By Ibironke Taiwo. BNSc., RN. Freelance Health Writer. Medical and Editorial review by The DLHATeam.
Rural African children hurdled together in outdoor
Chest infection in children affects the lower respiratory tract . The lower respiratory tract (LRT) is a series of air passage that transports air to and from the lungs for air exchange in the body. It is like an upside-down tree that includes the windpipe below the Adam's apple, and the rest of the air passage up to the lungs. Most of the structures making up the lower respiratory tract are contained within and protected by the chest wall. So, chest infections may involve any of the following parts of the lower respiratory tract; the windpipe (trachea) in the chest, the bronchi, bronchioles and lung tissue (alveoli). (see figure 1)
Figure 1: Showing the different parts of the lower respiratory tract. Cick on image to enlarge.
Although chest infection can affect people of all ages, children are mostly at risk, and this is because their lungs and immune system are not yet mature. [1]
Chest infection is a leading cause of disability and death amongst African children, especially among children under the age of five. [2] It is caused by more harmful germs that are called viruses and bacteria , which also cause respiratory conditions like coughs and sneezes.
The high occurrence of chest infection in African children is majorly attributed to factors such as malnutrition, limited access to healthcare, poverty, and environmental conditions.
It is important for parents, guardians, and healthcare providers to be aware of the germs that cause chest infection in African children, as this knowledge is used in the decision of the best course of treatment of the child. For instance, antibiotics are used when a chest infection is caused by bacteria, but are totally ineffective in chest infections caused by a virus.
This article will explain in clear and simple language the common types of chest infections and what causes them. It would also explain how you can know if your child has a chest infection, and what you can do to get your child the needed care.
There are two types of chest infections that can affect the different parts of the air passage and lungs. They are called bronchitis and pneumonia. These chest infections are described by their location and not necessarily by the specific germ that causes them. Their effects also depend on the parts of the body affected.
Bronchitis in children is due to the inflammation of the large breathing tubes called bronchi (see figure 1), thereby causing excessive production of mucus. This type of chest infection is mainly caused by viruses. It may also be caused by bacteria, chemical agents, dust, allergens, and tobacco smoke, especially in children over the age of 6. [3]
Bronchitis could be acute or chronic. Acute bronchitis is that whose symptoms develop quickly and don't last long. It is mild in most cases. [4] Chronic bronchitis is a long-term illness. It is often associated with asthma, foreign body aspiration, cystic fibrosis, or exposure to an airway irritant. [5] Acute bronchitis may progress to become chronic if left untreated or not treated properly.
Pneumonia is known to be the biggest infectious killer of children worldwide, causing more than 725,000 deaths among children under the age of 5 and 190,000 deaths among newborns.
Record also indicates that at least one child dies globally from pneumonia every 43 seconds.
Pneumonia doesn't have a particular cause; it can be caused by any of the following germs; bacteria, viruses, or fungi. Children whose immune systems are immature or diminished by malnutrition or diseases are more vulnerable to this infection. Pneumonia can be spread through airborne particles, body fluids, or contaminated surfaces.
It is important to know the cause of a chest infection, as the cause determines the treatment. The antibiotic medication is only effective for chest infections caused by bacteria and not effective for those caused by viruses. [6] Here are some common causes and risk factors to know
Other risk factors include:
Chest infection can be identified through the presence of various signs and symptoms that your child may experience.
It is vey important that you know these signs and symptoms so you can seek medical help for your child early.
The common signs and symptoms of chest infection in African children are:
In most cases, chest infection is diagnosed in children according to the symptoms exhibited.
Your child’s doctor will take a history from you and ask several questions about the details of your child’s illness. The questions will include, when and how the illnesses started, what you have done so far to treat it, whether you child is fully immunised, etc.
The doctor will then continue and perform a physical examination on your child, noting the general appearance and well-being, pulse rate, pattern of breathing, etc. The doctor will then use a stethoscope to listen to the breath sounds in the chest of your child to detect any cracking or rattling sounds.
At the end of the physical examination, your doctor is likely to have an idea of the type of chest infection that your child has, but my then order some tests for confirmation.
The doctor may order some laboratory tests to be done on blood and mucus obtained from your child to find out if the cause of the infection is bacterial or viral. This helps to identify the appropriate treatment to offer.
The oxygen level in your child's blood is also checked using pulse oximetry, as the occurrence of pneumonia can prevent your child's lungs from moving enough oxygen into the blood stream.
A chest X-ray is usually done on your child to confirm the clinical diagnosis that your child’s doctor made after the physical examination. This helps to detect the exact location or how severe the inflammation of the respiratory tract is in your child. [8].
A chest CT scan on your child usually provides more details than the chest X-ray does.
