Upper Respiratory Tract Infections In Children Research Articles

Longitudinal Microbiome Changes in Children Exposed to Proton Pump Inhibitors.

Proton pump inhibitor (PPI) use has been associated with an increased risk of gastrointestinal and upper respiratory infections in children. There are limited longitudinal data on the effect of PPI in children. The goal of this prospective observational study was to compare the stool and oropharyngeal microbiome of children before and after starting PPIs. We prospectively recruited participants from a gastroenterology clinic. Consented participants provided stool samples and oropharyngeal swabs at baseline and after 8 weeks of PPI therapy. Microbiome changes were measured by analyzing 16S sequencing from both body sites at both time points. Thirty-four participants completed the study and provided samples both at baseline and after 8 weeks on PPI therapy. Of those, 24 participants had sufficient sequencing from both stool and oropharyngeal samples at both time points. There were no differences between the pre-PPI and post-PPI samples using beta-diversity metrics in either the oropharynx or stool. There were, however, significant changes in specific taxa. There was an enrichment of Streptococcus in the stool after PPI use and a reduction in the relative abundance of Bifidobacterium , Peptostreptococcus , and Turicibacter ( P -values < 0.01). Furthermore, there was an increase in the relative abundance of oropharyngeal bacteria in the stool after PPI therapy. This enrichment of oropharyngeal bacteria in the stool was most prominent in younger participants. Further investigation is needed to determine the clinical and microbial factors that predispose or protect against microbiome changes due to PPI use and why young children are more susceptible to this PPI effect.

The incidence of upper respiratory infections in children is related to the concentration of vanadium in indoor dust aggregates.

It has been reported that the disease-initiated and disease-mediated effects of aerosol pollutants can be related to concentration, site of deposition, duration of exposure, as well as the specific chemical composition of pollutants. To investigate the microelemental composition of dust aggregates in primary schools of Vilnius and determine trace elements related to acute upper respiratory infections among 6-to 11-year-old children. Microelemental analysis of aerosol pollution was performed using dust samples collected in the classrooms of 11 primary schools in Vilnius from 2016 to 2020. Sites included areas of its natural accumulation behind the radiator heaters and from the surface of high cupboards. The concentrations of heavy metals (Pb, W, Sb, Sn, Zr, Zn, Cu, Ni, Mn, Cr, V, and As) in dust samples were analyzed using a SPECTRO XEPOS spectrometer. The annual incidence rates of respiratory diseases in children of each school were calculated based on data from medical records. The mean annual incidence of physician-diagnosed acute upper respiratory infections (J00-J06 according to ICD-10A) among younger school-age children was between 25.1 and 71.3% per school. A significant correlation was found between vanadium concentration and the number of episodes of acute upper respiratory infections during each study year from 2016 to 2020. The lowest was r = 0.67 (p = 0.024), and the highest was r = 0.82 (p = 0.002). The concentration of vanadium in the samples of dust aggregates varied from 12.7 to 52.1 parts per million (ppm). No significant correlations between the other trace elements and the incidence of upper respiratory infections were found, which could be caused by a small number of study schools and relatively low concentrations of other heavy metals found in the samples of indoor dust aggregates. A significant and replicable correlation was found between the concentration of vanadium in the samples of natural dust aggregates collected in primary schools and the incidence of acute upper respiratory infections in children. Monitoring the concentration of heavy metals in the indoor environment can be an important instrument for the prevention and control of respiratory morbidity in children.

Association of symptomatic upper respiratory tract infections with the alteration of the oropharyngeal microbiome in a cohort of school children in Côte d'Ivoire.

