THE INCREASING PREVALENCE OF ACUTE RESPIRATORY INFECTIONS AMONG INFANTS AND CHILDREN AND SUGGESTED NUTRITIONAL PREVENTION AND PRESCRIPTION: A LITERATURE REVIEW

A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital

Introduction: Acute Respiratory Tract Infection (ARI) is a common illness in children under five years old. The incidence of ARI in developing countries is ten times more than in developed countries. There are many risk factors for ARI, such as breastfeeding. Aim: The purpose of this study is to determine the relationship between exclusive breastfeeding with the occurrence of recurrent ARI in children under five. Method: This research uses an analytic research design with an observational study type and a cross-sectional study method. The numbers of samples in this study were 203 samples and tested using the chi-square test. The data of 203 samples in this study were obtained from primary data with structured interviews regarding exclusive breastfeeding and secondary data by looking at the patient's medical records regarding the occurrence of recurrent ARI. From 203 selected samples, 47.3% are exclusively breastfed, and 52.7% are not exclusive breastfeeding. Recurrent ARI events were calculated over the past year with the criteria for ARI greater than or equal to six times. Result: The results of this study are that 53.7% of samples do not have recurrent ARI, and 46.3% of samples have recurrent ARI. The results of this study show a p-value of 0.00, which means there is a significant relationship of exclusive breastfeeding with the occurrence of recurrent ARI in children under five years old. Conclusion: The incidence of Recurrent ARI in children under five years old with exclusive breastfeeding history is lower than children under five years old without exclusive breastfeeding history.

History of upper respiratory tract infection in the mother or siblings was associated with higher risk of acute lower respiratory tract infection in cases. Most upper respiratory tract infections were caused by viral pathogens and likely to occur in many members of the family. The study aimed to determine the existence and pattern of relationship between risk of acute respiratory infection (ARI) among infants and exposure to pre-existing maternal/caregiver acute respiratory tract infection. The study was designed as a community-based Nested case-control study of 1100 infants randomly selected from 12 communities out of 6 Local Government Areas of the 3 senatorial districts of Rivers State. A multistage random sampling technique was used in selecting the subjects up to the community level. Descriptive method was used to represent the characteristics of the subjects and the differences in ARI between exposed and unexposed infants were tested in a bivariate logistics regression at 5% level of significance. Odds ratio (OR) was used to interpret the size effect measures of ARI on exposure to pre-existing maternal/caregiver ARI differences. A total of 275 Cases of ARI and 825 controls were included in the study. Among exposed infants (N = 104), ARI cases were found to be higher n = 80 (76.9%) than in control n = 24 (23.1%). Whereas, among unexposed infants N = 991, ARI cases were found to be lower n = 195 (19.7%) than in control n = 796 (80.3%). For the exposed infants, the odds for ARI were 13.5 times significantly higher compared to those of their unexposed counterparts (OR-Unadjusted = 13.52, (p < 0.0001, 95% CI = 0.047 - 0.121)). The findings will widen the horizon in the etiological consideration of ARI among infants vis-à-vis exposure potential to pre-existing maternal/caregiver ARI via nursing care. Therefore, community-based sensitization programme on barrier nursing care techniques and personal hygiene practices should be on focus.

