Thursday, May 29, 2014

Pneumonia among top five causes of admission at UTH
By Masuzyo Chakwe
Thu 09 Jan. 2014, 14:00 CAT

Pneumonia is among the top five reasons for admission at UTH, says hospital head of renal unit Dr Aggrey Mweemba. Dr Mweemba said pneumonia was common among individuals with reduced immunity.

"Alcoholism, smoking, chronic kidney disease, chronic liver disease, chronic lung disease, the very young and old, and unconscious individuals have increased risk of pneumonia," he said.

Dr Mweemba, who is also Ministry of Health focal person for Kidney diseases explained that pneumonia was an infection or inflammation of the lung. He said the infection could involve part of a lung, the whole of it or both lungs.

Dr Mweemba said the causes of pneumonia included bacteria, viruses, fungi, autoimmune diseases (diseases where one's immune system fights its own lungs) and chemicals or drugs.

He said pneumonia was divided into three groups which are community-acquired or hospital-acquired pneumonia and pneumonia in the immune-compromised (individuals with reduced immunity).

"Community acquired pneumonia is a pneumonia that is picked up from the community where an individual lives. This is usually caused by a bacterium called Streptococcus pneumoniae. Several other bacteria can cause pneumonia. The type of bacteria causing pneumonia in an individual is dependent on the age of the patient, pregnancy and immune status," Dr Mweemba said.

He said bacterial pneumonia was usually severe and of sudden onset.
Dr Mweemba explained that hospital acquired pneumonia was picked up in a hospital setting when an individual had been admitted for a different medical condition.

He said this form of pneumonia was caused by bacterial infections different from the ones that cause community acquired pneumonia.
"These bugs cause a severe form of disease and commonly require more powerful antibiotics to treat as they may not respond to ordinary antibiotics. Pneumonia in the immune-compromised, is pneumonia that develops in individuals with low immunity," Dr Mweemba said.

"Individuals with low immunity include; organ transplants, untreated HIV infected persons, poorly controlled diabetics, cancer patients, and individuals on medications that reduce immune function."

He said in such individuals, harmless bugs such as viruses and fungi that usually do not cause disease in healthy people could cause severe illness.

Dr Mweemba said tuberculosis was another very important and common cause of pneumonia in the immune-compromised. He said healthy individuals could also get infected with tuberculosis although to a lesser degree than the immune-compromised.

Dr Mweemba said the common symptoms of pneumonia were sudden onset of a productive cough, fever, rigors, sharp and pricking chest pain (which is worse when one attempts to breathe) and shortness of breath.

"Fever and rigors can easily be confused with malaria, urinary tract infection, meningitis and any other severe infection. Joint pains, abdominal pains, yellowing of eyes and diarrhoea may be common with specific causes of pneumonia. Irritability, breathing faster than usual, fever and lack of feeding maybe the only symptoms in babies," he said.

Dr Mweemba said bacterial and viral pneumonia were of sudden onset whereas fungal and tuberculous pneumonia had an insidious onset.
He said bacterial pneumonia was usually severe and life-threatening whereas viral and fungi pneumonia were mild and self-limiting in healthy individuals, but fatal in those with low immunity.
Dr Mweemba said vaccinations could prevent some forms of bacterial and viral pneumonia.

"A number of these vaccines are part of the under five vaccinations provided to babies by most health centres and hospitals in Zambia. Adults can also seek vaccinations to prevent or reduce the severity of pneumonia," he said.

Dr Mweemba said other measures to reduce the risk of pneumonia include treating underlying illnesses such as HIV and diabetes, smoking cessation, hand washing and wearing of masks by the sick.

He said some special medicines could be given to risky populations to prevent these forms of pneumonia.

"Avoiding overcrowding and provision of well ventilated housing can prevent tuberculous pneumonia," said Dr Mweemba.

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