Abstract
BackgroundRecurrent respiratory tract infections (RRTIs) have a negative impact on both children’s health and family wellbeing. Deficiency of ZhengQi used to be an instinct factor driving RRTI in Traditional Chinese Medicine (TCM). Our clinical observations suggest that children with gastrointestinal heat retention syndrome (GHRS) may have a greater risk of catching respiratory tract infections (RTIs). GHRS is a new predisposing factor for RRTI and it is dietary related. This study is aimed to explore association between GHRS and RRTI.MethodsA prospective cohort study has been conducted in Beijing, China; children aged 1–18 were enrolled. TCM symptoms, demographic and physiological characteristics were recorded by using semi-structured questionnaire. GHRS was considered as a predisposing factor. Children were followed up for next 12 months. We contacted with their parents using a face-to-face questionnaire survey, via email or phone every 3 months. Episodes of RTIs were recorded in detail.ResultsThree hundred thirty four children were enrolled and 307 (91.92 %) followed up for 12 months. The incidence of RTI was 4.32 episodes per child-year (95 % CI 4.03–4.61). 69 (43.13 %) children in the group with GHRS suffered from RRTI; there were 48 (32.65 %) children in group without GHRS. The risk ratio (RR) value of RRTI occurrence was 1.32 (95 % CI 0.91–1.91, P = 0.139), and the attributable risk percent (AR%) was 24.28 %. Dry stool and irritability were positively correlated with RTI episodes, age and BMI were negatively correlated with RTI episodes in a linear regression model. Dry stool (OR = 1.510) was positively correlated with RRTI occurrence, age (OR = 0.889) and BMI (OR = 0.858) were negatively correlated with RRTI occurrence in our logistic regression model.ConclusionsGHRS is associated with RRTI in this cohort. Dry stool was positively associated with RRTI, and BMI was negatively associated with RRTI. Studies with larger sample size and longer follow up are needed to further evaluate this association. Relieving GHRS should be considered when TCM practitioners treat RRTI children, and this may protect children from suffering RTIs.Trial registrationChinese Clinical Trial Registry Number: ChiCTR-CCH-13003756
Highlights
Recurrent respiratory tract infections (RRTIs) have a negative impact on both children’s health and family wellbeing
Characteristics of the participants Convenience sample recruiting was developed and we designed the sample size as 167 participants for each group. 334 children were enrolled with approximately 20 % lost-follow-up concerning in practical research, and all of them were followed up for 12 months prospectively. 307 (91.92 %) out of 334 completed follow-up and 27 (8.08 %) children dropped out; 22 (6.59 %) of them were lost and 5 (1.56 %) of them refused to continue
11 (3.58 %) children did not suffer from RTI during 12-month follow-up period. 296 (96.42 %) children suffered at least 1 RTI episode within this period of time, 15 RTIs episodes was the most observed in this study. 4.32 RTI episodes for each child in 12 months was the average
Summary
Recurrent respiratory tract infections (RRTIs) have a negative impact on both children’s health and family wellbeing. Our clinical observations suggest that children with gastrointestinal heat retention syndrome (GHRS) may have a greater risk of catching respiratory tract infections (RTIs). Respiratory tract infection (RTI) is a major cause of morbidity and mortality worldwide especially in lowand middle-income countries. Lower respiratory tract infections (LRTI) (pneumonia predominantly) is one of the leading causes of death in infants and children, especially in developing countries. 2 million children who die from acute respiratory tract infections (ARTIs) each year [2, 3]. The true incidence of the condition in community may be much higher as usually parents do not consult their doctors when their children develop an upper respiratory tract infection (URTI) [4]
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