.
However, on June 22, the government, through the Ministry of Health, announced that the conjugated pneumococcal vaccination (PCV) was also given as a basic immunization program for all children in Indonesia. The implementation of PCV vaccination will begin next year with three doses, starting from when the child is two months, three months, and 12 months of age across the country.
PCV vaccination was introduced in eight regions in East Java Province in June 2021 and six areas in West Java Province in July 2021.
"Initially, the national PCV vaccination was planned in 2024, but we moved this forward to 2022. Of course, this will be a great blessing for all Indonesian children," Professor Kartasasmita, who once served as chair of the Indonesian Pediatrician Association (IDAI) Immunization Task Force, stated.
Based on results of the research, some 50 percent of the pneumonia cases in Indonesia are caused by the pneumococcal bacteria. The bacterial infection is easily transmitted through saliva or droplets.
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Pneumococcal bacteria can infect a person without causing symptoms, but that individual can infect others with more vulnerable health conditions, such as children under five and the elderly.
So far, PCV vaccination can only be accessed at health facilities by the public after bearing an independent cost of around Rp700 thousand per dose, whereas three injections are required for completing the entire PCV vaccination dosage.
“The inclusion of PCV vaccination in the basic immunization program that will be implemented next year will certainly proffer great benefits for treating pneumonia. Vaccination not only protects children from pneumonia but also reduces the possibility of children transmitting pneumococcal infections to kids or other people,” Professor Kartasasmita noted.
Meanwhile, Executive Secretary of the Indonesia Technical Advisory Group on Immunization (ITAGI), Dr. Julitasari Sundoro, M.Sc, M.P.H, spoke of her side hailing the national PCV vaccination program implemented by the government.
“PCV vaccination will reduce the number of pneumonia cases in the country if it is implemented nationally. The vaccination can also reduce cases of ear and brain inflammation that are also caused by the pneumococcal bacteria," Sundoro noted.
She is optimistic that the PCV vaccination program would be accompanied by education for parents to comply with the government’s program to complete the pneumonia vaccination for children.
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Editor: Suharto
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