The oropharyngeal microbiome plays an important role in protection against infectious agents when in balance. Despite use of vaccines and antibiotic therapy to prevent respiratory tract infections, they remain one of the major causes of mortality and morbidity in Low- and middle-income countries. Hence the need to explore other approaches to prevention by identifying microbial biomarkers that could be leveraged to modify the microbiota in order to enhance protection against pathogenic bacteria. The aim of this study was to analyze the oropharyngeal microbiome (OPM) of schoolchildren in Côte d'Ivoire presenting symptoms of upper respiratory tract infections (URTI) for better prevention strategy. Primary schools' children in Korhogo (n = 37) and Abidjan (n = 39) were followed for six months with monthly oropharyngeal sampling. Clinical diagnostic of URT infection was performed and nucleic acid extracted from oropharyngeal swabs were used for 16S rRNA metagenomic analysis and RT-PCR. The clinical examination of children's throat in Abidjan and Korhogo identified respectively 17 (43.59%) and 15 (40.54%) participants with visible symptoms of URTIs, with 26 episodes of infection in Abidjan and 24 in Korhogo. Carriage of Haemophilus influenzae (12%), Streptococcus pneumoniae (6%) and SARS-CoV-2 (6%) was confirmed by PCR. A significant difference in alpha diversity was found between children colonized by S. pneumoniae and those that were not (p = 0.022). There was also a significant difference in alpha diversity between children colonised with H. influenzae and those who were not (p = 0.017). No significant difference was found for SARS-CoV-2. Sphingomonas, Ralstonia and Rothia were significantly enriched in non-carriers of S. pneumoniae; Actinobacillus was significantly enriched in non-carriers of H. influenzae; Actinobacillus and Porphyromonas were significantly enriched in non-carriers of SARS-CoV-2 (p < 0.001). Nearly 40% of children showed clinical symptoms of infection not related to geographical location. The OPM showed an imbalance during H. influenzae and S. pneumoniae carriage. This study provides a baseline understanding of microbiome markers in URTIs in children for future research, to develop targeted interventions aimed at restoring the microbial balance and reducing the symptoms associated with RTIs.

Snoring, obstructive sleep apnea, and upper respiratory tract infection in elementary school children in Japan.

Both obstructivesleep apnea (OSA)and the common cold are disorders of the upper respiratory tract, and may be associated. However, studies on the association between OSA and upper respiratory tract infections (URTI) in children are scarce. The aim of this study was to investigate possible associations between snoring, the severity of OSA, and URTI in elementary school children. This was a cross-sectional study in a community cohort of elementary school children (first and second graders) in Japan. Information on sleep habits, history of URTI, and OSA risk was obtained from a parental questionnaire. Children underwent overnight tracheal sound recordings from which apnea-hypopnea index was estimated. Multivariable logistic analysis was employed to define the association between snoring, OSA, and URTI ≥ 3 episodes over six months. Of the 922 potential enrollees, 653 children and their parents (71%)agreed to participate in the study. Multivariable-adjusted ORs for URTI were 1.73 (95%CI: 1.16 to 2.59) in children who snored 1 to 4 nights per week and 2.82 (95%CI: 1.26 to 6.28) in snoring ≥ 5 nights per week compared with never snoring (reference). Likewise, subjectively reported louder snoring, as well as objectively defined louder sound levels, were significantly associated with URTI. In addition, OR for URTI in children with an estimated apnea-hypopnea index ≥ 2.0 events/hour was 2.65 (95%CI: 1.32 to 5.31) compared to children with apnea-hypopnea index less than 1.0 events/hour (reference). Snoring and severity of OSA as measured by nocturnal tracheal sound recordings were associated with increased susceptibility to URTI in elementary school children.

Pharmacological management of upper respiratory tract infections in children: An assessment of a tertiary institution practice in Nigeria

Objectives: Upper respiratory tract infections (URTIs) are the most common acute RTIs that occur in children. Therapy addressing symptoms is recommended for URTI management. The use of antibiotics without culture and sensitivity tests is a risk factor for antimicrobial resistance. Materials and Methods: This study was set to assess the pharmacological management of URTIs in children from a tertiary institution practice. This study was conducted in Alex Ekwueme Federal University Teaching Hospital, Abakaliki Ebonyi State, Nigeria. It was a retrospective review of 275 prescriptions of medicines for URTIs in children, from January to December 2021. A systematic sampling technique was used to collect data. Data were analyzed using the Statistical Package for the Social Sciences version 28.0. Results: Of the 275 sampled URTI cases, 157 (57.1%) occurred in male children. No laboratory test was conducted for 265 (96.4%) cases. The majority (207; 75.3%) were diagnosed as non-specific URTI. Other diagnoses include tonsillitis (46; 16.7%), otitis media (8; 2.9%), and rhinitis (6; 2.2%) among others. Antibiotics were the most prescribed medications, (212; 77.1%) followed by antihistamines, (110; 40.0%), vitamins (75; 27.3%), and antimalarials (55; 20.0%). The most prescribed antibiotic was amoxicillin-clavulanic acid (79; 28.7%). There was no statistically significant association between the age category of children and the number of medicines prescribed, whether antibiotics were prescribed, and the number of antibiotics prescribed (P &gt; 0.05). Conclusion: Antibiotics were the mainstay for the management of URTIs in the study center. This mode of therapy could lead to antimicrobial resistance since culture and sensitivity tests were not done before the initiation of antibiotic therapy.