The incidence of acute respiratory infections (ARI) in children is significantly higher than in adults. The largest number of registered cases occurs in children under 7 years of age. Against the background of the SARS — COV2 pandemic, there is a frequent intercurrent or combined course of ARI. A large taxonomic diversity of ARI pathogens, a high frequency of combined infection, the ability of pathogens to develop resistance to chemotherapy drugs significantly limit the arsenal of therapeutic and preventive options. All this determines the relevance of studying the effectiveness of probiotics as a means of treating and preventing ARI in children. Objective of the study: to evaluate the effectiveness of probiotics in the treatment and prevention of ARI in children based on a critical analysis of literary sources. Methods. An analysis of literary data presented in the scientific systems PubMed, EM BASE, Web of Science and Trip from December 2000 to June 2024 was carried out, dedicated to the clinical use of probiotics for ARI in children. The following keywords and phrases were used as a search query: respiratory infections, microbiota, immunity, cytokines, macrophages, secretory IgA, T-regulatory cells. Results. Clinical studies of recent years confirm that probiotics (mostly Lactocasebacillus GG, L. casei, Bifidobacterium spp.) reduce the frequency, duration and severity of acute respiratory viral infections in children by modulating the immune response (increasing the level of secretory IgA, stimulating the production of IFN-γ and suppressing the synthesis of proinflammatory cytokines). Probiotics have a strain-specific immunomodulatory effect on epithelial cells and cells of the immune system. Preventive use of probiotics reduced the risk of developing ARI by 10–32 %. The use of probiotics in ARIs reduced the duration of the disease by 0.5–1.5 days, decreased the likelihood of an uneven course and the need for antibacterial drugs by 18–25 %. Conclusion. The use of probiotics helps to reduce the frequency and duration of ARI episodes, as well as reduce the frequency of secondary bacterial complications. Their use is considered as one of the key tools for ensuring an effective immune response and increasing the resistance of the macroorganism to respiratory pathogens. To expand the range of probiotic strains used, to clarify their clinical and immunological effects, it is advisable to conduct further scientific research in this area.

A rapid, focused ethnographic study was carried out in a rural area of West Java, Indonesia to identify local beliefs, perceptions, and practices surrounding acute respiratory infections (ARI) in infants and young children. The study incorporates key informant interviews, open-ended interviews, and structured data collection from fifty mothers of young children selected to represent the geographical settlement pattern in the area: structured interviews with biomedical and indigenous health care providers; and structured interviews with fifty mothers who sought health care for an infant or young child with a respiratory illness. The most commonly perceived cause for ARI in children was air entering the body through some type of chill, exposure to draft or breeze, or change of weather. When fever or difficult breathing was present, mothers tended to increase the number and diversity the types of medicines used. Mothers recognized difficult as well as rapid breathing, both being described as "difficult breathing." More concern was expressed about fever than about difficulty in breathing. Effective medical care was more likely to be delayed for infants than for older children; infants were also more likely to be taken to an indigenous healer as the first-choice provider. Infants were less likely to receive an effective drug regimen even if appropriate medication was prescribed, because mothers commonly take the drugs in order to deliver them to the infant through breast milk.

Objectives: To determine the association between acute respiratory infection and type of feeding in children up to 2 years of age presenting at the pediatric outpatient department. Study Design: Case-control study. Place and duration of study: This study was conducted at the Department of Pediatrics, CMH Abbottabad, from October 2024 to March 2025. Methods: A total of 50 children aged ≤2 years presenting with acute respiratory infection were included in the study group. Another 50 children of the same age group without any diagnosis of infections or any serious illness were added in the control group. Interviews of mothers were conducted to find the feeding history of children during the first six months of life. Infants were then categorized into exclusive breastfeeding, exclusive formula feeding, and mixed feeding as per WHO classification. The association between feeding type and the incidence of infection was assessed using the chi-square test and odds ratios. Results: The mean age of children was 8.21±5.71 months with a predominant male population (61%). Exclusive formula feeding was the most common (60%), while exclusive breastfeeding was the least common (10%) in the study group. Conversely, exclusive breastfeeding was most common (56%) and exclusive formula feeding was least common (20%) in the control group. A statistically significant association was found between feeding type and the incidence of acute respiratory infection (p &lt; 0.0001). Infants on exclusive formula feeding had significantly higher odds of developing the infection (OR: 16.8), whereas exclusive breastfeeding was associated with the lowest risk. Conclusion: A significant association was found between feeding practices and the risk of acute respiratory infection in children up to 2 years of age.

