India registered the highest number of deaths among children under five years of age, due to respiratory illnesses in 2015, a Lancet study has revealed.

Lower respiratory tract infections (LRIs) such as Pneumococcal pneumonia, Haemophilus influenzae type b (Hib), Respiratory syncytial virus and Influenza are a leading cause of morbidity and mortality, particularly in children younger than five years.

In India, about 82,448 children died of Pneumococcal pneumonia, 20,987 deaths were attributed to Haemophilus influenzae type b (Hib), 8,415 died due to respiratory syncytial virus and 2,352 succumbed to Influenza in 2015 followed by Nigeria and Pakistan. Hib was a major cause of under-5 LRI mortality in India, responsible for 14.9% of LRI deaths, the study said.

In parallel, the LRIs caused 2.74 million deaths across the world in 2015 including all the studied countries.

The study done by Ali H. Mokdad, Institute for Health Metrics and Evaluation, University of Washington, Seattle, US, estimated the diseases burden in 195 countries with Global Burden of Disease study (GBD) 2015.

The study found that the burden of LRIs is highest in areas of low socio-demographic status, populations that depend on solid fuels for cooking and heating, and in malnourished and immune-impaired populations. The study has revealed that the under-5 LRI mortality was nearly the same in males and females at the global level, but in India it was 1.22 times higher in girls than in boys in India.

“In India, there is a preference for male child, and female newborns are not given preference for treatment and hospitalisation when they are sick. We introduced the vaccines but reach and acceptance of vaccination remains a problem. Over 150,000 children die due to pneumonia in India and over 40,000 to 60,000 due to vaccination preventable deaths. Children in rural areas remain malnourished and catch diseases faster. We are doing our best to prevent these deaths," said Ajay Khera, public health specialist and deputy commissioner in-charge, (child and adolescent health), at the ministry of health and family welfare.

Researchers have called for vaccination and improving nutrition in the affected countries. “Expanded use of the pneumococcal conjugate vaccine, interventions to improve under-5 nutrition, and a focus on appropriate case management could reduce the burden of LRI. Comprehensive and reliable data on LRI morbidity and mortality globally are still needed," the study said.

“LRI remains a largely preventable disease and cause of death, and continued efforts to decrease indoor and ambient air pollution, improve childhood nutrition, and scale up the use of the pneumococcal conjugate vaccine in children and adults will be essential in reducing the global burden of LRI," it said.

J.P. Nadda, Union minister for health and family welfare, in May this year introduced pneumococcal conjugate vaccine (PCV) in the Universal Immunization Programme (UIP).

“Pneumonia kills more children under five years of age in India than any other infectious disease. The pentavalent vaccine which was scaled up in all states under the UIP by 2015 protects against Haemophilus influenzae type b (Hib) pneumonia. Now, the introduction of PCV in the UIP will reduce child deaths from pneumococcal pneumonia. It will also reduce the number of children being hospitalized for pneumonia, and therefore reduce the economic burden on the families and the health cost burden on the country," Nadda had said while launching the vaccine in Himachal Pradesh.

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