A comprehensive assessment of postnatal risk factors associated with recurrent respiratory infections in preschool children
DOI:
https://doi.org/10.15574/PP.2023.96.81Keywords:
preschool children, recurrent respiratory infections, postnatal risk factors, odds ratioAbstract
Purpose - to determine the influence degree of particular postnatal risk factors to the likelihood of the recurrent course of acute respiratory infections (ARI) in preschool children.
Materials and methods. Three hundred and fourteen children (176 boys and 138 girls) aged 1 to 6 years old, undergoing inpatient treatment on ARI, were involved in the clinical study. The number of ARI episodes during their previous year of life, as well as the presence or absence of 19 potential postnatal risk factors associated with recurrent respiratory infections (RRI), were taken into account for the examined children. Additionally, two integral indices of ARI recurrence, namely the infection index (InI) and resistance index (InR), were calculated. The statistical processing of the primary digital data obtained was performed by IBM SPSS Statistics 28 licensed program. A сross-tabulation method was applied to compute the odds ratio (OR) and its 95% confidence interval (CI).
Results. The difference between the age subgroups of the examined preschool children in the ARI episodes number during their previous year of life was demonstrated (H=11.243; p=0.047). First of all, the higher incidence of ARI was detected among the patients aged 36 to 71 months compared with those aged 12 to 35 months. Besides, the weak but significant correlation was revealed between six stratified age subgroups of children and their clinical diagnoses (φc=0.183; p=0.006). The studied integral indicators of the recurrent course of ARI (InI and InR) are inversely correlated with the majority of the postnatal risk factors considered, with the degree of the relationship strength being higher for InR than for InI.
Conclusions. The majority of the potential RRI risk factors registered, namely 10 out of 19, separately increase the probability of children belonging to the group with more frequent ARI episodes. The most significant risk factors of RRI were as follows: 1) breastfeeding for 0-4 months after birth (OR=2.868; p<0.001; 95% CI: 1.681-4.895), 2) an older child in a family attending an organized childhood group (OR=2.814; p<0.001; 95% CI: 1.662-4.763); 3) second-hand smoke exposure (OR=2.537; p<0.001; 95% CI: 1.509-4.267). The prevalence of the studied RRI risk factors among the preschool children does not correlate with their significance in contributing to more frequent ARI episodes.
The study was conducted in accordance with the principles of the Declaration of Helsinki.
The study protocol was approved by the Local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children.
No conflict of interests was declared by the author.
References
Akeredolu FD, Akuse RM, Mado SM, Yusuf R. (2021). Relationship Between Serum Vitamin D Levels and Acute Pneumonia in Children Aged 1-59 Months in Nigeria. Journal of Tropical Pediatrics. 67(1): fmaa101. https://doi.org/10.1093/tropej/fmaa101; PMid:33739410
Akimbekov NS, Digel I, Sherelkhan DK, Lutfor AB, Razzaque MS. (2020). Vitamin D and the Host-Gut Microbiome: A Brief Overview. Acta histochemica et cytochemica. 53(3): 33-42. https://doi.org/10.1267/ahc.20011; PMid:32624628 PMCid:PMC7322162
Asyiroh H, Setyoningrum RA, Fatmaningrum W, Utomo B. (2021). Risk Factors of Recurrent Upper Respiratory Tract Infection in Children Aged 3-60 Months at Primary Healthcare Centers (Puskemas) in Gresik. Jurnal Respirasi. 7(1): 8-13. https://doi.org/10.20473/jr.v7-I.1.2021.8-13
Ballarini S, Rossi GA, Principi N, Esposito S. (2021). Dysbiosis in Pediatrics Is Associated with Respiratory Infections: Is There a Place for Bacterial-Derived Products? Microorganisms. 9(2): 448. https://doi.org/10.3390/microorganisms9020448; PMid:33671586 PMCid:PMC7926342
Chernyshova LI. (2018). Recurrent respiratory diseases in children: the physician's action algorithm (lecture). Sovremennaya pediatriya. 3(91): 92-97. https://doi.org/10.15574/SP.2018.91.92
Chiappini E, Santamaria F, Marseglia GL et al. (2021). Prevention of recurrent respiratory infections. Italian Journal of Pediatrics. 47: 211. https://doi.org/10.1186/s13052-021-01150-0; PMid:34696778 PMCid:PMC8543868
