29 January 2013

Uganda: Pneumonia - Not Just the Rain or Cold Weather

When children play in the rain, or get exposed to cold, often, their parents are quick to lock them indoors, fearing they might contract pneumonia.

But does exposure to rain really cause pneumonia? Some parents are further puzzled when their children get recurrent bouts of the disease, despite keeping them warm and indoors.


According to Dr. Eric Wobudeya, a paediatrician at Mulago Hospital, playing in the rain or exposure to coldness does not cause pneumonia. Wobudeya says pneumonia is caused by a virus or bacteria, the commonest being streptococcus pneumonia.

The infection causes the small sacs (alveoli) in the lungs to be filled with pus or fluid, which makes breathing painful and limits oxygen intake.

Phillipa Musoke, an associate professor at Makerere University College of Health School and Department of Paediatrics, adds that pneumonia is an acute respiratory infection that affects the lungs.

The condition gets worse when the episodes occur frequently. A child is said to have recurrent pneumonia, she explains, when he suffers more than three episodes of the disease in a year.

Musoke says recurrent pneumonia usually results from underlying causes such as gastroesophageal reflux disease, a digestive disorder. This may lead to aspiration, which puts the child at increased risk of recurrent pneumonia. Aspiration is the entry of substances from the gastrointestinal tract into the lungs.

Conditions like malnutrition and diseases like HIV, cancers and diabetes lower a child's immunity. When the immunity is compromised, the body cannot fight infections, predisposing the child to diseases like pneumonia.

Breath-related conditions, such as asthma and congenital lung or heart defects are among the risk factors, as they weaken one's immunity.

Pre-existing illnesses, such as HIV and measles may increase the risk.

Smoking, cooking on a charcoal stove or firewood and living in crowded and poorly ventilated houses also increase one's susceptibility to pneumonia.

Sabrina Kitaka, a senior paediatrician at Mulago Hospital, says while the natural defence can fight the infection, children whose immunity is compromised are at higher risk of developing recurrent pneumonia.

Pneumonia in children is the leading cause of admissions and the second cause of death in children under five, after malaria. Currently, about 50 children are admitted with pneumonia at Mulago.

Signs and symptoms

Kitaka says symptoms of pneumonia include cough, high temperature and fast breathing. Children older than five years may also suffer from chest pain.

Diagnosis and treatment

Wobudeya urges parents and caretakers to ensure that a child with pneumonia is diagnosed and given proper treatment to prevent recurrent episodes. An X-ray of the chest may be necessary to effectively diagnose pneumonia.


The best remedy is to stay away from people who have respiratory infections. Also practice good hygiene, such as washing your hands with soap and water to prevent contracting and spreading infections.

The pneumococcal vaccine can also help protect against streptococcus pneumonia bacteria, the common cause of respiratory infections. In addition, ensure you vaccinate your child against measles, influenza and whooping cough, as these diseases predispose one to pneumonia.

Adequate nutrition, such as exclusive breastfeeding is also essential in boosting immunity, thus guarding against infections like pneumonia.

Also avoid indoor air pollution, especially cooking and smoking, as this creates high levels of air pollution, a pneumonia risk factor.

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