Why men are more vulnerable to contracting and dying from pneumonia

Daniel has always believed that his body is capable of fighting off most illnesses on its own. He relied on simple over-the-counter medications like painkillers and trusted that staying hydrated and exercising regularly was enough to keep him healthy. For years, when he would get a cough or feel a little under the weather, he’d just grab some cough syrup or let it run its course, thinking it was nothing to worry about.

“I’ve been dealing with this cough that comes and goes. Sometimes I’d just take some cough syrup from the pharmacy, and it would go away for a while. A little flu here and there, but nothing I thought was serious,” he said, reflecting on his approach to his health.

Daniel isn’t someone who visits the doctor unless it’s absolutely necessary. He believes in handling things on his own and only goes to the hospital when there’s no other choice. So, when his spouse insisted that he see a doctor about his persistent cough, he reluctantly agreed but didn’t expect anything serious.

“I didn’t think it was anything major. I felt weak, sure, but I just thought it was a normal cough. Even when my spouse urged me to go, I figured it was just another cold or flu,” he explained.

To his surprise, the doctor diagnosed him with chronic pneumonia. Daniel was confused and shocked. He’s never smoked, tries to stay warm, avoids cold drinks, and doesn’t drink alcohol. To him, the diagnosis didn’t make sense.

“I couldn’t understand it. I take care of myself—I don’t smoke, I stay away from the cold, and I don’t drink. So how could this happen?” he said, still trying to wrap his head around the reality of the situation.

For Daniel, this diagnosis was a wake-up call. It challenged everything he thought he knew about his health and made him realise that sometimes, even the strongest body needs more than just simple self-care to fight off certain conditions.

Studies

Research has shown that men are more susceptible to contracting and dying from pneumonia than women. Several studies have highlighted this trend.

A 2008 study found that men are 30 per cent more likely to die from pneumonia, even when receiving intensive treatment.

A 2018 study discovered that men not only have a higher likelihood of developing pneumonia but are also more prone to complications like sepsis. Additionally, being male was independently linked to a higher risk of death within 90 days of diagnosis.

Dr Esther Mukuhi, a physician in Eastleigh, identifies several factors that make men more vulnerable to pneumonia. One key issue is a lack of awareness and the tendency to delay seeking treatment, which increases their risk.

She observes that the most common form of pneumonia she has seen in men is chronic obstructive pulmonary disease (COPD).  It’s a prevalent lung condition that makes breathing difficult, caused by damage to the lungs or airways. This leads to inflammation and restricted airflow. COPD is a progressive disease, meaning that its symptoms gradually worsen over time.

“Many men only seek hospital care when the situation becomes an emergency, by which time the disease has already progressed to a severe stage. Additionally, many confuse the symptoms of pneumonia with malaria and only come to the hospital after unsuccessfully trying to treat malaria or other illnesses on their own.

Several symptoms

She notes that pneumonia has several symptoms, including coughing (sometimes with phlegm), shortness of breath — especially during physical activity, wheezing or whistling sounds when breathing, chest tightness or heaviness, fatigue, frequent respiratory infections, and unexplained weight loss.

“When patients come to the hospital, we assess many factors. However, we always advise that if you have a persistent cough lasting for about 14 days, it’s important to seek medical attention and undergo some tests,” she says.

Pneumonia can lead to more serious conditions like sepsis (when the infection spreads through the body), acute respiratory distress syndrome (ARDS) – or severe breathing problems – organ failure, lung abscesses (pus-filled pockets in the lungs), or bacteremia (infection in the blood).

She recommends seeking proper medical attention and avoiding self-medication with over-the-counter drugs without a prescription. Instead, it's important to only use medications that are prescribed by a doctor for the specific condition.

Pneumonia is a lung infection where the air sacs fill with fluid or pus, making breathing difficult. It can be caused by bacteria, viruses, or fungi, and symptoms range from mild to severe, including cough, fever, chills, and difficulty breathing. Pneumonia is a leading cause of death worldwide, especially among children under 5, and also affects older adults and those with existing health problems. It spreads through direct contact with infected individuals. Diagnosis involves medical history, physical exams, and tests like chest X-rays.

Several factors can increase the risk of developing pneumonia:

Age

For children under 5, their immune systems are still developing, making them more vulnerable to infections.

Adults over 65: Older adults often have weaker immune systems and may have other health conditions that increase their risk.

Chronic health conditions

Conditions like asthma, chronic obstructive pulmonary disease (COPD), heart disease, diabetes, and liver disease can make the lungs more susceptible to infection.

Weakened immune system

People with HIV/AIDS, those undergoing chemotherapy, or individuals on immunosuppressive medications (e.g., after an organ transplant) are at higher risk.

Smoking

Smoking damages the lungs and weakens the immune system, making smokers more prone to respiratory infections like pneumonia.

Alcohol use

Excessive alcohol consumption can impair the immune system and increase the likelihood of aspiration pneumonia (caused by inhaling food, liquids, or vomit into the lungs).

Hospitalisation

People who are hospitalised, especially those in ICUs or on ventilators, have a higher risk of developing hospital-acquired pneumonia.

Malnutrition

Poor nutrition weakens the immune system, making it harder for the body to fight off infections like pneumonia.

Environmental exposure

Living or working in crowded conditions, such as nursing homes, daycares, or military barracks, can increase exposure to respiratory infections.

Recent respiratory infection

Having a cold or flu increases the risk of developing pneumonia, as these infections can weaken the lungs and make them more susceptible to bacterial or viral pneumonia.

Aspiration

Individuals who have difficulty swallowing, or who are bedridden and unable to clear their airways, are at higher risk for aspiration pneumonia.

The World Health Organisation reports that pneumonia claimed the lives of over 808,000 children under the age of 5 in 2017, accounting for 15 per cent of all deaths in this age group.

Additionally, adults over 65 and individuals with pre-existing health conditions are also at higher risk for pneumonia. In Kenya, pneumonia causes between 8,000 and 10,000 child deaths annually, making up about 1 in 5 of all child fatalities.

Globally, pneumonia took 2.5 million lives in 2019, with nearly one-third of these being children under 5, contributing to over 700,000 deaths each year.