Burden Of Respiratory Infections Research Articles

Polydopamine Nanoconjugate‐Coated Masks: An Efficient Barrier Against Airborne Pathogens

AbstractCurrent global burden of respiratory tract infections (RTIs) has thrown new challenges for researchers to design and develop efficient and multifaceted face masks. Airborne pathogens are highly transmissible through droplet nuclei/aerosol (<5 μm) which can be significantly reduced by wearing masks. Currently available disposable surgical masks have disparate limitations in terms of surface wettability, microbial penetration, dermal infections due to anaerobic reactions beneath the surface, discomfort, and eruption of chronic obstructive pulmonary diseases (COPD). These mask surfaces get contaminated with airborne pathogens along with commensal bacterial strains. Generation of high temperature and humidity during repetitive breathing allow bacteria to penetrate from the masks to respiratory tract causing serious complications. Till date, functionalized face masks with different microbicidal agents including nanomaterials experience restricted leaching of antimicrobial agents, cytotoxic effects, short‐lived microbicidal effects, inflammatory responses, negative impact on ecosystem, etc. To address these limitations, here, we have attempted fabrication of mussel mimetic biopolymer (PDA) and its aminoglycoside‐nanoconjugate‐coated face masks. Formation of a uniform layer on the surface not only acted as a potential barrier for infectious pathogens but also inhibited their entry, deactivated the adhered bacteria, imparted non‐immunogenic response with no harmful effects on the wearer's skin owing to the biocompatible nature and pH compatibility of PDA and their conjugates. Amongst all, PDA‐kanamycin (PDA−K)‐coated masks exhibited excellent microbicidal activity with the least bacterial infiltration efficiency.

Non-COVID Respiratory Infections Related Emergency Room Visits Among Autistic Adults in the United States

IntroductionThis is a retrospective study to examine the risk of non-COVID-19 respiratory infection (RI) related emergency department (ED) visits and hospitalizations among autistic adults compared to non-autistic adults using the 2018 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS). MethodsThe data were analyzed in 2022 using the ICD-10-CM codes to extract about 46,996 autistic case records that were matched by age and sex with non-autistic records (140,997) in a 1:3 case-control ratio. Respiratory infections were also identified using the ICD-10-CM codes and classified by type. Logistic regression models were conducted for the likelihood of presenting with RI infections to the ED and subsequent hospitalization. All models were adjusted for covariates. ResultsAutistics were more likely to present with any type of respiratory infection at the emergency department (AOR = 1.83: CI= 1.69-2.42), lower respiratory infections (AOR=1.37: CI=1.09-1.50), and pneumonia (AOR=2.42: CI=1.98-2.47) compared to non-autistics. They are also more likely to be hospitalized from RIs during ED visits (AOR=3.87: CI=3.21-4.30), including upper and lower RIs, pneumonia, and bronchitis. ConclusionsAutistic individuals were more likely to experience emergency department visits and hospitalizations due to respiratory infections compared to non-autistic individuals. Amid growing evidence of the disproportionate impact of COVID-19 on the autistic population, our findings highlight a broader, pre-existing burden of respiratory infections among autistic adults in the US that extends beyond the recent pandemic.

Acute Respiratory Tract Infections in Pediatric Populations of Slum Areas: Navigating Challenges and Dynamics of Immune Responses.

The study presents a thorough examination of immune responses in pediatric populations within slum areas, specifically addressing respiratory infections. It explores the impact of slum conditions on respiratory health, detailing the epidemiology of infections, including common pathogens and environmental factors. The review delves into the etiology, clinical manifestations, and challenges associated with viral respiratory infections, co-infections, and complications in slum environments. The discussion extends to immune responses in pediatric respiratory infections, emphasizing unique challenges in diagnosis and treatment within slum areas. Prevention and intervention strategies are highlighted, encompassing vaccination programs, health education, and improving living conditions. It underscores the importance of targeted interventions, accounting for socio-economic factors, community-based strategies, and culturally sensitive approaches. It proposes the exploration of novel approaches and the development of vaccines tailored to prevalent respiratory pathogens in slum settings. Furthermore, the feasibility and impact of routine immunization programs, emphasizing accessibility, acceptance, and long-term sustainability are explored. It advocates strengthening primary healthcare systems, investing in healthcare workforce training, and improving diagnostic facilities. The potential of digital health technologies in enhancing surveillance, early detection, and the development of mobile applications or telemedicine platforms is discussed. In conclusion, the study emphasizes the multifaceted challenges faced by children in slum areas regarding respiratory infections, necessitating informed, interdisciplinary interventions. Addressing healthcare disparities, improving living conditions, and enhancing vaccination coverage are deemed crucial for mitigating the burden of respiratory infections. This review calls for collaborative efforts among researchers, healthcare professionals, policymakers, and community stakeholders to develop sustainable solutions for enhanced respiratory health in slum-dwelling pediatric populations.

