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Pandolfi E, Loconsole D, Chironna M, van Summeren J, Paget J, Raponi M, Russo L, Campagna I, Croci I, Concato C, Perno CF, Tozzi AE, Linardos G, Bartolucci V, Ciampini S, Muda AO, De Angelis L, Ciofi Degli Atti ML, Rizzo C. Pre-COVID-19-pandemic RSV epidemiology and clinical burden in pediatric primary care in Italy: a comparative analysis across two regions for the 2019/2020 season. BMC Infect Dis 2024; 24:388. [PMID: 38605310 PMCID: PMC11007985 DOI: 10.1186/s12879-024-09229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season. METHODS A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations. RESULTS Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration. CONCLUSIONS This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.
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Affiliation(s)
- Elisabetta Pandolfi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Daniela Loconsole
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Maria Chironna
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | | | - John Paget
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | | | - Luisa Russo
- Division of Metabolism, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ilaria Campagna
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ileana Croci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Carlo Concato
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Carlo Federico Perno
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alberto Eugenio Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giulia Linardos
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Veronica Bartolucci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Sara Ciampini
- Local Health Unit, Public Health Service, Rome, Italy
| | - Andrea Onetti Muda
- Department of Laboratories, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Luigi De Angelis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | | | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Gao Y, Feng X, Yuan T, Li M, Wei M, Li S. Post-pandemic trends: Epidemiological and etiological insights into acute respiratory infections in southern China. Diagn Microbiol Infect Dis 2024; 109:116293. [PMID: 38598951 DOI: 10.1016/j.diagmicrobio.2024.116293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
Data on people suspected with acute respiratory infections (ARIs) from August 2022 to December 2023 in southern China were analyzed. Following the COVID-19 pandemic, the positive detection rates of respiratory pathogens increased to 56.9%. Influenza A virus (IAV) emerged as the predominant prevalence pathogen (52.1%), followed by Mycoplasma pneumoniae (Mp: 21.2%), and SARS-CoV-2 (11.6%). Mp, IAV, and Human rhinovirus (HRV) infection were the primary etiologies of ARIs patients under age 18, accounting for 49.4%, 48.6%, and 21.7%, respectively. Mp, HRV, Respiratory syncytial virus (RSV), and Adenovirus (ADV) contributed to ARIs cases in virtually every month in this group, with Mp being particularly notable for its consistent presence and high co-infection rate (31.0%). IAV was predominant in the 19 to 59 age group (88.6%), SARS-CoV-2 was responsible for most of ARIs in the elderly group (82.5%). This study provides valuable insights into the dynamic nature of respiratory pathogens post COVID-19 era.
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Affiliation(s)
- Yuquan Gao
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China
| | - Xudong Feng
- Department of Clinical Laboratory, Ningbo Medical Center Lihuili Hospital, Affiliated Lihuili Hospital of Ningbo University, Ningbo, PR China
| | - Ting Yuan
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China; Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Min Li
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Muyun Wei
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shuangshuang Li
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China; Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Albutti A, Mahdi HA, Alwashmi AS, Alfelali M, Barasheed O, Barnes EH, Shaban RZ, Booy R, Rashid H. The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial. J Infect Public Health 2024; 17 Suppl 1:34-41. [PMID: 37055268 DOI: 10.1016/j.jiph.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/04/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. METHODS A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. RESULTS A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had 'possible ILI' and two (0.4 %) had 'possible COVID-19'. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3-4.0] for intervention relative to control). CONCLUSION This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. TRIAL REGISTRATION This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.
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Affiliation(s)
- Aqel Albutti
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Hashim A Mahdi
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia.
| | - Ameen S Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Mohammad Alfelali
- Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi Arabia.
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia.
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Ramon Z Shaban
- New South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, NSW 2151, Australia; Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, NSW 2006, Australia; Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
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Gao Y, Ma Y, Feng D, Zhang F, Wang B, Liu X, Zhu B, Xie H, Zhao L, Long X, Chen Y, Wang B, Jiang J, Zhu Z, Zhang Y, Cui A, Xia B, Mao N. Epidemiological Characteristics of Human Parainfluenza Viruses Infections - China, 2019-2023. China CDC Wkly 2024; 6:235-241. [PMID: 38633430 PMCID: PMC11018516 DOI: 10.46234/ccdcw2024.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction A retrospective study based on sentinel surveillance was conducted in 10 provincial-level administrative divisions (PLADs) in China to enhance the understanding of the epidemiological characteristics of human parainfluenza viruses (HPIVs). Methods From January 2019 to June 2023, respiratory specimens were collected from individuals with acute respiratory infections (ARIs) and screened for four HPIVs serotypes and other common respiratory viruses using multiplex real-time polymerase chain reaction (PCR). This study analyzed the association of HPIVs infections with seasonal patterns, geographical distribution, demographic profiles, clinical features, and co-infection status. Results During the study period, a total of 12,866 ARIs were included. The overall detection rate of HPIVs was 6.15%, varying from 5.04% in 2022 to 9.70% in 2020. The median age of HPIVs-infected patients was 3 years. HPIV2 was more prevalent among individuals aged 5-17 years (42.57%), while HPIV4 was more common in those over 65 years (12.24%). HPIV3 (54.16%) and HPIV1 (27.18%) were the predominant serotypes, and their prevalence exhibited significant seasonal fluctuations post- coronavirus disease 2019 (COVID-19) pandemic. The peak of HPIV3 shifted three months later in 2020 compared to 2019 and returned to a summer peak thereafter. Two peaks of HPIV1 were observed in 2021 following the peak of HPIV3. Additionally, co-infections were frequent in HPIVs cases (overall rate: 22.12%), with human rhinovirus being the most common co-infecting virus. Conclusions The prevalence of HPIVs in China was predominantly due to HPIV3 and HPIV1, and their seasonal patterns were altered by pandemic restrictions. Hence, continuous surveillance of HPIVs is essential.
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Affiliation(s)
- Yixuan Gao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yingwei Ma
- Precision Medicine Research Center, Children’s Hospital of Changchun, Changchun City, Jilin Province, China
| | - Daxing Feng
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, Henan Province, China
| | - Feng Zhang
- Laboratory of Viral Diseases, Qingdao Municipal Centre for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Biao Wang
- Virus Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou City, Gansu Province, China
| | - Xiaoqing Liu
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang City, Gansu Province, China
| | - Bing Zhu
- Virus Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou City, Guangdong Province, China
| | - Hui Xie
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Academy for Preventive Medicine, Institute of Tuberculosis Control Research and Prevention, Beijing, China
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoru Long
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Chen
- Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot City, Inner Mongolia Autonomous Region, China
| | - Bing Wang
- Shenyang Prefecture Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China
| | - Jie Jiang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Zhen Zhu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Aili Cui
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Baicheng Xia
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Naiying Mao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
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Ilboudo AK, Cissé A, Milucky J, Tialla D, Mirza SA, Diallo AO, Bicaba BW, Charlemagne KJ, Diagbouga PS, Owusu D, Waller JL, Talla-Nzussouo N, Charles MD, Whitney CG, Tarnagda Z. Predictors of severity and prolonged hospital stay of viral acute respiratory infections (ARI) among children under five years in Burkina Faso, 2016-2019. BMC Infect Dis 2024; 24:331. [PMID: 38509462 PMCID: PMC10953152 DOI: 10.1186/s12879-024-09219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Viruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children < 5 years in Burkina Faso. METHODS Data were collected from four SARI sentinel surveillance sites during October 2016 through April 2019. A SARI case was a child < 5 years with an acute respiratory infection with history of fever or measured fever ≥ 38 °C and cough with onset within the last ten days, requiring hospitalization. Very severe ARI cases required intensive care or had at least one danger sign. Oropharyngeal/nasopharyngeal specimens were collected and analyzed by multiplex real-time reverse-transcription polymerase chain reaction (rRT-PCR) using FTD-33 Kit. For this analysis, we included only SARI cases with rRT-PCR positive test results for at least one respiratory virus. We used simple and multilevel logistic regression models to assess factors associated with very severe viral ARI and viral SARI with prolonged hospitalization. RESULTS Overall, 1159 viral SARI cases were included in the analysis after excluding exclusively bacterial SARI cases (n = 273)very severe viral ARI cases were common among children living in urban areas (AdjOR = 1.3; 95% CI: 1.1-1.6), those < 3 months old (AdjOR = 1.5; 95% CI: 1.1-2.3), and those coinfected with Klebsiella pneumoniae (AdjOR = 1.9; 95% CI: 1.2-2.2). Malnutrition (AdjOR = 2.2; 95% CI: 1.1-4.2), hospitalization during the rainy season (AdjOR = 1.71; 95% CI: 1.2-2.5), and infection with human CoronavirusOC43 (AdjOR = 3; 95% CI: 1.2-8) were significantly associated with prolonged length of hospital stay (> 7 days). CONCLUSION Younger age, malnutrition, codetection of Klebsiella pneumoniae, and illness during the rainy season were associated with very severe cases and prolonged hospitalization of SARI involving viruses in children under five years. These findings emphasize the need for preventive actions targeting these factors in young children.
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Affiliation(s)
- Abdoul Kader Ilboudo
- Laboratoire National de Référence-Grippes (LNR-G), Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso.
| | - Assana Cissé
- Laboratoire National de Référence-Grippes (LNR-G), Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Jennifer Milucky
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dieudonné Tialla
- Laboratoire National de Référence-Grippes (LNR-G), Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Sara A Mirza
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alpha Oumar Diallo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brice W Bicaba
- Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Kondombo Jean Charlemagne
- Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Potiandi Serge Diagbouga
- Laboratoire National de Référence-Grippes (LNR-G), Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Daniel Owusu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica L Waller
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ndahwouh Talla-Nzussouo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana
- Dexis Professional Services, 1331 Pennsylvania Avenue NW Suite 300, Washington, DC, 20004, USA
| | - Myrna D Charles
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cynthia G Whitney
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zekiba Tarnagda
- Laboratoire National de Référence-Grippes (LNR-G), Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
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Islam M, Islam K, Dalal K, Hossain Hawlader MD. In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh. BMC Pediatr 2024; 24:38. [PMID: 38216932 PMCID: PMC10787469 DOI: 10.1186/s12887-024-04525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under five globally, particularly in regions like South Asia and sub-Saharan Africa. Bangladesh has made substantial progress in reducing child mortality, yet pneumonia remains a significant contributor to under-five deaths. This study aimed to investigate the association between in-house environmental factors and childhood ARI, considering factors such as household crowding, smoking, and sanitation facilities. METHODS This case-control study was conducted at a tertiary-level children's hospital in Dhaka, Bangladesh, from March to September 2019. The study included children aged 6-59 months. Cases were children with ARI symptoms, while controls were children without such symptoms. Rigorous matching by age and gender was employed to ensure comparability. Data were collected through structured questionnaires, and bivariate and conditional logistic regression analyses were performed. RESULTS Several household environmental factors were significantly associated with childhood ARIs. Children from overcrowded households (AOR = 2.66, 95% CI = 1.52-4.71; p < 0.001), those using unclean cooking fuels (OR = 2.41, 95% CI: 1.56, 3.73; p = < 0.001), those exposed to in-house smoking (AOR = 1.74, 95% CI = 1.01, 3.05; p = 0.04) and those with unimproved sanitation facilities faced higher odds (AOR = 4.35, 95% CI = 2.14-9.26) of ARIs. Additionally, preterm birth and higher birth order were associated with an increased risk of ARI. In contrast, exclusive breastfeeding was a protective factor. CONCLUSION In-house environmental factors, including sanitation, crowding and in-house smoking, significantly influence childhood ARIs. Additionally, birth order and preterm birth play a crucial role. Promoting exclusive breastfeeding is associated with a lower ARI risk among under-five children in Bangladesh. These findings can guide interventions to reduce ARIs in low-income regions, particularly in South Asia.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Kariul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Sundsvall, 851 70, Sweden.
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Wulandari RA, Fauzia S, Kurniasari F. Investigations on the risk factors of Acute Respiratory Infections (ARIs) among under-five children in Depok City, Indonesia. Ann Ig 2024; 36:15-25. [PMID: 37772476 DOI: 10.7416/ai.2023.2580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Background Acute Respiratory Infections are caused by pathogens that spread rapidly. Acute Respiratory Infections include upper respiratory tract infections and lower respiratory tract infections. According to the World Health Organization (2019), Acute Respiratory Infections rank fourth among diseases that affect children with high morbidity. Indonesia's under-five mortality rate due to Acute Respiratory Infections rank first among the Association of Southeast Asian Nations. Under-five mortality due to Acute Respiratory Infections in Indonesia accounts for 22.30% of the total under-five mortality cases. Study design and methods This cross-sectional study was conducted with a total of 100 mother and child pairs selected by simple random sampling. Internal and external factors, including nutritional status, maternal age, maternal education level, presence of a smoker in the house, house ownership, household size, temperature, humidity, lighting, ceilings, floors, walls, and ventilation were investigated as the risk factors of Acute Respiratory Infections among under-five children in this study. Results Our cross-sectional study found that 68 out of 100 under-five children in this study were infected with Acute Respiratory Infections during the study period. Among the risk factors, our multivariate analysis suggests that presence of smokers, maternal age, and inadequate ceiling conditions were the potential determinants of Acute Respiratory Infections among under-five children in Depok City. Conclusions Despite the limitations of this study, we believe our results could give a comprehensive overview of the risk factors of Acute Respiratory Infections in under-five children.
