Bhopal, Apr 9: Indian and international experts in child health have urged to take immediate steps to control and prevent pneumonia, which they said is the leading cause of death among children under five years of age in India.

"India leads the world in under-five mortality, with 20 lakh children dying every year," said Dr RK Agarwal, President of Indian Academy of Pediatrics (IAP) on the occasion of the first Pneumococcal Disease Conference. "Of these, four lakh deaths are due to pneumonia."

The two-day conference is jointly hosted by the Asian Strategic Alliance for Pneumococcal disease prevention (ASAP) and IAP. About 160 pediatricians from India and officials from the Union Ministry of Health are participating in the event. Pneumonia is inflammation of the lungs. The bacteria Streptococcus pneumoniae or pneumococcus is the leading cause.

Streptococcus pneumoniae can also cause other serious infections such as bacteremia (blood infection), meningitis (infection of the coverings of brain and spinal cord), sinusitis (infection of the sinuses) and otitis media (middle ear infection). "This group of diseases is collectively called pneumococcal disease, which besides acute illness and sufferings can also lead to long term sequelae like brain damage, paralysis, learning disabilities, speech delays and at times death," said Dr Rohit Agrawal, Secretary General, Indian Academy of Pediatrics.

"Half of all severe cases of pneumonia and pneumonia deaths are caused by pneumococcus," said Dr Nitin Shah, Member, ASAP and President, Indian Academy of Pediatrics 2006.

Dr Shyam Kukreja, another member of ASAP, said the pneumococcal conjugate vaccine, now available in India, can prevent half of the deaths due to pneumococcal disease. "Mass vaccination can prevent death of one lakh children in India each year."

Dr. Marzio Babille, UNICEF's chief of health in India said pneumonia is the "forgotten killer of children." Pneumonia kills more children than any other illness - more than AIDS, malaria and measles combined - according to UNICEF data.

Doctors use antibiotics to treat children with pneumonia, but increasing incidence of drug-resistant pneumococcus is a cause for concern, Dr Camilla Rodrigues, Consultant Microbiologist at PD Hinduja National Hospital and Medical Research Centre, Mumbai, said at the conference.

The speakers and participants were unanimous about the pivotal role of pneumococcal conjugate vaccine (PCV7) in preventing pneumococcal disease in infants and children younger than 24 months. It also helps to protect older children up to 9 years.

As a next step, both ASAP and IAP have agreed to represent to the Ministry of Health to include PCV7 in the National Immunization Programme.

The World Health Organization (WHO) has identified the inclusion of PCV7 in national immunization programmes as a priority, particularly in countries where the mortality rate of children under five years old is more than 50 per 1,000 live births, or where more than 50,000 children die annually. India is an ideal candidate for inclusion of PCV7 in the National Immunization Programme, as with under-five mortality of 72 and annual death burden of more than 200,000 under the age of five years, it meets with both the above criteria.