Promoting equitable access to infection prevention for people with different vulnerabilities: a scoping review

Immunostimulants are gradually being used in the prevention and treatment of recurrent respiratory tract infections in susceptible children, but their drug effects have not been quantified. The purpose of this study was to confirm the efficacy of immunostimulants in the prevention and treatment of recurrent respiratory tract infections in susceptible children. A model-based meta-analysis was used to describe the time course of placebo and immunostimulants in the prevention of respiratory tract infections in children. The cumulative number of respiratory tract infections was used as an indicator of efficacy. A meta-analysis was used to analyze the incidence of drug-related adverse events. Fourteen articles with 2400 pediatric subjects were finally included in the analysis. The results showed that the cumulative number of respiratory tract infections increased linearly with time, with the incidence of respiratory tract infections in the placebo group being 0.65 (95% confidence interval [CI], 0.55-0.75) per month. OM-85 BV and pidotimod reduced the incidence of respiratory tract infections by 0.21 (95%CI, 0.16-0.26) and 0.19 (95%CI, 0.17-0.21) compared to placebo per month, respectively. Pidotimod and OM-85 BV can effectively reduce the incidence of respiratory tract infections in susceptible children, with no significant increase in the incidence of drug-related adverse events when compared with placebo (risk ratio values were 1.07 [95%CI, 0.66-1.71] and 1.31 [95%CI, 0.54-3.19], respectively). This study provides quantitative support for the application of immunostimulants for the prevention of recurrent respiratory tract infections in children.

Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.

ABSTRACTBackgroundAdolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices due to limited knowledge, low availability or acceptability of modern contraceptives, gender inequality and cultural practices like child marriage. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches and synthetic evidence on this topic is scarce. To help fill this knowledge gap and to identify where further research is needed, we will conduct a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. This information is valuable to both policymakers and researchers as it provides a synthesis of existing interventions, highlights best practices for their implementation and identifies potential avenues for future research.MethodsThis review will include studies on SRH preventive and educational interventions targeting AYAs aged 10–24 years in LMICs. It encompasses interventions delivered by lay health workers or via technological means, assessing various outcomes including but not limited to SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections and gender-based violence. Key databases, including PubMed via MEDLINE and Embase, will be searched from 1 January 2000 up to 23 January 2024, using a comprehensive search strategy. Screening will be conducted using Covidence software. Data extraction will cover study details, methods, intervention strategies, outcomes and findings. A narrative synthesis will be conducted following synthesis without meta-analysis guidelines.Ethics and disseminationThe scope of this scoping review is limited to publicly accessible databases that do not require prior ethical approval for access. The findings will be disseminated through peer-reviewed journal publications, as well as presentations at national and international conferences and stakeholder meetings in LMICs.Scoping review registration The final protocol is prospectively registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).

Review question/objective The objective of this systematic review is to identify the best available research evidence related to the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in people with chronic respiratory diseases, focusing on measures of adherence and health outcomes. The specific review questions to be addressed are: 1. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in terms of inhalation regimens and inhalation techniques in people with chronic respiratory diseases? 2. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy on health service utilization and patient outcomes including symptoms, pulmonary function, and quality of life? 3. What is the effectiveness of various designs, in terms of components, modes and intensities, of educational and supportive interventions for improving adherence to inhalation therapy? Inclusion criteria Types of participants This review will consider studies that include adults aged 18 or above, with a clinical diagnosis of chronic respiratory disease and prescribed self-administered inhalation therapy as a long term regular treatment, irrespective of the type of inhaler used. For the purposes of this review, "chronic respiratory diseases" is defined by WHO in 2007 as "the chronic diseases of the airways and other structures of the lung" (p.5). 1 Inhalation therapy is defined as "a treatment in which a substance is administered to the respiratory tract with inspired air". 6 This review will focus on inhalation of drugs. Those studies with prescribed administration of oxygen and water will be excluded. There is no universal standard for how long a treatment is undertaken to be defined as a "long term treatment". Acute episodic drug treatments, such as a course of antibiotics, will be excluded. Types of interventions of interest All educational interventions, with or without supportive programs, designed to improve the chronic respiratory disease sufferers inhalation technique and adherence to their prescribed inhalation therapy will be considered. Those studies that involve comparison of different types of inhalation medications, inhaler devices or inhalation methods to improve the adherence to inhalation therapy will be excluded. For the TRUNCATED AT 350 WORDS

