Overlooked early symptoms and the devastating impact of pneumonia on children
Strengthening these preventive and treatment measures remains crucial in reducing the devastating impact of pneumonia on children in Kenya and across the world.
Every 43 seconds, a child succumbs to pneumonia, yet many parents unknowingly overlook early symptoms, mistaking persistent coughs and flu-like signs for a common cold. This delay in seeking medical intervention often leads to late diagnoses, increasing the risk of severe complications.
Joyce*, a mother of four from Kayole, knows this pain first-hand. She endured the heartbreak of having her baby’s cleft lip surgery postponed not once, but three times — all because of an illness she initially dismissed as a mild flu.
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“The morning of the surgery, after all the searching and finally finding a free hospital, I was excited that my baby would finally get the procedure. It meant she could feed properly,” Joyce recalls.
“But what had started as a simple flu the week before turned out to be mild pneumonia. We had no choice but to go back home.”
The disappointment was crushing, but the nurses warned her that proceeding with surgery while the baby had pneumonia could lead to complications — even death. So, with a heavy heart, she returned home, hoping for another chance.
Twice more, the same condition forced her baby to be turned away. Each time, she followed the prescribed medications diligently, hoping for a full recovery before the next attempt. Finally, on the fourth scheduled surgery, her child was healthy enough to undergo the procedure successfully.
“I never imagined a flu could be this serious,” Joyce admits. “But after everything, I learned that what seems minor can have major consequences.”
Pneumonia is a serious lung infection that causes inflammation in the air sacs (alveoli), leading them to fill with fluid or pus. This build-up makes breathing difficult and reduces the amount of oxygen reaching the body. The infection can be triggered by bacteria, viruses, or fungi, with streptococcus pneumoniae being a leading bacterial cause, while viruses such as influenza and respiratory syncytial virus (RSV) also contribute.
Although pneumonia can affect people of all ages, it poses a greater risk to children, particularly those under five.
Severe complications
The World Health Organisation (WHO) reports that every 43 seconds, a child dies due to pneumonia, highlighting its devastating impact on young lives. Delays in recognising symptoms and seeking medical care often worsen the condition, increasing the likelihood of severe complications or death.
Dr Esther Mwaura from Eastleigh emphasises that pneumonia is far more lethal than many people realise. She warns that parents should never dismiss flu or cold symptoms as minor, especially in children, who are significantly more vulnerable. Having witnessed many young lives lost to the disease, she stresses the importance of early detection and prompt medical attention to prevent severe complications.
Mwaura recalls a case of twin infants who were admitted to a facility where she worked.
Despite being under constant monitoring, one of the twins unfortunately did not survive. Reflecting on her experience, she says that in less than three months, she witnessed five children lose their lives to pneumonia — a reality that deeply affected her.
"When parents bring in a child struggling to breathe, with a blocked nose and grunting sounds, and I ask how long the symptoms have persisted, many say three days or more. It’s distressing because, in children, the early signs of pneumonia often resemble those of a common cold. Ignoring what seems like a simple flu can put a child's life in grave danger," she warns.
She cautions against using homemade remedies on children or giving them over-the-counter medications without a doctor’s prescription, emphasising that such practices can put their lives at risk.
Mwaura notes that in children under five, pneumonia symptoms can range from mild to severe, often mimicking common colds, which makes early detection crucial.
Early stages
In the early stages, a child may develop a mild cough, nasal congestion, and a low-grade fever. They may seem tired but still engage in normal activities. Some children might have sneezing and a runny nose, leading many parents to assume it’s just a regular flu. However, unlike a common cold, pneumonia can quickly worsen.
As the infection progresses, symptoms become more pronounced.
The cough becomes persistent and produces mucus, often making it harder for the child to breathe. Fever rises significantly, sometimes accompanied by chills, sweating, and loss of appetite.
The child may refuse to breastfeed or eat, showing signs of discomfort. Fast breathing (more than 40 breaths per minute for children aged 1-5 years and over 50 breaths per minute for infants) is a key warning sign. Some children may also wheeze or have difficulty sleeping due to congestion.
In severe cases, pneumonia becomes life-threatening. The child may struggle to breathe, with flaring nostrils, grunting sounds, or chest retractions (where the skin pulls in around the ribs with each breath). Their lips, fingertips, or face may turn bluish due to low oxygen levels. Extreme fatigue, difficulty staying awake, confusion, or persistent vomiting are also signs of severe pneumonia.
At this stage, immediate medical attention is critical, as delayed treatment increases the risk of complications such as respiratory failure, dehydration, or sepsis. Parents should seek urgent care if their child has difficulty breathing, refuses fluids, shows signs of dehydration (dry lips, sunken eyes, or fewer wet diapers), or becomes unresponsive.
Public health concern
Pneumonia remains a significant public health concern in Kenya, claiming between 8,000 and 10,000 young lives annually. This translates to nearly 20 per cent of all child deaths in the country, making it one of the leading killers of children under five.
On a global scale, the disease was responsible for 2.5 million deaths in 2019, with children under five accounting for nearly one-third of these fatalities — over 700,000 deaths each year.
As the primary infectious cause of mortality in young children, pneumonia contributes to approximately 15 per cent of global deaths in this age group. The disease is commonly caused by bacteria such as streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both of which can be prevented through vaccination.
Studies have shown that vaccines targeting these bacteria can reduce pneumonia cases by 22-35 per cent and lower overall child mortality by 4 per cent.
In response to the persistent burden of pneumonia, Kenya's Ministry of Health has implemented the Kenya Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (KAPPD).
This initiative aligns with key national development goals, including Vision 2030 and Universal Health Coverage (UHC), to enhance child survival efforts. The strategy includes a range of preventive measures, with a strong emphasis on vaccination, as well as improved diagnosis, treatment, and overall healthcare access.
Despite advancements in tackling childhood diseases, pneumonia-related deaths have declined at a slower rate compared to other leading causes of child mortality. This is particularly concerning because many pneumonia deaths are preventable through straightforward interventions, such as vaccination, timely diagnosis, and access to appropriate treatment.
Strengthening these preventive and treatment measures remains crucial in reducing the devastating impact of pneumonia on children in Kenya and across the world.
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