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      Acute respiratory infections among under-5 children in India: A situational analysis

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          Abstract

          Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Emergence of newer pathogenic organisms, reemergence of disease previously controlled, wide spread antibiotic resistance, and suboptimal immunization coverage even after many innovative efforts are major factors responsible for high incidence of ARI. Drastic reduction in the burden of ARI by low-cost interventions such as hand washing, breast feeding, availability of rapid and feasible array of diagnostics, and introduction of pentavalent vaccine under National Immunization Schedule which are ongoing are necessary for reduction of ARI.

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          Epidemiology and etiology of childhood pneumonia.

          Igor Rudan, Cynthia Boschi-Pinto, Zrinka Biloglav … (2008)
          Childhood pneumonia is the leading single cause of mortality in children aged less than 5 years. The incidence in this age group is estimated to be 0.29 episodes per child-year in developing and 0.05 episodes per child-year in developed countries. This translates into about 156 million new episodes each year worldwide, of which 151 million episodes are in the developing world. Most cases occur in India (43 million), China (21 million) and Pakistan (10 million), with additional high numbers in Bangladesh, Indonesia and Nigeria (6 million each). Of all community cases, 7-13% are severe enough to be life-threatening and require hospitalization. Substantial evidence revealed that the leading risk factors contributing to pneumonia incidence are lack of exclusive breastfeeding, undernutrition, indoor air pollution, low birth weight, crowding and lack of measles immunization. Pneumonia is responsible for about 19% of all deaths in children aged less than 5 years, of which more than 70% take place in sub-Saharan Africa and south-east Asia. Although based on limited available evidence, recent studies have identified Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus as the main pathogens associated with childhood pneumonia.
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            Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates.

            James P. Watt, Lara J. Wolfson, Katherine L O'Brien … (2009)
            Haemophilus influenzae type b (Hib) is a leading cause of childhood bacterial meningitis, pneumonia, and other serious infections. Hib disease can be almost completely eliminated through routine vaccination. We assessed the global burden of disease to help national policy makers and international donors set priorities. We did a comprehensive literature search of studies of Hib disease incidence, case-fatality ratios, age distribution, syndrome distribution, and effect of Hib vaccine. We used vaccine trial data to estimate the proportion of pneumonia cases and pneumonia deaths caused by Hib. We applied these proportions to WHO country-specific estimates of pneumonia cases and deaths to estimate Hib pneumonia burden. We used data from surveillance studies to develop estimates of incidence and mortality of Hib meningitis and serious non-pneumonia, non-meningitis disease. If available, high-quality data were used for national estimates of Hib meningitis and non-pneumonia, non-meningitis disease burden. Otherwise, estimates were based on data from other countries matched as closely as possible for geographic region and child mortality. Estimates were adjusted for HIV prevalence and access to care. Disease burden was estimated for the year 2000 in children younger than 5 years. We calculated that Hib caused about 8.13 million serious illnesses worldwide in 2000 (uncertainty range 7.33-13.2 million). We estimated that Hib caused 371,000 deaths (247,000-527,000) in children aged 1-59 months, of which 8100 (5600-10,000) were in HIV-positive and 363,000 (242,000-517,000) in HIV-negative children. Global burden of Hib disease is substantial and almost entirely vaccine preventable. Expanded use of Hib vaccine could reduce childhood pneumonia and meningitis, and decrease child mortality. GAVI Alliance and the Vaccine Fund.
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              Pneumococcal vaccines WHO position paper - 2012 - recommendations.

              (2012)
              This article presents the World Health Organization (WHO) recommendations on the use of pneumococcal vaccines excerpted from the Pneumococcal vaccines WHO position paper - 2012 recently published in the Weekly Epidemiological Record. The current document replaces the position paper on the use 7-valent pneumococcal conjugate vaccine published in 2007. Incorporating the most recent developments in the field of pneumococcal vaccines this position paper focuses on the currently available 10-valent and 13-valent conjugate vaccines and their introduction and use in national immunization programmes. It also deals with the 23-valent polysaccharide vaccine, though in less detail than provided in the April 2008 position paper which remains valid. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines worldwide. This paper reflects the recommendations of the WHO's Strategic Advisory Group of Experts (SAGE) on immunization. Recommendations on the use of pneumococcal vaccines were discussed by SAGE at its meetings in November 2006 (conjugate vaccine) and April 2008 (polysaccharide vaccine) and most recently in November 2011. Evidence presented at these meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. Copyright © 2012. Published by Elsevier Ltd.. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Nat Sci Biol Med
                Journal ID (iso-abbrev): J Nat Sci Biol Med
                Journal ID (publisher-id): JNSBM
                Title: Journal of Natural Science, Biology, and Medicine
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0976-9668
                ISSN (Electronic): 2229-7707
                Publication date (Print): Jan-Jun 2014
                Volume: 5
                Issue: 1
                Pages: 15-20
                Affiliations
                [1] Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
                [1 ] Dept of Community medicine, Indira Gandhi Medical College and Research Institute, Puducherry, Puducherry, India
                Author notes
                Address for correspondence: Dr. Kalaiselvi Selvaraj, Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry - 605 009, India. E-mail: Kalaiselvi.dr@ 123456gmail.com
                Article
                Publisher ID: JNSBM-5-15
                DOI: 10.4103/0976-9668.127275
                PMC ID: 3961922
                PubMed ID: 24678190
                SO-VID: 5ecbcfc8-2cbf-4d40-8043-f569ace3624d
                Copyright © Copyright: © Journal of Natural Science, Biology and Medicine
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Subject: Review Article

                ScienceOpen disciplines: Life sciences
                Keywords: acute respiratory infections,control of acute respiratory infection,disease burden,national immunization schedule,pneumonia,under-5 children,vaccine status
                Data availability:
                ScienceOpen disciplines: Life sciences
                Keywords: acute respiratory infections, control of acute respiratory infection, disease burden, national immunization schedule, pneumonia, under-5 children, vaccine status

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