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Severe Pneumonia Can Be Effectively Treated at Home


05 January 2008
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A new study sponsored by the World Health Organization (WHO) shows children with severe pneumonia can be effectively treated at home and do not need to be hospitalized. The World Health Organization calls this finding hugely significant for developing countries.  It says the change of treatment will save many children's lives and take pressure off health systems. Lisa Schlein reports for VOA from WHO headquarters in Geneva.

Pneumonia is the largest single killer of children under age five around the world.  The World Health Organization says almost four children die from pneumonia every minute.  Most are in developing countries.

Current WHO guidelines recommend that severe and very severe cases of pneumonia be treated in the hospital with injectable antibiotics.  But, recent studies show severe cases of pneumonia can be treated just as effectively at home with oral antibiotics.

A Medical Officer with WHO's Department of Child and Adolescent Health and Development, Shamim Qazi, says children in developing countries will greatly benefit from this simpler way of treating pneumonia.

"The first benefit is that when you treat a child in a hospital, you also expose the child to hospital infections," he said.  "And the second is the child needs four times injections.  Third, you need nurses and doctors who spend time on that.  In developing countries with a limited number of hospital beds and nurses and doctors available, it basically overburdens the health system.  In many places, they do not have enough beds to admit all children.  So, they sometimes put three children in one bed." 

The study was conducted in Pakistan by researchers from Boston University School of Public Health and supported by the World Health Organization and U.S. Agency for International Development (USAID).  It involved more than 2,000 children with severe pneumonia who were randomly assigned to get either injectable antibiotics in a hospital or antibiotic pills at home.

Doctor Qazi says the study confirms the findings of three other trials at sites in Africa, Asia, Europe and Latin America.  He says the potential impact of these results is enormous.

"If we can treat a large majority of severe pneumonia at home with just oral antibiotics, which is simple to give twice a day, which is less costly," he noted.  "It is $1 to $2 per course for a child."

Doctor Qazi says home treatment is beneficial for other reasons as well.  He notes families in the poorest countries may live far away from hospitals.  In many cases, he says parents may not be able to leave their homes to accompany a sick child for in-patient treatment. 

Also, he says, children with pneumonia are vulnerable to infections, because of a weakened immune system and could be at increased risk in crowded hospital wards.

However, he says a small number of cases of very severe pneumonia will still require treatment with injectable antibiotics in a hospital.

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