Probiotics for the prevention of respiratory tract infections: a systematic review

Isoprinosine, an in vitro immuno-enhancing agent principally acting by stimulating T-lymphocytes, is one of a number of agents sometimes used in an attempt to prevent recurrent respiratory infections in children, although there are no formal trials for this particular drug. We performed a placebo-controlled double-blind trial to assess the efficacy of isoprinosine (50 mg/kg per day) for 6 weeks followed by 50 mg/kg per day twice weekly for 6 weeks in the prevention of frequent acute respiratory tract infections in 102 children aged 4-8 years. A total of 43 children treated with isoprinosine and 41 with placebo finished the study. Despite a transient increase in the total number of CD3+, CD4+ and CD8+ T-lymphocytes after 6 weeks of daily isoprinosine treatment, there was no difference in the number and length of duration of acute respiratory infections, number of antibiotic courses and number of days with cough, pharyngitis, rhinitis and increased body temperature (> or = 37.0 degrees C and > or = 38.0 degrees C). There were no changes in markers of T- or B-lymphocyte activation (CD25, HLA-DR, CD45RA/RO, CD23). Attempts at immunomodulation using isoprinosine in the dose and for the duration used may increase the total numbers of both CD4 and CD8 T-lymphocytes but is ineffective in prevention of respiratory tract infections in childhood.

Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. This study aims to evaluate the knowledge, attitude, and practice of Malaysian Hajj and Umrah pilgrims towards the prevention of RTIs in 2018 and determine correlations among three domains. A cross-sectional study was conducted among 225 Umrah and Hajj pilgrims. Knowledge, attitude, and practice (KAP) towards RTI prevention was assessed by using a validated self-administered questionnaire among pilgrims attending a weekly orientation course organized by private Hajj/Umrah companies. Out of 225 participants, 65.9% of respondents were female with the mean (SD) age of 46.74 (13.38) years. The interquartile range (IQR) score for knowledge is 18.0 (6.0), the mean scores of attitude and practice are 32.65 (4.72) and 25.30 (4.9). respectively. Significant and negative linear correlations between knowledge and practice (r = −0.232, p < 0.001), and attitude and practice (r = 0.134, p = 0.045) were observed. Results from the current study showed good knowledge of RTIs among Malaysian pilgrims. However, a poor attitude was reflected in their preventive practice behaviors. This will further help in the prevention and management of RTIs during Hajj and Umrah. Therefore, an extensive educational health campaign should be provided to pilgrims to create awareness.

Immunomodulatory effect of pleuran (β-glucan from Pleurotus ostreatus) in children with recurrent respiratory tract infections

It remains uncertain as to whether nutrient supplementation for the general population considered healthy could be useful in the prevention of RTIs, such as COVID-19. In this systematic review and meta-analysis, the evidence was evaluated for primary prevention of any viral respiratory tract infection (RTI) such as SARS-CoV-2, through supplementation of nutrients with a recognized role in immune function: multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long-chain polyunsaturated fatty acids. The search produced 15,163 records of which 93 papers (based on 115studies) met the inclusion criteria, resulting in 199,055subjects (191,636 children and 7,419 adults) from 37 countries. Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately. By stratifying the meta-analysis by world regions, only studies performed in Asia showed a significant but heterogeneous protective effect of zinc supplementation on RTIs (RR 0.86, 95% CI 0.7-0.96, I2 =79.1%, p=.000). Vitamin D supplementation in adults significantly decreased the incidence of RTI (RR 0.89, 95% CI 0.79-0.99, p=.272), particularly in North America (RR 0.82 95% CI 0.68-0.97), but not in Europe or Oceania. Supplementation of nutrients in the general population has either no or at most a very limited effect on prevention of RTIs. Zinc supplementation appears protective for children in Asia, whilst vitamin D may protect adults in the USA and Canada. In 10/115 (8.7%) studies post-hoc analyses based on stratification for nutritional status was performed. In only one study zinc supplementation was found to be more effective in children with low zinc serum as compared to children with normal zinc serum levels.