Short-Term Action for America’s Health: Health Care, Public Health, and Community Collaboration to Reduce the Burden of Respiratory Infections, Opioid Use Disorder, and Other Public Health Threats

Short-Term Action for America’s Health: Health Care, Public Health, and Community Collaboration to Reduce the Burden of Respiratory Infections, Opioid Use Disorder, and Other Public Health Threats

Assessing Respiratory Tract Infections' Prevalence and Microbial Profiles in Mechanically Ventilated Patients: Insights From Broncho Alveolar Lavage Examination.

Introduction Chest infections represent a significant challenge in mechanically ventilated patients, often leading to adverse outcomes despite advancements in critical care. This prospective study was conducted in the intensive care unit of tertiary referral care, with objectives to assess chest infection prevalence, microbial profiles, and outcomes in mechanically ventilated patients through broncho-alveolar lavage (BAL) examination. Methodology This prospective study involved 38 patientsaged 15 to 65 yearswho were receiving mechanical ventilation and underwent BAL. The procedureof BALwas followed as per the guidelines and recommendations outlined by the American Thoracic Society for Bronchoscopic Lavage. Microbial analysis involves the use of microscopic examination and quantitative culture methods. Different staining techniques were utilized to identify bacteria, fungi, and mycobacteria. Complications and adverse events were monitored and recorded. Results Out of the 38 patients who underwent BAL, the majority, 30 (78.94%), were found to have chest infections, with gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii, being the causative agents. The antibiotic sensitivity profiles indicated that the organisms were susceptible to carbapenems and broad-spectrum β-lactam/β-lactamase inhibitor combinations while showing resistance to fluoroquinolones. Despite adequate treatment, mortality remained significant in 12 (31.57%) patients. Conclusion Study findings underscore the importance of proactive surveillance, early diagnosis, and targeted management strategies to mitigate the burden of respiratory infections in critical care settings.

Respiratory health and the Syrian conflict: a scoping literature review

ABSTRACT Conflict adversely affects respiratory health in both direct and indirect ways among populations whose health is already compromised through the compounding effects of conflict. Our aim is to review academic and grey literature relevant to respiratory health in the Syrian conflict (now more than a decade in duration) to explore its impacts on populations across Syria. We performed a scoping literature review of academic and grey literature on respiratory health in Syria between March 2011 (taken as the start of the conflict for practicality) and December 2023. Of 11,472 papers screened, 34 met the inclusion criteria, of which 29 were peer reviewed. Key themes identified included the impact of conflict on asthma diagnosis and management; the burden of respiratory tract infections (RTIs) and COVID-19; the impact of chemical weapon use and the impact of destruction and interruptions to the health system(s) across Syria on respiratory health. This review highlights the need for more in-depth exploration of the impact of conflict on respiratory health in Syria with focus on social determinants, for example, shelter, public health interventions, smoking cessation, and supporting early diagnosis and treatment of respiratory conditions to counter the effects that conflict has had on respiratory health.

Residential exposure to mold, dampness, and indoor air pollution and risk of respiratory tract infections: a study among children ages 11 and 12 in the Danish National Birth Cohort.

