Kenya still struggling with killer pneumonia despite strides

James Lewa (left), nurse in charge at Balah dispensary in Laisamis, Marsabit County, attends to a child. [Nanjinia Wamuswa, Standard]

At 5pm, Akorto Barnai arrives with her sick child at Balah dispensary in Laisamis, Marsabit County.

“The baby has been coughing, the body's temperature is high and has refused to be breastfed,” she says through a translator, since she does not understand Kiswahili.

On examination, James Lewa, the nurse in charge, diagnoses pneumonia - a form of acute respiratory infection that affects the lungs, according to World Health Organisation.

Easy decision

However, resolving to seek treatment at the hospital facility was not an easy decision for Akorto.

She says: “I live very far, and before coming, we tried treating the baby using traditional herbs mixed with camel soup. I decided to come when it seemed not to be working.”

Lewa is confident the child will be cured because the infection is not severe.

“Some cases arrive at the facility too late and I have to refer them to county referral hospital in Marsabit,” he says, adding that a major cause of pneumonia among locals is poor ventilation in manyattas.

Akorto is one of the parents who might have unknowingly lost a child to pneumonia, one of the most treatable diseases, with readily available and affordable antibiotics.

Yet, pneumonia remains the leading infectious killer of children below five years in the world. In Kenya, the most recent data indicates that it accounts for 10,628 deaths every year.

According to (WHO 2016) data, globally pneumonia accounts for 16 per cent of all deaths of children below five years, killing 920,136 children in 2015.

To reduce the number of children dying of Pneumonia, in 2011, and through the support of GAVI Alliance, Kenya introduced pneumococcal vaccines (PCV10). Children are vaccinated free of charge.

Dr Ambrose Agweyu, Paediatrician and Clinical Research Fellow (Kemri-Wellcome Trust Research Programme) says the PCV10 has helped reduce pneumonia dramatically.  

"The PCV10 vaccine has been shown to reduce the number of children below five years hospitalised with pneumonia by 25 per cent," he said, adding the vaccine also confers protection against other severe childhood illnesses like sepsis and meningitis.

Dr Agweyu says Kenyans were still getting the vaccine (with others like Hib vaccine, diphtheria, whooping cough and measles), that protect against pneumonia.

Investing in prevention, protecting against and treating pneumonia have helped contribute to reduction of under five years mortality in Kenya from an estimated 19,000 deaths annually in 2012 (WHO Global Data Repository) to estimated 10,628 deaths in 2016 (WHO Global Health observatory).

He, however, explains thus: "At 10,628 deaths every year, the mortality rate is still unacceptably high for a preventable and treatable condition".

Despite the Government providing antibiotics for treating pneumonia for free for children below five years, not all children access treatment. 

Lewa says local people have to walk more than 15km to Balah dispensary. “This discourages them from seeking medical attention till it is severe,” he says. 

The roads are bad and hence avoided by motorists. Many have to walk, as the only other available means is use boda boda. 

More than 90 per cent of locals are illiterate and do not value early treatment much. Language barrier is the other problem.

“Some come, but a lot of information is lost through interpretation,” he says.

Osman Warfa, the head of Neonatal, Child and Adolescent Health Unit in the Ministry of Health, says tendency to seek early medical care is important in treating pneumonia. 

"Only 67 per cent of children with pneumonia are taken to a health facility. Parents or guardians should seek care immediately when a child develops cough or experiences difficulty in breathing," says Dr Warfa.