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Affiliation(s)
- R A Wulandari
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java, 16424, Indonesia
| | - S Fauzia
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java, 16424, Indonesia
| | - F Kurniasari
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java, 16424, Indonesia
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Ye H, Zhang S, Zhang K, Li Y, Chen D, Tan Y, Liang L, Liu M, Liang J, An S, Wu J, Zhu X, Li M, He Z. Epidemiology, genetic characteristics, and association with meteorological factors of human metapneumovirus infection in children in southern China: A 10-year retrospective study. Int J Infect Dis 2023; 137:40-47. [PMID: 37816430 DOI: 10.1016/j.ijid.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES This study aimed to determine the epidemiological and genetic features of human metapneumovirus (HMPV) infection in children in southern China, and the effect of meteorological factors on infection. METHODS 14,817 children (≤14 years) with acute respiratory tract infections from 2010 to 2019 were examined for HMPV and other respiratory viruses by real-time quantitative polymerase chain reaction. Full-length F gene of 54 positive samples were sequenced and subjected to phylogenetic analysis. The correlation between the HMPV-positive rate and meteorological factors was analyzed by linear regression analysis. RESULTS HMPV was detected in 524 (3.5%) children, who were mostly younger than 1 year. The seasonal peak of HMPV prevalence mainly occurred in spring. Respiratory syncytial virus was the most common virus coinfected with HMPV (5.3%). Phylogenetic analysis revealed that the sequenced HMPV strains belonged to four sublineages, including A2b (1.9%), A2c (31.5%), B1 (50.0%), and B2 (16.7%). After adjusting for all meteorological factors, sunshine duration was inversely correlated with the HMPV-positive rate. CONCLUSION HMPV is an important respiratory pathogen that causes acute respiratory tract infections in children in southern China, particularly in children ≤5 years old. The prevalence peak of HMPV in this area appeared in spring, and the predominant subtype was B1. Meteorological factors, especially long sunshine duration, might decrease the HMPV prevalence.
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Affiliation(s)
- Hengming Ye
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China; Public Health Service Center of Bao'an District, Shenzhen, China
| | - Shuqing Zhang
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Kexin Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yizhe Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Delin Chen
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yongyao Tan
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Linyue Liang
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Minjie Liu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jingyao Liang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu An
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jueheng Wu
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xun Zhu
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Mengfeng Li
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Cancer Institute, Southern Medical University, Guangzhou, China
| | - Zhenjian He
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China.
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9
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Miller KM, Barnett TC, Cadarette D, Bloom DE, Carapetis JR, Cannon JW. Antibiotic consumption for sore throat and the potential effect of a vaccine against group A Streptococcus: a systematic review and modelling study. EBioMedicine 2023; 98:104864. [PMID: 37950997 PMCID: PMC10663680 DOI: 10.1016/j.ebiom.2023.104864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Antibiotic consumption can lead to antimicrobial resistance and microbiome imbalance. We sought to estimate global antibiotic consumption for sore throat, and the potential reduction in consumption due to effective vaccination against group A Streptococcus (Strep A). METHODS We reviewed and analysed articles published between January 2000 and February 2022, identified though Clarivate Analytics' Web of Science search platform, with reference to antibiotic prescribing or consumption, sore throat, pharyngitis, or tonsillitis. We then used those analyses, combined with assumptions for the effectiveness, duration of protection, and coverage of a vaccine, to calculate the estimated reduction in antibiotic prescribing due to the introduction of Strep A vaccines. FINDINGS We identified 101 studies covering 38 countries. The mean prescribing rate for sore throat was approximately 5 courses per 100 population per year, accounting for approximately 5% of all antibiotic consumption. Based on 2020 population estimates for countries with empiric prescribing rates, antibiotic consumption for sore throat was estimated to exceed 37 million courses annually, of which half could be attributable to treatment for Strep A. A vaccine that reduces rates of Strep A infection by 80%, with 80% coverage and 10 year's duration of protection, could avert 2.8 million courses of antibiotics prescribed for sore throat treatment among 5-14 year-olds in countries with observed prescribing rates, increasing to an estimated 7.5 million averted if an effective vaccination program also reduced precautionary prescribing. INTERPRETATION A vaccine that prevents Strep A throat infections in children may reduce antibiotic prescribing for sore throat by 32-87% depending on changes to prescribing and consumption behaviours. FUNDING The Wellcome Trust, grant agreement number 215490/Z/19/Z.
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Affiliation(s)
- Kate M Miller
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia; School of Population and Global Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Timothy C Barnett
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia; Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
| | - Daniel Cadarette
- Harvard Kennedy School, Harvard University, Cambridge, MA, United States
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Jonathan R Carapetis
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia; Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Jeffrey W Cannon
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia; Centre for Child Health Research, Medical School, University of Western Australia, Nedlands, Western Australia, Australia.
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10
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Stevens ER, Agbakoba R, Mann DM, Hess R, Richardson SI, McGinn T, Smith PD, Halm W, Mundt MP, Dauber-Decker KL, Jones SA, Feldthouse DM, Kim EJ, Feldstein DA. Reducing prescribing of antibiotics for acute respiratory infections using a frontline nurse-led EHR-Integrated clinical decision support tool: protocol for a stepped wedge randomized control trial. BMC Med Inform Decis Mak 2023; 23:260. [PMID: 37964232 PMCID: PMC10644670 DOI: 10.1186/s12911-023-02368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Overprescribing of antibiotics for acute respiratory infections (ARIs) remains a major issue in outpatient settings. Use of clinical prediction rules (CPRs) can reduce inappropriate antibiotic prescribing but they remain underutilized by physicians and advanced practice providers. A registered nurse (RN)-led model of an electronic health record-integrated CPR (iCPR) for low-acuity ARIs may be an effective alternative to address the barriers to a physician-driven model. METHODS Following qualitative usability testing, we will conduct a stepped-wedge practice-level cluster randomized controlled trial (RCT) examining the effect of iCPR-guided RN care for low acuity patients with ARI. The primary hypothesis to be tested is: Implementation of RN-led iCPR tools will reduce antibiotic prescribing across diverse primary care settings. Specifically, this study aims to: (1) determine the impact of iCPRs on rapid strep test and chest x-ray ordering and antibiotic prescribing rates when used by RNs; (2) examine resource use patterns and cost-effectiveness of RN visits across diverse clinical settings; (3) determine the impact of iCPR-guided care on patient satisfaction; and (4) ascertain the effect of the intervention on RN and physician burnout. DISCUSSION This study represents an innovative approach to using an iCPR model led by RNs and specifically designed to address inappropriate antibiotic prescribing. This study has the potential to provide guidance on the effectiveness of delegating care of low-acuity patients with ARIs to RNs to increase use of iCPRs and reduce antibiotic overprescribing for ARIs in outpatient settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04255303, Registered February 5 2020, https://clinicaltrials.gov/ct2/show/NCT04255303 .
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Affiliation(s)
| | | | - Devin M Mann
- NYU Grossman School of Medicine, New York, NY, USA
| | - Rachel Hess
- University of Utah Health, Salt Lake City, UT, USA
| | | | | | - Paul D Smith
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Wendy Halm
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- University of Wisconsin School of Nursing, Madison, WI, USA
| | - Marlon P Mundt
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | | | | | - Eun Ji Kim
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - David A Feldstein
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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11
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Saha R, Majumdar A, Chaudhuri RD, Chatterjee A, Lo M, Dutta S, Chawla-Sarkar M. Molecular epidemiology of circulating human adenoviruses among acute respiratory infection patients seeking healthcare facilities in West Bengal, India. Virology 2023; 588:109912. [PMID: 37913611 DOI: 10.1016/j.virol.2023.109912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
Human adenovirus (HAdV) causes acute respiratory infections leading to mortality in children. This study analyzes the circulating respiratory HAdV genotypes in West Bengal, India during 2018-2022 among symptomatic patients. The overall positivity rate was 6.8%, out of which 26.4% were co-infected with other respiratory viruses. Children aged 2 to 5 years were mostly infected. Phylogenetic analysis revealed that the recombinant HAdV-B type 7/3, which has remarkable outbreak potential, predominantly circulated in this region followed by the non-recombinant HAdV-B type 3/3. Moreover, the amino acid sequences encoded by both the hexon and fiber genes of these two circulating strains possessed a few mutations that mostly diverged from the prototype strain, although the divergence was less pronounced in case of the amino acids encoded by the fiber gene of HAdV-B type 3/3. Overall, the results underscore the need for continuous surveillance of respiratory HAdV types to combat future possible epidemics.
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Affiliation(s)
- Ritubrita Saha
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Agniva Majumdar
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Ratul Datta Chaudhuri
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Ananya Chatterjee
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mahadeb Lo
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Shanta Dutta
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mamta Chawla-Sarkar
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India.
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12
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Vivaldi G, Pfeffer PE, Talaei M, Basera TJ, Shaheen SO, Martineau AR. Long-term symptom profiles after COVID-19 vs other acute respiratory infections: an analysis of data from the COVIDENCE UK study. EClinicalMedicine 2023; 65:102251. [PMID: 38106559 PMCID: PMC10721552 DOI: 10.1016/j.eclinm.2023.102251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/04/2023] [Accepted: 09/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background Long COVID is a well recognised, if heterogeneous, entity. Acute respiratory infections (ARIs) due to other pathogens may cause long-term symptoms, but few studies compare post-acute sequelae between SARS-CoV-2 and other ARIs. We aimed to compare symptom profiles between people with previous SARS-CoV-2 infection, people with previous non-COVID-19 ARIs, and contemporaneous controls, and to identify clusters of long-term symptoms. Methods COVIDENCE UK is a prospective, population-based UK study of ARIs in adults. We analysed data for 16 potential long COVID symptoms and health-related quality of life (HRQoL), reported between January 21 and February 15, 2021, by participants unvaccinated against SARS-CoV-2. We classified participants as having previous SARS-CoV-2 infection or previous non-COVID-19 ARI (≥4 weeks prior) or no reported ARI. We compared symptoms by infection status using logistic and fractional regression, and identified symptom clusters using latent class analysis (LCA). This study is registered with ClinicalTrials.gov, NCT04330599. Findings We included 10,171 participants (1311 [12.9%] with SARS-CoV-2 infection, 472 [4.6%] with non-COVID-19 ARI). Both types of infection were associated with increased prevalence/severity of most symptoms and decreased HRQoL compared with no infection. Participants with SARS-CoV-2 infection had increased odds of problems with taste/smell (odds ratio 19.74, 95% CI 10.53-37.00) and lightheadedness or dizziness (1.74, 1.18-2.56) compared with participants with non-COVID-19 ARIs. Separate LCA models identified three symptom severity groups for each infection type. In the most severe groups (representing 22% of participants for both SARS-CoV-2 and non-COVID-19 ARI), SARS-CoV-2 infection presented with a higher probability of problems with taste/smell (probability 0.41 vs 0.04), hair loss (0.25 vs 0.16), unusual sweating (0.38 vs 0.25), unusual racing of the heart (0.43 vs 0.33), and memory problems (0.70 vs 0.55) than non-COVID-19 ARI. Interpretation Both SARS-CoV-2 and non-COVID-19 ARIs are associated with a wide range of symptoms more than 4 weeks after the acute infection. Research on post-acute sequelae of ARIs should extend from SARS-CoV-2 to include other pathogens. Funding Barts Charity.
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Affiliation(s)
- Giulia Vivaldi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Paul E. Pfeffer
- Barts Health NHS Trust, London, UK
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mohammad Talaei
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tariro Jayson Basera
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Seif O. Shaheen
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrian R. Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
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13
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Vestesson E, De Corte K, Chappell P, Crellin E, Clarke GM. Antibiotic prescribing in remote versus face-to-face consultations for acute respiratory infections in primary care in England: an observational study using target maximum likelihood estimation. EClinicalMedicine 2023; 64:102245. [PMID: 37842171 PMCID: PMC10568332 DOI: 10.1016/j.eclinm.2023.102245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/28/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Background The COVID-19 pandemic has led to an ongoing increase in the use of remote consultations in general practice in England. Although the evidence is limited, there are concerns that the increase in remote consultations could lead to more antibiotic prescribing. Methods In this cohort study, we used patient-level primary care data from the Clinical Practice Research Datalink to estimate the association between consultation mode (remote versus face-to-face) and antibiotic prescribing in England for acute respiratory infections (ARI) between April 2021 and March 2022. Eligibility criteria were applied at both practice-level and patient-level. 400 practices in England were sampled at random and then 600,000 patients were randomly sampled from the eligible patients (whose sex was recorded). Consultations for acute respiratory infections were identified. All antibiotic prescriptions were included, with the exception of antituberculosis drugs and antileprotic drugs, as identified through chapter 5.1 of the British National Formulary. The CPRD Aurum data was linked to the COVID-19 ONS infection survey by region. All analyses were done at the individual level. Repeated consultations from the same patient within 7 days were grouped together. We used targeted maximum likelihood estimation, a causal machine learning method with adjustment for infection type and patient-level, clinician-level and practice-level factors. Findings There were 45,997 ARI consultations (34,555 unique patients) within the study period, of which 28,127 were remote and 17,870 were face-to-face. For children, 48% of consultations were remote and, for adults, 66% were remote. For children, 42% of remote and 43% of face-to-face consultations led to an antibiotic prescription; the equivalent values for adults were 52% and 42%, respectively. After adjustment with TMLE, adults with a remote consultation had 23% (odds ratio [OR] 1.23, 95% CI: 1.18-1.29) higher chance of being prescribed antibiotics than if they had been seen face-to-face. We found no significant association between consultation mode and antibiotic prescribing in children (OR 1.04 95% CI: 0.98-1.11). Interpretation The higher rates of antibiotic prescribing in remote consultations for adults are cause for concern. We see no significant difference in antibiotic prescribing between consultation mode for children. These findings should inform antimicrobial stewardship activities for health-care professionals and policy makers. Future research should examine differences in guideline-compliance between remote and face-to-face consultations to understand the factors driving antibiotic prescribing in different consultation modes. Funding None.