The burden of respiratory tract infections (RTIs) is high in childhood. Several residential exposures may affect relative rates. To determine risk of RTIs in children ages 11 and 12 by residential exposures. We included children in the Danish National Birth Cohort (DNBC) at ages 11 and 12. We estimated incidence risk ratios (IRR) and 95% confidence intervals (CI) for counts of RTIs within the last year by exposure to mold/dampness, gas stove usage, summer and winter candle-burning, fireplace usage, cats and dogs indoors, and farmhouse living. We also estimated IRR and 95% CI for RTIs for predicted scores of four extracted factors ('owned house', 'mold and dampness', 'candles', and 'density') from exploratory factor analyses (EFA). We included 42 720 children with complete data. Mold/dampness was associated with all RTIs (common cold: IRRadj 1.09[1.07, 1.12]; influenza: IRRadj 1.10 [1.05, 1.15]; tonsillitis: IRRadj 1.19 [1.10, 1.28]; conjunctivitis: IRRadj 1.16 [1.02, 1.32]; and doctor-diagnosed pneumonia: IRRadj 1.05 [0.90, 1.21]), as was the EFA factor 'mold/dampness' for several outcomes. Gas stove usage was associated with conjunctivitis (IRRadj 1.25 [1.05, 1.49]) and with doctor-diagnosed pneumonia (IRRadj 1.14 [0.93, 1.39]). Candle-burning during summer, but not winter, was associated with several RTIs, for tonsillitis in a dose-dependent fashion (increasing weekly frequencies vs. none: [IRRadj 1.06 [0.98, 1.14], IRRadj 1.16 [1.04, 1.30], IRRadj 1.23 [1.06, 1.43], IRRadj 1.29 [1.00, 1.67], and IRRadj 1.41 [1.12, 1.78]). Residential exposures, in particular to mold and dampness and to a lesser degree to indoor combustion sources, are related to the occurrence of RTIs in children.

An Overview of Bacterial Respiratory Tract Infections and their Etiologies

Background: Respiratory tract infections (RTIs) are considered as one of the most important causes of morbidity and mortality, worldwide. A wide variety of bacteria and viruses are responsible for the development of RTIs. Considering the importance of respiratory tract infections, this study aimed to provide an overview of the most important respiratory tract infections and inflammations of bacterial origin and their etiologies.
 Results: A literature review was conducted to find original studies associated with respiratory infections. Articles that provided evidence on respiratory tract infections as well as their clinical manifestations and etiologies were included in this research.
 Conclusion: Considering the importance and economic burden of respiratory tract infections as well as their diversity and widespread prevalence in different communities, it is necessary to implement preventive measures at the national level to control and deal with respiratory diseases with high prevalence in all age groups, in addition to observing the principles of health and hygiene.

Knowledge, Attitude and Practices Regarding Tuberculosis Infection Control Practices among Health Care Workers at Tertiary Care Centre, Rajnandgaon

Tuberculosis infectious disease owns highest burden of respiratory infection. India being the largest contributor to global Tuberculosis cases. Mycobacterium tuberculosis mode of transmission by respiratory route require airborne precautions to be strictly followed in healthcare settings to minimize the transmission. Research was plan to assess fundamentals of Tuberculosis infection control among healthcare workers. Questionnaire based cross-sectional study which included sociodemographic characteristics, with twenty-five questions on knowledge of Tuberculosis, attitude and practices for Tuberculosis infection control was conducted in Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Medical College, Rajnandgaon Chhattisgarh from April 2023 to May 2023. 156 HCWs with mean age group 36 ± 9.7 (18-59) years participated in the study. Healthcare workers included were nurses (55.1%) and technicians (44.8%). Knowledge and attitude score observed in our study is 90.3% and 92.3% levelled as good to moderate but at the same time good to moderate practice observed is 59.6%. Certain deficiencies regarding some areas of preventive measures of tuberculosis was observed among participants which require improvement by conducting training sessions.

High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022-2023.

Given reduced immunity levels for seasonally occurring respiratory infections and the experience of an unusually early, severe wave of RSV infections during 2021, a preexisting clinician-led reporting system (CLRS) was updated to prospectively monitor the anticipated high burden of respiratory infections (ARI) in German pediatric hospitals during fall/winter 2022-2023. From September 13, 2022 through March 31, 2023, children hospitalized with ARI as a primary diagnosis were monitored via a national CLRS established by the German Society for Pediatric Infectious Diseases (DGPI). Once a week, the CLRS collected overall number of new hospital admissions, ARI-related admissions according to pathogen (SARS-CoV-2, RSV, influenza, and other), plus number of patients admitted to ICU with ARI as a primary diagnosis. With a high participation among children's hospitals across Germany (22.8%), 76 centers submitted 1,053 survey reports. ARI-related hospital admissions showed a steep rise starting in late September 2022 and reached their highpoint in early December 2022 (50.1% of all admissions). In parallel, the average number of newly admitted patients (aNA) with RSV (3.6) peaked, as did those with influenza (2.1) one week later. The average highpoint of ARI patients on ICU (aICU) (2.9) was reached shortly thereafter. Again, RSV (1.6) und influenza (1.2) were predominant pathogens. In fall/winter 2022-2023, German hospitals reported a sharp increase in patients with ARIs. While RSV and influenza represented the greatest proportion of ARI, SARS-CoV-2 played a less significant role. Systematic, dynamic collection of ARI data is critical for assessing real burdens on the health care system.

