JALALABAD, 22 December 2008 (IRIN) - An outbreak of pneumonia in eastern Afghanistan has killed at least six children in the past two weeks and pneumonia cases in some central provinces have risen sharply, according to health officials.

Up to 3,000 children with pneumonia, acute bronchitis and other respiratory diseases have sought treatment at hospitals in Jalalabad, capital of Nangarhar Province, over the past two months, Baz Mohammad Sherzad, deputy director of the provincial health department, told IRIN on 22 December.

Most are children under five. "Pneumonia cases have increased significantly compared to the same period last year," Sherzad said.

Cold weather poses a threat to vulnerable households: Access to health services is limited and people lack knowledge about how to protect children.

Health officials in the central province of Daykundi said pneumonia cases had risen sharply in December - with the situation aggravated by high food prices and food insecurity: Families cannot afford nutritious food which makes children more vulnerable to diseases, according to experts. "Every day about 60 patients with pneumonia and respiratory diseases visit our hospital," Asif Wahidy, an official at Daykundi's central hospital, told IRIN on the phone.

Afghanistan's infant mortality rate is 165 deaths per 1,000 live births, and one child in four does not reach his/her fifth birthday largely due to diseases such as pneumonia and diarrhoea, according to the UN Children's Fund (UNICEF).

Vulnerable groups

Health workers at hospitals in Jalalabad said most patients were children of internally displaced persons and returnees who have little access to sanitation and clean drinking water.

"These children are very prone to infectious diseases," said Wahidullah Habibi, a paediatrician at Jalalabad hospital, adding that IDPs and returnees from neighbouring Pakistan could not afford to buy fuel to keep their children warm in winter.

"Most families sleep and live in one room in large numbers in order to keep warm, thereby creating a favourable environment for contagious diseases to spread," Habibi said.

Acute food insecurity, poor hygiene and lack of awareness about infectious diseases has further exacerbated such vulnerabilities, health specialists said.

Not enough beds

Public health officials in Jalalabad assured IRIN they had adequate medication and staff to treat pneumonia patients. Their main concern was the shortage of hospital beds.

"We… cannot accommodate all patients," said Habibi of Jalalabad's main hospital where some patients were lying on the floor.

Access to quality health services has been a major problem for many people. Donors are providing funds to build capacity and improve service delivery.

The single largest donor, the US Agency for International Development (USAID) will give US$236 million to support health services in the next five years, the Health Ministry said on 21 December.

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