Üniversite Hastanesine Başvuran Çocuklarda COVID-19 Pandemisi İlaç Dışı Müdahalelerin Üst Solunum Yolu Enfeksiyonlarına Etkisi

Aim: To determine effects of non-pharmaceutical COVID-19 precaution measures on the frequency of upper respiratory tract infection (URTI) in children aged 6-18. Materials And Methods: The research is of cross-sectional type. The sample size was calculated as 316 people. The participation rate is 84.81% (n= 268). The dependent variable of the study is URTI in the last year; The independent variables are sociodemographic characteristics, characteristics related to URTI, and measures taken regarding the COVID-19 pandemic. The data were collected from the people who applied to the university hospital pediatrics polyclinic. Results: The frequency of URTI in children in the study group in the last year is 36.6% and compared to the pre-pandemic period, the frequency of URTI has decreased by 71.3%. Previous history of hospitalization for any reason increases the status of having URTI in the last year by 1.9 times (95% CI 1.1- 3.3); mask usage in the child being rarely/occasionally increases the status of having URTI in the last year by 2.7 times (95% CI 1.2-6.1), mask usage never increasing status of having URTI in last one year by 6 times (%95 CI 1.5-23.8) increase. Conclusion: Compared to the pre-pandemic period, the frequancy of URTI in children decreased by 71.3% according to the data received from parents. In the study,it was determined that using only the masks from the public health measures applied during the COVID-19 pandemic was effective in reducing the frequency of upper respiratory tract infection and that the use of masks in the community, especially in children, should be encouraged. Children with a history of hospitalization should be provided with masks in public areas.

The Interactive Effects between Drought and Air Pollutants on Children's Upper Respiratory Tract Infection: A Time-Series Analysis in Gansu, China.

As a destructive and economic disaster in the world, drought shows an increasing trend under the continuous global climate change and adverse health effects have been reported. The interactive effects between drought and air pollutants, which may also be harmful to respiratory systems, remain to be discussed. We built the generalized additive model (GAM) and distributed lag nonlinear model (DLNM) to estimate the effects of drought and air pollutants on daily upper respiratory infections (URTI) outpatient visits among children under 6 in three cities of Gansu province. The Standardized Precipitation Index (SPI) based on monthly precipitation (SPI-1) was used as an indicator of drought. A non-stratified model was established to explore the interaction effect of SPI-1 and air pollutants. We illustrated the number of daily pediatric URTI outpatient visits increased with the decrease in SPI-1. The interactive effects between air pollutants and the number of daily pediatric URTIs were significant. According to the non-stratified model, we revealed highly polluted and drought environments had the most significant impact on URTI in children. The occurrence of drought and air pollutants increased URTI in children and exhibited a significant interactive effect.

A Meta-Analysis of the Effectiveness of Vitamin C in the Prevention and Treatment of Childhood Upper Respiratory Tract Infections

Background: The effectiveness of vitamin C in the prevention and treatment of pediatric upper respiratory tract infections was evaluated in a meta-analysis. Methods: A total 2,573 children with upper respiratory tract infections were included in the meta-analysis, 1,280 of whom received vitamin C and 1,293 who received control medication. The analysis of findings related to the studies included was done through random or fixed effects model to determine whether vitamin C supplementation could stop and control upper respiratory tract infections in children using mean difference (MD) with 95% confidence intervals (CIs). Results: On average, vitamin C-treated children had fewer upper respiratory tract infection bouts, their illness lasted shorter (MD -0.84; 95% CI -1.47 to -0.20, P = 0.009), and they were less contagious than the control. Conclusions: The number of episodes and illness duration of upper respiratory tract-infected pediatric subjects were considerably reduced in the intervention group (vitamin C) compared to the control. Due to the small sample size in four of 11 studies and the limited number of studies included for comparison, the outcomes should be carefully examined.