Environmental risk factors for respiratory infection and wheeze in young children: A multicentre birth cohort study.

Respiratory infections and wheeze have a considerable impact on the health of young children and consume significant healthcare resources. We aimed to evaluate the effect of environmental factors on respiratory infections and symptoms in early childhood. Environmental risk factors including: daycare attendance; breastfeeding; siblings; damp within the home; environmental tobacco smoke (ETS); child's bedroom flooring; animal exposure; road traffic density around child's home; and solid fuel pollution within home were assessed in children recruited to the GO-CHILD multicentre prospective birth cohort study. Follow-up information on respiratory infections (bronchiolitis, pneumonia, otitis media and cold or flu), wheeze and cough symptoms, healthcare utilisation and medication prescription was collected by postal questionnaires at 12 and 24 months. Log binomial and ordered logistic regression models were fitted to the data. Follow-up was obtained on 1344 children. Daycare was associated with increased odds of pneumonia (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.04-5.49), bronchiolitis (OR = 1.40, 1.02-1.90), otitis media (OR = 1.68, 1.32-2.14) and emergency department attendance for wheeze (RR = 1.81, 1.17-2.80). Breastfeeding beyond 6 months was associated with a reduced odds of bronchiolitis (OR = 0.55, 0.39-0.77) and otitis media (OR = 0.75, 0.59-0.99). Siblings at home was associated with an increased odds of bronchiolitis (OR = 1.65, 1.18-2.32) and risk of reliever inhaler prescription (RR = 1.37, 1.02-1.85). Visible damp was associated with an increased odds of wheeze (OR = 1.85, 1.11-3.19), and risk of reliever inhaler (RR = 1.73, 1.04-2.89) and inhaled corticosteroid prescription (RR = 2.61, 1.03-6.59). ETS exposure was associated with an increased odds of primary care attendance for cough or wheeze (OR = 1.52, 1.11-2.08). Dense traffic around the child's home was associated with an increased odds of bronchiolitis (OR = 1.32, 1.08-2.29). Environmental factors likely influence the wide variation in infection frequency and symptoms observed in early childhood. Larger population studies are necessary to further inform and guide public health policy to decrease the burden of respiratory infections and wheeze in young children.

Respiratory viruses in rural Zambia during the second year of the COVID-19 pandemic

ObjectivesLimited data on respiratory infections are available from sub-Saharan Africa during the COVID-19 pandemic. The objective of this study was to evaluate the burden of respiratory viruses in rural Zambia from 2019-2021. MethodsSurveillance was initiated at Macha Hospital in Zambia in December 2018. Each week, patients with respiratory symptoms were enrolled from the outpatient clinic. Nasopharyngeal samples were collected and tested for respiratory pathogens. The prevalence of respiratory symptoms and viruses in 2021 was compared to results from 2019 and 2020. ResultsAfter seeing few cases of influenza virus and respiratory syncytial virus in 2020, a return to prepandemic levels was observed in 2021. Rhinovirus/enterovirus, parainfluenza virus 1-4, and adenovirus circulated from 2019 to 2021, while human metapneumovirus and human coronaviruses (HKU1, 229E, OC43, and NL63 subtypes) were observed sporadically. SARS-CoV-2 was observed consistently in 2021 after being first identified in December 2020. The proportion of participants with co-infections in 2021 (11.6%) was significantly higher than in 2019 (6.9%) or 2020 (7.7%). ConclusionDeclines in influenza virus and respiratory syncytial virus were reversed once public health measures were lifted. Respiratory viruses contributed to a significant burden of respiratory infections in 2021. This study provides important information about respiratory viruses in this changing context and underrepresented region.

