Helps Ethiopean ChildrenAfrica has the highest child mortality rate of any continent. Ethiopia sits in the middle of the child mortality ranking of countries throughout Africa with 59 out of 1,000 children dying before the age of five. While it is not as high as the rate of 76 per 1,000 children found in sub-Saharan Africa, it is much worse than many developed nations, which average around 6 deaths per 1,000 children annually. New research, however, shows that childhood mortality can be significantly lowered in Africa using an antibiotic that could help Ethiopian children prevent blindness.

Azithromycin Helps Ethiopian Children

Trachoma is the leading bacterial infection that causes blindness. In an effort to lower the number of cases of trachoma, researchers preemptively gave azithromycin, an antibiotic effective at fighting trachoma, to thousands of children under the age of nine in Ethiopia. The researchers administered these doses of azithromycin to children twice a year.

After observing the children for several years, they came to a shocking discovery: azithromycin will help Ethiopian children live longer. Not only did the bi-annual antibiotic prevent against trachoma, as the researchers believed it would, but it also protected against many other common ailments as well. For those children in the case study, the childhood mortality rate was cut in half.

The discovery seemed too good to be true, so this group of researchers tried to replicate their findings in other African nations with higher child mortality rates. Close to 200,000 children were given azithromycin in Tanzania, Malawi and Niger. While the results were not quite as impressive as cutting the child mortality rate in half, as seen with Ethiopia, the results were still high. The twice-yearly drug lowered child mortality rates between 14 to 19 percent in each country.

Research Into Other Illnesses

Research must continue before Africa will see widespread use of azithromycin for children. If approved for widespread use, this antibiotic could help prevent some of the common illnesses that lead to child mortality. These common illnesses include:

  • Pneumonia: Pneumonia kills nearly 100,000 children per year in Africa. This accounts for 16 percent of childhood death under the age of five. Currently, when children contract pneumonia, only one third are able to receive lifesaving antibiotic treatment.
  • Diarrhoeal disease: Diarrhea is the leading cause of death in children under the age of five. Diarrhea is a common infection in the bowels. It is completely preventable and treatable, yet it is estimated that 525,000 children in Africa die annually from this illness.
  • Malnutrition: Malnutrition contributes to childhood mortality rates. While the use of azithromycin will not be able to prevent malnutrition, it may be able to help prevent other ailments that the body is not able to fight off because of the lack of nutrients and calories.

Long term effects of azithromycin used to prevent ailments in children are not known. However, the studies have shown promising results in saving the lives of hundreds of thousands of African children. With a few more years of research and more funding, these researchers may be able to permanently lower the childhood mortality rate in Africa. Not only will this research continue to help Ethiopian children but it will also help children of other nations, ensuring they live into adulthood.

Kathryn Moffet
Photo: Pexels

Pneumonia in India accounts for 20 percent of the deaths worldwide caused by pneumonia. Pneumonia is an acute respiratory infection which affects the lungs. It causes difficulty in breathing and limits oxygen intake. It can be caused by bacteria, fungi or viruses and is a contagious disease.

Pneumonia symptoms include a cough, difficulty in breathing, fast breathing or wheezing. Infants may experience an inability to feed or drink, unconsciousness or convulsions, or worse. Pneumonia is the largest infectious cause of death among children in the world.

India has the highest number of deaths by pneumonia and diarrhea among children. Pneumonia in India in children under five is caused by malnutrition, low birth weight, non-exclusive breastfeeding, lack of measles immunization, indoor air pollution and overcrowding.

Pneumonia in India can be fatal to all, but is especially dangerous to young children. According to the  World Health Organization (WHO), one in three deaths in India is caused by pneumonia. Pneumonia in India is the leading cause of infant deaths. Every year almost 200,000 children under five die of pneumonia in India. On a global level, pneumonia kills around 900,000 children in the world every year.

In 2016, India managed to achieve improvement of 7 percentage points in the GAPPD score. The GAPPD score measures the use of interventions that protect, treat and prevent phenomena and diarrhea. India’s 2016 score was 41 percent, a major improvement achieved by improving exclusive breastfeeding rates and the Hib vaccine, but well short of its target score of 86 percent.

