Pneumonia remains a major public health concern

Mar 05, 2022 Features / Columnists, Peeping Tom

Kaieteur News – When a loved one dies, it leaves a lot of pain. The emotional stress of losing someone often leads to casting blame as to responsibility for the death.
A few days ago, a letter appeared in the newspaper in which the family of an unnamed elderly person blamed the National Infectious Hospital for negligence and resulting death of their loved one. The hospital cannot respond to the charges because no name was supplied.
The facts in this case are not fully known. It is therefore not the intention of the column to undertake an op-ed post mortem of this case, except to say that all the facts need to be known before aspersions are cast.
What is known generally is that pneumonia is very deadly in elderly persons. A recent health article pointed out that in the United States, pneumonia is the 3rd most common cause of hospitalisation in the persons over the age of 65.
Pneumonia should always be taken seriously. Underlying conditions can worsen the prognosis, especially if those underlying conditions are related to the respiratory or cardiovascular systems.
While the elderly remain of special interest, it should be observed that pneumonia is a leading cause of death in children under five years. According to the World Health Organization, about 1.6 million children die each year from pneumonia worldwide which amounts to 18 percent of all deaths for children in this age group.
Early treatment is desirable but detecting pneumonia at home can be deceptive. There have been cases in which there were no signs of fever at all to indicate an infection. And while the patient may not seem seriously ill, this is far from so since once the lungs become affected, it is dogged fight to regain health, especially in the elderly.
Pneumonia was a serious public health concern in British Guiana. In 1874, pneumonia accounted for almost three percent of deaths in Georgetown. In that same year 131 cases of pneumonia were treated at the colonial hospital in Georgetown. Almost one in every three of those patients died. In the estate (rural) hospitals, more than 3,000 were treated for pneumonia in the same year. The mortality rate was two percent higher than at the colonial hospital in Georgetown.
Pneumonia continued to be a problem to the end of the century. According to Jamellah Bayley, pneumonia and tuberculosis accounted for 38 percent of total deaths in 1894/1895 in British Guiana.
During colonialism, many young adults, less than 45 years old, succumbed to this condition, leaving their families to fend for themselves in difficult times. Even as late as 1961, the annual pneumonia mortality rate was above 11 per every 10,000 persons for persons above the age of 45. And if you factor in bronchitis, it was more than 20 per every 10,000 for the same age range.
As sanitation and living conditions improved there was a decline in the mortality rate of pneumonia. But it remains a serious public health concern right through to the present.
In the first decade of the 21st century, Guyana was listed among the top 10 countries with the highest pneumonia mortality per million persons. That is not likely to have changed much during the second decade of the 21st century.
Before the pandemic, pneumonia and influenza accounted for 4.42% of total deaths. Before the advent of COVID-19, these two infectious diseases were already a serious public health concern.
COVID has made the situation worse. Last November, Dr. Zulfikar Bux wrote in this newspaper that more than half of the COVD-related deaths were due to respiratory failure with many caused by pneumonia.
One study found that COVID pneumonia causes extreme damage to lung tissue and may result in organ damage. The mortality from COVID pneumonia has been said to be high.
Persons who develop the severe form of COVID-19 are susceptible to pneumonia. And those that and are elderly are at an increased risk of succumbing.
COVID-19, however, is not the only cause of pneumonia. It is for this reason that the incidence of pneumonia needs to be addressed countrywide and not simply in the context of the COVID-19 pandemic.
The elderly and small children remain extremely vulnerable to all kinds of lung infections and these can easily develop into pneumonia. As a public health concern, special attention must be paid to the incidence of pneumonia in the elderly and in toddlers.
(The views expressed in this article are those of the author and do not necessarily reflect the opinions of this newspaper.)

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