Acute respiratory infections start hitting children badly

SETTING IN OF WINTER

On average, over 1,300 cases being reported per day at allied hospitals

Rawalpindi

The incidence of acute respiratory infections (ARIs) have started hitting badly the population particularly children in this region of the country after the setting in of winter as for the last one week, the paediatrics departments at the allied hospitals in town have been receiving well over 1,300 child cases with ARIs per day on average.

The ARIs that are classified as upper respiratory tract infections or lower respiratory tract infections are the major cause of mortality among children aged less than five years especially in developing countries including Pakistan and even worldwide, 20 per cent mortality among children aged less than five years can be attributed to respiratory tract infections predominantly pneumonia associated.

The increase in number of child cases with ARIs hints that majority of parents are unaware of the measures to be taken to avoid winter related ailments or they do not take the matter as seriously as it is, said Head of Paediatrics Department at Rawalpindi Medical College Professor Dr. Rai Muhammad Asghar while talking to ‘The News’ on Sunday.

He said the paediatrics departments operating at the allied hospitals in town receive nearly 2,000 child patients per day on average at their emergency and outpatients departments of which an estimated 1,300 to 1,400 child patients are being presented with ARIs per day and the number is continuously on the rise after the setting in of winter.

It is important that two of the three teaching hospitals including Holy Family Hospital and Benazir Bhutto Hospital operate full-fledged paediatrics departments in town.

Upper respiratory tract infections are the most common infectious diseases that include rhinitis (common cold), sinusitis, acute pharyngitis or tonsillopharyngitis, epiglottitis, ear infections, and laryngitis and of these ear infections and pharyngitis cause the more severe complications — deafness and acute rheumatic fever, respectively.

The common lower respiratory tract infections in children are pneumonia and bronchiolitis in which respiratory rate is a valuable clinical sign for diagnoses as the child patients suffering from these infections cough and breath rapidly. The presence of lower chest wall indrawing identifies the more severe nature of pneumonia, said Dr. Rai.

He added it is alarming that the paediatrics departments at the allied hospitals are receiving over 400 child patients with pneumonia per day on average and the number is on the rise. “On average, around 1,000 child patients are being presented to the allied hospitals with upper respiratory tract infections including colds, sore throat, cough and flu per day.”

He said a number of factors are responsible for spread of respiratory tract infections but the most important ones are poor socioeconomic factors; low level of literacy, suboptimal breast feeding, malnutrition and unsatisfactory level of immunisation coverage.

He, like many other health experts, said that dry chill accompanied with high pollution level in the air is causing spread of respiratory tract infections and immediate rain as well as heavy wind is needed to cleanse the air quality, which seems to be engulfed by dusty clouds, toxic metals and vapours.

Dr. Rai said that by creating awareness among public on preventive measures needed to avoid respiratory tract infections, the spread of ARIs can be controlled.

To avoid upper and lower respiratory tract infections including pneumonia, children should be protected from cold by using warm clothing while infants should be breastfed at least for two years. Parents should avoid children from getting wet to avoid pneumonia and the environment of the children should be kept clean, he said.

He added that children below five years of age must be administered pneumococal vaccine and haemophilus influenzae type B (HIB) vaccine which is available under Expanded Program on Immunization. Both the vaccines are available at the allied hospitals free of cost, he said.

He added that to safeguard school-going children from winter related infections, parents should not allow them to consume ice cream, cold drinks and other like cold dishes. They should be protected from cold and should be given green tea with honey, he said.

Both the infants and school going children should be protected from all types of smoke that contains greater number of allergens, he said.

To a query, Dr. Rai said the ARIs are highly contagious and can be passed by tiny droplets produced during sneezing or coughing of infected persons and touching things with hands and tissues that others touch.

The incidence of ARIs can be avoided among children and infants through simple low cost interventions like hand washing and breastfeeding and these should be followed religiously by parents, he said.

He added that overcrowding in a room as happened in winter contaminates the environment if the room is not properly ventilated and it may cause ARIs including pneumonia. The rooms in which children and infants are kept should have proper ventilation system and should be in access of sunlight, he said.

It is important that pneumococal vaccine as part of EPI has already been introduced at the allied hospitals that provides major cover against pneumonia. Three doses of pneumococal vaccine are administered to infants at the age of six weeks, 10 weeks and 14 weeks and parents may bring infants to the allied hospitals for the vaccine’s administration, said Dr. Rai.

It is need of the time to make parents aware of the fact that infants who are breastfed have least chances of getting respiratory tract infections including pneumonia, he said.

He said that children should be given healthy diet in winter including fresh fruits, milk, egg and meat products as malnourished children are more likely to get seasonal infections in winter as compared to well-nourished children.