Introduction: Acute Respiratory Infection (ARI) is a major health problem in under-five children which can cause death. Exclusive breastfeeding can prevent infections, one of which is ARI. Objective: This study aims to examine the relationship between exclusive breastfeeding and the risk of ARI in under-five children. Method: This research uses a literature review approach which measures the relationship between exclusive breastfeeding and the risk of ARI in under-five children. The data source uses secondary data in the form of articles obtained through two databases, namely Scopus and Springer Link. Result: There are 5 articles that meet the requirements for research. Four out of five articles prove that exclusive breastfeeding reduces the risk of children under five getting ARI. The finding of a higher risk of ARI in the group of children under five who are not exclusively breastfed can be caused by a decrease in the immunity of children under five, seeing that breast milk is proven to fight infection. The content of sIgA and lactoferrin in breast milk and immunization can increase the immune system in children under five who suffer from ARI. Conclusion: Breast milk has nutrients in it which are useful for preventing infectious diseases, such as ARI and pneumonia in children under five. Given the influence on the health of children under five, the findings of this study demonstrate the need for improvements in breastfeeding programs, with a particular emphasis on exclusive breastfeeding and ARI management. There is a need for widely accessible health workers, information, and services connected to care for moms.

ABSTRACTBackground and AimsWhen predicting the risk of childhood acute respiratory infections (ARI) among under‐five children, categorizing drinking water sources remains controversial in Bangladesh. The study aimed to assess the impact of main two drinking water sources on childhood ARI status.MethodsFrom January to April 2023, a hospital‐based case‐control study was carried out involving 216 cases and 216 controls among under‐five children in Dhaka, Bangladesh. Children with ARI symptoms were considered as cases, while controls were without ARI symptoms. Piped water sources were categorized as improved sources, while tube well/boreholes as unimproved. Bivariate and multivariate logistic regression were performed to assess the relationship between two different water source categories and childhood ARI status.ResultsAround 57% of households with cases had access to improved water sources while for controls it was 68.1%. Households with improved water sources had a 51% lower risk of having under‐five children with ARIs (AOR: 0.5, 95% CI: 0.3–1.0, p = 0.039). Prematurity (AOR: 1.8, 95% CI: 1.1–3.0, p = 0.025), delayed initiation of breastfeeding (AOR: 3.0, 95% CI:1.8–4.8, p < 0.001), exposed to in‐house smoking (AOR: 3.0, 95% CI: 1.9–5.0, p < 0.001) were associated with increased risk of childhood ARI. Older children had a lower risk of having ARI than infants.ConclusionPiped drinking water sources are associated with a lower risk of ARI among under‐five children in Bangladesh. Water purification practices may act as a protective mechanism against ARI in households with piped water sources. Water supply infrastructure and behavioral strategies programs in areas with unimproved water sources could reduce the burden of ARI.

Background: Acute Respiratory Infections are classified into the upper and lower respiratory tract infections, contributing to the leading cause of death among children under five globally. The estimation showed the deaths of more than 800,000 children under five every year or about 2,200 per day. One of the risk factors for ARI in children under five years of age is secondary exposure to tobacco smoke. This study aimed to examine the effect of cigarette smoke exposure and acute respiratory infection in children under five. Subjects and Method: This was meta analysis and systematic review. The study was conducted by collecting published articles from Google Scholar, Pubmed, and Springer Link databases, from year 2010 to 2019. Keywords used “risk factor” OR “passive smoking” OR “secondhand smoking” AND “ARI due to children under five”. The inclusion criteria were full text, using English language, using cross-sectional study design, and reporting adjusted odds ratio. The collected articles were selected by PRISMA flow chart. The quantitative data were analyzed by fixed effect model using Revman 5.3. Results: 6 studies from Cameroon, Ethiopia, India, Nepal, and Nigeria reported that tobacco smoke exposure increased the risk of acute respiratory infection in children under five (aOR=1.39; 95% CI= 1.22 to 1.58; p&lt;0.001). Conclusion: Tobacco smoke exposure increases the risk of acute respiratory infection in children under five. Keywords: tobacco smoke, acute respiratory infection, children under five Correspondence: Maya Ayu Riestiyowati. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: maaya.ayuu.ma@gmail.com. Mobile: 081235840067.

