Abstract
Neonatal pneumonia is a devastating condition. Most deaths in sub-Saharan Africa can be attributed to preventable diseases, including pneumonia, diarrhoea and malaria, which together killed an estimated 2.2 million children under the age of 5 years in 2012, accounting for a third of all under-five deaths in this region. Some countries are making progress in reducing mortality through community-based health schemes; however, most countries in this region are far from achieving the World Health Organization Sustainable Development Goals for reducing childhood morbidity and mortality. The microorganisms causing neonatal pneumonia are well known. Both bacteria and viruses are commonly responsible, while fungal organisms occur in the context of nosocomial disease, and parasites occur in HIV-infected children. The common bacterial pathogens are group B streptococci (and other streptococcal species) and Gram-negative organisms, most notably Escherichia coli and Klebsiella spp. The viruses that predominate are the common respiratory pathogens, namely respiratory syncytial virus, human rhinovirus, and influenza virus. Viral disease is often nosocomial and transmitted to infected neonates in the neonatal intensive care unit or other neonatal facilities by infected parents and staff. Neonatal pneumonia often presents with non-specific respiratory distress in newborns. In the premature infant it is often indistinguishable from surfactant deficiency-associated respiratory distress syndrome. Therefore, diagnostic testing that is cheap and reliable is urgently sought in this region. All neonates with pneumonia must receive broad-spectrum antibiotic cover. This usually entails the combination of penicillin and an aminoglycoside. A lack of appropriate drugs and neonatal intensive care unit facilities are hampering progress in managing neonatal pneumonia.
Highlights
Neonatal pneumonia (NP) is a common problem in sub-Saharan Africa
Epidemiology A United Nations Children’s Fund (UNICEF) report in 2013 suggested that the global under-five mortality rate has been reduced by 47 % since 1990 [2], yet this still means that 216 million children under 5 years of age died in the subsequent 23 years
The highest mortality rates are found in the low-income countries of sub-Saharan Africa and South Asia [2]
Summary
Neonatal pneumonia (NP) is a common problem in sub-Saharan Africa. this condition contributes to an enormous burden of ill-health, morbidity, and mortality. Between 2009 and 2011, a study of the leading causes of death in the Taabo Health and Demographic Surveillance System (HDSS) in south-central Côte d’Ivoire (a rural region of West Africa) revealed that of the 712 deaths analysed, maternal and neonatal conditions accounted for 8.3 % of deaths, primarily due to pneumonia (n = 19) and birth asphyxia (n = 16) in newborns [6]. Even in this region of the world, in spite of challenges, interventions have led to mortality reductions. Pneumonia is a common cause of hypoxia and where medical care is insufficient and resources scarce, mortality may be influenced by the unavailability of oxygen in many countries [35]
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