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Affiliation(s)
- Emma Vestesson
- The Health Foundation, London, UK
- University College London Great Ormond Street Institute of Child Health, London, UK
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14
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Lima AKS, Banho CA, Sacchetto L, de Carvalho Marques B, dos Santos MG, Ribeiro MR, Gandolfi FA, Sakomura TP, Estofolete CF, Nogueira ML. Seasonal respiratory virus trends in pediatric patients during the COVID-19 pandemic in Brazil. Braz J Microbiol 2023; 54:1827-1834. [PMID: 37589928 PMCID: PMC10484886 DOI: 10.1007/s42770-023-01087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
Acute respiratory infections are a constant public health problem causing childhood morbidity and mortality worldwide. Reported cases of major respiratory infections decreased in 2020 after restrictive measures were adopted to contain the COVID-19 pandemic, but there is little data on the impact after these measures were relaxed in the subsequent years. This study conducted molecular analysis to identify rhinovirus, respiratory syncytial virus, influenza A virus, and adenovirus in SARS-CoV-2-negative samples taken from symptomatic pediatric patients during 2021 and 2022 to ascertain the impact of pandemic response measures within the broader epidemiological scenario. The positivity rates found were 28.3% and 50.8%, in 2021 and 2022, respectively, representing a significant increase (1.8 times) in the circulation of non-SARS-CoV-2 viruses after the reduction of non-pharmacological measures to contain the COVID-19 pandemic. Within the positive samples, rhinovirus and respiratory syncytial virus were most frequent (44.4 and 18% in 2021; 44.5 and 22.5% in 2022), whereas influenza A and adenovirus were found in lower frequency (12.5 and 5.5% in 2021; 13.4 and 4.9% in 2022, respectively). Because these different respiratory virus diseases produce similar symptoms, diagnosis based on clinical condition alone can be inaccurate, and more reliable testing is required to select the best therapeutic approach for each case. The loosening of restrictive measures to contain the COVID-19 pandemic led to higher numbers of other respiratory infections in pediatric patients. Ongoing surveillance and differential diagnosis of respiratory viruses are required to better understand their seasonal patterns after the COVID-19 pandemic to guide prevention and control strategies.
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Affiliation(s)
- Ana Karoline Sepedro Lima
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Cecília Artico Banho
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Lívia Sacchetto
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Beatriz de Carvalho Marques
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Mariana Guedes dos Santos
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Milene Rocha Ribeiro
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Flora A. Gandolfi
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade, São José do Rio Preto, São Paulo, Brazil
| | - Tatiana Pissolati Sakomura
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade, São José do Rio Preto, São Paulo, Brazil
| | - Cássia Fernanda Estofolete
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
- Hospital de Base, São José do Rio Preto, São Paulo, Brazil
| | - Maurício Lacerda Nogueira
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
- Hospital de Base, São José do Rio Preto, São Paulo, Brazil
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX USA
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15
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Gayawan E, Egbon OA, Adegboye O. Copula based trivariate spatial modeling of childhood illnesses in Western African countries. Spat Spatiotemporal Epidemiol 2023; 46:100591. [PMID: 37500230 DOI: 10.1016/j.sste.2023.100591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/21/2022] [Accepted: 05/31/2023] [Indexed: 07/29/2023]
Abstract
Acute respiratory infections (ARI), diarrhea, and fever are three common childhood illnesses, especially in sub-Saharan Africa. This study investigates the marginal and pairwise correlated effects of these diseases across Western African countries in a single analytical framework. Using data from nationally representative cross-sectional Demographic and Health Surveys, the study analyzed specific and correlated effects of each pair of childhood morbidity from ARI, diarrhea, and fever using copula regression models in fourteen contiguous Western African countries. Data concerning childhood demographic and socio-economic conditions were used as covariates. In this cross-sectional analysis of 152,125 children aged 0-59 months, the prevalence of ARI was 6.9%, diarrhea, 13.8%, and fever 19.6%. The results showed a positive correlation and geographical variation in the prevalence of the three illnesses across the study region. The estimated correlation and 95% confidence interval between diarrhea and fever is 0.431(0.300,0.539); diarrhea and ARI is 0.270(0.096,0.422); and fever and ARI is 0.502(0.350,0.614). The marginal and correlated spatial random effects reveal within-country spatial dependence. Source of water and access to electricity was significantly associated with any of the three illnesses, while television, birth order, and gender were associated with diarrhea or fever. The place of residence and access to newspapers were associated with fever or ARI. There was an increased likelihood of childhood ARI, diarrhea, and fever, which peaked at about ten months but decreased substantially thereafter. Mother's age was associated with a reduced likelihood of the three illnesses. The maps generated could be resourceful for area-specific policy-making to speed up mitigation processes.
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Affiliation(s)
- Ezra Gayawan
- Department of Statistics, Federal University of Technology, Akure, Nigeria
| | - Osafu Augustine Egbon
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil; Department of Statistics, Universidade Federal de São Carlos, Brazil.
| | - Oyelola Adegboye
- Menzies School of Health Research, Charles Darwin University, Casuarina 0810, NT, Australia
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16
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Cortes-Ramirez J, Gatton M, Wilches-Vega JD, Mayfield HJ, Wang N, Paris-Pineda OM, Sly PD. Mapping the risk of respiratory infections using suburban district areas in a large city in Colombia. BMC Public Health 2023; 23:1400. [PMID: 37474891 PMCID: PMC10360249 DOI: 10.1186/s12889-023-16179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 06/22/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) in Cúcuta -Colombia, have a comparatively high burden of disease associated with high public health costs. However, little is known about the epidemiology of these diseases in the city and its distribution within suburban areas. This study addresses this gap by estimating and mapping the risk of ARI in Cúcuta and identifying the most relevant risk factors. METHODS A spatial epidemiological analysis was designed to investigate the association of sociodemographic and environmental risk factors with the rate of ambulatory consultations of ARI in urban sections of Cúcuta, 2018. The ARI rate was calculated using a method for spatial estimation of disease rates. A Bayesian spatial model was implemented using the Integrated Nested Laplace Approximation approach and the Besag-York-Mollié specification. The risk of ARI per urban section and the hotspots of higher risk were also estimated and mapped. RESULTS A higher risk of IRA was found in central, south, north and west areas of Cúcuta after adjusting for sociodemographic and environmental factors, and taking into consideration the spatial distribution of the city's urban sections. An increase of one unit in the percentage of population younger than 15 years; the Index of Multidimensional Poverty and the rate of ARI in the migrant population was associated with a 1.08 (1.06-1.1); 1.04 (1.01-1.08) and 1.25 (1.22-1.27) increase of the ARI rate, respectively. Twenty-four urban sections were identified as hotspots of risk in central, south, north and west areas in Cucuta. CONCLUSION Sociodemographic factors and their spatial patterns are determinants of acute respiratory infections in Cúcuta. Bayesian spatial hierarchical models can be used to estimate and map the risk of these infections in suburban areas of large cities in Colombia. The methods of this study can be used globally to identify suburban areas and or specific communities at risk to support the implementation of prevention strategies and decision-making in the public and private health sectors.
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Affiliation(s)
- Javier Cortes-Ramirez
- Centre for Data Science, Queensland University of Technology, Brisbane City, Australia.
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, St Lucia, Australia.
- Faculty of Health, University of Santander, Santander, Colombia.
- Queensland University of Technology, O Block D Wing Room D722. Ring Road, Kelvin Grove Campus, Victoria Park Road. Kelvin Grove, Kelvin Grove, QLD, 4059, Australia.
| | - Michelle Gatton
- Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane City, Australia
| | | | - Helen J Mayfield
- School of Public Health, The University of Queensland, St Lucia, Australia
| | - Ning Wang
- National Centre for Chronic and Noncommunicable Disease Control and Prevention. Chinese Centre for Disease Control and Prevention, Beijing, China
| | | | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, St Lucia, Australia
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Chen X, Zhang P, Ma Y. Prevalence of acute infection in adults with asthma exacerbation: A systematic review and meta-analysis. Ann Thorac Med 2023; 18:132-151. [PMID: 37663878 PMCID: PMC10473064 DOI: 10.4103/atm.atm_422_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/29/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Acute respiratory infections are a major trigger of asthma exacerbations. This study sought to estimate the overall proportion of viruses, atypical pathogens, and bacteria detected in adults with asthma exacerbations. METHODS PubMed, EMBASE, and Cochrane Library databases and all related studies from the reviews and references were searched from inception to February 13, 2020. Two authors independently performed study selection, data extraction, as well as quality evaluation. Subsequently, meta-analysis, between-study heterogeneity, and publication bias assessment were conducted on RStudio. RESULTS Forty-three eligible studies comprising 3511 adults were included, of which 21 publications mentioned multiple infections during acute asthma attacks. Meta-analysis showed an acute infection prevalence of 40.19% (95% confidence interval [CI] 34.53%-45.99%). Viruses, atypical pathogens, and bacteria were detected in 38.76% (95% CI 32.02%-45.71%), 8.29% (95% CI 2.64%-16.27%), and 7.05% (95% CI 3.34%-11.81%) of asthmatics during exacerbations, respectively. Rhinovirus infections are always the dominant trigger for exacerbations with a proportion of 20.02% (95% CI 14.84%-25.73%). Substantial heterogeneity across studies (Cochran Q test: 479.43, P < 0.0001, I2 = 91.2%) was explained by subgroup analysis, indicating that year, region, population, respiratory secretion, detection method, pathogen, and study quality were all influencing factors. CONCLUSION This meta-analysis provided the first quantitative epidemiological data for adults, and in the future, more research and health-care supports are necessary in this area.
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Affiliation(s)
- Xi Chen
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Pingan Zhang
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yanliang Ma
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
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B M, Patel Nidhi B, N S, G R, A K, Patel Divyankakumari N. Awareness among mothers on acute respiratory tract infections in under five children at north Gujarat, India. Bioinformation 2023; 19:713-715. [PMID: 37885776 PMCID: PMC10598362 DOI: 10.6026/97320630019713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/28/2023] Open
Abstract
Acute respiratory infections (ARI) account for 14.3% of new born mortality and 15.9% of death among children aged 1 to 5 in India, making them significant contributors to morbidity and mortality in children. However, the bulk of these fatalities would be avoided if mothers were aware of the symptoms and signs of infections so that prompt referrals could be made. The goal of the current study was to gauge mothers of children under the age of five's knowledge of ARI and examine how well an education programme did in raising that knowledge. The information was gathered from 60 mothers of young children under the age of five in different areas around Gujarat State in India. The pre-intervention-post-test methodology was used. The mean pre-test observation score was 8.51, the mean post-test score was 19.31, and the mean difference was 11. There were 60 samples; the pre-test and post-test scores had standard deviations of 4.59 and 2.54, respectively. The calculated "t" value was also 17.29, the DF was 59, and the table value of "t" was 1.67. These findings demonstrate that the educational programme on ARI was successful in increasing the mother's knowledge.
