Posted by: davidjolson | 02/11/2011

Pneumonia in Africa – The silent killer

This guest blog was written by Jeanette Strydom, the communications officer at Africa Health Placements, a member organization of GHC based in Johannesburg.

JOHANNESBURG, South Africa — Pneumonia — Africa’s silent killer — is responsible for more deaths of children under the age of 15 than AIDS and malaria combined. This forgotten killer, however, does not receive the same amount of attention as AIDS, TB and malaria do.

Pneumonia causes inflammation of one or both lungs in the chest — usually due to infection — which causes a disruption of the normal process of gas exchange, in turn affecting oxygen supply to the tissues. This infection is completely preventable but also potentially fatal if the correct antibiotics are not administered.

Pneumonia kills more children per year than any other illness – the death rates are around 1.7 million children worldwide, every year. Children with HIV have a higher risk of contracting pneumonia, becoming very sick and dying than children who are HIV negative. Additionally, they fare worse on treatment, which is often further complicated by the need for a range of antibiotics to counter the numerous opportunistic infections that will take place. This makes treatment more expensive and increases the risk of resistance to the drugs, all of which makes Africa an even bigger target.

Dr Andrew Mbewe, the regional advisor for Child and Adolescent Health and Development at the Regional Office for Africa of the World Health Organization (WHO), states that “in sub-Saharan Africa four diseases or conditions are responsible for more than 70% of deaths among children less than five years of age: diarrhea, malaria, malnutrition and pneumonia.” All of which is worse where HIV is prevalent.

It has been proven that with the rise of HIV in South Africa, pneumonia cases among children have escalated. The children’s wards of South African hospitals are full of children with this potentially lethal combination.  Professor Madhi, co-director of the Respiratory and Meningeal Pathogens Research Unit of WITS University, explains that “the incidence of hospitalization for pneumonia has increased exponentially in tandem with the increase in the HIV epidemic over the past two decades.”

The professor estimates that, “currently 50% of children who are hospitalized for pneumonia in South Africa are HIV infected, even though they make up less than 5% of the childhood population.” The fatality rate for HIV-infected children with pneumonia in hospital is about 7% compared to about 1.5% for children who are not infected. Frightening odds.

A new pneumonia vaccine was rolled out in Africa in January and is reported to have the potential to save more than half a million lives per year. The vaccine will protect children against pneumococcal disease which is one of the leading causes of pneumonia. The lifesaving vaccine will be administered as a series of three injections, being distributed by The GAVI Alliance, which is a health partnership between the public and private sectors. They have already rolled out in Sierra Leone, Yemen, Honduras and Guyana – and are set to spread to more countries when additional funding becomes available to them. This vaccine has been available in the USA for the last year (which is also where it has been tested).

The new vaccine costs £2.20 (±R27.00) in South Africa as compared to the £38 (±R444.00) in Europe. This is the result of a deal between GAVI and the two manufacturers, Pfizer and GSK. The discounted rate is only a fraction above the cost of production. According to GSK, the vaccine takes up to a year to produce and is one of the most technically sophisticated of all their vaccines.

They are also said to be working on a second childhood vaccine against rotavirus – the main cause of serious diarrhea – which in turn causes many deaths on the continent. Could this pneumonia vaccine be an answer?


  1. Every clinician should read this,together we would save more lives,julian-Uganda

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