The effect of echinacea in the prevention of upper respiratory infections in children with acute lymphoblastic leukemia

Background: The efficacy of echinacea products to treat upper respiratory tract infections (URTI) has been shown in some studies, however, there are few studies considering the efficacy of echinacea to prevent URTI. Therefore this study aimed to assess the effect of echinacea in the prevention of URTI in these children.&#x0D; Materiala and Methods: This retrospective cross-sectional study was conducted on 60 children with ALL in Shahid Sadoughi hospital from September 2020 to September 2021. These Children were divided into two groups (n=30). The case group received immunogen syrup, containing echinacea purpura root extract (200 mg/ml). This syrup was prescribed in the intervention group as 2 ml for children in the age range of 2-8 years and 0.5 ml for children in the age range of 1-2 years old for 3 months. The control group did not receive echinacea syrup. These patients were followed for 3 months regarding URTI.&#x0D; Results: The frequency of URTI in the case and control groups was 40% and 66.7%, respectively, and a significant difference was noted between the two groups in terms of the frequency of URTI (P&lt;0.05). Moreover, 23.3% of patients who received echinacea developed a second URTI, while 53.3% of patients who did not receive echinacea developed a second URTI (P&lt;0.05). The mean time for the second URTI in the case and the control groups was 42.3±13.93, and 48.3±13.96 days, respectively (P=0.086). Regarding reducing the duration of URTS symptoms, there was no significant difference between the two groups (P&gt;0.05).&#x0D; Conclusion: According to the results, echinacea can be effective in decreasing the occurrence of URTI in these children. Therefore, regarding the efficacy of echinacea in decreasing URTI, it is recommended to use echinacea in the prevention of URTI.

Bacillus clausii UBBC-07 in the symptom management of upper respiratory tract infections in children: a double blind, placebo-controlled randomised study.

In children, upper respiratory tract infections (URTIs) are one of the most common causes of infections which often require outpatient consultations with the doctor. The purpose of this study was to evaluate the effect of probiotic Bacillus clausii UBBC-07 on symptom management of URTIs in children. In this double blind, randomised, placebo-controlled study, 90 children (age 4-7 years) with URTIs were equally divided into two groups, the probiotic and placebo. The children were instructed to take B. clausii UBBC-07 spores (2×109 per 5 ml vial) or placebo suspension daily twice for three months. The total duration of the study was 6 months, 3 months treatment and 3 months follow-up period. The parameters assessed were the mean number of URTIs, duration and severity of URTIs, absenteeism from school/childcare and immunity parameters, such as immunoglobulin (Ig)M, IgG, IgE and salivary IgA levels. At the end of treatment, there was a significant decrease in the number, duration and severity of URTIs in the probiotic treated group as compared to the baseline and placebo. IgE levels were significantly decreased and salivary IgA levels were significantly increased in the probiotic treated group suggesting probiotic mediated Th1/Th2 immune homeostasis to alleviate URTIs in children. In conclusion, B. clausii UBBC-07 may help in the reduction of symptoms of URTIs. The trial was registered prospectively with the Clinical Trial Registry of India (CTRI Reg. No: CTRI/2018/08/015282).

Antimicrobial Stewardship Strategies Including Point-of-Care Testing (POCT) for Pediatric Patients with Upper-Respiratory-Tract Infections in Primary Care: A Systematic Review of Economic Evaluations.

