With an oxygen mask on and a cannula attached to one hand, three-year-old Farhana Akhtar was lying in her bed in the pneumonia ward of Dhaka Shishu Hospital and Institute, still struggling to breathe.

Her mother Habiba Akhter sat at one corner of the bed, staring blankly at her daughter, while the father, Abbas Uddin, waited outside the ward.

A resident of Keraniganj, Abbas, in his early 40s, said his child had been suffering for almost two weeks.

"She contracted both pneumonia and asthma, and was in the ICU for five days. She was moved to the ward after her condition improved but the progress has been slow since then."

The ward, with 19 seats, is now completely full, as the 681-bed hospital has been witnessing a surge in pneumonia cases since the arrival of winter.

In the first 19 days of this month, 372 children with pneumonia were admitted to the hospital. The number of such patients admitted last month was 388, according to the hospital data.

On December 18 alone, 17 children were admitted to the hospital with pneumonia.

However, the number of admitted patients dropped to 298 by yesterday, as many children were released after recovery.

In October and November, some 345 and 388 children were hospitalised respectively. In those months last year, the numbers were 320 and 308.

The data showed that till yesterday, 3,384 children were admitted to the hospital with the infection. The number was 3,103 in 2022.

"The number is increasing as children are most vulnerable to this disease," Prof Dr Md Jahangir Alam, director of the hospital, told The Daily Star recently.

"There are some days still left in the month and I fear the number of inpatients may exceed 500 by the end of the year."

An infection that inflames the air sacs in one or both lungs, pneumonia is the global leading cause of death among children under five as a single disease.

According to the icddr,b, approximately 2-3 children die every hour from pneumonia in the country. At least 24,000 die every year.

Just in the past 53 days, 92 children have died only at Dhaka Shishu hospital.

Around the world, pneumonia remains among the top five infectious diseases to kill children under five, accounting for 14 percent of 0.7 million deaths from infectious diseases, icddr,b data showed.

Physicians said air pollution is one of the main contributing factors behind cold-related diseases, especially pneumonia.

Speaking to The Daily Star yesterday, Prof Iffat Ara Shamsad, child specialist and head of pediatrics at Dhaka Medical College Hospital, said air pollution stands as one of the main causes as children's respiratory systems are immature.

A WHO study showed that about one-third of pneumonia deaths are due to air pollution.

She added that children are mostly affected by virus and bacteria from the air. "Air pollution is linked to many respiratory complications, including asthma and pneumonia. Curbing it would surely reduce the number of children suffering from such complications."

Prof Jahangir said, "There aren't many trees in Dhaka. As a result, when winter comes to this polluted city, children get sick easily."

Along with elderly people, children are most affected from pneumonia and some other diseases like asthma, bronchiolitis, and even diarrhea, during the change of the season as their immune systems are weaker than other age groups, he explained.

Experts have advised parents to keep a lookout for symptoms -- medium or high fever, cough, and laboured or fast breathing -- and rush them to hospitals as soon as these signs are visible.

PATIENTS STUCK IN LONG LINES

Visiting Dhaka Shishu Hospital and Institute recently, this correspondent saw a large number of children and their parents waiting in line to see doctors at the outdoor department.

Eight-year-old Samia Sultana, who lives with her family in Adabor, was seen waiting with her parents, while suffering from fever, cough and severe headache for at least four days.

Sultana Begum, a resident of Rampura area, spent over two hours in line with her eight-month-old baby.

"My girl has been suffering from fever and cough for the past three days. I cannot even breastfeed her due to the cough," said the 35-year-old mother.

The scenes were grim at the Pneumonia Research Centre of the hospital as well, where all the 16 critical care seats occupied.

Jahangir said most of the patients of the hospital are from areas like Adabor and Mirpur. "The environment in those areas is poor due to immense pollution. We've also been getting patients from outside Dhaka."

The doctor suggested taking up a balanced diet, enriched with vitamin D; wearing masks and comfortable warm clothes; and regular exercising to help prevent contracting cold-related diseases.