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Affiliation(s)
- Mahalakshmi B
- />Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
| | - Bharatbhai Patel Nidhi
- />Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
| | - Sivasubramanian N
- />Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
| | - Ramalakshmi G
- />College of Nursing, S.G.R.R University, Dehradun, Uttarkhand-248001,India
| | - Krishnan A
- />Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
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Amadu I, Seidu AA, Mohammed A, Duku E, Miyittah MK, Ameyaw EK, Hagan JE, Musah MH, Ahinkorah BO. Assessing the combined effect of household cooking fuel and urbanicity on acute respiratory symptoms among under-five years in sub-Saharan Africa. Heliyon 2023; 9:e16546. [PMID: 37346351 PMCID: PMC10279788 DOI: 10.1016/j.heliyon.2023.e16546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Background This study sought to investigate the association between urbanicity (rural-urban residency), the use of solid biomass cooking fuels and the risk of Acute Respiratory Infections (ARIs) among children under the age of 5 in sub-Saharan Africa (SSA). Methods Cross-sectional data from the most recent surveys of the Demographic and Health Survey Program conducted in 31 sub-Saharan African countries were pooled for the analysis. The outcome variables, cough and rapid short breath were derived from questions that asked mothers if their children under the age of 5 suffered from cough and short rapid breath in the past two weeks preceding the survey. To examine the associations, multivariable negative log-log regression models were fitted for each outcome variable. Results Higher odds ratios of cough occurred among children in urban households that use unclean cooking fuel (aOR = 1.05 95% CI = 1.01, 1.08). However, lower odds ratios were observed for rural children in homes that use clean cooking fuel (aOR = 0.93 95% CI = 0.87, 0.99) relative to children in urban homes using clean cooking fuel. We also found higher odds ratios of short rapid breaths among children in rural households that use unclean cooking fuel compared with urban residents using clean cooking fuel (aOR = 1.12 95% CI = 1.08, 1.17). Conclusion Urbanicity and the use of solid biomass fuel for cooking were associated with an increased risk of symptoms of ARIs among children under five years in SSA. Thus, policymakers and stakeholders need to design and implement strategies that minimize children's exposure to pollutants from solid biomass cooking fuel. Such interventions could reduce the burden of respiratory illnesses in SSA and contribute to the realization of Sustainable Development Goal 3.9, which aims at reducing the number of diseases and deaths attributable to hazardous chemicals and pollution of air, water and soil.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Emperiks Research, NT0085, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Box 256, Ghana
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Queensland, Australia
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Hen Mpoano (Our Coast), Takoradi P.O. Box AX 296, Ghana
| | - Michael K. Miyittah
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Environmental Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Mohammed Hafiz Musah
- Department of Health Information Management, Tamale Teaching Hospital, Tamale, Ghana
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Kumar A, Bahal A, Singh L, Ninawe S, Grover N, Suman N. Utility of multiplex real-time PCR for diagnosing paediatric acute respiratory tract infection in a tertiary care hospital. Med J Armed Forces India 2023; 79:286-291. [PMID: 37193516 PMCID: PMC10182280 DOI: 10.1016/j.mjafi.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Acute respiratory infections (ARIs) are responsible for considerable morbidity and mortality among children all over the world. Many of the etiologic agents of the infections especially viral go undiagnosed for lack of requisite facility and the cost factors. We have used a commercially available platform for diagnosis of ARIs in children receiving inpatient and outpatient services in a tertiary care centre. Methods The framework of the study was prospective and observational. In this study, clinical samples of children suffering from ARIs were subjected to real-time multiplex PCR targeting both viral and bacterial pathogens. Results Of 94 samples received at our centre (49 male and 45 female), the positivity for respiratory pathogens was detected in 50 (53.19%) samples. Clinical symptoms of patients and age distribution have been elaborated in text. A single pathogen (n = 29/50), two pathogens (15/50) and three pathogens (n = 6/50) were detected by multiplex RT-PCR. Of 77 isolates detected, maximum numbers were of human rhinovirus (HRV) (n = 14) (18.18%) Streptococcus pneumoniae (n = 14) (18.18%) followed by Staphylococcus aureus (n = 10) (12.98%). Conclusion The epidemiology of ARIs considering viral etiologies is poorly understood due to less number of studies especially in Indian subcontinent. The advent of latest advanced molecular methods has made it possible to identify common respiratory pathogens and has contributed to cover the gap in existing knowledge.
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Affiliation(s)
- Anshu Kumar
- Graded Specialist (Microbiology), Command Hospital (Western Command), Chandimandir, India
| | - Ashish Bahal
- Classified Specialist (Path & Micro) Army Hospital (R&R), Delhi Cantt, India
| | - Lavan Singh
- Classified Specialist (Path & Micro) Army Hospital (R&R), Delhi Cantt, India
| | - S.M. Ninawe
- Graded Specialist (Microbiology), Army Hospital (R&R), Delhi Cantt, India
| | - Naveen Grover
- Senior Adviser (Path & Micro), Army Hospital (R&R), Delhi Cantt, India
| | - Neha Suman
- Graded Specialist (ENT), Command Hospital (Western Command), Chandimandir, India
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Soja SM, Wegener R, Kille N, Castell S. Merging citizen science with epidemiology: design of a prospective feasibility study of health events and air pollution in Cologne, Germany. Pilot Feasibility Stud 2023; 9:28. [PMID: 36814323 PMCID: PMC9944383 DOI: 10.1186/s40814-023-01250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/17/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Citizen science as an approach to merge society and science is not a new paradigm. Yet it is not common in public health, epidemiology, or medical sciences. SMARAGD (Sensors for Measuring Aerosols and ReActive Gases to Deduce health effects) assesses air pollution at participants' homes or workplaces in Cologne, Germany, as feasibility study with a citizen science approach. Personal exposure to air pollutants is difficult to study, because the distribution of pollutants is heterogeneous, especially in urban areas. Targeted data collection allows to establish connections between air pollutant concentration and the health of the study population. Air pollution is among the most urgent health risks worldwide. Yet links of individualized pollution levels and respiratory infections remain to be validated, which also applies for the feasibility of the citizen science approach for epidemiological studies. METHODS We co-designed a prospective feasibility study with two groups of volunteers from Cologne, Germany. These citizen scientists and researchers determined that low-cost air-quality sensors (hereafter low-cost sensors) were to be mounted at participants' homes/workplaces to acquire stationary data. The advantage of deploying low-cost sensors is the achievable physical proximity to the participants providing health data. Recruitment started in March 2021 and is currently ongoing (as of 09/22). Sensor units specifically developed for this study using commercially available electronic sensor components will measure particulate matter and trace gases such as ozone, nitrogen oxides, and carbon monoxide. Health data are collected using the eResearch system "Prospective Management and Monitoring-App" (PIA). Due to the ongoing SARS-CoV-2 pandemic, we also focus on COVID-19 as respiratory infection. DISCUSSION Citizen science offers many benefits for science in general but also for epidemiological studies. It provides scientific information to society, enables scientific thinking in critical discourses, can counter anti-scientific ideologies, and takes into account the interests of society. However, it poses many challenges, as it requires extensive resources from researchers and society and can raise concerns regarding data protection and methodological challenges such as selection bias.
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Affiliation(s)
- Sara-Marie Soja
- grid.7490.a0000 0001 2238 295XDepartment for Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr. 7, Brunswick, Lower Saxony 38124 Germany
| | - Robert Wegener
- grid.8385.60000 0001 2297 375XForschungszentrum Jülich, Institute for Energy and Climate Research, IEK-8: Troposphere, Wilhelm-Johnen-Straße, Jülich, North Rhine-Westphalia 52428 Germany
| | - Natalie Kille
- grid.8385.60000 0001 2297 375XForschungszentrum Jülich, Institute for Energy and Climate Research, IEK-8: Troposphere, Wilhelm-Johnen-Straße, Jülich, North Rhine-Westphalia 52428 Germany
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr. 7, Brunswick, Lower Saxony, 38124, Germany. .,German Centre for Infection Research (DZIF), Inhoffenstr. 7, Brunswick, Lower Saxony, 38124, Germany.
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Li C, Liao R, Zhu W, Jiang G, Wang Y, Li L, Zhang T, Lv Q. Spatiotemporal dynamics and potential ecological drivers of acute respiratory infectious diseases: an example of scarlet fever in Sichuan Province. BMC Public Health 2022; 22:2139. [PMID: 36411416 DOI: 10.1186/s12889-022-14469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECT Scarlet fever is an acute respiratory infectious disease that endangers public health and imposes a huge economic burden. In this paper, we systematically studied its spatial and temporal evolution and explore its potential ecological drivers. The goal of this research is to provide a reference for analysis based on surveillance data of scarlet fever and other acute respiratory infectious illnesses, and offer suggestions for prevention and control. METHOD This research is based on a spatiotemporal multivariate model (Endemic-Epidemic model). Firstly, we described the epidemiology status of the scarlet fever epidemic in Sichuan Province from 2016 to 2019. Secondly, we used spatial autocorrelation analysis to understand the spatial pattern. Thirdly, we applied the endemic-epidemic model to analyze the spatiotemporal dynamics by quantitatively decomposing cases into endemic, autoregressive, and spatiotemporal components. Finally, we explored potential ecological drivers that could influence the spread of scarlet fever. RESULTS From 2016 to 2019, the incidence of scarlet fever in Sichuan Province varied much among cities. In terms of temporal distribution, there were 1-2 epidemic peaks per year, and they were mainly concentrated from April to June and October to December. In terms of transmission, the endemic and temporal spread were predominant. Our findings imply that the school holiday could help to reduce the spread of scarlet fever, and a standard increase in Gross Domestic Product (GDP) was associated with 2.6 folds contributions to the epidemic among cities. CONCLUSION Scarlet fever outbreaks are more susceptible to previous cases, as temporal spread accounted for major transmission in many areas in Sichuan Province. The school holidays and GDP can influence the spread of infectious diseases. Given that covariates could not fully explain heterogeneity, adding random effects was essential to improve accuracy. Paying attention to critical populations and hotspots, as well as understanding potential drivers, is recommended for acute respiratory infections such as scarlet fever. For example, our study reveals GDP is positively associated with spatial spread, indicating we should consider GDP as an important factor when analyzing the potential drivers of acute infectious disease.
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Nieman DC, Sakaguchi CA. Physical activity lowers the risk for acute respiratory infections: Time for recognition. J Sport Health Sci 2022; 11:648-655. [PMID: 35995362 PMCID: PMC9391085 DOI: 10.1016/j.jshs.2022.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/19/2022] [Accepted: 08/04/2022] [Indexed: 05/30/2023]
Abstract
Physical inactivity is a well-established risk factor for chronic diseases, such as cardiovascular disease, cancer, and diabetes mellitus. There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections (ARIs). ARIs, such as the common cold, influenza, pneumonia, and coronavirus disease 2019 (COVID-19), are among the most pervasive diseases on earth and cause widespread morbidity and mortality. Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny. Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness, even after adjusting for other risk factors. The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects, including enhanced surveillance of key immune cells and reduced chronic inflammation. Scientific consensus groups, including those who submitted the Physical Activity Guidelines for Americans, have not yet given this area of research the respect that is due. It is time to add "reduced risk for ARIs" to the "Exercise is Medicine" list of physical activity-related health benefits.
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Affiliation(s)
- David C Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
| | - Camila A Sakaguchi
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA
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Lei C, Lou CT, Io K, SiTou KI, Ip CP, U H, Pan B, Ung COL. Viral etiology among children hospitalized for acute respiratory tract infections and its association with meteorological factors and air pollutants: a time-series study (2014-2017) in Macao. BMC Infect Dis 2022; 22:588. [PMID: 35786346 PMCID: PMC9250746 DOI: 10.1186/s12879-022-07585-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background The associations between viral etiology of acute respiratory infections (ARI) with meteorological factors and air pollutants among children is not fully understood. This study aimed to explore the viral etiology among children hospitalized for ARI and the association of meteorological factors and air pollutants with children hospitalization due to viral ARI. Methods Electronic health record data about children (aged between 1 month and 14 years) admitted for ARI at Kiang Wu Hospital in Macao between 2014 and 2017 was analyzed retrospectively. xMAP multiplex assays were used to detect viruses in the nasopharyngeal swab and distributed-lag nonlinear model (DLNM) was used to evaluate associations. Results Among the 4880 cases of children hospitalization due to ARI, 3767 (77.2%) were tested positive for at least one virus and 676 (18%) exhibited multiple infections. Enterovirus (EV)/rhinovirus (HRV), adenovirus (ADV), respiratory syncytial virus (RSV) and influenza virus (IFV) were the most common viral pathogens associated with ARI and human bocavirus (hBOV) exhibited the highest multiple infection rates. Meteorological factors and air pollutants (PM10, PM2.5 and NO2) were associated with the risk of viral ARI hospitalization. The relative risk of viral infection increased with daily mean temperature but plateaued when temperature exceeded 23 °C, and increased when the relative humidity was < 70% and peaked at 50%. The effect of solar radiation was insignificant. Air pollutants (including PM10, PM2.5, NO2 and O3) showed strong and immediate effect on the incidence of viral infection. Conclusions The effects of mean temperature, relative humidity and air pollutants should be taken into account when considering management of ARI among children. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07585-y.
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Affiliation(s)
- Cheng Lei
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - Cheong Tat Lou
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - King Io
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - Kin Ian SiTou
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - Chong Pak Ip
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - HongJin U
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - Baoquan Pan
- Department of Pediatrics, Kiang Wu Hospital, Macao, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Science, University of Macau, Macao, China. .,Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, China.
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Nshimiyimana Y, Zhou Y. Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda. BMC Public Health 2022; 22:1209. [PMID: 35715771 PMCID: PMC9205046 DOI: 10.1186/s12889-022-13532-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Globally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda. Methods A cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years. Results In Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12–1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06–1.53), and farm workers (1.25; 95% CI: 1.11–1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48–59 months (OR: 0.69; 95% CI: 0.60–0.80), breastfed children (OR: 0.83; 95% CI: 0.76–0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69–0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61–0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda. Conclusion Policy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children’s healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13532-y.
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Affiliation(s)
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China.
