& çâÌæÚUæð´ ·¤è ¥ôÚU Îð¹Ùæ ÁæÚUè ÚU¹ð´ ¥ÍæüÌ ¥ÂÙð ÜÿØ ÂÚU ŠØæÙ ÚU¹ð´Ð ãæÚU Ù ×æÙð´, €UØô´ç·¤ ·¤æ× ·¤ÚUÙð âð ¥æÂ·¤ô ©gðàØ ·¤è Âýæç# ãôÌè ãñ ¥õÚU ÁèßÙ ·¤æ ¹æÜèÂÙ ÎêÚU ãôÌæ ãñÐ ÖÜð ãè ÁèßÙ ×ð´ ç·¤ÌÙè Öè ·¤çÆÙæ§ü €UØô´ Ù ¥æ°, çÁ™ææâæ ¥õÚU ©ˆâæã ÕÙæ° ÚU¹ð´Ð ŠØæÙ ÚU¹ð´, ÜÿØ ã×ðàææ ¥æÂ·Ô¤ Âæâ ãôÌð ãñ´ çÁ‹ãð´ ÂæÙð ·Ô¤ çÜ° ÂýØæâ ¥æÂ ·¤Öè Öè àæéM¤ ·¤ÚU â·¤Ìð ãñ´Ð

The Way to Save Babies from Death by Pneumonia

By Sanjiva Wijesinha
***Four million babies die of pneumonia every year — most of them in the developing world. Nearly all deaths can be prevented if the disease is recognised early and treated properly. A distinguished Indian professor says that to do this, accurately timing the rate at which an infant breathes in far more useful in diagnosing pneumonia than listening to the child's chest with a stethoscope. Gemini News Service reports on a number of ways to save children's lives.
Accurately timing the rate at which an infant JLl breathes could be far more useful th diagnosing the deadly disease of childhood pneumonia than listening to the child's chest with a stethoscope.
So says Professor Vijay Kumar, former head of Ihe department of paediatrics and community medicine at India's Postgraduate Institute of Medicine in Chandigarh, and now a consultant for the World I icalth Organisation (WHO). He was talking tn Colombo, where a WHO global programme for controlling respiratory infections in children was unveiled.
Acute respiratory disease constitutes one of the major killers of children. Four million die each year. Most deaths take place In what ts euphemistically called the developing world — and more than 70 per cent are due to pneumonia or lung infection.
In the Third World, unlike in the developed world (where virus infections are more common), over two-thrtds of these pneumonias are caused by bacteria such as streptococcus and hacmophllus. Both are amenable to antibiotic therapy.
Most pneumonia deaths can be prevented if the disease is recognised early and treated properly. The WHO meeting aimed to update paediatrictavis working in city hospitals and general practitioners and health workers practising on the periphery.
It ts vital that a child's illness Is recognised early as a potentially dangerous pneumonia so that the child is taken to a doctor In time and started on a proper course of treatment.
Kumar's most important message was that one does not have to wait for a laboratory test or a chest X-ray or even a stethosocopc to be put on the child's chest to diagnose pneumonia. The impdrlaijl ' criteria arc :
• An increased respiratory rate — based on the fact that a child with lung infection breathes more rapidly than normal:
• Indrawing of the muscles between .the ribs — caused by the increased respiratory effort requred io suck air into the infected lungs.
Based on such criteria, a health worker in the village, or even a sick child's own mother, would be able to detect early that a child has pneumonia. Being aware of the initial signs of this deadly disease, they will easily know when a child needs medical attention.
It naturally follows that they should be armed with the, knowledge of where the child' should be taken for appropriate treatment.
In fact, the number of deaths due to pneumonia could be lowered with better community knowledge of the disease and the availability of a very cheap drug. according to a study reported in the British Medical Journal The Lancet.
4n .1988 tlje Society of Education. Action and Research in Community Health introduced a programme of intensive health education. Improved child care and immunisation into 58 villages in central India and compared them with 44 other Indian villages where there was no such programme.
After a year the number of deaths from pneumonia was 8.1 per 1.000 children under five in the intervention area and 17.5 in the other villages. The drug used to treat pneumonia, co-trlmoxazole. costs 2.5 US cents a child per year. The study showed that giving people in the community adequate health information and then making them responsible for seeking health care. would pay dividends.
As far as practical advice to parents and health workers Is concerned, the normal values for respiratory rates In children should be :
• Child under two months — 60 breaths per minute
• Child between two and twelve months — 50 breaths per minute
• Child over one year — 40 breaths per minute
If a sick child is breathing at a faster rate than this, the child needs an oral antibiotic. Il in addition to rapid respiration there Is also chest indrawing, it is better lo . hospitalise the child and begin a course of antibiotics by Intramuscular or intravenous Injection.
Children under two months arc the most susceptible to death from pneumonia, so even milder cases tn this age group the best managed In hospital.
The other important fact brought out al the WHO meeting is that most chlklren with coughs do not need antibiotics Ail tlicy need Is normal feeding, increased amounts of fluids, warm sweet drinks such as lemon lea. coriander waler etc. to mmHIk the throat — and observation to make sure they do not develop the features of pneumonia.
So the lake home message from WHO is this : to detect early pneumonia tn children, counting a child's respiratory rate (with a watch or stopwatch) is more useful than waiting lor a doctor to examine the child’s chest with a stethoscope or an X-ray.
Once the stopwatch has detected the child needing treatment for pneumonia Ila next step Is equally important. The child must be taken to a doctor — one preferably ar nod with a stethoscope — so that treatment with an appropriate course of antibiotics ran begin. - GEMINI NEWS
Dr. Saiyiua Wyeainha Is Chief Paediatric Surgeon at the Colombo Children's HospUal tn Sdlunka.