Pneumonia: One of the top five deadliest diseases for children in Malaysia

S. pneumoniae is not only the most common cause of bacterial pneumonia, but is also the top cause of deaths due to pneumonia in children. — Positive Parenting

Pneumonia is one of the top five causes of childhood death in Malaysia, according to the Department of Statistics.

What makes this infectious disease so deadly to children?

Pneumonia is a lung infection that causes the air sacs (alveoli) in the lungs to fill up with fluid or pus, making it difficult to breathe in enough oxygen for the body.

Anyone can get infected, but infants, the aged and sick people are the most vulnerable due to their weaker immune systems.

Globally, around 1.4 million children under five years of age die every year because of pneumonia.

Unicef has also reported that few caregivers recognise the symptoms of pneumonia and only half of infected children are given the appropriate treatment.

As the symptoms are similar to the common cold or flu, many parents may not realise the severity of their child’s condition until it is too late.

Types of pneumonia

Doctors may categorise pneumonia into how or where the infection started, i.e.:

  • Hospital-acquired pneumonia, which occurs during a stay in a hospital or when receiving outpatient treatment.

    The illness can be more severe as the infectious bacteria may be resistant to antibiotics.

  • Community-acquired pneumonia, which starts somewhere other than a hospital or healthcare facility, and is more common.

    This type of pneumonia can be caused by bacteria, viruses, fungi or chemicals.

Pneumonia can also be categorised based on the cause of the infection:

> Bacteria

Streptococcus pneumoniae (pneumococcus) is the most common cause of bacterial pneumonia.

It is also the top source of pneumonia-linked deaths in children.

Other bacteria include Haemophilus influenzae type B (Hib), Klebsiella pneumoniae, Chlamydia pneumoniae and others.

> Virus

Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in children.

Other viruses include the influenza virus (types A and B), rhinovirus (common cold virus), and coronavirus (like SARS-CoV and SARS-CoV-2).

> Fungi

Pneumocystis jirovecii is an example of a fungi that can cause fungal pneumonia.

However, this is less common and tends to happen to people with chronic health problems or weakened immune systems.

> Chemicals

Different substances in different forms (liquid, gas, small particles) can cause inflammation of the lungs when inhaled.

This includes toxic and poisonous chemicals, as well as food and drinks (aspiration pneumonia).

Is it or is it not?

It can be hard to recognise the symptoms of pneumonia in children.

The symptoms not only range from mild to severe, but they also depend on the cause and health status of your child.

They may include:

  • Fever
  • Cough
  • Wheezing
  • Rapid breathing
  • Trouble breathing
  • Skin, lips or fingertips that look blue
Symptoms in babies might be vague, like fussiness or trouble feeding.

Treatment and prevention

Prompt and correct symptom identification is crucial to ensure early and appropriate care, which is vital for pneumonia.

If uncertain, it is best to seek doctors’ advice early on to be sure, rather than waiting for your child’s condition to worsen.

If treatment is delayed, complications may arise, such as:

> Bacteraemia

This is where the infection spreads into the bloodstream, leading to septic shock and blood pressure dropping to a dangerous level.

> Lung abscesses

Pockets of pus may build up in the lungs.

The child may also cough out pus and have a high fever.

> Pleurisy

The pleura (the two layers of tissue enveloping the lungs) become swollen and cause a sharp chest pain when breathing deeply.

If the swelling is untreated, fluid may fill the area between the pleura, causing pleural effusion (“water” around the lungs) and empyema (pus collection).

> Respiratory and organ failure

The lungs may be unable to function properly enough to transfer oxygen and remove carbon dioxide to and from the blood.

This can be life-threatening as organs such as the kidneys and heart, may also fail to function as normal.

> Death

Protection against pneumonia includes practising proper hygiene and handwashing, providing optimal nutrition, avoiding indoor pollution and smoking, and reducing other risk factors.

Immunisation against pneumococcus, influenza, Hib, measles and pertussis (whooping cough) is also vital.

Vaccines for Hib, measles and pertussis are part of our National Immunisation Programme (NIP), and the pneumococcal vaccine will soon be included in the NIP as well.

The annual influenza vaccine is available in both public and private healthcare facilities.

For pneumonia, early treatment is crucial for a higher survival rate.

In any case, it is always best to take protective and preventive measures.

Datuk Dr Musa Mohd Nordin is a consultant paediatrician and neonatologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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