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Merera A, Asena T, Senbeta M. Bayesian multilevel analysis of determinants of acute respiratory infection in children under the age of five years in Ethiopia. BMC Pediatr 2022; 22:123. [PMID: 35272658 PMCID: PMC8908561 DOI: 10.1186/s12887-022-03187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute respiratory tract infection (ARI) is one of the leading causes of illness and mortality in children under the age of five worldwide. Pneumonia, which is caused by a respiratory tract infection, kills about 1.9 million children under the age of 5 years around the world. The majority of these deaths occur in underdeveloped countries. According to the 2016 Ethiopia Demographic and Health Survey (EDHS), the prevalence rate of ARI in Ethiopia was 7%. Prevalence is defined as the number of infectious diseases present at a given period in relation to the total number of children under the age of five who have been exposed to ARI. The goal of this study was to determine the risk factors for acute respiratory infection among children under the age of five in Ethiopia. METHODS To provide representative samples of the population, a community-based cross-sectional sampling scheme was designed. Bayesian multilevel approach was employed to assess factors associated with the prevalence of ARI among children under age five in Ethiopia. The data was collected from 10,641 children under the age of 5 years out of which 9918 children were considered in this study. RESULTS The ARI prevalence rate in children under the age of 5 years was assessed to be 8.4%, somewhat higher than the country's anticipated prevalence rate. Children whose mothers did not have a high level of education had the highest prevalence of ARI. The key health, environmental, and nutritional factors influencing the proportion of children with ARI differed by area. Tigray (15.3%) and Oromia (14.4%) had the highest prevalence of ARI, while Benishangul Gumuz had the lowest prevalence (2.6%). The use of vitamin A was investigated, and the results revealed that roughly 43.1% of those who received vitamin A had the lowest prevalence of ARI (7.7%) as compared to those who did not receive vitamin A. Diarrhea affected 11.1% of children under the age of five, with the highest frequency of ARI (24.6%) and the highest prevalence of ARI reported in children whose drinking water source was unprotected/unimproved (9.4%). CONCLUSIONS The prevalence of ARI among children under the age of 5 years was found to be strongly affected by the child's age, household wealth index, mother's educational level, vitamin A supplement, history of diarrhea, maternal work, stunting, and drinking water source. The study also found that the incidence of ARI varies significantly between and within Ethiopian areas. When intending to improve the health status of Ethiopian children, those predictive variables should be taken into consideration.
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Affiliation(s)
- Amanuel Merera
- Department of Statistics, Mizan-Tepi University, Mizan-Tepi, Ethiopia
| | - Tilahun Asena
- Department of Statistics, Arba Minch University, Arba Minch, Ethiopia.
| | - Mebratu Senbeta
- Department of Economics, Arba Minch University, Arba Minch, Ethiopia
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Foo D, Sarna M, Pereira G, Moore HC, Regan AK. Longitudinal, population-based cohort study of prenatal influenza vaccination and influenza infection in childhood. Vaccine 2022; 40:656-665. [PMID: 35000794 DOI: 10.1016/j.vaccine.2021.11.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/21/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Influenza vaccination is recommended to protect mothers and their infants from influenza infection. Few studies have evaluated the health impacts of in utero exposure to influenza vaccine among children more than six months of age. METHODS We used probabilistically linked administrative health records to establish a mother-child cohort to evaluate the risk of influenza and acute respiratory infections associated with maternal influenza vaccination. Outcomes were laboratory-confirmed influenza (LCI) and hospitalization for influenza or acute respiratory infection (ARI). Adjusted hazard ratios (aHRs) accounted for child's Aboriginal status and were weighted by the inverse-probability of treatment. RESULTS 14,396 (11.5%) children were born to vaccinated mothers. Maternally vaccinated infants aged < 6 months had lower risk of LCI (aHR: 0.33; 95% CI: 0.13, 0.85), influenza-associated hospitalization (aHR: 0.39; 95% CI: 0.16, 0.94) and ARI-associated hospitalization (aHR: 0.85; 95% CI: 0.77, 0.94) compared to maternally unvaccinated infants. With the exception of an increased risk of LCI among children aged 6 months to < 2 years old following first trimester vaccination (aHR: 2.28; 95% CI: 1.41, 3.69), there were no other differences in the risk of LCI, influenza-associated hospitalization or ARI-associated hospitalization among children aged > 6 months. CONCLUSION Study results show that maternal influenza vaccination is effective in preventing influenza in the first six months and had no impact on respiratory infections after two years of age.
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Affiliation(s)
- Damien Foo
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Mohinder Sarna
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway; enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Hannah C Moore
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Annette K Regan
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; School of Nursing and Health Professions, University of San Francisco, San Francisco, California, United States; Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States
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Kawano A, Kim Y, Meas M, Sokal-Gutierrez K. Association between satellite-detected tropospheric nitrogen dioxide and acute respiratory infections in children under age five in Senegal: spatio-temporal analysis. BMC Public Health 2022; 22:178. [PMID: 35081933 PMCID: PMC8790943 DOI: 10.1186/s12889-022-12577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is growing evidence to suggest that exposure to a high concentration of nitrogen dioxide (NO2) can lead to a higher incidence of Acute Respiratory Infections (ARIs) in children; however, such an association remains understudied in Sub-Saharan Africa due to the limited availability of exposure data. This study explored this association by using the satellite-detected tropospheric NO2 concentrations measured by Sentinel-5 Precursor and ARI symptoms in children under age five collected in the Demographic and Health Survey (DHS) in Senegal. METHODS We matched the daily tropospheric NO2 exposure with the individual ARI symptoms according to the DHS survey clusters spatially and temporally and conducted a logistic regression analysis to estimate the association of exposure to NO2 with ARI symptoms in two preceding weeks. RESULTS We observed a positive association between exposure to continuous levels of NO2 and ARI symptoms after adjusting for confounders (OR 1.27 per 10 mol/m2, 95% CI: 1.06 - 1.52). When the association was further examined by quartile exposure categories, the 4th quartile category was positively associated with symptoms of ARI after adjusting for confounders (OR 1.71, 95% CI: 1.08-2.69). This suggests that exposure to certain high levels of NO2 is associated with the increased risk of children having symptoms of ARI in Senegal. CONCLUSIONS This study highlights the need for increased research on the effects of ambient NO2 exposure in Africa as well as the need for more robust, ground-based air monitoring in the region. For a country like Senegal, where more than 90% of the population lives in areas that do not meet the national air quality standards, it is urgently required to implement air pollution prevention efforts to protect children from the health hazards of air pollution.
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Affiliation(s)
- Ayako Kawano
- School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94704, USA
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Michelle Meas
- School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94704, USA
| | - Karen Sokal-Gutierrez
- School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94704, USA.
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Tizifa TA, Kabaghe AN, McCann RS, Nkhono W, Mtengula S, Takken W, Phiri KS, van Vugt M. Incidence of clinical malaria, acute respiratory illness, and diarrhoea in children in southern Malawi: a prospective cohort study. Malar J 2021; 20:473. [PMID: 34930300 DOI: 10.1186/s12936-021-04013-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background Malaria, acute respiratory infections (ARIs) and diarrhoea are the leading causes of morbidity and mortality among children under 5 years old. Estimates of the malaria incidence are available from a previous study conducted in southern Malawi in the absence of community-led malaria control strategies; however, the incidence of the other diseases is lacking, owing to understudying and competing disease priorities. Extensive malaria control measures through a community participation strategy were implemented in Chikwawa, southern Malawi from May 2016 to reduce parasite prevalence and incidence. This study assessed the incidence of clinical malaria, ARIs and acute diarrhoea among under-five children in a rural community involved in malaria control through community participation. Methods A prospective cohort study was conducted from September 2017 to May 2019 in Chikwawa district, southern Malawi. Children aged 6–48 months were recruited from a series of repeated cross-sectional household surveys. Recruited children were followed up two-monthly for 1 year to record details of any clinic visits to designated health facilities. Incidence of clinical malaria, ARIs and diarrhoea per child-years at risk was estimated, compared between age groups, area of residence and time. Results A total of 274 out of 281 children recruited children had complete results and contributed 235.7 child-years. Malaria incidence was 0.5 (95% CI (0.4, 0.5)) cases per child-years at risk, (0.04 in 6.0–11.9 month-olds, 0.5 in 12.0–23.9 month-olds, 0.6 in 24.0–59.9 month-olds). Incidences of ARIs and diarrhoea were 0.3 (95% CI (0.2, 0.3)), (0.1 in 6.0–11.9 month-olds, 0.4 in 12.0–23.9 month-olds, 0.3 in 24.0–59.9 month-olds), and 0.2 (95% CI (0.2, 0.3)), (0.1 in 6.0–11.9 month-olds, 0.3 in 12.0–23.9 month-olds, 0.2 in 24.0–59.9 month-olds) cases per child-years at risk, respectively. There were temporal variations of malaria and ARI incidence and an overall decrease over time. Conclusion In comparison to previous studies, there was a lower incidence of clinical malaria in Chikwawa. The incidence of ARIs and diarrhoea were also low and decreased over time. The results are promising because they highlight the importance of community participation and the integration of malaria prevention strategies in contributing to disease burden reduction. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-04013-5.
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Wani MA, Mishra AK, Sharma S, Mayer IA, Ahmad M. Source profiling of air pollution and its association with acute respiratory infections in the Himalayan-bound region of India. Environ Sci Pollut Res Int 2021; 28:68600-68614. [PMID: 34275076 DOI: 10.1007/s11356-021-15413-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
The studies related to air pollutants and their association with human health over the mountainous region are of utmost importance and are sparse especially over the Himalayan region of India. The linkages between various atmospheric variables and clinically validated data have been done using various datasets procured from satellite, model reanalysis, and surface observations during 2013-2017. Aerosol optical depth, air temperature, and wind speed are significantly related (p < 0.001) to the incidence of acute respiratory infections with its peak during winter. Model-derived particulate matter (PM2.5) shows high contributions of black carbon, organic carbon, and sulfate during winter. The wind roses show the passage of winds from the south-west and southern side of the region. Back trajectory density plot along with bivariate polar plot analyses have shown that most of the winds coming from the western side are taking a southward direction before reaching the study area and may be bringing pollutants from the Indo-Gangetic Plain and other surrounding regions. Our study shows that the accumulation of pollutants in the Himalayan valley is owing to the meteorological stability with significant local emissions from burning of biomass and biofuels along with long-range and mid-range transport during the winter season that significantly correlated with the incidence of acute respiratory infections in the region.
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Affiliation(s)
- Manzoor A Wani
- Department of Geography and Regional Development, University of Kashmir, Srinagar, India.
| | - Amit K Mishra
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India.
| | - Saloni Sharma
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Ishtiaq A Mayer
- Department of Geography and Regional Development, University of Kashmir, Srinagar, India
| | - Mukhtar Ahmad
- Indian Meteorological Department, Rambagh, Srinagar, India
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Abstract
INTRODUCTION In low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia. METHODS A cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection. RESULTS The total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631-2.887), mother's no education (AOR = 2.050,95% CI: 1.017-4.133), mother's Primary education (AOR = 2.387, 95% CI:1.176-4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578-2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210-0.314), mothers not working (AOR = 0.773, 95% CI:0.630-0.948), not stunted (AOR = 0.663, 95% CI: 0.552-0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395-2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI. CONCLUSIONS Childhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.
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Affiliation(s)
- Amanuel Mengistu Merera
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
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Wang C, Liu J, Mi Y, Chen J, Bi J, Chen Y. Clinical features and epidemiological analysis of respiratory human adenovirus infection in hospitalized children: a cross-sectional study in Zhejiang. Virol J 2021; 18:234. [PMID: 34844615 PMCID: PMC8628464 DOI: 10.1186/s12985-021-01705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022] Open
Abstract
Background HAdV is one of the common pathogens in hospitalized children with acute respiratory infections (ARIs). We aim to describe the clinical and laboratory features, epidemiological characteristics, and HAdV species and/or types of inpatients with HAdV respiratory infections. Methods Respiratory samples were gathered from inpatients diagnosed ARIs in Children’s Hospital, Zhejiang University School of Medicine, and were detected by using Direct Immunofluorescence Assay from 2018 to 2019. PCR amplification and sequencing of the hypervariable zone of hexon gene were used for genotyping. The clinical and laboratory features, and HAdV genotyping, and epidemiological characteristic analysis were retrospectively performed. Results Of 7072 samples collected, 488 were identified as HAdV-positive. The overall detection rate was 6.9%. The peaked detection rate was 14.1% in January 2019. HAdV-positive cases with ARIs mainly appeared in winter. The detection rate was highest among children between 6 months and 2 years (8.7%, 123/1408). Clinical diagnosis included pneumonia (70.3%, 343/488), bronchitis (7.0%, 34/488) and acute upper respiratory tract infection (22.7%, 111/488). The common clinical manifestations were fever (93.4%, 456/488), cough (94.7%, 462/488), wheezing (26.2%, 128/488), and shortness of breath (14.8%, 72/488). 213 (43.6%) cases had co-infection and 138 (28.3%) cases had extrapulmonary symptoms. 96(19.7%) cases had intrapulmonary and intrathoracic complications.78 (16.0%) had an underlying condition, most of which were congenital heart diseases (20.5%, 16/78). The proportions of hyperpyrexia, duration of fever > 10 days, severe pneumonia, and wheezing in the co-infection group were remarkably higher than those in HAdV single-infection group (all p < 0.05). The proportions of duration of hospitalization, duration of fever > 10 days, wheezing, shortness of breath, change in level of consciousness, serosal fluids, extrapulmonary symptoms, co-infections and underlying diseases were significantly higher in severe pneumonia group than those in the mild pneumonia group (all p < 0.05). Four HAdV species were successfully identified in 155 cases and presented by 8 genotypes. HAdV-B3 (56.1%, 87/155) and HAdV -B7 (31.0%, 48/155) were the most predominant detected types and occurred commonly in different severity groups (p = 0.000), while, HAdV-B55 was detected only in the severe group. HAdV-B7’s detection rate in the severe pneumonia group was significantly higher than the non-severe pneumonia group. Conclusion HAdV detection rate is related to age and season. Bronchopneumonia accounts for about 70% HAdV-positive inpatients. The common clinical manifestations include hyperpyrexia, cough, wheezing, and shortness of breath. HAdV-B3 and HAdV-B7 are the most common types in children diagnosed with respiration infections.