Background: Antenatal care (ANC) offers a valuable opportunity to reduce the risk of acute respiratory infections (ARIs) in children under five; however, its impact remains less understood and has not been comprehensively synthesised. This systematic review aimed to assess evidence on the association between ANC utilisation and ARIs in children under five. Methods: A systematic search was conducted in PubMed, CINAHL, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025. PRISMA 2020 guidelines were followed in reporting. A qualitative synthesis was performed for all ARI outcomes, and a meta-analysis was conducted for pneumonia. Results: Eleven observational studies assessed the association between ANC utilisation and ARIs. Three ARI-related outcomes were identified: pneumonia (n = 4), pertussis (n = 2), and general ARIs (n = 5). ANC attendance was generally associated with reduced odds of respiratory infections across studies. The pooled analysis of two case–control studies (n = 2; total n = 956) showed a non-significant association between ANC attendance and pneumonia in children (pooled OR = 1.46; 95% CI: 0.91, 2.35; I2 = 0%). Conclusion: Our review suggests a potential protective effect of ANC, though evidence from the pneumonia-focused meta-analysis was inconclusive. Improving access to quality ANC may reduce respiratory infections, but more studies are needed across different populations.

Background: exclusive breastfeeding has been shown to protect infants from contracting various diseases. The aims of this study were: to examine the relationships between infant feeding patterns and the risk of Acute Respiratory Infections (ARI), and to assess the importance of some factors that can increase such risk. Methods: a case-control study was carried out during the period between February 1st 2005 - May 1st 2005. The study included 137 infants who were hospitalized in the Children Welfare Teaching Hospital for ARIs during the period of study (a case definition of acute lower respiratory infection as given by the WHO (1995) was used). The Control group included 157 healthy infants who were randomly selected from two primary health care centers of the AI-Karkh sector of Baghdad for immunization. The risk of various factors thought to be associated to ARI were studied, these being: non-modifiable (age, gender, birth order, parent education, crowded residence, family history of asthma and history of ARIs in household members in previous 2 weeks) and modifiable (short duration of breastfeeding, cigarette smoking in proximity to the infant, delayed immunization and malnutrition). Logistic regression was used to adjust for confounders and for calculating adjusted odds ratios. Results: formula fed infants had a 2.7 times higher risk (CI:1.6-4.68) for ARIs compared to breast fed infants. Infants who had undergone a short duration of breastfeeding (&lt;3 months) had a 1.4 times increased risk or ARI (CI: 0.89—2.23). Additional factors that were associated with higher ARIs were, female gender (OR= 2.0, CI:1.3-3.3), low educational level of mothers (OR= 6.4, CI:3.2-12.7) and fathers (OR=4.5, CI:2.27-8.78), crowded residence (OR= 4.5, CI: 2.6-7.8), positive history of ARIs in household members in the 2 weeks prior to the study (OR= 5.5, CI:3.3-9.3), family history of asthma (OR = 2.6, CI:1.4-4.9), and daily smoking of ≥7 cigarettes in proximity to the infant (OR = 2.0, CI:1.1-3.4). Age, birth order, delayed immunization and malnutrition, were not found to significantly increase the infants’ risk of ARIs. Multiple logistic regression showed that ARIs in household members during the 2 weeks prior to the study, low educational level of mothers, short duration of breastfeeding, living in a crowded residence, and family history of asthma or allergy were all significantly associated with an increase in the risk of ARIs. Conclusions: short duration of breastfeeding is the only modifiable factor which showed a significant relationship with ARIs. The Promotion of breastfeeding is highly recommended as a strategy to reduce the risk of ARIs in infants.

