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Coughing children overwhelm doctors
A health worker monitors the breathing rate of a child who has been suffering from pneumonia. PHOTO/UNICEF
What you need to know:
- Experts suggest the widespread infections emanate from children’s low immunity.
Hospital officials in different parts of the country have said their facilities are overwhelmed with children presenting with severe flu, cough and other respiratory illnesses.
In the widespread infections coming barely two months after schools fully reopened on January 10 after a two-year hiatus, some children have presented high temperatures and vomiting, several pediatricians said.
Dr Rosemary Byanyima, the acting executive director of Mulago National Referral Hospital, told Monitor at the weekend that they need more space to accommodate the patients.
“Our pediatric ward was getting full and over the weekend, we were thinking of how to expand space for the pediatric admissions in case it [infection] and admissions continue to increase,” she said.
Dr Mukuzi Muhereza, a doctor at Nakaseke Hospital, said some sick children are sleeping on the floor because the beds are full.
“Where I work, we thought that the new refurbished pediatric ward will never fill, but now we have floor cases. And this is a rural hospital,” he said.
Other officials from Mbale Regional Referral Hospital, The Children’s Clinic Naalya in Wakiso, and parents across the country spoke of their frustration with the seemingly drug-resistant outbreak among mainly pupils.
Dr Daniel Tumwine of The Children’s Clinic in Naalya, said: “Many of those who got very ill were wheezing, and some had signs of severe pneumonia. Signs of severe pneumonia include fast breathing, difficulty in breathing, and tiredness. Almost all had a fever, and on checking they would either have a sore throat, inflamed eardrums, or both.”
Pneumonia is the second leading cause of death in hospitals in the country after malaria, according to details in the 2019/2020 and 2020/2021 health sector performance reports. Pneumonia killed 3,350 and 2,944 people in 2020 and 2021, respectively.
Parent gives a syrup to a child. Parents have been warned against self medication. PHOTO/Courtesy UN
Government scientists say they are investigating the exact cause of the spike in respiratory illnesses, which are understood not to be Covid-19 related.
Some health workers have, however, suggested that the children are catching the infections because their immunity weakened during the two-year pandemic-induced lockdown when they stayed home, with little exposure to germs, bacteria and viruses.
According to this school of thought, the reopening of schools resulted in children in crowding in schools where many picked infections either from colleagues or the through exposure to viruses and bacteria in the learning environment.
“In the rainy season, we always experience increases [in influenza cases], but many of us thought the rise in December and January was unusual because it was not so wet in January,” Prof Pontiano Kaleebu, the director of Uganda Virus Research Institute, said.
In Uganda, the drier season runs from November to early March, although weatherman has communicated that the rains should start falling soon.
Researchers at Makerere University said in a report titled, “Epidemiology and Surveillance of Influenza Viruses in Uganda between 2008 and 2014,” that influenza circulates throughout the year with two peaks; a major one from September to November and a minor one from March to June.
Flu is an infectious disease caused by influenza viruses. The Makerere researchers found that the peaks of the waves generally coincided with times of higher humidity, lower temperature, and higher rainfall.
“The predominant strains of influenza varied over the years: Seasonal Influenza A(H3) virus was predominant from 2008 to 2009 and from 2012 to 2014; Influenza A(H1N1) was dominant in 2010; and Influenza B virus was dominant in 2011,” the report reads in part.
Dr Tumwine of the Children’s Clinic said their pediatricians are suspecting that majority of children may be having respiratory “syncytial virus, mycoplasma (fungi) or any of the numerous viruses that they would have just brushed off before Covid-19.” Syncytial virus infects the lungs and breathing passages.
Similarly, Dr Emmanuel Tugainayo, the director of Mbale Regional Referral Hospital, said: “We have not gotten back feedback from the national scientists, but is likely that these are viral infections”.
But the viral infection “is not Covid-19,” according to Dr Byanyima.
“Viral infections come in a wave and they spread widely because they are airborne. We are also thinking that because of the restriction of movement of people and isolation, immunity of children could have gone down. These viral infections when you get it you develop immunity,” she said.
Dr Tumwine further explained that the lockdown limited children’s movement and exposure to infections in the environment, which birthed double-edged outcomes.
“This was a good thing. Even asthma levels dropped as fewer vehicles went on the road to pollute the air, but also germs that trigger asthma attacks also couldn’t spread. A side effect of this has been that children developed less immunity to the germs,” he explained.
He added: “Studies upon studies have shown that children who get repeated childhood viral (not bacterial) infections end up as healthier adults, with less cancers due to their more robust immune system.”
According to Dr Tumwine, a large proportion of the respiratory illnesses are “stubborn”, and non-responsive to conventional treatment. “The majority of kids do get better through symptomatic treatment. They may take up to four weeks to get well,” he added.
Parents speak out
Ms Joanne Ssewanga, a resident of Kampala, shares her frustration of a protracted struggle to heal her daughter.
“I take her to school, two days she comes back with that flu and cough, I make her sit home for a week [during which I] treat her very well. [Then she returns] and attends school the next week and she comes back with it (infection) again. I kept quiet, and angry me let her be at school up to now,” she said.
Ms Prossy Otuma from Arua said:“I have given up on the cough and flu, too much medication already.”
But partly, this delayed healing is also not very surprising given the past reports from the Ministry of Health that the cases of drug resistance are on the rise in the country due to self-medication and poor adherence to medication.
But Ms Haddasah Kamudo, another resident of Kampala, said her son took two weeks to fully recover and he has not caught cough and flue again.
“Luckily enough his is a boarding-only school. [So, they don’t mix with outsiders]. As we speak, he is ok. May God see our young ones through,” she said.
Dr Rosemary Byanyima, the acting executive director of Mulago National Referral Hospital
Dr Byanyima said the degree of illness can also depend on the dose of infecting agents that you are exposed to. This means making infected children sit close to other learners in class can increase the chance of infection.
Ms Catherine Aseku of Kumi District said she contracted cough and flu from her children.
“We have been having episodes of cough, flu and fever. We just visited the hospital on Sunday [February 27] and another daughter didn’t go to school today [Friday] again [because of the disease] and I am also down,” she said.
Adherence to preventive measures of wearing of facemask and social distancing, experts said, reduced other respiratory diseases besides Covid-19.
Some parents told Daily Monitor that learners who are showing symptoms of respiratory diseases are being advised to stay home to minimise the spread while treatment is also being administered to those in boarding schools with sickbays.
Mr Gershom Mwesiga from Rakai District, said his daughter was still in hospital. “Mine has been admitted for four days because of cough. She coughs and vomits and her eyes turn reddish,” he said.
Avoid self-medication
Dr Tugainayo tasked parents to avoid self-medication.
“The parents should seek medical intervention immediately instead of keeping them at home and dilly-dallying and giving them what they think will work, because some of them (cases) present like pneumonia which is life-threatening,” he said.
He added: “[Parents of] children who already have underlying conditions like asthma should be more concerned to bring their children for medical attention very early.”
Other pediatricians warned that administering the wrong dosage to their children could worsen the infection.
They said that depending on the condition, some children may require nebulization, which is the administration of medicine through a mask or intravenous medication.
“So, it is important you visit your pediatrician or doctor early on,” Dr Tumwine said.
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