Relevance. Respiratory infections are an urgent problem for organized groups, including military ones, since the transmission of pathogens by airborne droplets and household contact routes, physical and psychological stress on adaptive mechanisms contribute to the development of the epidemic process. There is no doubt that vaccination makes a significant contribution to the prevention of respiratory infections, but the contingent remains vulnerable to other pathogens against which there are no vaccines. Therefore, the search for new methods of non-specific prevention is necessary in maintaining the health of persons permanently residing in collectives. Aim. Evaluation of the possibility of using the topical form of the recombinant interferon α-2b drug for the prevention of acute respiratory viral infections in organized groups. Materials and methods. The work was carried out according to the methodology of a multicenter (3 Centers) double-blind controlled trial involving 3,235 people aged 18 to 22 years, who were divided into three groups: 1 gy. - received a recombinant interferon α-2b (Grippferon) drug 3 drops in each nasal passage 2 times a day in for two weeks; 2 g. - saline solution intranasally according to the same scheme; 3 g. - the volunteers did not receive anything. The frequency of respiratory infections was studied. Results and discussion. Medical monitoring of the study participants, which was carried out for 2 months, showed that in the groups from the Center 1, the incidence of acute respiratory diseases for 2 months in the main group (gr. 1) was 2.3 times lower than in the control (gr. 2) and the comparison group (gr. 3). In the Center 2 The data corresponded to the dynamics of Center 1: the incidence values were 2.4-2.5 times lower in Group 1. In Center 3, the values were 2.0-2.1, respectively. The epidemic effect of intranasal administration of the topical form of the drug recombinant interferon α-2b is due to its effect on the factors of mucosal immunity, which contributes to non-specific protection and increased body resistance against respiratory infections. Conclusions. The presented advantages of the recombinant interferon α-2b drug make it possible to draw attention to the clinical feasibility of its use for preventive purposes in organized groups, including military ones, from the position of high epidemiological effectiveness, both pre-exposure and post-exposure prevention of acute respiratory viral infections.

IntroductionCardiovascular diseases (CVDs) have become the most significant contributor to non-HIV/AIDS-related deaths in people living with HIV (PLWH). The increased risk for CVDs in PLWH is attributed to a combination of traditional risk factors, the effects of chronic inflammation, and antiretroviral therapy-related metabolic changes.ObjectiveThe main objective of this scoping review is to systematically map and summarize evidence on the strategies, components, and theories used in health education and physical activity interventions to prevent cardiovascular diseases in PLWH.Inclusion criteriaPeer-reviewed publications including relevant grey literature published in English will be included. The literature will focus on health education and physical activity interventions for people living with HIV, at risk of CVDs, aged between 18 years to 65 years. The literature publication will range between 2000 and June, 30th 2025, and intervention studies will include diverse research designs and literature sources from a broad array of settings including healthcare and community settings.MethodsElectronic databases to be searched will include PubMed, Scopus, CINAHL, and Embase, as well as grey literature such as Google Scholar, WHO Digital Publications (IRIS), and Proquest Thesis and Dissertation Global. A three-step process of screening consisting of titles/abstracts screening, full article screening, and manual search for references from identified articles will be conducted by two independent reviewers. In case of any discrepancies or disagreements, a third reviewer will be called upon to address the controversy. A data extraction form will be adapted from the Joanne Briggs Institute (JBI) standardized data extraction tool and key findings will be presented in tabular or diagram format followed by a narrative summary. Reporting of the scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist.Review protocol registrationThe scoping review protocol is registered with Open Science Framework (https://osf.io/4wfkh/).

