Dear Doctor, My two year-old-son coughs a lot especially when school begins. The coughing gets worse at night and early in the morning. I am worried because my friends are of the opinion that he is developing asthma. Last month, I took him to hospital and I was told it is pneumonia. Is there a connection between asthma and pneumonia?
Mary
Dear Mary, Both asthma and pneumonia affect the lungs, or the respiratory system of a child. While asthma is a chronic allergic disease, pneumonia is most often an acute lung infection. If your child has pneumonia, the alveoli (small sacs in the lungs) are filled with pus and fluid from the infection, making breathing painful while limiting oxygen intake. Pneumonia is the largest cause of death in children, more than Aids, malaria and tuberculosis combined. Asthma on the other hand is a leading cause of school absenteeism in the world, and it is the most common chronic disease among children of both high and low income countries.
Some symptoms occur in both diseases. Both diseases often present with cough, difficulty in breathing, restlessness, malaise, failure to breastfeed and sometimes vomiting. Pneumonia however is additionally more likely to be accompanied with rapid breathing, fever, chills, increased work of breathing, lower chest wall in drawing and convulsions. Asthmatic children frequently have shortness of breath, feel out of breath, may gasp for air, may have trouble breathing out, with chest tightness and wheezing.
Similar risk factors for both diseases include poor nutrition, indoor air pollution, and low birth weight, parental smoking and living in crowded homes. Specific additional risk factors for asthma include genetic predisposition and environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways, such as indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander); extreme emotional arousal such as anger or fear, and physical exercise.
Asthma cannot be cured, but can be controlled. There are short-term medications that relieve symptoms. Children with persistent symptoms must take long-term medication daily. With medical support, each child can learn the triggers and how to prevent an attack.
While pneumonia can be cured effectively by use of antibiotics, vaccination remains the most effective way to prevent it.
— Dr Ombeva Malande is a paediatrics and child health expert