The management of a chest infection in African children follows the same two-prong global clinical approaches; medication and non-medication. The specific types of medications used in Africa may differ from coutry to country and to more industrialised countries based on availability and cost.
The specific medication that your doctor uses to treat your child’s chest infection will depend on the cause of the infection, which could be viral or bacterial. For infections caused by bacteria (pneumonia), antibiotics are usually prescribed [9].
For infections caused by viruses (bronchitis), the symptoms usually clear up by themselves after a few days or weeks of supportive care, and antibiotics are not applicable. Pain and fever reliefs are provided using acetaminophen (paracetamol) or ibuprofen in dosages that are appropriate for your child’s age. [10].
Supportive non-medication treatment helps to also clear the chest infection.
Chest infection in children generally including those in Africa responds well to treatment, while sometimes it could be very serious and deadly, especially if they are down with pneumonia [11].
Some of the common complications seen, include:
As a parent, you have a big role to play in preventing your child from developing a chest infection and also preventing others from getting infected. The following are helpful tips to prevent your child from getting a chest infection:
The challenges and barriers associated with treating chest infection in Africa contribute to the rise in the death and disability rates associated with the condition.
The following are some of the challenges and barriers affecting the management of chest infections in African children.
Conclusion
Chest infections in African children is a major health concern affecting the lower respiratory tract. It is a leading cause of disability and death among children under the age of 5.
The two common types of chest infections are pneumonia and bronchitis. And they are often caused by bacteria or virus respectively.
If not diagnosed and treated early childhood chest infections can lead to serious complications.
The high occurrence of chest infection in African children is attributed to factors such as poverty, malnutrition, limited access to healthcare, overcrowding, and exposure to indoor air pollution from cooking with solid fuels. Also, the high burden of diseases such as HIV/AIDS can weaken the immune systems of children, making them more susceptible to infections.
Children with chest infection may exhibit symptoms such as coughing, difficulty breathing, fever, chest pain, and fatigue, while doctor's examination, chest X rays and laboratory tests are often used to diagnose the condition.
Treatment for chest infections in African children includes antibiotics for bacterial infections, antiviral medications for viral infections, and supportive care such as adequate nutrition, hydration, and oxygen therapy if needed.
Prevention strategies like vaccination, promoting good hygiene practices, improving diet and living conditions, and increasing access to healthcare services are crucial in reducing the burden of chest infections in African children.
Overall, addressing the complex factors contributing to chest infections in African children requires multiple approaches that combine medical interventions, public health initiatives, and social support systems to improve outcomes and reduce the impact of these infections on vulnerable populations.
REFERENCES
1. Parviz Habib. Chest infection. [Internet n.d]. Accessed September 7, 2024. Available from here.
2. Unicef. Pneumonia in children: Everything you need to know. [November 10, 2023]. Accessed September 8, 2024. Available from here.
3. Barbara Behr, Jessica Cripe. Bronchitis in Children. Cincinnati Children's. [April, 2022]. Accessed September 8, 2024. Available from here.
4. Cedars Sinai. Acute Bronchitis in Children. [Internet n.d]. Accessed September 8, 2024. Available from here.
5. Patrick L Carolan, Girish D Sharma. Pediatric Bronchitis. Medscape. [June 22, 2023]. Accessed September 9, 2024. Available from here.
6. NHS inform. Chest infection. [December 6, 2022]. Accessed September 9, 2024. Available from here.
7. World Health Organization. Pneumonia in children. [Internet] November 11, 2022. Accessed September 8, 2024. Available from here.
8. American Lung Association. Pneumonia Symptoms and Diagnosis. [August 12, 2024]. Accessed September 9, 2024. Available from here.
9. NHS. Chest infection. [June 21, 2023]. Accessed September 9, 2024. Available from here.
10. Milton Keynes University Hospital NHS Foundation Trust. Care of a child with a chest infection/pneumonia. [Internet n.d]. Accessed September 9, 2024. Available from here.
11. John Hopkins Medicine. Pneumonia. [Internet n.d]. Accessed September 10, 2024. Available from here.
12. Gatta F, Rope K, Gopal A, Poonam. What Are the Complications of Pneumonia? WebMD. [Last reviewed: May 14, 2024]. Accessed September 10, 2024. Available from here.
13. Okafor, C., Olaniran, A., & Darj, E. (2023). Challenges and recommendations for addressing under-five pneumonia morbidity and mortality in Nigeria. African Health Sciences, 23(2), 193–201. Available from here.
Related:
Asthma in African Children: Causes, Symptoms and Care
African Parents, Can You Tell If Your Baby Has Common Cold or Chest Infection?
Should African Babies With Minor Illnesses Be Immunised?
Common Cold in Babies: What African Parents Should Know
Fever in children: What African parents need to know
Published: October 1, 2024
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