A new vaccine to protect children was introduced in India this year as part of the Universal Immunization Program. Called the pneumococcal conjugate vaccine (PCV), this new vaccine will be available to children who need it, especially the underprivileged. Millions of children will receive the vaccine for free. The vaccine protects children from pneumococcal diseases like pneumonia and meningitis.

The aim of this vaccine is to reduce the death of children from pneumococcal pneumonia. “No child should die from the vaccine-preventable disease,” said the Union Minister for Health and Family Welfare in India.

To fight pneumonia, a threefold strategy needs to be incorporated:

  1. Protection: Exclusive breastfeeding for six months, vitamin A and zinc supplementation and adequate nutrition
  2. Prevention via vaccination: Pneumococcus, HIV Protection, promotion of washing and hygiene, reduction of indoor air pollution
  3. Treatment: improving care-seeking behavior, community case management and health facility case management

India has taken significant initiatives to fight against this disease. Through implementing this threefold strategy, overcoming pneumonia in India is hopeful.

Aishwarya Bansal

Photo: Flickr

According to the World Health Organization, 9.2 million children under the age of 5 die every year, many from preventable conditions that could be treated with simple healthcare interventions. The majority of these deaths occur in Sub-Saharan Africa and South Asia, where the child mortality rate is 175 per 1000 (compared to 6 per 1000 in industrialized countries).

Many of the diseases that kill children younger than 5-years-old are caused by lack of access to healthcare facilities, improper hygiene and sanitation, unclean water and not enough food, and low levels of education and information. The top three causes of child mortality are:

1. Pneumonia
About 15 percent of child mortality deaths are caused by pneumonia. In 2013, pneumonia killed an estimated 935,000 children under the age of 5. Pneumonia occurs when the air sacs in the lungs, the alveoli, are filled with pus and fluid. This makes breathing difficult, and does not allow the infected person to intake enough oxygen. Those who are malnourished have weaker immune systems and are therefore at a higher risk of dying from pneumonia. Pneumonia is also more likely to affect those who have pre-existing illnesses such as HIV, who live in an area where levels of indoor air pollution are high because of cooking with biomass fuels like wood or dung, who live in crowded homes, or those who have parents who smoke. While pneumonia can be treated with antibiotics, only one third of the children infected with pneumonia get the antibiotics necessary to cure them.

2. Diarrhoeal Disease
Each year, diarrhea kills 760,000 children under the age of 5. It is caused by unclean drinking water, contaminated food or person-to-person contact and poor hygiene. Malnourished children are more susceptible to diarrhea, and children in developing countries are likely to contract at least three cases of diarrhea each year. Since diarrhea leads to malnourishment, those who are already weakened by the disease are likely to contract it again. Diarrhea then leads to severe dehydration, which leads to death. It can be treated with rehydration zinc supplements. A good method of preventing diarrhea is decreasing levels of malnutrition, therefore making children less likely to be infected with the disease.

3. Malaria
In Africa, a child dies every minute from malaria, a disease caused by parasites. These parasites are transmitted to people from mosquito bites. The symptoms are first expressed as fever, chills and vomiting, and can then progress to severe illness and death if not treated within 24 hours. Malaria is preventable through the use of mosquito nets and levels of deaths caused by malaria are decreasing. Malaria related mortality cases in Africa have fallen 54 percent since 2000.

Child mortality is also high in countries that have a high Maternal Mortality Rate (MMR). More than a third of child mortality deaths occur in the first month of life and are related to pre-term birth, birth asphyxia (suffocation), and infections. In order to reduce Child Mortality, Maternal Mortality rates also have to decrease. This can happen with increased access to healthcare facilities and increased prenatal visits.

Child mortality rates are decreasing, but there is still work to be done. Vaccinations, adequate nutrition and increasing education will all help to decrease the levels of child mortality.

Ashrita Rau

Sources: WHO 1, WHO 2, WHO 3, WHO 4
Photo: Flickr

infectious diseases
Out of the eight Millennium Development Goals agreed upon by the U.N., three of them are dedicated to resolving serious health issues: child and maternal mortality, HIV/AIDS, malaria and other diseases. Despite progress made in each of these goals over the past 14 years, reducing the child mortality rate has proven to be one of the most difficult goals to achieve.