High burden of RSV and influenza in patients presenting with suspected pneumonia in the emergency room of a German tertiary hospital in fall of 2022

PurposeBacterial pneumonia, a major cause of respiratory tract infections (RTI), can be challenging to diagnose and to treat adequately, especially when seasonal viral pathogens co-circulate. The aim of this study was to give a real-world snapshot of the burden of respiratory disease and treatment choices in the emergency department (ED) of a tertiary care hospital in Germany in the fall of 2022.MethodsAnonymized analysis of a quality control initiative that prospectively documented all patients presenting to our ED with symptoms suggestive of RTI from Nov 7th to Dec 18th, 2022.Results243 patients were followed at the time of their ED attendance. Clinical, laboratory and radiographic examination was performed in 92% of patients (224/243). Microbiological work-up to identify causative pathogens including blood cultures, sputum or urine-antigen tests were performed in 55% of patients (n = 134). Detection of viral pathogens increased during the study period from 7 to 31 cases per week, while bacterial pneumonias, respiratory tract infections without detection of a viral pathogen and non-infectious etiologies remained stable. A high burden of bacterial and viral co-infections became apparent (16%, 38/243), and co-administration of antibiotic and antiviral treatments was observed (14%, n = 35/243). 17% of patients (41/243) received antibiotic coverage without a diagnosis of a bacterial etiology.ConclusionDuring the fall of 2022, the burden of RTI caused by detectable viral pathogens increased unusually early. Rapid and unexpected changes in pathogen distribution highlight the need for targeted diagnostics to improve the quality of RTI management in the ED.

Acetate-encapsulated Linolenic Acid Liposomes Reduce SARS-CoV-2 and RSV Infection.

Emergent Coronaviridae viruses, such as SARS-CoV-1 in 2003, MERS-CoV in 2012, and SARS-CoV-2 (CoV-2) in 2019, have caused millions of deaths. These viruses have added to the existing respiratory infection burden along with respiratory syncytial virus (RSV) and influenza. There are limited therapies for respiratory viruses, with broad-spectrum treatment remaining an unmet need. Since gut fermentation of fiber produces short-chain fatty acids (SCFA) with antiviral potential, developing a fatty acid-based broad-spectrum antiviral was investigated. Molecular docking of fatty acids showed α-linolenic acid (ALA) is likely to interact with CoV-2-S, NL63-CoV-S, and RSV-F, and an ALA-containing liposome interacted with CoV-2 directly, degrading the particle. Furthermore, a combination of ALA and a SCFA-acetate synergistically inhibited CoV2-N expression and significantly reduced viral plaque formation and IL-6 and IL-1β transcript expression in Calu-3 cells, while increasing the expression of IFN-β. A similar effect was also observed in RSV-infected A549 cells. Moreover, mice infected with a murine-adapted SARS-CoV-2 (MA10) and treated with an ALA-liposome encapsulating acetate showed significant reductions in plaque-forming units present in lung tissue and in infection-associated lung inflammation and cytokines. Taken together, these results demonstrate that the ALA liposome-encapsulating acetate can be a promising broad antiviral therapy against respiratory infections.

Travel-related respiratory symptoms and infections in travellers (2000-22): a systematic review and meta-analysis.

Respiratory tract infections (RTIs) are common in travellers due to the year-round or seasonal presence of respiratory pathogen and exposure to crowded environments during the itinerary. No study has systematically examined the burden of RTI infections among travellers. The aim of this systematic review and meta-analysis is to evaluate the prevalence of RTIs and symptoms suggestive of RTIs among travellers according to risk groups and/or geographic region, and to describe the spectrum of RTIs. The systematic review and meta-analysis was registered in PROSPERO (CRD42022311261). We searched Medline, Embase, Scopus, Cochrane Central, Web of Science, Science Direct and preprint servers MedRxiv, BioRxiv, SSRN and IEEE Xplore on 1 February 2022. Studies reporting RTIs or symptoms suggestive of RTIs in international travellers after 1 January 2000 were eligible. Data appraisal and extraction were performed by two authors, and proportional meta-analyses were used to obtain estimates of the prevalence of respiratory symptoms and RTIs in travellers and predefined risk groups. A total of 429 articles on travellers' illness were included. Included studies reported 86 841 symptoms suggestive of RTIs and 807 632 confirmed RTIs. Seventy-eight percent of reported respiratory symptoms and 60% of RTIs with available location data were acquired at mass gatherings events. Cough was the most common symptom suggestive of respiratory infections, and the upper respiratory tract was the most common site for RTIs in travellers. The prevalence of RTIs and respiratory symptoms suggestive of RTIs were 10% [8%; 14%] and 37% [27%; 48%], respectively, among travellers. Reporting of RTIs in travellers denoted by publication output was found to correlate with global waves of new respiratory infections. This study demonstrates a high burden of RTIs among travellers and indicates that travellers' RTIs reflect respiratory infection outbreaks. These findings have important implications for understanding and managing RTIs among travellers.

