Common Respiratory Infections Research Articles

Genotypic diversity, virulence, and molecular genetic tools in Histoplasma.

SUMMARYHistoplasmosis is arguably the most common fungal respiratory infection worldwide, with hundreds of thousands of new infections occurring annually in the United States alone. The infection can progress in the lung or disseminate to visceral organs and can be difficult to treat with antifungal drugs. Histoplasma, the causative agent of the disease, is a pathogenic fungus that causes life-threatening lung infections and is globally distributed. The fungus has the ability to germinate from conidia into either hyphal (mold) or yeast form, depending on the environmental temperature. This transition also regulates virulence. Histoplasma and histoplasmosis have been classified as being of emergent importance, and in 2022, the World Health Organization included Histoplasma as 1 of the 19 most concerning human fungal pathogens. In this review, we synthesize the current understanding of the ecological niche, evolutionary history, and virulence strategies of Histoplasma. We also describe general patterns of the symptomatology and epidemiology of histoplasmosis. We underscore areas where research is sorely needed and highlight research avenues that have been productive.

A Retrospective Study on Effectiveness of Antimonium Tartaricum 200 for Respiratory Complaints in Paediatric Age Group

Common upper respiratory tract infections in children are Nasopharyngitis (common cold), Acute tonsillopharyngitis (sore throat) and common lower respiratory tract infections epiglottitis, laryngitis, larygotracheo bronchitis, spasmodic laryngitis, Pneumonia, Bronchiolitis, Bronchial asthma etc. Aim: The study’s objectives are to highlight the incidence of respiratory in kids and identify the effectiveness of Antimonium tartaricum 200 for respiratory complaints in paediatric age group.

Increase in acute mastoiditis at the end of the COVID-19 pandemic.

Common respiratory infections were significantly reduced during the COVID-19 pandemic due to general protective and hygiene measures. The gradual withdrawal of these non-pharmaceutical interventions (NPI) was associated with a notable increase in these infections, particularly in pediatric and adult otorhinolaryngology. The aim of this retrospective monocentric study was to evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM). Pre-pandemic clinical data of AM cases from 2011 to 2019 were compared with infection counts from January 2020 to June 2023 for seasonal periodicity, age-specific differences, pathogens, and complication rates in a German third-level hospital. Out of 196 patients with AM 133 were children, the majority between 1 and 5years of age. Complications of AM, such as meningitis, brain abscess, and sinus vein thrombosis, were more common in adults (87%) than in children (17%). Morbidity and mortality rates were similar before, during and after the pandemic. Pneumococci were the most common pathogen in both age groups, with a post-pandemic cumulation of Streptococcus pyogenes infections in children. While pre-pandemic cases clustered in spring, seasonality was absent in all age groups during the main phase of the pandemic. The cessation of NPI caused a steep rise in AM cases in both age groups starting from December 2022. NPI during the COVID-19 pandemic reduced the incidence of AM. Their reversal led to a substantial increase in the incidence of AM during the post-pandemic period, which may be due to a general increase in viral respiratory infections and an insufficiently trained immune system.

Epidemic Features and Megagenomic Analysis of Childhood Mycoplasma Pneumoniae post COVID-19 Pandemic: A 6-year Study in Southern China

ABSTRACT With the atypical rise of Mycoplasma pneumoniae infection (MPI) in 2023, prompt studies are needed to determine the current epidemic features and risk factors with emerging trends of MPI to furnish a framework for subsequent investigations. This multicentre, retrospective study was designed to analyse the epidemic patterns of MPI before and after the COVID-19 pandemic, as well as genotypes and the macrolide resistance-associated mutations in MP sampled from pediatric patients in Southern China. Clinical data was collected from 133674 patients admitted into investigational hospitals from June 1, 2017, to November 30, 2023. Metagenomic next-generation sequencing (mNGS) data were retrieved based on MP sequence positive samples from 299 pediatric patients for macrolide resistance-associated mutations analysis. Pearson’s chi-squared test was used to compare categorical variables between different time frames. The monthly average cases of pediatric common respiratory infection diseases were increased without enhanced public health measures after the pandemic, especially for influenza, respiratory syncytial virus infection, and MPI. The contribution of MPI to pneumoniae was similar to that in the outbreak in 2019. Compared mNGS data between 2019-2022 and 2023, the severity of MP did not grow stronger despite higher rates of macrolide-resistance hypervariable sites, including loci 2063 and 2064, were detected in childhood MP samples of 2023. Our findings indicated ongoing surveillance is necessary to understand the impact of post pandemic on MP transmission disruption on epidemic season and severity of clinical outcomes in different scenarios.