Every year, more than six million children die before they reach their fifth birthday due to preventable infectious diseases according to the U.N. In a recent report, USAID revealed that the following three diseases are the greatest contributors to that statistic:

1. Pneumonia is the cause of approximately 17 percent of deaths in children under the age of five. Especially among infants, pneumonia is a serious lung infection. Pneumonia causes more deaths in children than AIDS, malaria, and measles combined according to UNICEF.

2. Diarrhea is the second most deadly condition for children under five, causing nine percent of deaths. Compared to adults, children are particularly susceptible to diarrhea because a greater proportion of their bodyweight is made up of water. Even though it is such a dangerous condition for children, only 44 percent of children in developing countries suffering with diarrhea actually receive treatment according to the World Health Organization (WHO).

3. Malaria closely follows diarrhea, causing about seven percent of all child deaths. Even though malaria is easily spread through a mosquito bite, this disease can be just as easily prevented through insecticide-treated mosquito nets and effective antibiotics. Although 1.1 million deaths caused by malaria have been averted since the start of the U.N.’s Millennium Development Goals in 2000, malaria is still a major health issue in developing countries.

Pneumonia, diarrhea and malaria together account for about a third of all child deaths globally. The symptoms and effects of all of these diseases can become severe if the infected person is malnourished or does not receive the proper necessary treatment. As a result, these three diseases are all the more rampant in developing countries.

Similarly to the U.N.’s goal to reduce the child mortality rate by two-thirds, staff members of both WHO and UNICEF worked together to create the Global Action Plan for Pneumonia and Diarrhea (GAPPD). This integrated plan seeks to end child deaths caused by these two preventable diseases by 2025. The GAPPD will also combine the practices for  treating both pneumonia and diarrhea since the causes and treatment for these two diseases are inter-related.

Global poverty is directly related to the spread of infectious diseases in developing countries. This is why The Borgen Project along with so many other organizations work to decrease the multi-layered issue of poverty across the globe.

– Meghan Orner

Sources: Daily Times, WebMDWorld Health Organization, World Health Organization

Worldwide, pneumonia is the leading cause of death among children under five. In 2011 alone, pneumonia caused the deaths of 1.3 million children and accounted for 18% of child deaths – mostly in developing regions such as Sub-Saharan Africa and South Asia.

According to the Gates Foundation, “if properly diagnosed, childhood pneumonia can be effectively treated in a three-day course of antibiotics at a cost of only .21 to .42 US cents.” The Gates Foundation Pneumonia Program’s priority is “to promote full-scale delivery of currently available pneumococcal and meningococcal vaccines” in order to save 2.9 million children and prevent 52 million cases of pneumonia.

On July 11, the Bill and Melinda Gates Foundation named Keith Klugman as Director of the Gates Foundation Pneumonia Program beginning August 5.

As an accomplished professor and researcher, Klugman’s resume is very impressive. Formerly the William H. Foege’s Chair and Professor in the Hubert Department of Global Health at the Rollins School of Public Health at Emory University in Atlanta, Klugman’s research has centered around “antibiotics, antimicrobial resistance, and vaccines for bacterial pathogens – particularly the pneumococci.”

Klugman was also the Co-Director of the Respiratory and Meningeal Pathogens Research Unit of the University of Witwatersrand, the Medical Research Council and the National Institute for Communicable Diseases in Johannesburg, South Africa, according to the American Society for Microbiology. After assuming his new leadership position at the Gates Foundation, he will remain an Honorary Professor in the Respiratory and Meningeal Pathogens Research Unit.

During the course of his career, “Klugman has chaired or served on numerous expert committees for the World Health Organization (WHO) in Geneva, the Wellcome Trust in London, and the Centers for Disease Control (CDC).
He is also the Chair of the International Board of the American Society for Microbiology, “the largest single life science Society with over 40,000 members worldwide”, and the Treasurer of the Executive Committee of the International Society for Infectious Diseases.

Trained in South Africa and a postdoctoral graduate of the Rockefeller University in New York, Klugman stands out as one of the leading figures in the field of Microbiology.

– Lauren Yeh

Sources: The Gates Foundation, mBio, The Gates Foundation
Photo: Emory University