Pneumonia in children before and during the COVID-19 pandemic: an observation from a climate change and environmental perspective in Indonesia

Abstract

Background. Pneumonia is the second leading cause of child mortality in Indonesia. The COVID-19 pandemic in Indonesia is increasing a challenging environment for children’s respiratory health. 
 This study aims to examine pneumonia in children using the perspective of climate change and the changing environment in Indonesia before and during COVID-19 pandemic. 
 Materials and methods. This research is a retrospective longitudinal study conducted during the period 2017–2020. The study area of the study is in Indonesia. All the province and city in Indonesia are included in this study. The number of children surveyed each year is 30.73 million. Outdoor air quality, temperature and rainfall observations were carried out at 185 observation stations spread throughout Indonesia
 Results. In Indonesia, child pneumonia cases declined by 39.42% from 2017 (511,434 cases) to 2020 (309,838 cases) during the COVID-19 pandemic, with a 47.06% decrease in mortality. Outdoor air quality worsened by 51.64% pre-pandemic (2017–2019), improving notably in 2020. Conversely, temperature and rainfall, which decreased before 2017–2019, sharply increased in 2020, with rainfall at 524 mm and temperatures rising by 0.7°C compared to 2019.
 Limitations. A detailed analysis and cautious interpretation are necessary due to the complex, suggestive links between air quality, climate, behavior, and respiratory health highlighted in this study, especially during the pandemic.
 Conclusion. The pandemic triggered unexpected shifts. Reduced cases correlated with better air quality due to lockdowns and behavior changes, while increased temperature and rainfall may have hindered pathogen transmission.