Upper-respiratory-tract infections (URTIs) are among the main causes of antibiotic prescriptions in pediatric patients. Over one-third of all antibiotic prescriptions for URTIs in children are estimated to be inappropriate, as the majority of URTIs are caused by viral agents. Several strategies, including clinical scoring algorithms and different point-of-care tests (POCTs) have been developed to help discriminate bacterial from viral URTIs in the outpatient clinical setting. A systematic review of the literature was conducted following PRISMA guidelines with the objective of summarizing evidence from health–economic evaluations on the use of POCT for URTIs in pediatric outpatients. A total of 3375 records identified from four databases and other sources were screened, of which 8 met the inclusion criteria. Four studies were classified as being of high reporting quality, and three were of medium quality. Five out of eight studies concluded in favor of strategies that included POCTs, with an additional study finding several POCTs to be cost-effective compared to usual care but over an acceptable WTP threshold. This review found POCT could be a valuable tool for antimicrobial stewardship strategies targeted towards childhood URTIs in primary care.

Economic Evaluation of Using Daily Prednisolone versus Placebo at the Time of an Upper Respiratory Tract Infection for the Management of Children with Steroid-Sensitive Nephrotic Syndrome: A Model-Based Analysis.

BackgroundChildhood steroid-sensitive nephrotic syndrome is a frequently relapsing disease with significant short- and long-term complications, leading to high healthcare costs and reduced quality of life for patients. The majority of relapses are triggered by upper respiratory tract infections (URTIs) and evidence shows that daily low-dose prednisolone at the time of infection may reduce the risk of relapse.ObjectiveThe aim of this study was to assess the cost effectiveness of a 6-day course of low-dose prednisolone at the start of a URTI when compared with placebo.MethodsA state-transition Markov model was developed to conduct a cost-utility analysis with the outcome measured in quality-adjusted life-years (QALYs). Resource use and outcome data were derived from the PREDNOS2 trial. The analysis was performed from a UK National Health Service perspective and the results were extrapolated to adulthood. Model parameter and structural uncertainty were assessed using sensitivity analyses.ResultsThe base-case results showed that administering low-dose prednisolone at the time of a URTI generated more QALYs and a lower mean cost at 1 year compared with placebo. In the long-term, low-dose prednisolone was associated with a cost saving (£176) and increased effectiveness (0.01 QALYs) compared with placebo and thus remained the dominant treatment option. These findings were robust to all sensitivity analyses.ConclusionA 6-day course of low-dose prednisolone at the time of a URTI in children with steroid-sensitive nephrotic syndrome has the potential to reduce healthcare costs and improve quality of life compared with placebo.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-022-00334-6.

Parental Knowledge, Attitudes and Practices on Antibiotics Use for Childhood Upper Respiratory Tract Infections in Kicukiro District, Rwanda

Parents’ attitudes and expectations towards antibiotics use for children’s Upper Respiratory Tract Infections are among major causes of antibiotics misuse and the latter leads to the antimicrobial resistance. Thus, this study aimed at assessing parents’ knowledge, attitude and practices on antibiotics use for childhood URTIs in Kicukiro District. A cross-sectional study was conducted and a questionnaire was used to collect data from a sample size of 384 parents with under 12 years of age attending selected Health Centers in Kicukiro District. (SPPS) version 21 was used for data analysis; Chi-square test and regression analysis were used to examine the association between variables. The study findings indicated that 88.5% of parents were female, 39.6% aged from 25 to 34 years, 81.8% were married, 42.2% completed secondary education, 50% had 2 to 4 children and 57% of them were in economic class 2. The study revealed that 40.4% of parents had low level of knowledge of antibiotics use towards antibiotics use and 62% of them had poor practices regarding antibiotics use for childhood URTIs. Parents with increased level of education, higher economic position, with high knowledge and positive attitude use were more likely to have good practices towards antibiotics use than their corresponding counterparts. In conclusion, parents from Kicukiro District had poor knowledge and poor practices regarding antibiotics use for children’s URTIs. Hence, the study recommended that educational interventions for parents are needed to reduce antibiotics misuse by raising awareness on indications of antibiotics, their side effects and the emergence of antimicrobial resistance.

