Pneumonia is a severe infection of the lung that can be caused by a contagious agent such as bacteria, fungus, virus or parasites (Franco, 2017, p. 621). These transmittable agents reach the lungs through various methods, such as inhalation, breathing or hematogenous spread from other infections in the body (Lewis et al., 2017, p. 500).
Pneumonia can be categorized as community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). To be classified as CAP, the individual with pneumonia should not have been hospitalized or lived in a long-term care center within the last two weeks. As for HAP, the individual contracts pneumonia within two days after hospitalization, non-intubation, and the symptoms were not present upon admission (Lewis et al., 2017, p. 501).
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The types of microbes causing CAP are mainly bacterial, but around five to ten percent of the cases are caused by viruses. The most common bacterium causing CAP is Streptococcus pneumoniae, a gram-positive bacterium (Franco, 2017, p. 624). CAP can also be caused by a fungal infection, and according to the Centers for Disease Control and Prevention (CDC), CAP caused by fungi is increasing in the southwestern USA, like California or Arizona. The disease is named Coccidioidomycosis, also known as valley fever.
Despite the type of pneumonia and the different organisms causing it, the disease process is almost the same. When the infectious agent penetrates the lungs, it provokes an inflammatory response from the body. During the inflammation, blood flow and vascular permeability increase. This increase stimulates the neutrophils, a type of white blood cell that engulfs the organisms. As more and more neutrophils are attracted to the inflammation site, it induces edema in the respiratory tract, and the fluid from the capillaries and tissues shifts to the alveoli. Alveoli filled with fluid cannot perform their gas exchange function properly. This condition causes a ventilation-perfusion mismatch (V/Q mismatch), leading to hypoxia, a condition of low oxygen level at the cellular level (Lewis et al., 2017, p. 502). The stage in which the lungs are inflamed and filled with fluid is called congestion. The next stage of pneumonia is consolidation, where neutrophils, red blood cells, and fibrin (exudates) fill the alveoli. Additionally, in the subsequent phase of consolidation, the fluid with red blood cells, fibrin, and lung cells in the lungs creates a solid mass (Franco, 2017, p. 623).
Symptoms of pneumonia linked to bacterial or fungal infection include cough (either productive or nonproductive), fever, exhaustion, pleuritic chest pain, shortness of breath, crackles on lung sounds, tachycardia, tachypnea and dyspnea (Lewis et al., 2017, p. 502). RS’s complaints of shortness of breath, cough, and chest pain when she arrived at ASVH emergency room are suggestive of pneumonia symptoms.
The Problem Of Pneumonia And Other Diseses In Ethiopia
Ethiopia is an extremely populated nation in Africa that struggles with low revenue. This country is part of a landmass known as the Horn of Africa. It is defined as “a peninsula in the East African region that protrudes from the eastern edge of the continent of Africa. It lies south of the Gulf of Aden and southwest of the Red Sea” (Maps of the World). Trade is a major part of this peninsula’s economy, mainly achieved by exporting goods that other parts of the world might desire in order to generate income.
Although Ethiopia is a landlocked country, there is still abundant water in some parts of it. The country exports a variety of products such as coffee, vegetables, livestock, electrical machinery and shoes (World’s Leading Exports). These exports result in higher revenues for Ethiopia compared to other African countries. Despite the incoming flow of money, Ethiopia is still considered a low-income country as 24% of its population lives below the poverty line. Being the second most populated country in Africa, Ethiopia has many needs to meet in order to ensure the well-being of its people.
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While there are many relatively healthy individuals within the country, the overall situation is far from ideal. Despite the relatively high level of health among the populace for a low-income country, there are numerous health issues that persist. The three main health problems in Ethiopia are pneumonia, HIV/AIDS, and malaria. Even though there are organizations trying to address these health issues, they remain quite common, and improving the prevention rate is essential for the overall health of the country.
Many diseases that are prevalent in third-world countries could be prevented with proper healthcare, funding, and the right supplies. Pneumonia is no exception. According to the Mayo Clinic, pneumonia is a disease that fills a person’s lungs with fluid, making it difficult to breathe and causing chest pain and coughing up of fluid. It is not common in high-income countries as the treatment is expensive and recovery is typically swift. Poverty is the primary reason why this disease is so prevalent, with the cost of effective vaccines being prohibitive. UNICEF reports that pneumonia predominantly affects children under five, “accounting for 15 per cent of deaths, or roughly 940,000 children a year. However, deaths from the disease have decreased by 44 per cent since 2000.”
Although the incidence of pneumonia has decreased by almost half, a significant number of children are still dying from this disease. The underdeveloped healthcare system in Ethiopia struggles to support the entire country effectively. There have been improvements in the number of individuals who can be treated, but with half the country living below the poverty line, affordable healthcare is difficult for most to find. There are organizations like Human Expansion Workers or HEWs who offer free healthcare to individuals needing basic services like “emergency services, inpatient hospital facilities and doctor care” (United States Legal).
“As of 2015, there were more than 38,000 HEWs, like Ms. Muluemebet, operating in over 16,000 healthcare posts across the country. Each healthcare post serves approximately 5,000 people, meaning the vast majority of Ethiopia’s 99 million population can access free, basic healthcare.” Providing posts that offer free healthcare is a significant step taken to help people. Although the vast number of people needing care poses a challenge, it is a step towards preventing these diseases. Access to this kind of healthcare is more manageable than having to go to a hospital because it’s free and broadly distributed.
While pneumonia is a common problem, there is another significant health threat: HIV and AIDS. AIDS is a familiar issue worldwide but is especially prevalent in developing countries like Ethiopia.
The final health concern most common in Ethiopia is malaria. Malaria, transmitted by mosquitoes to humans or other animals, presents symptoms such as an enlarged liver, decreased red blood cells, fever, and an enlarged spleen.