The effect of activity and face masks on exhaled particles in children.

Despite the high burden of respiratory infections among children, the production of exhaled particles during common activities and the efficacy of face masks in children have not been sufficiently studied. To determine the effect of type of activity and mask usage on exhaled particle production in children. Healthy children were asked to perform activities that ranged in intensity (breathing quietly, speaking, singing, coughing, and sneezing) while wearing no mask, a cloth mask, or a surgical mask. The concentration and size of exhaled particles were assessed during each activity. Twenty-three children were enrolled in the study. Average exhaled particle concentration increased by intensity of activity, with the lowest particle concentration during tidal breathing (1.285 particles/cm3 [95% CI 0.943, 1.627]) and highest particle concentration during sneezing (5.183 particles/cm3 [95% CI 1.911, 8.455]). High-intensity activities were associated with an increase primarily in the respirable size (≤ 5 µm) particle fraction. Surgical and cloth masks were associated with lower average particle concentration compared to no mask (P = 0.026 for sneezing). Surgical masks outperformed cloth masks across all activities, especially within the respirable size fraction. In a multivariable linear regression model, we observed significant effect modification of activity by age and by mask type. Similar to adults, children produce exhaled particles that vary in size and concentration across a range of activities. Production of respirable size fraction particles (≤ 5 µm), the dominant mode of transmission of many respiratory viruses, increases significantly with coughing and sneezing and is most effectively reduced by wearing surgical face masks.

Allergic sensitization in low-income urban children: relationship with current symptoms of asthma and rhinitis.

Recent information on the prevalence of allergic sensitization (AS) in children from low-income urban areas is limited. We conducted a cross-sectional, randomized, population-based study to determine the prevalence of AS, and its relationship with asthma and rhinitis in low-income schoolchildren in Santiago, Chile. The parents answered a standardized questionnaire on respiratory symptoms, and a skin prick test (SPT) for common aeroallergens was performed on all children. In the 545 schoolchildren studied (mean age 8.3 ± 0.9 years), the prevalence of positive SPT was 25.5%. The current prevalence of asthma, rhinitis, and rhinoconjunctivitis was 20%, 43.4%, and 27.8%, respectively. SPT was positive in 30.6%, 32.8%, and 38.0% of children with current asthma, rhinitis, and rhinoconjunctivitis, respectively. Positive SPT was significantly associated with rhinitis and rhinoconjunctivitis (p < 0.001) but not with asthma. Breastfeeding for at least 4 months was significantly protective against AS (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.26-0.78; p = 0.008); no other factor studied was associated with AS. The prevalence of AS was low; less than 40% of children with current asthma, rhinitis, or rhinoconjunctivitis symptoms evidenced AS. The prevalence of non-atopic asthma and rhinitis is consistent with previous findings in children from low-income urban areas. Other environmental factors, such as the high burden of respiratory infections and environmental pollution, might be more critical than atopy for developing asthma and rhinitis in schoolchildren from deprived urban areas.

Human Bocavirus infection among children with respiratory tract infection in Ibadan, Nigeria.