SERUM LEVEL OF SOME CYTOKINES IN CHILDREN 6-10 YEARS OLD WITH HIGH FREQUENCY OF ACUTE RESPIRATORY INFECTIONS

Objective: improved diagnosis of immune disorders in children aged 6-10 years old, who are often ill od upper respiratory tract infections (URTI), on the basis of these data, further investigation of serum equalities of cytokines, a way of diagnosing with indications in healthy children.&#x0D; Materials and methods. There were 60 children of 6 to 10 years of age, from which 2 groups were formed: 1). children who are often ill with URTI (n=30); 2). children, who do not get sick often URTI (n=30).&#x0D; Results. among children of 6-10 years of age, as often ill with URTI, the frequency of registration of high indications in place of interleukin-6 blood serum (by 53.3%, p&lt;0.05), TNF (by 63.3%, p &lt;0.05) and low indications for interleukin-10 (by 33.3%, p&lt;0.05), it was established that there was a high probability (odds ratio) of an increase serum interleukin-6, TNF and a decrease in interleukin-10 as a reference value, it is associated with the presence of an increased incidence of URTI in children.&#x0D; Conclusion. in children aged 6-10 years, as they often fall ill with URTI, may tend to intensify pro-inflammation of the immune reactions, which still does not ensure a decrease in serious illness on URTI and unsafe side of the development of opportunistic diseases.

Parental Knowledge, Attitudes and Practices on Antibiotics use for Childhood Upper Respiratory Tract Infections in Kicukiro District, Rwanda

Parents’ knowledge and expectations towards antibiotics use for children’s Upper Respiratory Tract Infections are contributing factors of antibiotics misuse and the latter leads to the antimicrobial resistance. Thus, this study aimed at assessing parents’ knowledge, attitudes and practices on antibiotics use for childhood URTIs in Kicukiro District, Rwanda. A cross-sectional study was conducted using a structured questionnaire for data collection from a sample size of 384 parents of under 12 years of age children attending selected Health Centers in Kicukiro District. (SPPS) version 21 was used for data analysis; Chi-square test and regression analysis were used to examine the association between dependent and independent variables. The study findings indicated that 88.5% of parents were female, 39.6% aged from 25 to 34 years, 81.8% were married, 42.2% completed secondary education, 50% had 2 to 4 children and 57% were in economic class 2. Only 23.2% of parents had high level of knowledge of antibiotics; 40.1% had positive attitudes and 62% had poor practices towards antibiotics use for childhood URTIs. Employed parents with increased level of education, in higher economic position demonstrated good practices towards antibiotics use. Parents’ high level of knowledge and positive attitudes regarding antibiotics use had also good practices on antibiotics with AOR=13.371, 95% CI= [3.604-49.617], p&lt;0.001, and AOR=0.309, 95% CI=[0.96-0.489], p&lt;0.001 respectively, compared to their corresponding counterparts. In conclusion, majority of parents in Kicukiro District had low level of knowledge of antibiotic use, negative attitudes towards antibiotic use and poor practices towards antibiotics utilization for childhood URTIs. Factors associated with good parental practices towards ABs use for children’s URTIs include having 5 or more children, higher education, employment, high economic class, high knowledge of antibiotics and positive attitudes towards ABs use. Health education for parents should be urgently done to reduce antibiotics misuse by raising awareness on their indications of antibiotics, side effects and the emergence of antimicrobial resistance. Keywords: Antibiotics, Attitudes and Knowledge, Children, Misuse, Parents, Kicukiro District, Rwanda

KNOWLEDGE, ATTITUDE, AND PRACTICE OF PARENTS REGARDING ANTIBIOTIC USAGE IN TREATING CHILDRENS UPPER RESPIRATORY TRACT INFECTION ATTENDING PRIMARY HEALTH CARE CENTERS IN AL-MADINAH CITY

