Vaccination coverage against pneumonia, the leading preventable cause of under-five child deaths worldwide, is low in the most-affected countries, according to data to be released in The Lancet medical journal on 12 September.
Though vaccines exist to fight two bacteria responsible for more than one million child deaths a year, their roll-out in Asia and Africa has been slow due to lack of money and awareness, according to research groups specializing in pneumonia.
“Prevention of pneumococcal and Hib [haemophilius influenzae type b] cases and deaths is imminently achievable, but countries must demonstrate the political will to prioritize [put first] prevention,” said Orvin Levine, executive director of a pneumonia research initiative at the US-based Johns Hopkins Bloomberg School of Public of Health.
Rwanda and The Gambia recently launched donor-backed pneumococcal vaccination campaigns, while South Africa funded its own roll-out.
In 2000 an estimated 826,000 children died worldwide from pneumococcal disease and 370,000 from Hib, according to data gathered by the London School of Hygiene and Tropical Medicine, Johns Hopkins and the UN World Health Organization. All together, 14.5 million children were infected by one of the two diseases in 2000, the year examined by the study. Both pneumococcal disease and Hib most often show up as pneumonia and occasionally as meningitis.
Most pneumococcal infections in 2000 were in Asia (51 percent), while most deaths were in Africa (54 percent), the researchers say.
Johns Hopkins associate professor Kate O’Brien said the data proves the need for more prevention in at-risk countries. “The need for vaccination and improved treatment is particularly urgent in Africa and Africa, which together account for 95 percent of all pneumococcal deaths.”
The study says the 10 countries with the highest incidence of pneumococcal infections, accounting for 66 percent of cases worldwide, were – highest rate to lowest: India, China, Nigeria, Pakistan, Bangladesh, Indonesia, Ethiopia, Democratic Republic of Congo, Kenya and the Philippines.
|Pneumococcal infection, percentage global cases|
|3%||Indonesia, Ethiopia, Democratic Republic of Congo|
|Source: WHO, 2000|
Of these countries, Bangladesh, India and Indonesia are eligible for subsidized pneumococcal vaccines from the GAVI Alliance (formerly known as the Global Alliance for Vaccines and Immunisation), but have not yet applied. With GAVI support, each vaccine dose can cost as little as 15 US cents.
The Hib bacterium caused 8.1 million serious illnesses in 2000 – an increase over an earlier WHO annual estimate of five million – leaving up to 35 percent of survivors with permanent disabilities, according to WHO. Though Hib disease is preventable, hundreds of thousands of children die annually from the illness, which is difficult to diagnose.
Johns Hopkins associate in international health, James Watt, said Hib is almost entirely preventable with the vaccine.
India led the world in Hib infections in 2000 with 72,000 reported cases, followed by 34,000 in Nigeria, 24,000 in Ethiopia, 22,000 in Democratic Republic of Congo and 19,000 in China.