Objective Children younger than 5 years, particularly children below 2 years, are among the most vulnerable groups for developing anemia and infections. This review is intended to assess the association between anemia and childhood acute respiratory infections (ARTIs), acute gastroenteritis (AGE), and urinary tract infections (UTIs). Methods PubMed was searched for published articles from January 2000 to August 2021 in English using the following terms: anemia and acute respiratory tract infections in children; anemia and UTIs in children; anemia and AGE in children. The data extraction were conducted by two investigators using the same methodology. Using descriptive statistics, the data from different sources were synthesized, including medians and ranges. Results A total of 426 articles and 27 original articles and 1 systematic review were included. Iron deficiency anemia is common among children between 6 months and 3 years of age. This age group can be considered a highly susceptible age for contraction of ARTI and AGE. Children below 5 years suffer five to six episodes of acute ARTI per year on average, and pneumonia accounts for the highest number of deaths, which is around 1.1 million each year. When considered, the odds ratio of anemia to increase the susceptibility of contracting lower ARTI would range from 2 to 5.7. Also, anemic children were 10 times more susceptible to developing acute recurrent ARTI and 4 times more susceptible to contracting pneumonia. Respiratory syncytial virus is the commonest viral etiology. Anemia would increase the risk of diarrhea by 2.9-fold in toddlers, while mild anemia, moderate anemia, and severe anemia would increase the susceptibility to contract AGE by 1.6, 1.6, and 8.9 times, respectively. Rotavirus is the commonest etiology. Some studies observed a protective effect of mild to moderate iron-deficient anemia from respiratory infections. Conclusion Infectious disease imposes a heavy burden on the health sector in a country. The highest susceptibility for infections and the development of anemia would be due to inadequate nutrition supplementation to meet the demand during rapid body growth. Therefore, based on the available evidence, one can take the necessary steps to reduce the infectious disease burden by correcting the anemia status in children.

ASIA is a continent with many people who still have and use biomass or solid fuel use (SFU) for cooking and various household air pollution. Previous research has mentioned the negative effects of household air pollution on the incidence of acute respiratory infections in children under 5 years. Acute respiratory diseases have even become the cause of at least 4 million deaths of children under 5 years old every year in the world. The meta-analysis aimed to estimate the correlation between household air pollution and the incidence of acute respiratory infections in children under five in ASIA. This study was a meta-analysis. Primary data is taken through the electronic databases such as: PubMed, Science Direct, Web of Science, Springer Link and Cochrane Database. By using the search keywords "Household air pollution AND acute respiratory tract infections AND adjusted odds ratio", "indoor air pollution AND acute respiratory tract infections AND adjusted odds ratio", and "paparan asap rumah tangga DAN ISPA DAN adjusted odds ratio". Articles taken between 2013-2023. Statistical analysis was performed using the RevMan 5.3. 7 articles qualified for quantitatively analysis. The exposure of household air pollution can increases the risk of acute respiratory infections 3 times in children under five and statistically significant (OR 3.36; 95% CI: 2.96 – 3.81; p value &lt; 0.001). Exposureto household air pollution is a significant risk factor for the incidence of acute respiratory infections in children under 5 years.&#x0D;