Background: Upper respiratory tract infections are common in children and represent a significant cause of antibiotic abuse. Parents knowledge and attitudes often contribute to inappropriate prescription of antibiotics and promoting antibiotics resistance. Aims and objectives: This study was conducted to assess parental knowledge and to identify their attitudes and practices related to antibiotic use in the treatment of childhood upper respiratory tract infections (URTIs). Methods: This cross‐sectional study is conducted in Al-Madinahcity using validated and translated questionnaire which was distributed toattending parents in primary health care centers. Results: The results show that the Parents have moderate level of knowledge of the use of antibiotics for upper respiratory tract infections in children. The majorityof parents (50.9%) correctly sated that respiratory infections are often caused by a virus and do not need antibiotics. In this study, the majority of parents (40.1%) sated that Antibiotics should be given to all children when they develop a fever (high temperature). 21.4% of the of parents indicate that Antibiotics do not have any side effects. Regard to Parents practice toward the use of antibiotics for upper respiratory tract infections in children. The results of this study showed that (46.3%) 0f therespondents stated the most common symptoms leading to a visit to the physician is fever. n this study, (64.7%) of the of parents indicate that they thought that their physiciansprescribed antibiotics only because they asked him or her to do so. Also, (68.9%) of the of parents indicated that they asked the doctor directly to prescribe their child an antibiotic. Regard to Parents attitude about the use of antibiotics for upper respiratory tract infections in children. The results of this study showed that moderate level of attitudeof the use of antibiotics for upper respiratory tract infections in children(61.7%) of the parents stated that antibiotics are used too much and unnecessarily, And (28.8%) of the parents indicated that they would change pediatrician because he/she did not prescribe antibiotics for their child as you wanted. Conclusion:the findings of this study demonstrated that most of the participants were educated but misconceptions regarding antibiotic use in URTIs in children. This misconceptions led to inappropriate attitude and practice. Thus, launching public educational campaigns and encouraging physicians to educate parents regarding the proper use of antibiotics are recommended.

HUBUNGAN STATUS GIZI DENGAN KEJADIAN ISPA PADA BALITA DI PUSKESMAS TOMPASO KABUPATEN MINAHASA

Backgropund: Developmental problems in children in Indonesia and in developing countries are generally caused by two things, namely poor nutritional conditions and infectious diseases. The high number of Upper Respiratory Tract Infection (URTI) is caused by one of the factors that must also be known by the public is the nutritional status including malnutrition. Aime: This study aims to find the correlation between of nutritional status with the incidence of ispa in toddlers in the tompaso health center of minahasa regency. Method: This research used quantitative with a cross sectional approach. Sampling in this study using the Purposive Sampling method obtained the number of samples as many as 62 respondents. The study was conducted by calcilating of z-score nutritional status of toddlers according to WHO and according to health professional assesment. The data analyzed using the Chi-square test. Results: The results of the study based on the characteristics of nutritional status obtained 30 toddlers have good nutritional status, 12 toddlers were over-nourished , 11 toddlers were obese, and 9 toddlers were malnourished. Then, there were 32 toddlers who were experiencing URTI and there were 30 toddlers who did not or had previously experienced URTI. Data analysis showed p = 0.003 &lt; = 0.05. Conclusion: this study concluded there was a relationship between nutritional status and the incidence of URTI in children under five at the Tompaso Public Health Center, Minahasa Regency.Keywords: Nutritional Status; Upper Respiratory Tract Infection; Toddler.

EFFICACY AND SAFETY OF CANDELABRA ALOE EXTRACT (ALOE ARBORESCENS MILL.) IN PREVENTION AND TREATMENT OF UPPER RESPIRATORY TRACT INFECTIONS OF VARIOUS AETIOLOGIES.

The aim: To evaluate therapeutic effects of a product containing Aloe arborescens extract (AA) as the active substance in children aged 3-18 years with a diagnosed viral or bacterial upper respiratory tract infection and to assess their carers' satisfaction with the use of the product. The above-mentioned product is also indicated to control the loss of appetite. Thus, the study also assessed the effect of AA on this parameter. Materials and methods: A total of 6764 patients (children aged 3-18 years) were included in the study, which was conducted by 279 paediatrics and family medicine specialists (or being in the course of specialisation) from 237 centres. The efficacy was evaluated of the basis of reduction of upper respiratory tract infections (URIs) symptoms between the first and second visits with the application of the chi-square test. Results: The most common primary diagnoses for which AA was used were common colds and recurrent acute URIs of viral aetiology. Symptoms reduction or resolution were reported in over: 81% of children with sore throat and/or hoarseness, 72% of children with earache, 64% of children with nasal discharge and/or the feeling of congested nose, 63% of children with cough, 89% of children with fever and 82% of children with sleep disturbances. Improvement in appetite was achieved in more than 66% of children. Almost 60% of the paediatric patients or their carers included in the study group were very satisfied with the efficacy of AA. More than 66% of carers were very satisfied with the dosing regimen and the vast majority of them (99%) would recommend the preparation to others. Two children demonstrated adverse effects (diarrhoea, abdominal pain) that were induced by application of the studied product. They resolved after its discontinuation. Conclusions: AA applied in treatment of URIs in children highly effectively reduces symptoms of the diseases. Paediatric patients and their carers are satisfied with therapeutic effects of the syrup with regards to its all indications.