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Affiliation(s)
- Caiyun Wang
- Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China.
| | - Juanjuan Liu
- Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China
| | - Yumei Mi
- Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China
| | - Jing Chen
- Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China
| | - Jing Bi
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China
| | - Yinghu Chen
- Department of Infectious Disease, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Binsheng Road, Hangzhou, 310052, China
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Peña-Tuesta I, Del Valle-Vargas C, Petrozzi-Helasvuo V, Aguilar-Luis MA, Carrillo-Ng H, Silva-Caso W, Del Valle-Mendoza J. Community acquired Acinetobacter baumannii in pediatric patients under 1 year old with a clinical diagnosis of whooping cough in Lima, Peru. BMC Res Notes 2021; 14:412. [PMID: 34758882 PMCID: PMC8579657 DOI: 10.1186/s13104-021-05826-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
Objective This study aimed to determine the prevalence of A. baumannii in children aged less than 1 year admitted with a clinical diagnosis of whooping cough. Results A total of 225 nasopharyngeal samples from children under 1 year old hospitalized with clinical diagnosis of whooping cough were studied from January 2010 to July 2012. The presence of A. baumannii was detected in 20.89% (47/225) of the nasopharyngeal swab samples. Among the 47 patients with A. baumannii: 5 were diagnosed with A. baumannii monoinfection, 17 co-infection with bacteria, 7 co-infection with virus and 18 co-infection with bacteria + virus. It was observed that 51.6% (116/225) were children between 29 days and 3 months old, this same group had the highest overall prevalence with 53.3%. The most common co-infecting pathogens were Bordetella pertussis in 55.3%, Adenovirus in 42.6% and Mycoplasma pneumoniae in 23.4%. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05826-y.
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Affiliation(s)
- Isaac Peña-Tuesta
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | | | - Veronica Petrozzi-Helasvuo
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Hugo Carrillo-Ng
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Wilmer Silva-Caso
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Juana Del Valle-Mendoza
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.
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Sabharwal S, Datta S, Wattal C, Sachdeva A. A prospective study of prevalence of respiratory viruses causing acute respiratory infection in pediatric in-patients during pre- COVID times. Indian J Med Microbiol 2021; 39:429-433. [PMID: 34556348 DOI: 10.1016/j.ijmmb.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To find out the prevalence of respiratory viruses causing Acute Respiratory Infection in pediatric in-patients during Pre-COVID times. METHODS Nasal swabs were collected from children in the age group of 1 month-16 years who were admitted at our hospital with Acute Respiratory Infection. Samples were subjected to nucleic acid extraction and Real time polymerase chain reaction to detect 16 RNA viruses and 2 DNA viruses. The results were interpreted in context of most prevalent viruses detected, their seasonal distribution, co-infecting viruses, co-morbidities in patients with effect thereof and use and effect of antibiotics in those positive for viral etiology. RESULTS Of the 250 children recruited in the study, viral pathogen was detected in 74% cases. RSV was the most common virus detected with 36.2% positivity (92/254) followed by rhino/entero (19.2%, 49/254), PIV 1,2,3,4 (9.4%, 24/254), Influenza A,B,C (8.2%, 21/254), adenovirus & HBoV (6.2%, 16/254), coronavirus HKU1, NL63, OC43, 229E (4.3%, 11/254), H1N1 (4.7%, 12/254) and hMPV (0.7%, 2/254). Co-infection with 2 or more viruses was seen in 34% cases. Among the cases on whom antibiotics were started, they were withdrawn following test results in 42.3% of the cases. CONCLUSION The prevalence of viral etiology is high amongst children especially ≤2 years. RSV, rhino/enterovirus, PIV 1,2,3,4 and Influenza virus were more prevalent than others. Rapid, early detection of virus with multiplex PCR will help in early cohorting of the patients thus reducing nosocomial spread of these viruses and prevent injudicious use of antibiotics.
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Affiliation(s)
- Sukriti Sabharwal
- Department of Clinical Microbiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Sanghamitra Datta
- Department of Clinical Microbiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Chand Wattal
- Department of Clinical Microbiology, Sir Ganga Ram Hospital, New Delhi, India.
| | - Anil Sachdeva
- Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India
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Kurskaya OG, Prokopyeva EA, Anoshina AV, Leonova NV, Simkina OA, Komissarova TV, Sobolev IA, Murashkina TA, Kazachkova EA, Alekseev AY, Strakhovskaya MG, Shestopalov AM, Sharshov KA. Low incidence of human coronavirus among hospitalized children in Novosibirsk city, Russia during pre-pandemic period (2013-2020). J Microbiol Immunol Infect 2021; 55:336-340. [PMID: 34565695 PMCID: PMC8451474 DOI: 10.1016/j.jmii.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/12/2021] [Accepted: 07/29/2021] [Indexed: 11/18/2022]
Abstract
We investigated the incidence of 15 respiratory viruses among 2991 children with acute respiratory infections in Novosibirsk city, Russia, prior to the COVID-19 pandemic (2013-2020). Viral infections were detected in 72.5% cases. The incidence of human coronavirus was 2% (Alphacoronaviruses, 63%; Betacoronaviruses, 37%).
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Affiliation(s)
- O G Kurskaya
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - E A Prokopyeva
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia; Medical Department, Novosibirsk State University, Novosibirsk, Russia.
| | - A V Anoshina
- Department of Infectious Diseases, Novosibirsk Children's Municipal Clinical Hospital N(o)6, Novosibirsk, Russia.
| | - N V Leonova
- Department of Infectious Diseases, Novosibirsk Children's Municipal Clinical Hospital N(o)6, Novosibirsk, Russia.
| | - O A Simkina
- Department of Respiratory Infections, Novosibirsk Children's Municipal Clinical Hospital N(o)3, Novosibirsk, Russia.
| | - T V Komissarova
- Department of Respiratory Infections, Novosibirsk Children's Municipal Clinical Hospital N(o)3, Novosibirsk, Russia.
| | - I A Sobolev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - T A Murashkina
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - E A Kazachkova
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - A Yu Alekseev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - M G Strakhovskaya
- Department of Biophysics, Faculty of Biology, M.V. Lomonosov Moscow State University, Moscow, Russia.
| | - A M Shestopalov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - K A Sharshov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
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Tan HMJ, Tan MS, Chang ZY, Tan KT, Ee GLA, Ng CCD, Hwang YKW, Koh YLE, Low YPS, Tan NC. The impact of COVID-19 pandemic on the health-seeking behaviour of an Asian population with acute respiratory infections in a densely populated community. BMC Public Health 2021; 21:1196. [PMID: 34158019 PMCID: PMC8219514 DOI: 10.1186/s12889-021-11200-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background The COVID-19 pandemic led to the implementation of various non-pharmaceutical interventions (NPI) as the Singapore government escalated containment efforts from DORSCON Orange to Circuit Breaker. NPI include mandatory mask wearing, hand hygiene, social distancing, and closure of schools and workplaces. Considering the similar mode of transmission of COVID-19 and other pathogens related to acute respiratory infections (ARI), the effects of NPI could possibly lead to decreased ARI attendances in the community. This study aims to determine the year-on-year and weekly changes of ARI attendances across a cluster of polyclinics following the implementation of NPI. Methods The effect of the nation-wide measures on the health-seeking behaviour of the study population was examined over three periods: (1) 9 weeks prior to the start of Circuit Breaker (DORSCON Orange period), (2) 8 weeks during the Circuit Breaker, and (3) 9 weeks after easing of Circuit Breaker. Data on ARI attendances for the corresponding periods in 2019 were also extracted for comparison and to assess the seasonal variations of ARI. The average weekly workday ARI attendances were compared with those of the preceding week using Wilcoxon signed rank test. Results ARI attendances dropped steadily throughout the study period and were 50–80% lower than in 2019 since Circuit Breaker. They remained low even after Circuit Breaker ended. Positivity rate for influenza-like illnesses samples in the community was 0.0% from the last week of Circuit Breaker to end of study period. Conclusions NPI and public education measures during DORSCON Orange and Circuit Breaker periods appear to be associated with the health-seeking behaviour of the public. Changing levels of perceived susceptibility, severity, benefits and barriers, and widespread visual cues based on the Health Belief Model may account for this change. Understanding the impact of NPI and shifts in the public’s health-seeking behaviour will be relevant and helpful in the planning of future pandemic responses.
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Affiliation(s)
- Hwee Mian Jane Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore. .,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore.
| | - Mui Suan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Zi Ying Chang
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Kee Tung Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Guan Liang Adrian Ee
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Chee Chin David Ng
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Ying Khee William Hwang
- National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore.,SingHealth Duke-NUS Family Oncology Academic Clinical Program, Singapore, Singapore
| | - Yi Ling Eileen Koh
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Yan Ping Sarah Low
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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Zhang Y, Qiao L, Yao J, Yu N, Mu X, Huang S, Hu B, Li W, Qiu F, Zeng F, Chen C, Zhou Y, Zhang B, Cai T, Wang W, Wu X, Zhou Y, Wang G, Situ B, Lan S, Li N, Li X, Li Z, Li X, Wang C, Yang C, Feng P, Wang H, Zhu S, Xiong Y, Luo M, Shen W, Hu X, Zheng L. Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China. BMC Pediatr 2021; 21:284. [PMID: 34140022 PMCID: PMC8212487 DOI: 10.1186/s12887-021-02759-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023] Open
Abstract
Background Acute respiratory infections (ARI) cause considerable morbidity and mortality worldwide, especially in children. Unfortunately, there are limited multi-center data on common viral respiratory infections in south China. Methods A total of 4403 nasal swabs were collected from children in 10 cities in Guangdong, China in 2019. Seven respiratory viruses, influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV) and parainfluenza virus types 1–3 (PIV1, PIV2 and PIV3), were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed. Results The results showed that at least one virus was detected in 1099 (24.96 %) samples. The detection rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13 % (314/4403), 5.31 % (234/4403), 4.02 % (177/4403), 3.04 % (134/4403), 1.70 % (75/4403) and 1.16 % (51/4403), respectively. The detection rate of RSV was highest in 0–6-month-old children at 18.18 % (106/583), while the detection rate of IFA was highest in 12–18-year-old children at 20.48 % (17/83). The total detection rates in winter and spring were 35.67 % (219/614) and 34.56 % (403/1166), higher than those in summer, 17.41 % (284/1631), and autumn, 19.46 % (193/992). Conclusions RSV and IFA were the main respiratory viruses in children. With increasing age the detection rate of RSV decreased in children, but the trends for the detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02759-0.
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Affiliation(s)
- Yajie Zhang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Qiao
- Guangdong 999 Brain Hospital, Guangzhou, China
| | - Jinxiu Yao
- Yangjiang People's Hospital, Yangjiang, China
| | - Nan Yu
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoping Mu
- Guangdong Women and Children Hospital, Guangzhou, China
| | | | - Bo Hu
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weixuan Li
- The First People's Hospital of Foshan, Foshan, China
| | - Feng Qiu
- Nanhai Hospital, Southern Medical University, Foshan, China
| | - Fangyin Zeng
- The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Cong Chen
- Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Yuqiu Zhou
- Zhuhai Maternal and Child Health Hospital, Zhuhai, China
| | | | - Tian Cai
- Nanhai District People's Hospital of Foshan, Foshan, China
| | - Weijia Wang
- Zhongshan People's Hospital, Zhongshan, China
| | - Xianjin Wu
- Central People's Hospital of Huizhou, Huizhou, China
| | - Yiwen Zhou
- Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Guochang Wang
- School of Economics, Jinan University, Guangdong, Guangzhou, China
| | - Bo Situ
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuling Lan
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Na Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiu Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zihua Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xin Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Congrong Wang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chao Yang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pingfeng Feng
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongxia Wang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sijing Zhu
- Nanfang College of Sun Yat-Sen University, Guangdong, Guangzhou, China
| | - Yufeng Xiong
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Luo
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjuan Shen
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangdong, Guangdong, China
| | - Xiumei Hu
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Lei Zheng
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Charkaluk ML, Rousseau J, Dehouck-Vallois M, Jarreau PH, Nuytten A, Treluyer L, Ancel PY, Torchin H. Occurrence and severity of acute respiratory infections during the first year among very preterm infants: an Epipage-2 cohort analysis. Eur J Pediatr 2021; 180:1833-1840. [PMID: 33527179 DOI: 10.1007/s00431-021-03956-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/25/2022]
Abstract
This study aims to describe the incidence of acute respiratory infections (ARI) during the first year in infants born before 32 weeks' gestation, and to analyze and study the risk factors as well as factors associated with oxygen requirement among infants with an ARI, in the palivizumab era. This study included 2571 infants from a nationwide French population-based cohort (Epipage 2). ARI at 1-year corrected age was identified by parental questionnaires. Risk and severity factors included those already known, and detailed information about neonatal morbidities. ARI occurred in 52.2% (n = 1349) of infants. Oxygen therapy was used in 33.2% (n = 391) of infants with an ARI. Risk factors for AII were male sex, bronchopulmonary dysplasia, presence of siblings at home, and childcare in the community together with incomplete treatment palivizumab. Mechanical ventilation in the neonatal period, bronchopulmonary dysplasia, and discharge between October and March were associated with more frequent oxygen requirement. No other factors describing neonatal morbidities were associated with risk of ARI or oxygen requirement.Conclusion: ARIs are still very common during the first year of life of very preterm children, and oxygen therapy is frequently needed. Educational strategies are needed in all families with a very preterm infant. What is Known: • Acute respiratory infections (ARIs) are the first cause of rehospitalizations in preterm children, with bronchopulmonary dysplasia being the main risk factor. • Palivizumab prophylaxis has proven its effect against severe RSV infections, but it is not universal. What is New: • No factor describing neonatal morbidity, except BPD, was associated with ARI occurrence or severity. • BPD and discharge during RSV season were the only factors associated with O2 requirement during ARI.