Background: Prevention of respiratory infection among workers in geriatric facilities is important because the workers can transmit these infections to the elderly. Therefore, this study intended to assess the knowledge and compliance of preventive behavior against respiratory tract infection among these workers. Methods: Data were collected from 202 workers in geriatric facilities via a questionnaire-based survey from July 19 to August 8, 2014. Data were analyzed using the SPSS 21.0 program. Results: Among the workers, 44.6% experienced respiratory tract infection in the last 1 year. The score for knowledge of respiratory tract infection prevention among the workers was 10.6 points out of 12. The average score for compliance of the preventive behavior against respiratory tract infection was 34.6 points out of 48. The correlation between preventive knowledge and compliance of the preventive behavior against respiratory tract infection was not verified (r=0.00, P=0.967). Conclusion: In this study, the level of knowledge of respiratory infection prevention among the workers in the elderly care facility was high. However, the level of compliance was not sufficiently high. In addition, no correlation was found between their preventive knowledge and compliance. Therefore, a preventive program that focuses on the compliance of respiratory infection prevention rather than on its knowledge needs to be developed.

Bacterial attachment to host cells is the initial step in the pathogenesis of infection. Our studies and those of others also showed that there is a significant correlation between the attachment of bacteria to human pharyngeal epithelial cells and the occurrence of respiratory tract infections. We identified the receptor on human pharyngeal epithelial cells which mediate binding of Moraxella catarrhalis and Haemophilus influenzae. In an attempt to prevent occurrence of infections, the effects of povidone-iodine gargling on the incidence of respiratory infections were investigated. The subjects included a total of 23 adult patients, both males and females, with chronic respiratory diseases showing repeated infections. Patients were asked to gargle more than 4 times/day with povidone-iodine gargle over extended periods of time, i.e. from several months up to over 2 years. The incidence of episodes of acute exacerbation of chronic respiratory infections decreased significantly when compared with that before use of povidone-iodine gargle. Episodes of infections with Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA) and H. influenzae were reduced by about 50%. Results of this study suggest that povidone-iodine gargle is effective in providing a significant reduction in the incidence of acute exacerbations of chronic respiratory disease. We assume that the colonized bacteria were destroyed and thus infection could not occur. Therefore, povidone-iodine gargle may be used in these patients as a preventive therapy. Further studies are needed to find out the mechanism of action of this drug for the prevention of respiratory tract infections.

Objective To explore the effect of health education on improving awareness of preven-tion of upper respiratory tract infection of parents of leukemia children. Methods 25 parents were ran-domly chosen, and comprehensive health education interventions were provided, including lectures, advisory guidance and brochures. The awareness of prevention of upper respiratory tract infection of parents was e-valuated before and after health education,and the results underwent χ test. Results After health educa-tion, the awareness of prevention of upper respiratory tract infection of parents significantly improved com-pared with that before. Conclusions Health education can improve awareness of prevention of upper res-piratory tract infection of parents and decrease the incidence of upper respiratory tract infections. Key words: Leukemia; Upper respiratory tract infection; Health education

There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings. The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. A systematic search was conducted to identify systematic reviews relating to digital interventions for the workplace, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The review protocol was registered in the Open Science Framework. The following databases were searched: PubMed, Web of Science, MEDLINE, PsycINFO, and Cochrane Library. Data were extracted using a predefined extraction table. To assess the methodological quality of a study, the AMSTAR-2 tool was used to critically appraise systematic reviews of health care interventions. The literature search resulted in 11,875 records, which was reduced to 14 full-text systematic literature reviews with the use of Covidence to remove duplicates and screen titles and abstracts. The 14 included reviews were published between 2014 and 2023, comprising 9 systematic reviews and 5 systematic reviews and meta-analyses. AMSTAR-2 was used to complete a quality assessment of the reviews, and the results were critically low for 7 literature reviews and low for the other 7 literature reviews. The most common types of digital intervention studied were cognitive behavioral therapy, mindfulness/meditation, and stress management followed by other self-help interventions. Effectiveness of digital interventions was found for many mental health symptoms and conditions in employee populations, such as stress, anxiety, depression, burnout, and psychological well-being. Factors such as type of technology, guidance, recruitment, tailoring, and demographics were found to impact effectiveness. This umbrella review aimed to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. Despite the low quality of the reviews, best practice guidelines can be derived from factors that impact the effectiveness of digital interventions in the workplace. OSF Registries osf.io/rc6ds; https://doi.org/10.17605/OSF.IO/RC6DS.