Chicoulaa B, Haas H, Viala J, Salvetat M, Olives JP. (2017). How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey. International Journal of General Medicine. 10: 61-68. https://doi.org/10.2147/IJGM.S125806; PMid:28293116 PMCid:PMC5345982
Cuppari C, Colavita L, Miraglia Del Giudice M, Chimenz R, Salpietro C. (2020). Recurrent respiratory infections between immunity and atopy. Pediatric allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology. 31; Suppl 24: 19-21. https://doi.org/10.1111/pai.13160; PMid:32017215
Esposito S, Ballarini S, Argentiero A, Ruggiero L, Rossi GA, Principi N. (2022). Microbiota profiles in pre-school children with respiratory infections: Modifications induced by the oral bacterial lysate OM-85. Frontiers in Cellular and Infection Microbiology. 12: 789436. https://doi.org/10.3389/fcimb.2022.789436; PMid:36051241 PMCid:PMC9425436
Esposito S, Jones MH, Feleszko W et al. (2020). Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus Statement from the World Association of Infectious Diseases and Immunological Disorders (WAidid). Microorganisms. 8(11): 1810. https://doi.org/10.3390/microorganisms8111810; PMid:33213053 PMCid:PMC7698530
Feketea G, Bocsan CI, Stanciu LA, Buzoianu AD, Zdrenghea MT. (2020). The Role of Vitamin D Deficiency in Children with Recurrent Wheezing - Clinical Significance. Frontiers in Pediatrics. 8: 344. https://doi.org/10.3389/fped.2020.00344; PMid:32695735 PMCid:PMC7338661
Fesenko MYе, Zyuzina LS, Fastovets MM, Kalyuzhka OO, Melashchenko OI. (2019). Aacute Respiratory Recurrent Infections in Children. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 19(4): 34-38. https://doi.org/10.31718/2077-1096.19.4.34
Kansen HM, Lebbink MA, Mul J et al. (2020). Risk factors for atopic diseases and recurrent respiratory tract infections in children. Pediatric Pulmonology. 55: 3168-3179. https://doi.org/10.1002/ppul.25042; PMid:32841506 PMCid:PMC7589449
Km R, Gupta V, Ahmad S, Ranhotra S, Issrani R, Prabhu N. (2015). Assessment of Anemia as a Risk Factor for Acute Lower Respiratory Tract Infections in Children: A Case-Control Study. International Journal of Clinical Pediatrics. International Journal of Clinical Pediatrics. 4(2-3): 149-153. https://doi.org/10.14740/ijcp220w
Nagaraju K, Shah R, Ganapathy S et al. (2021). Practical Approach for the Diagnosis, Prevention, and Management of Recurrent Upper Respiratory Tract Infection in Children: Report from an Expert Closed-group Discussion. Pediatric Infectious Disease. 3: 105-112. https://doi.org/10.5005/jp-journals-10081-1321
Nicolai A, Frassanito A, Nenna R et al. (2017). Risk Factors for Virus-induced Acute Respiratory Tract Infections in Children Younger Than 3 Years and Recurrent Wheezing at 36 Months Follow-Up After Discharge. The Pediatric infectious disease journal. 36(2): 179-183. https://doi.org/10.1097/INF.0000000000001385; PMid:27798551
Pasternak G, Lewandowicz-Uszyńska A, Królak-Olejnik B. (2020). Nawracające zakażenia dróg oddechowych u dzieci. [Recurrent respiratory tract infections in children]. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 49(286): 260-266. PMID: 32827422.
Schaad UB, Esposito S, Razi CH. (2016). Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide. Archives of Pediatric Infectious Diseases. 4(1): e31039. https://doi.org/10.5812/pedinfect.31039
Trandafir LM, Boiculese LV, Dimitriu G, Moscalu M. (2017). Recurrent respiratory tract infections in children. E-Health and Bioengineering Conference (EHB). Sinaia, Romania. 741-744. https://doi.org/10.1109/EHB.2017.7995530
Voloshin OM, Marushko YuV, Savchenko II. (2023). А bootstrap analysis of immune status in preschool children suffering from recurrent respiratory infections. Modern Pediatrics. Ukraine. 3(131): 13-21. https://doi.org/10.15574/SP.2023.131.13
Voloshyn OM, Marushko YuV. (2022). Comprehensive Assessment of Vitamin D Status in Preschool Children Suffering from Recurrent Respiratory Infections. Medical Science of Ukraine. 18(1): 14-22. https://doi.org/10.32345/2664-4738.1.2022.03
Zhou B, Niu W, Liu F et al. (2021). Risk factors for recurrent respiratory tract infection in preschool-aged children. Pediatrsc Research. 90: 223-231. https://doi.org/10.1038/s41390-020-01233-4; PMid:33173178
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Ukrainian Journal of Perinatology and Pediatrics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