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Affiliation(s)
- Marie-Laure Charkaluk
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France.
- Service de néonatologie, Hôpital Saint Vincent de Paul, GHICL, Boulevard de Belfort, 59020, Lille cedex, France.
- Université Catholique de Lille, F-59000, Lille, France.
| | | | | | - Pierre-Henri Jarreau
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France
- Department of Neonatal Medicine, Cochin Port-Royal Hospital, FHU PREMA, APHP.centre, Paris, France
| | - Alexandra Nuytten
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France
- Clinique de néonatalogie, Hôpital Jeanne de Flandre, CHU Lille, F-59000, Lille, France
| | - Ludovic Treluyer
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France
- CHU Amiens-Picardie, F-80054, Amiens, France
| | - Pierre-YvesY Ancel
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France
- CIC P1419, AP-HP, APHP.CUP, F-75014, Paris, France
| | - Héloïse Torchin
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France
- Department of Neonatal Medicine, Cochin Port-Royal Hospital, FHU PREMA, APHP.centre, Paris, France
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Gómez-Gómez A, Sánchez-Ramos EL, Noyola DE. Diabetes is a major cause of influenza-associated mortality in Mexico. Rev Epidemiol Sante Publique 2021; 69:205-213. [PMID: 34023186 DOI: 10.1016/j.respe.2021.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Influenza is a major cause of mortality worldwide. Most influenza-associated deaths are associated with cardiovascular or respiratory disorders. However, a large proportion of influenza-associated deaths do not have respiratory or cardiovascular disorders declared as the underlying cause of death. Diabetic individuals are at increased risk for influenza-mortality. In this study, we assessed the contribution of diabetes to influenza-associated mortality in Mexico. METHODS Diabetes influenza-associated mortality was estimated for the Mexican population using National Mortality Databases from the Mexican Ministry of Health from 1998 through 2015. Diabetes influenza-associated mortality was calculated applying Serfling cyclical regression models to weekly mortality rates for persons 20-59 years, 60 and more years, and all ages, and by sex. RESULTS There was a high correlation between weekly pneumonia and influenza mortality and diabetes-related mortality. Yearly influenza-associated diabetes mortality rates varied between 2.0 and 5.9/100,000. Up until the 2005-2006 season, diabetes-associated mortality rates were higher in females, while after that season rates were higher in males. Yearly influenza-associated diabetes mortality rates for adults 20-59 years of age ranged between 1.7 and 3.4/100,000, while estimates for adults 60 years and older ranged between 16.3 and 46.1/100,000. Approximately one third of estimated diabetes influenza-associated deaths occurred in adults 20-59 years of age. On average, diabetes deaths accounted for 19.6% of estimated influenza-associated all-cause mortality. CONCLUSION Diabetes is a major cause of estimated influenza-associated mortality in Mexico. Health-care authorities and professionals in countries with high diabetes prevalence should be aware of the potential impact of influenza in individuals with this condition.
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Affiliation(s)
- A Gómez-Gómez
- Internal Medicine Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | | | - D E Noyola
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Avenida Venustiano Carranza 2405, 78210 San Luis Potosí, Mexico.
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Lei C, Yang L, Lou CT, Yang F, SiTou KI, Hu H, Io K, Cheok KT, Pan B, Ung COL. Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017. BMC Infect Dis 2021; 21:306. [PMID: 33771128 PMCID: PMC7995389 DOI: 10.1186/s12879-021-05996-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/17/2021] [Indexed: 01/22/2023] Open
Abstract
Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.
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Affiliation(s)
- Cheng Lei
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Lisong Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Cheong Tat Lou
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Fan Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Kin Ian SiTou
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - King Io
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Kun Tat Cheok
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Baoquan Pan
- Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
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Islam M, Sultana ZZ, Iqbal A, Ali M, Hossain A. Effect of in-house crowding on childhood hospital admissions for acute respiratory infection: A matched case-control study in Bangladesh. Int J Infect Dis 2021; 105:639-645. [PMID: 33684561 DOI: 10.1016/j.ijid.2021.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Despite previous studies conducted to identify potential household factors, no conclusive evidence exists regarding the effect of in-house crowding on hospitalization for acute respiratory infection (ARI) in Bangladesh. Hence, the aim of this study was to detect such an association in children aged 6-59 months. METHODS An age and sex-matched case-control study was conducted involving 348 children in Bangladesh. In-house crowding was measured by people-per-bedroom. Conditional logistic regression was performed to identify the association between in-house crowding and hospitalization for ARI. RESULTS In-house overcrowding was associated with a 2.9-fold (95% confidence interval 1.80-4.73) greater adjusted odds of hospitalization for ARI compared to children from less crowded houses. In-house overcrowding was common in rural areas and in households with a poor economic status. Suboptimal breastfeeding and household tobacco smoke exposure were found to prevail in overcrowded households. CONCLUSION In-house overcrowding is associated with an increased risk of hospitalization for ARI in young children. Eliminating the fraction of the ARI burden due to in-house overcrowding will rely on increasing awareness regarding indoor air pollution and ventilation in the house and making efforts to avoid smoking in dwellings. Along with the management of crowding, child nutrition and exclusive breast-feeding requirements should be continued for a wide range of child health benefits.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Zeeba Zahra Sultana
- Cambridge Programme to Assist Bangladesh in Lifestyle and Environmental Risk Reduction, University of Cambridge, Cambridge, UK
| | - Adiba Iqbal
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Mohammad Ali
- Uttara Adhunik Medical College and Hospital, Dhaka, 1230, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh; Global Health Institute, North South University, Bashundhara, Dhaka, 1229, Bangladesh.
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Hoseini-Tavassol Z, Ejtahed HS, Soroush AR, Sajjadpour Z, Hasani-Ranjbar S, Larijani B. Natural Derived Nasal Spray; a Proposed Approach for COVID-19 Disease Control. Infect Disord Drug Targets 2021; 21:e160921191568. [PMID: 33602078 DOI: 10.2174/1871526521666210218201113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/24/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022]
Abstract
Considering the importance of COVID-19 disease pandemic, emerged by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in line with other studies to find appropriate prevention or treatment methods for this virus infection, proposing the use of natural derived ingredients as an approach for COVID-19 disease control was our study objective. Here we reviewed previous studies on natural derived nasal sprays and found that some known natural derived ingredients have antiviral properties, so their topical use as a nasal spray is effective in reducing the symptoms of respiratory infections, and it also has potential of decreasing viral load including titer of coronaviruses, in the nasal cavity. It seems that use of carrageenan or other herbal ingredients nasal spray may block the SARS-CoV-2 virus entering to the lung cells of a contaminated person and also can prevent virus transmission to other susceptible persons. Further, noticing what we know about novel 2019 coronavirus so far, we suggested carrageenan that has an unspecific physical antiviral activity and some other natural derived ingredients as a choice in coping with SARS-CoV-2 virus infection.
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Affiliation(s)
- Zahra Hoseini-Tavassol
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad-Reza Soroush
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sajjadpour
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Zhao YL, Gou ZP, Shang JH, Li WY, Kuang Y, Li MY, Luo XD. Anti-microbial Effects In Vitro and In Vivo of Alstonia scholaris. Nat Prod Bioprospect 2021; 11:127-135. [PMID: 33389714 PMCID: PMC7778864 DOI: 10.1007/s13659-020-00294-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/15/2020] [Indexed: 02/05/2023]
Abstract
Alstonia scholaris could be used as a traditional medicinal plant in China for the treatment of acute respiratory, which might be caused by respiratory tract infections. The investigation tested the anti-infective effects of total alkaloids extract (TA) from leaves of A. scholaris, and as a result, TA inhibited herpes simplex virus type 1 (HSV-1), respiratory syncytial virus (RSV) and influenza A virus (H1N1) in vitro respectively. In addition, the survival days of mice were prolonged, and the lung weights and mortality of mice were decreased significantly, after oral administrated TA in H1N1 and beta-hemolytic streptococcus infectious models in vivo respectively. The finding supported partly the traditional usage of A. scholaris in the treatment of respiratory infections.
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Affiliation(s)
- Yun-Li Zhao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China
| | - Zhong-Ping Gou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jian-Hua Shang
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China
| | - Wan-Yi Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Yu Kuang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Ming-Yuan Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China.
| | - Xiao-Dong Luo
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China.
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China.
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Núñez-Samudio V, Landires I. Epidemiology of viral respiratory infections in a pediatric reference hospital in Central Panama. BMC Infect Dis 2021; 21:43. [PMID: 33422002 PMCID: PMC7796567 DOI: 10.1186/s12879-020-05720-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Acute respiratory infections (ARIs) are a worldwide public health problem. It is estimated that up to 80% of cases of ARIs are caused by viruses. In Central America, however, we identified few epidemiologic studies on the main ARI-related viruses in hospitalized children. Methods This study retrospectively analyzed the clinical charts of patients ages 29 days to 14 years admitted with diagnoses of ARIs in a pediatric reference hospital in central Panama during 2016. The variables analyzed were age, sex, signs, symptoms, and diagnosis at admission. Samples of patients to whom a viral panel was indicated were analyzed via quantitative polymerase chain reaction, qPCR. Results The most common virus was respiratory syncytial virus (RSV; 25.9%), followed by influenza A virus (10.6%), rhinovirus (10.6%), parainfluenza type 3 (PIV-3; 8.2%) and adenovirus (5.9%). However, virus detection varied with patient age and season. RSV and Influenza virus were respectively identified mainly during July–November and May–July. All cases of viral co-infection occurred in children < 5-years-old. Both influenza A (H1N1) pdm09 and rhinovirus were detected in all pediatric ages analyzed in this study, unlike RSV and PIV-3, which were only present in children < 5-years-old. Conclusions This study analyzed the epidemiological patterns of different respiratory viruses in pediatric patients with ARI from central Panama and found that the prevalence of the specific respiratory viruses identified varied with season and age. The most common viruses were RSV, influenza A, and rhinovirus. There were no reports of human metapneumovirus associated with ARI, which may be explained by the time and geographic location of the study. Knowledge of the local epidemiology of respiratory viruses in tropical countries is helpful in forecasting the peaks of hospitalizations due to ARIs and may help improve prevention efforts aiming at respiratory disease control in these settings.
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Affiliation(s)
- Virginia Núñez-Samudio
- Instituto de Ciencias Médicas, PO Box 0710-00043, Las Tablas, Los Santos, Panama.,Sección de Epidemiología, Departamento de Salud Pública, Región de Salud de Herrera, Ministry of Health, Chitré, Panama
| | - Iván Landires
- Instituto de Ciencias Médicas, PO Box 0710-00043, Las Tablas, Los Santos, Panama. .,Centro Regional Universitario de Azuero (CRUA), Universidad de Panamá, Chitré, Herrera, Panama. .,Hospital Joaquín Pablo Franco Sayas, Región de Salud de Los Santos, Ministry of Health, Las Tablas, Panama.
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da Costa Souza L, Bello EJM, Dos Santos EM, Nagata T. Molecular and clinical characteristics related to rhinovirus infection in Brasília, Brazil. Braz J Microbiol 2021; 52:289-298. [PMID: 33410102 PMCID: PMC7787651 DOI: 10.1007/s42770-020-00411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/19/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Human rhinovirus (HRV) is one of the most common human viral pathogens related to infections of the upper and lower respiratory tract, which can result in bronchiolitis and pneumonia. However, the relevance of HRV in human health was under-estimated for long time due to the absence of molecular targets for influenza and influenza-like syndrome surveillance in Brasília, Brazil. Objectives The main objective of this study was analyze the clinical characteristics and outcomes of HRV infections in comparison with patients without HRV and other common respiratory viruses. Materials and Methods For this purpose, new specific primer sets were designed based on the high throughput sequencing analysis in previous study. These primers were used for HRV detection by RT-qPCR and Sanger sequencing of amplified cDNA of 5′ genomic region. The phylogenetic tree with representative HRV isolates was constructed using the Mega X software. Statistical analysis considering the patient profiles were performed using IBM SPSS program with non-parametric tests. Results The most prevalent virus in negative samples was rhinovirus (n = 40), including three rhinovirus species (rhinovirus A, B, and C). The odds ratio associated with HRV infection was 2.160 for patients younger than 2 years and 4.367 for people living in rural areas. The multiple analysis showed lower chance of patients with HRV presenting respiratory distress. Conclusion In this study, it was reported the predominance of rhinoviruses in cases of respiratory illness for negative patients for the influenza and influenza-like syndrome surveillance, being rhinorrhea, the most significant symptom associated with the disease. Supplementary Information The online version contains supplementary material available at 10.1007/s42770-020-00411-0.