Lacticaseibacillus rhamnosus GG DSM 33156 effects on pathogen defence in the upper respiratory tract: a randomised, double-blind, placebo-controlled paediatric trial.

Acute upper respiratory tract infections (URTIs) are caused by numerous viruses and bacteria. URTIs can be a cause of morbidity and are among the most common reasons for visiting healthcare practitioners and prescribing antibiotics to children in addition to causing absenteeism from school and work. Oral intake of Lacticaseibacillus rhamnosus GG DSM 33156 has shown beneficial health effects in several clinical trials, primarily relating to immune function and gastrointestinal health in children and adults. It has also been suggested that oral intake of L. rhamnosus GG DSM 33156 can reduce the incidence rate and alleviate symptoms of URTIs in children. We here report the results of a randomised, double-blind, placebo-controlled trial of 619 children aged 2-6 years conducted at a single centre in Scotland. The children, who were in day care or primary school, were followed over a 16-week intervention period with 309 randomised in the active group and 310 in the placebo group. The parents or guardians reported a daily healthcare status and any presumed episodes of URTI, which were subsequently confirmed by a general practitioner. The investigational product was well tolerated in the trial. Although a general trend towards a beneficial effect was observed, this trial did not demonstrate that L. rhamnosus GG DSM 33156 significantly reduced the incidence of URTIs, diagnosed by a general practitioner according to prespecified criteria (primary endpoint). Moreover, none of the secondary efficacy endpoints were met. Applying a Ward's hierarchical clustering, two separate clusters, focussing on four quality of life-related endpoints, were identified. Cluster 1 was associated with more severe URTI characteristics than cluster 2. Cluster 2 was significantly enriched with children who consumed the product, indicating that the symptoms children experience during an URTI are alleviated by the intake of L. rhamnosus GG DSM 33156. The study is registered at ClinicalTrials.gov ID: NCT03636191.

The Role of the Moraxella catarrhalis CopB Protein in Facilitating Iron Acquisition From Human Transferrin and Lactoferrin.

Moraxella catarrhalis is a Gram-negative bacterium that is responsible for a substantial proportion of upper respiratory infections in children and lower respiratory infections in the elderly. Moraxella catarrhalis resides exclusively on the mucosal surfaces of the upper respiratory tract of humans and is capable of directly acquiring iron for growth from the host glycoproteins human transferrin (hTf) and human lactoferrin (hLf). The iron-bound form of these glycoproteins is initially captured by the surface lipoproteins Tf or Lf binding protein B (TbpB or LbpB) and delivered to the integral outer membrane TonB-dependent transport (TBDT) proteins, Tf binding protein A (TbpA) or Lf binding protein A (LbpA). The extraction of iron involves conformational changes in Lf and Tf to facilitate iron removal followed by its transport across the outer membrane by a well characterized process for TBDTs. Surprisingly the disruption of the gene encoding another TBDT, CopB, results in a reduction in the ability to grow on human Tf or Lf. The possibility that this could have been due to an artifact of mutant construction that resulted in the inhibition of TonB-mediated process was eliminated by a complete deletion of the CopB gene. A systematic evaluation of the impact on growth under various conditions by deletions of the genes encoding TbpA, LbpA, and CopB as well as mutations of the iron liganding residues and TonB box region of CopB was implemented. The results indicate that although CopB is capable of effectively acquiring iron from the growth medium, it does not directly acquire iron from Tf or Lf. We propose that the indirect effect on iron transport from Tf and Lf by CopB could possibly be explained by the association of TBDTs at gaps in the peptidoglycan layer that may enhance the efficiency of the process. This concept is supported by previous studies demonstrating an indirect effect on growth of Tf and Lf by deletion of the peptidoglycan binding outer membrane lipoprotein RmpM in Neisseria that also reduced the formation of larger complexes of TBDTs.