Background. Human Bocavirus (HBoV), which is an ssDNA virus of the family Parvoviridae, is responsible for 21.5 % of childhood respiratory tract infections (RTIs) annually. Among the four genotypes currently known, HBoV-1 has been associated with acute RTI. Although there have been studies on HBoV in some countries, there is limited information on this virus in sub-Saharan Africa where there is the highest burden of RTI. This study aimed to characterize the circulating strains of HBoV in Ibadan, Nigeria. Methods. Nasopharyngeal and oropharyngeal swab samples were collected from 333 children ≤5 years old presenting with RTI attending hospitals in Ibadan, whose parents assented, from 2014 to 2015. Twenty-three HBoV isolates were sequenced after a nested PCR and phylogenetic analysis was carried out using mega 6 software.Results. A total of 27 children tested positive for the HBoV-1 genotype by PCR and 23 of the 27 isolates were successfully sequenced. The 23 HBoV-1 isolates from this study have been assigned GenBank accession numbers KY701984–KY702006. Phylogram analysis indicated that the isolates belong to the same clades. Six isolates aligned closely to the reference strains ST1 and ST2, while 17 isolates showed a high level of divergence to the reference isolates.Conclusion. This study highlights the contribution of HBoV to RTIs in Nigeria and that HBoV-1 strains are associated with the infection.

COVID-19 public health measures reduce the incidence of respiratory infectious diseases.

Children and the elderly are two special subpopulations for coronavirus disease 2019 (COVID-19) and respiratory tract infections (RTIs). The study aimed to evaluate the effect of COVID-19 public health measures on the burden of RTIs in China by performing a two-center investigation. The electronic medical records of all inpatients in departments of pediatrics and respiratory medicine of Taizhou Fourth People's Hospital (Taizhou, China) and Shaanxi Provincial People's Hospital (Xi'an, China) during January 1, 2019 to June 30, 2021 were analyzed. A total of 18,084 child inpatients and 14,802 adult inpatients were included. The vast majority (88.3%-90.6%) of the adult inpatients were the elderly, aged over 50 years. The numbers of child and adult (elderly) inpatients, and the proportions of RTI-associated diseases substantially decreased during COVID-19 pandemic (2020-2021) compared to that before the pandemic (2019) in Taizhou and Xi'an. A significantly higher proportion of LRTI-associated diseases was observed in elderly female inpatients (53.4-55.6%) than elderly male inpatients (34.3-41.5%) (p < 0.001) in spite of more male inpatients than female inpatients (1.94-1.95:1). COVID-19-related interventions provide an additional beneficial effect on reduction of RTI-associated diseases in both children and the elderly.

Respiratory health in Syria: an analysis of primary data from the Syrian American Medical Society

Abstract Despite a decade of conflict, there has been little exploration of respiratory health in Syria. We explore the burden and trends of respiratory consultations in Syrian American Medical Society (SAMS) facilities in northwest Syria using mixed methods. We performed i) a scoping review of available academic and grey literature on respiratory health in Syria between 2011 and 2020 (17 databases) and ii) a retrospective review of routinely collected data relating to respiratory presentations in SAMS' facilities between March 2017 and June 2020. We identified 23 papers (19 peer-reviewed); 7 analysed primary data. Key themes included the impact of conflict on asthma diagnosis and management, the burden of respiratory tract infections (RTIs), the impact of chemical weapons and those relating to the destruction of the health system. In our quantitative analysis, data were available for 5,058,864 consultations, of which 1,228,722 (24%) were respiratory presentations. 45% of respiratory presentations were from hospitals, 44% from primary healthcare clinics and 9% from mobile clinics. The median monthly number of respiratory cases was 30,279 (25,792-33,732) out of a median 128,923 total monthly consultations (112,917-140,189). 73% of respiratory consultations were for children. Key findings include: respiratory presentations accounted for up to 38% of consultations each month with seasonal variation. RTIs accounted for 91% of all respiratory presentations. A steep decrease in consultations occurred between the end of 2019 (160,000) and the first quarter of 2020 (90,000), correlating with an escalation of violence in Idlib governorate. This study presents the largest quantitative analysis of respiratory data collected during the Syrian conflict. Our findings support the need for improved measures to aid the prevention, diagnosis and management of respiratory conditions during conflict. Further work exploring such interventions is needed. Key messages We present the largest study of the burden of respiratory presentations during the Syrian conflict accounting for 1,228,722 (24%) of all consultations; of these 72% were for children. Despite the burden of respiratory disease in the Syrian conflict, optimisation of respiratory health is neglected. Public health measures which address the causes and consequences are needed.