Why Pneumococcal Infections is a Global Health Problem
Pneumococcal infections are mainly caused by streptococcus pneumoniae also known as pneumococcus. Serious pneumococcal infections are a major global health problem. By the year 2010, the World Health Organization estimates that more than 1.6 million people – including more than 800,000 children under the age of 5 years – die every year from pneumococcal infections (Georgiev, 2009). Nearly all of these infections and deaths occur in the world’s poorest countries. These include Sub-Saharan African countries, Latin America, South Asia, some parts of Europe and Australia. In Latin America, epidemiological studies show that infants younger than 6 months have a higher risk of infection, while the southern Indian children have high rate of disease colonization at younger ages than those in the United States (World Health Organization, 2011). Populations of indigenous Australians, Indians living in the US, and native Alaskans have disproportionately high prevalence rates similar to the trend in some African countries such as Gambia although determining the role of socioeconomic factors in relation to incidence rates is difficult (Painter, 2012). In Europe, children below age of 2 years forms the population at higher risk of pneumococcal infection with such rates reducing with person’s age. The disease incidence is also estimated to be lower in Europe – Germany, Finland and England - and the United States although scientists believe this may be due to genetic susceptibility and blood-liberal culture collection practices in the US (Painter, 2012). This also explains why the disease is more prevalent among the native Alaskan, Indians, African Americans, and Africa natives than other races.
Disease Process, Risk Factors and Prevention
The most severe form of pneumococcal disease is pneumococcal meningitis which is also one of the most fatal childhood illnesses. Susceptibility to pneumococcal disease is especially high in small children in developing world and in patients in developed world with a number of underlying disorders, including immunoglobulin and complement deficiencies, multiple myeloma, functional asplenia, lung and kidney diseases, and HIV-infection. When a person is infected, fluids fill the lungs preventing oxygen from reaching the bloodstream. Its symptoms include coughs, high body fever, shortness of breath or rapid breathing, chills, and pain in the chest. The treatment of pneumococcal infections has become a complicated global problem due to antibiotic resistance. Streptococcus pneumoniae’s increased resistance to penicillin has led to adoption of other medications such as macrolides, fluoroquinolones, among other non beta-lactam antibiotics for pneumococcal infections.
The global emergence of drug resistant starains of S. pneumoniae emphasizes the need for prevention of infections through immunization (American Academy of Pediatrics, 2010). The pneumococcal vaccine provides specific prevention against pneumonia and other infections of S. pneumoniae such as otitis media and other upper respiratory tract infections. Such vaccination has been demonstrated to prevent pneumonia in otherwise healthy patients with an efficiency of between 65% to about 85% (Painter, 2012). The Centers for Disease Control and Prevention (CDC) recommends a one-time revaccination after 5 years for people in high-risk categoris including previously vaccinated up to 5 years ago and those aged above 65 years of age at the time the primary vaccine is administered (Centers for Disease Control and Prevention, 2010). Many other subsequent and recent studies have continued to demonstrate decreased rates of new infections of both invasive and non-invasive pneumococcal infections (Painter, 2012).
Nursing Responsibilities in Prevention and Treatment
The nursing role in diagnosis and treatment of pneumococcal infections is immense. Nurses play a critical role in ensuring that they are adequately informed on vaccination and procurement of sufficient vaccines, in diagnosis and identification of infected patients and those at risk of infection, in organizing pneumonia clinics and in designing nursing care plans for patients (Georgiev, 2009). It is only until such roles are discharged carefully that significant impact can be realized on morbidity and mortality rates. Today, there is increasing awareness among the nursing fraternity across different regions on the severity of pneumococcal infections and predisposing factors such as influenza infections. Such knowledge has led to overwhelming positive outcomes in control of pneumococcal infections due to increased commitment in administration of vaccines and treatment. There is also overwhelming need for collaboration of the nurses with other healthcare professionals in dealing with the disease infections especially in identifying training needs, targeting and educating at-risk groups, administration of vaccines, devising strategies for reluctant patients, positive advertisements and health promotions materials among other roles.
Conclusion
In conclusion, pneumococcal disease is indeed, a global health issue that require more attention with regard to treatment and prevention strategies. Epidemiological research data show high prevalence and mortality rates in developing countries and other economical poor regions such as Latin America, India and African countries. Such countries need global funding especially in supporting vaccination programmes, diagnosis, and early treatment. Vaccination has been shown to be effective intervention measure with potential to reduce new infections by over 85%. Nurses have also been shown to play a key responsibility in patient education on the disease process, predisposing factors, its lethal complications and in administering vaccines.
American Academy of Pediatrics (2000). Recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine (Prevnar), pneumococcal polysaccharide vaccine, and antibiotic prophylaxis. Pediatrics, 106, 362 -366.
Centers for Disease Control and Prevention (2010). Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine. Morbidity and Mortality Weekly Report, 59(31):1102-1106.
References
Georgiev, V. (2009). National Institute of Allergy and Infectious Disease: Impact on global health. London: Springer.
Painter, A. R. (2012). Preventing pneumococcal disease: Increasing vaccination in high-risk populations. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Preventing-Pneumococcal-Disease.aspx
World Health Organization (2011). Pneumonia. Retrieved from http://www.who.int/mediacentre/factsheets/fs331/en/index.html