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Affiliation(s)
- Larissa da Costa Souza
- Pós-graduação em Biologia Microbiana, Campus Darcy Ribeiro, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, 70910-900, Brazil.,Laboratório Central de Saúde Pública do Distrito Federal, Brasília, DF, 70830-010, Brazil
| | | | | | - Tatsuya Nagata
- Pós-graduação em Biologia Microbiana, Campus Darcy Ribeiro, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, 70910-900, Brazil.
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Furuse Y, Tamaki R, Suzuki A, Kamigaki T, Okamoto M, Saito-Obata M, Nakagawa E, Saito M, Segubre-Mercado E, Tallo V, Lupisan S, Oshitani H. Epidemiological and clinical characteristics of children with acute respiratory viral infections in the Philippines: a prospective cohort study. Clin Microbiol Infect 2020; 27:1037.e9-1037.e14. [PMID: 32950713 DOI: 10.1016/j.cmi.2020.09.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Viral acute respiratory infection (ARI) remains a major global health problem, especially among children in low- and middle-income countries. The study was conducted to reveal aetiological significance of respiratory viruses among both non-hospitalized and hospitalized children. METHODS A cohort study of children with ARI at the household, primary healthcare facility, and hospital levels was conducted alongside a hospital-based study including non-cohort children from 2014 to 2016 in the Philippines. The ARI cases were recorded at households and healthcare facilities, and a clinical investigation was performed. Nasopharyngeal swabs were collected from the symptomatic children and tested for respiratory viruses via polymerase chain reaction. Then, the association between healthcare facility utilization and viral detection was investigated. RESULTS Overall, 18,514 ARI cases were enrolled in the cohort study, and samples were collected from 4735 of these cases. The hospital-based study detected 648 ARI cases, all of which were sampled. Rhinovirus (22.2%; 1052/4735) was most frequently detected followed by respiratory syncytial virus (12.0%; 566/4735). Enterovirus (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-2.8), human metapneumovirus (2.1, 1.4-3.2), rhinovirus (2.1, 1.8-2.6), and respiratory syncytial virus (1.6, 1.2-1.9) were significantly more prevalent in the ARI cases at healthcare facilities than in those in households. Of all ARI cases, 0.6% required hospitalization while 1.8% were hospitalized among the respiratory syncytial virus-positive cases (3.8, 3.0-4.9). CONCLUSIONS We determined the prevalence of respiratory viruses among children with ARIs at the household, primary healthcare facility, and hospital levels and the association with clinical characteristics. In particular, we discovered a significant disease burden and impact of respiratory syncytial virus infections as well as a considerable aetiological implication of rhinovirus infections.
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Affiliation(s)
- Yuki Furuse
- Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan; Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan.
| | - Raita Tamaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Suzuki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taro Kamigaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mariko Saito-Obata
- RITM-Tohoku Collaborating Research Center on Emerging and Reemerging Infectious Diseases, Muntinlupa, Philippines
| | - Emiko Nakagawa
- RITM-Tohoku Collaborating Research Center on Emerging and Reemerging Infectious Diseases, Muntinlupa, Philippines
| | - Mayuko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Veronica Tallo
- Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Socorro Lupisan
- Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Perezbusta-Lara N, Tirado-Mendoza R, Ambrosio-Hernández JR. Respiratory infections and coinfections: geographical and population patterns. GAC MED MEX 2020; 156:265-272. [PMID: 32831337 DOI: 10.24875/gmm.20000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Acute respiratory infections are the second cause of mortality in children younger than five years, with 150.7 million episodes per year. Human orthopneumovirus (hOPV) and metapneumovirus (hMPV) are the first and second causes of bronchiolitis; type 2 human orthorubulavirus (hORUV) has been associated with pneumonia in immunocompromised patients. Objective To define hOPV, hMPV and hORUV geographical distribution and circulation patterns. Method An observational, prospective cross-sectional pilot study was carried out. Two-hundred viral strains obtained from pediatric patients were genotyped by endpoint reverse transcription polymerase chain reaction (RT-PCR). Results One-hundred and eighty-six positive samples were typed: 84 hOPV, 43 hMPV, two hORUV and 57 co-infection specimens. Geographical distribution was plotted. hMPV, hOPV, and hORUV cumulative incidences were 0.215, 0.42, and 0.01, respectively. Cumulative incidence of hMPV-hORUV and hMPV-hOPV coinfection was 0.015 and 0.23; for hOPV-hMPV-hORUV, 0.035; and for hORUV-hOPV, 0.005. The largest number of positive cases of circulating or co-circulating viruses occurred between January and March. Conclusions This study successfully identified circulation and geographical distribution patterns of the different viruses, as well as of viral co-infections.
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Affiliation(s)
- Norvell Perezbusta-Lara
- Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Microbiología y Parasitología, Ciudad de México, México
| | - Rocío Tirado-Mendoza
- Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Microbiología y Parasitología, Ciudad de México, México
| | - Javier R Ambrosio-Hernández
- Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Microbiología y Parasitología, Ciudad de México, México
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Gao M, Yao X, Mao W, Shen C, Zhang Z, Huang Q, Cui D, Sun H, Zou W. Etiological analysis of virus, mycoplasma pneumoniae and chlamydia pneumoniae in hospitalized children with acute respiratory infections in Huzhou. Virol J 2020; 17:119. [PMID: 32738914 PMCID: PMC7395355 DOI: 10.1186/s12985-020-01380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Acute respiratory infections are a common disease in children with high mortality and morbidity. Multiple pathogens can cause acute respiratory infections. A 2-year survey of hospitalized children was conducted to understand the epidemic situation, seasonal spread of pathogens and the improvement of clinical diagnosis, treatment and prevention of disease in Huzhou, China. METHODS From September 2017 to August 2019, 3121 nasopharyngeal swabs from hospitalized children with acute respiratory infections were collected, and real-time PCR was used to detect various pathogens. Then, pathogen profiles, frequency and seasonality were analyzed. RESULTS Of the 3121 specimens, 14.45% (451/3121) were positive for at least one pathogen. Of the single-pathogen infections, RSV (45.61%, 182/399) was the most frequent pathogen, followed by PIVs (14.79%, 59/399), ADV (14.54%, 58/399), MP (10.78%, 43/399), and IAV (5.26%, 21/399). Of the 52 coinfections, RSV + PIVs viruses were predominantly identified and accounted for 40.38% (21/52) of cases. RSV was the most frequent pathogen in all four groups. The highest positive rate of the pathogens occurred in the winter (21.26%), followed by autumn (14.98%), the summer (14.11%) and the spring (12.25%). CONCLUSION Viruses are the main pathogens in hospitalized children with acute respiratory infections in Huzhou city, Zhejiang Province, China. Among the pathogens, RSV had the highest detection rate, and MP is also a common pathogen among children with acute respiratory infections. This study provided a better understanding of the distribution of pathogens in children of different ages and seasons, which is conducive to the development of more reasonable treatment strategies and prevention and control measures.
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Affiliation(s)
- Min Gao
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Xing Yao
- Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Wei Mao
- Department of Respiratory Diseases, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Cuifen Shen
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Zongxin Zhang
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Qiuling Huang
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China
| | - Dawei Cui
- Department of Blood Transfusion, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Haiyan Sun
- Department of Clinical Laboratory, Shaoxing Second Hospital, Shaoxing, 312000, Zhejianeg Province, China
| | - Weihua Zou
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China.
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Nickbakhsh S, Ho A, Marques DFP, McMenamin J, Gunson RN, Murcia PR. Epidemiology of Seasonal Coronaviruses: Establishing the Context for the Emergence of Coronavirus Disease 2019. J Infect Dis 2020; 222:17-25. [PMID: 32296837 PMCID: PMC7184404 DOI: 10.1093/infdis/jiaa185] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/14/2020] [Indexed: 12/23/2022] Open
Abstract
Public health preparedness for coronavirus (CoV) disease 2019 (COVID-19) is challenging in the absence of setting-specific epidemiological data. Here we describe the epidemiology of seasonal CoVs (sCoVs) and other cocirculating viruses in the West of Scotland, United Kingdom. We analyzed routine diagnostic data for >70 000 episodes of respiratory illness tested molecularly for multiple respiratory viruses between 2005 and 2017. Statistical associations with patient age and sex differed between CoV-229E, CoV-OC43, and CoV-NL63. Furthermore, the timing and magnitude of sCoV outbreaks did not occur concurrently, and coinfections were not reported. With respect to other cocirculating respiratory viruses, we found evidence of positive, rather than negative, interactions with sCoVs. These findings highlight the importance of considering cocirculating viruses in the differential diagnosis of COVID-19. Further work is needed to establish the occurrence/degree of cross-protective immunity conferred across sCoVs and with COVID-19, as well as the role of viral coinfection in COVID-19 disease severity.
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Affiliation(s)
- Sema Nickbakhsh
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Antonia Ho
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Diogo F P Marques
- Public Health Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - Jim McMenamin
- Public Health Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - Rory N Gunson
- West of Scotland Specialist Virology Centre, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Pablo R Murcia
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Zhuo C, Wei X, Zhang Z, Hicks JP, Zheng J, Chen Z, Haldane V, Walley J, Guan Y, Xu H, Zhong N. An antibiotic stewardship programme to reduce inappropriate antibiotic prescribing for acute respiratory infections in rural Chinese primary care facilities: study protocol for a clustered randomised controlled trial. Trials 2020; 21:394. [PMID: 32398065 PMCID: PMC7216131 DOI: 10.1186/s13063-020-04303-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Inappropriate prescribing of antibiotics for acute respiratory infections at the primary care level represents the major source of antibiotic misuse in healthcare, and is a major driver for antimicrobial resistance worldwide. In this study we will develop, pilot and evaluate the effectiveness of a comprehensive antibiotic stewardship programme in China's primary care hospitals to reduce inappropriate prescribing of antibiotics for acute respiratory infections among all ages. METHODS We will use a parallel-group, cluster-randomised, controlled, superiority trial with blinded outcome evaluation but unblinded treatment (providers and patients). We will randomise 34 primary care hospitals from two counties within Guangdong province into the intervention and control arm (1:1 overall ratio) stratified by county (8:9 within-county ratio). In the control arm, antibiotic prescribing and management will continue through usual care. In the intervention arm, we will implement an antibiotic stewardship programme targeting family physicians and patients/caregivers. The family physician components include: (1) training using new operational guidelines, (2) improved management and peer-review of antibiotic prescribing, (3) improved electronic medical records and smart phone app facilitation. The patient/caregiver component involves patient education via family physicians, leaflets and videos. The primary outcome is the proportion of prescriptions for acute respiratory infections (excluding pneumonia) that contain any antibiotic(s). Secondary outcomes will address how frequently specific classes of antibiotics are prescribed, how frequently key non-antibiotic alternatives are prescribed and the costs of consultations. We will conduct a qualitative process evaluation to explore operational questions regarding acceptability, cultural appropriateness and burden of technology use, as well as a cost-effectiveness analysis and a long-term benefit evaluation. The duration of the intervention will be 12 months, with another 24 months' post-trial long-term follow-up. DISCUSSION Our study is one of the first trials to evaluate the effect of an antibiotic stewardship programme in primary care settings in a low- or middle-income country (LMIC). All interventional activities will be designed to be embedded into routine primary care with strong local ownership. Through the trial we intend to impact on clinical practice and national policy in antibiotic prescription for primary care facilities in rural China and other LMICs. TRIAL REGISTRATION ISRCTN, ID: ISRCTN96892547. Registered on 18 August 2019.
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Affiliation(s)
- Chao Zhuo
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Laboratory of Guangdong-Hong Kong -Macao Great Bay, Guangzhou Medical University, 151 Yanjiang Xi Rd, Guangzhou City, 510120 Guangdong China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Zhitong Zhang
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - Jinkun Zheng
- Yuebei People’s Hospital, Shaoguan, Guangdong China
| | - Zhixu Chen
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Laboratory of Guangdong-Hong Kong -Macao Great Bay, Guangzhou Medical University, 151 Yanjiang Xi Rd, Guangzhou City, 510120 Guangdong China
| | - Victoria Haldane
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Laboratory of Guangdong-Hong Kong -Macao Great Bay, Guangzhou Medical University, 151 Yanjiang Xi Rd, Guangzhou City, 510120 Guangdong China
| | - John Walley
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - Yubao Guan
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Laboratory of Guangdong-Hong Kong -Macao Great Bay, Guangzhou Medical University, 151 Yanjiang Xi Rd, Guangzhou City, 510120 Guangdong China
| | - Hongyan Xu
- Yuebei People’s Hospital, Shaoguan, Guangdong China
| | - Nanshan Zhong
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Laboratory of Guangdong-Hong Kong -Macao Great Bay, Guangzhou Medical University, 151 Yanjiang Xi Rd, Guangzhou City, 510120 Guangdong China
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