Book ReviewsThe Management of Acute Respiratory Infections in Children: Practical Guidelines for Outpatient Care Husn FrayhaMD Husn Frayha Head, Section of Infectious Diseases, Department of Pediatrics, MBC 58, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia Search for more papers by this author Published Online:24 Apr 2019https://doi.org/10.5144/0256-4947.1997.264aSectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionAcute respiratory tract infections are frequent in children, and are associated with high morbidity and mortality, particularly in underdeveloped and developing countries. Children with acute respiratory infections account for a significant proportion of patients seen at primary health facilities. It is estimated that pneumonia is responsible for 25% of deaths in children under five years of age in developing countries.This WHO book is intended for health staff working in outpatient first-level health care facilities. It provides guidelines for initial assessment and management of children with acute respiratory infections, and identification of children whose condition is sufficiently serious to warrant referral to hospital. The aim is to improve the outcome of children with acute respiratory infections, particularly young infants who are at the highest risk of complications and death from pneumonia.The approach to case management is summarized in two fold-out charts. One deals with the “Management of the Child with Cough or Difficult Breathing,” and the other with the “Management of the Child with an Ear Problem or Sore Throat.” These charts are reasonably sized and suitable for posting on an office wall and/or carrying around in a folder. They serve as quick and practical references to the management of children presenting with acute respiratory problems.Each chapter ends with a list of the essential skills and knowledge required by health workers for the management of acute respiratory infections. The book uses simple and clear terminology that makes it easy to read. The instructions are easy to follow. Technical words are defined at the end of the book.The first chapter includes a description of how to select the appropriate case management chart for assessment, classification and treatment of acute respiratory infections. Chapters 2, 3 and 4 focus on the assessment of a child presenting with cough or breathing difficulty. They provide instructions on how to obtain the necessary information about the child's illness by asking the appropriate questions, and looking for physical signs and symptoms that would identify those with severe disease that require referral to a hospital for treatment. These chapters contain many well-designed illustrative diagrams and case examples that reinforce their educational objective. Chapter 5 describes treatment guidelines for children who do not require hospitalization. These include detailed instructions on the dosages and administration of a select number of antibiotics, home care instructions to prevent dehydration and malnutrition, monitoring of fever and use of antipyretics and bronchodilators whenever indicated. While many of the acute lower respiratory tract infections may be due to a viral etiology and thus may not require antibiotics, the lack of viral diagnostic testing and close follow-up, and the possibility of superimposed bacterial infections may justify the empirical use of antibiotics in many of these patients. Such practices, on the other hand, may contribute to the global problem of increasing bacterial resistance.Chapter 6 deals with the assessment, classification and management of a child presenting with an ear problem. The instructions for the management of chronic ear infection are particularly well designed.Chapter 7 describes the management of a child with sore throat. The criteria for use of antibiotics in these health facilities where cultures are not available are pertinent.The annexes complement the material described in the main chapters. Of particular usefulness are the recommendations for use of rapid-acting bronchodilators. The failure to mention erythromycin for treatment of pertussis (Annex 2) is a shortcoming.This book will be useful for its stated purpose, i.e., health workers in primary health care centers in underdeveloped and developing countries with limited health facilities. While the recommendation for widespread use of antibiotics in young children with pneumonia is largely understandable, this practice will undoubtedly contribute to the ever-increasing problem of bacterial resistance. The choice of antibiotics, particularly for treatment of lower respiratory infections, is influenced by cost considerations. The applicability of the antibiotic treatment guidelines to other health care settings is limited. Previous article Next article FiguresReferencesRelatedDetailsCited byKhoja D (2019) The Management of Acute Respiratory Infections: Saudi National Protocol for Diagnosis and Treatment, Annals of Saudi Medicine , 18:1, (86-86), Online publication date: 1-Jan-1998. Volume 17, Issue 2March 1997 Metrics History Published online24 April 2019 InformationCopyright © 1997, Annals of Saudi MedicinePDF download

To explore the correlation of temperament type and mother's emotional state with acute respiratory tract infections in children so as to provide evidence for comprehensive treatment of the infections. A total of 200 children aged between 3 and 6 were enrolled in this study from two kindergartens of Guangzhou and Hengyang. The mothers were invited to complete a questionnaire of the children's general information followed by assessment using children's temperament scale and the Depression-Anxiety-Stress Scale. The total incidence of acute respiratory infection was significantly higher in children with a hard- to-raise temperament than the easy- to-raise children (P < 0.05); the incidences of acute rhinitis, acute pharyngitis, acute laryngitis and acute bronchitis were all significantly higher in the hard-to-raise children (P < 0.05). A significant positive correlation was identified between the total number of episodes of acute respiratory tract infection in children and their mothers' stress and anxiety levels (P < 0.01). Acute rhinitis and acute tracheitis in the children were both positively correlated with the mothers' stress scores (P < 0.05), while acute pharyngitis and acute laryngitis were positively correlated with the mothers' anxiety scores (P < 0.05), while acute bronchitis was positively correlated with the mothers' stress and anxiety scores (P < 0.05). Multiple linear regression analysis with the factors influencing the types of acute respiratory tract infections in children as the independent variables suggested that the easy-to-raise type of temperament was a protective factor against acute rhinitis in children (P < 0.05), while mothers' anxiety was a risk factor of acute laryngitis in children (P < 0.05); the mothers' stress was a risk factor for acute bronchitis in children (P < 0.05). Acute respiratory tract infection in children is closely related to the temperament type of the children and the emotional state of the mothers, which are important therapeutic targets in comprehensive interventions of acute respiratory tract infection in children.