Delayed hospitalisation spikes winter mortality, especially among children

As the winter intensifies, cold-related diseases, including pneumonia, diarrhoea, and respiratory illness, see a seasonal spike in the country, especially among children.

The severity of winter illnesses and mortality among patients is increasing due to ignorance of symptoms, delayed hospitalisation and negligence on the part of guardians, said physicians.

According to data from the Directorate General of Health Services, in the last 24 hours, 3,156 people, including children, have been admitted to hospitals across the country due to acute respiratory infections (ARI) and cold-related diarrhoea. Four of them have died.

Six children died while undergoing treatment at the Bangladesh Shishu Hospital and Institute over the past week, hospital sources told The Business Standard (TBS). 

Infograph: TBS

Dr Kamruzzaman, assistant professor of Respiratory Medicine at the Bangladesh Shishu Hospital and Institute, told TBS, "Child patients are arriving at the hospital in severe condition, especially those coming from outside the capital. Many patients in Dhaka are also reaching the hospital late mainly due to the negligence of their parents, increasing the risk of death."

Besides, mortality is high among patients who have other diseases, along with pneumonia or other cold-related diseases, he said.

"A child patient who had kidney problems died of pneumonia in our hospital on Sunday. So, those who are already suffering from other diseases should be very careful during winter," Dr Md Kamruzzaman added.

According to physicians, in the northern district of Thakurgaon, the rate of children suffering from pneumonia and cold diarrhoea is increasing over the past month. Around 60-70 children are being admitted to various hospitals in the district every day with pneumonia and diarrhoea. 

Dr Shahjahan Newaz, a renowned child specialist in Thakurgaon, told TBS that most patients with pneumonia and diarrhoea are going to the doctor at the last moment. 

"Children under two years of age suffer from pneumonia and diarrhoea the most. But the problem is that these patients are coming to the doctor in severe conditions. As a result, it takes time for the patient to recover and the risk of death increases," Dr Shahjahan Newaz said, advising parents to dress their children in warm clothes at all times.

As many as 3.24 lakh people have been affected by various cold-related diseases in the last one and a half months, according to the Directorate General of Health Services data. Among them, 73 died.

Winter usually triggers diseases such as flu, pneumonia, bronchitis and diarrhoea as humidity drops during this season and dust particles increase in the air, aggravating the diseases.

The parents of Shafit – an eight-month-old baby admitted to Ward 8 of Shishu Hospital, told TBS, "Two days ago, we admitted our kid to icddr,b at Mohakhali with severe diarrhoea. He recovered from diarrhoea but somehow got a fever. We then came to this hospital. Doctors ran some tests and we are waiting for the report."

Bangladesh Shishu Hospital and Institute is admitting an average of 20 children with pneumonia every day, according to hospital sources. 

Apart from this, patients with diarrhoea, asthma, and bronchitis are increasing. 

Moreover, an average of 10 children are admitted with pneumonia every day at the Children's Department of Dhaka Medical College and Hospital.

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) is admitting 350 patients with diarrhea every day. Around 60%-70% of them are pediatric patients, most of whom are under the age of five.

According to the icddr,b data, some 24,300 children aged 0-5 years die of pneumonia in Bangladesh every year. From this count, 67 children, under the age of five, die of pneumonia every day. Of these, 52% of children die at home without getting any treatment.

Symptoms that should not be ignored

Dr Kamruzzaman said parents must be very attentive to symptoms such as fever, frequent breathing, fluttering chest, and breath sound in their children. If there is any noise while breathing, if there is vomiting, then it is a sign of pneumonia. 

If these symptoms appear, parents should immediately go to the doctor, he said, adding that saline should be given to children in case of cold diarrhoea.

During winter, children must be dressed in warm clothes, and their heads and ears should be covered up, he said.

Children should not be taken outside the house or to a marketplace, babies under six months should be breastfed frequently (Babies under 6 months), babies above six months should be fed seasonal vegetables and fruits along with breastmilk, and their noses should be kept clean at all time, said the respiratory medicine expert. 

Antibiotics cannot be given to children without prescriptions. Parents can apply olive oil to avoid skin allergy, said Dr Kamruzzaman, assistant professor of Respiratory Medicine at the Bangladesh Shishu Hospital.