The Role of Human Mobility Flow in the Region-to-Region Spread of Respiratory Syncytial Virus Infection among Infants: An Infographic Analysis.

The region-to-region spread of human infectious diseases is considered to be dependent on the human mobility flow (HMF). However, it has been hard to obtain the evidence for this. Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in Japan 2020, the government has enforced countermeasures against COVID-19 nationwide, namely the restriction of personal travelling, universal masking, and hand hygiene. As a result, the spread of acute respiratory infections had been effectively controlled. However, COVID-19 as well as pediatric respiratory syncytial virus (RSV) infections were not well-controlled. The region-to-region spread of pediatric RSV infections in 2020-2021 was recognizable unlike those in 2018 and 2019. In this study, we investigated the correlation between the trend of regional reports of the pediatric RSV infections and the HMF based on cellular phone signal data. Upon closer examination of both epidemiological trend and HMF data, the spread of pediatric RSV infection from one region to another was logically explained by HMF, which would serve as the evidence of the dependence of regional transmission on HMF. This is the first solid evidence where this correlation has been clearly observed for the common respiratory infections. While social implementation of infection control measures has successfully suppressed the droplet-mediated respiratory infections, such as influenza, but not the airborne infections, it was suggested that the aerosol transmission and adult asymptomatic carrier were involved in the transmission of RSV akin to COVID-19.

An RNA-hydrolyzing recombinant minibody prevents both influenza A virus and coronavirus in co-infection models

With the lifting of COVID-19 non-pharmaceutical interventions, the resurgence of common viral respiratory infections was recorded in several countries worldwide. It facilitates viral co-infection, further burdens the already over-stretched healthcare systems. Racing to find co-infection-associated efficacy therapeutic agents need to be rapidly established. However, it has encountered numerous challenges that necessitate careful investigation. Here, we introduce a potential recombinant minibody-associated treatment, 3D8 single chain variable fragment (scFv), which has been developed as a broad-spectrum antiviral drug that acts via its nucleic acid catalytic and cell penetration abilities. In this research, we demonstrated that 3D8 scFv exerted antiviral activity simultaneously against both influenza A viruses (IAVs) and coronaviruses in three established co-infection models comprising two types of coronaviruses [beta coronavirus—human coronavirus OC43 (hCoV-OC43) and alpha coronavirus—porcine epidemic diarrhea virus (PEDV)] in Vero E6 cells, two IAVs [A/Puerto Rico/8/1934 H1N1 (H1N1/PR8) and A/X-31 (H3N2/X-31)] in MDCK cells, and a combination of coronavirus and IAV (hCoV-OC43 and adapted-H1N1) in Vero E6 cells by a statistically significant reduction in viral gene expression, proteins level, and approximately around 85%, 65%, and 80% of the progeny of ‘hCoV-OC43–PEDV’, ‘H1N1/PR8–H3N2/X-31’, and ‘hCoV-OC43–adapted-H1N1’, respectively, were decimated in the presence of 3D8 scFv. Taken together, we propose that 3D8 scFv is a promising broad-spectrum drug for treatment against RNA viruses in co-infection.

Allergia agli antibiotici beta-lattamici: i miti da sfatare e le azioni pratiche da adottare

The penicillins (amoxicillin) are among the most effective and safe antibiotics for many common bacterial respiratory infections in paediatric age and should be avoided only when a true allergy is highly suspected. Severe true antibiotic allergies are rare and allergies are often overestimated. In high-income countries, 5-15% of patients report a penicillin allergy. However, in most cases (> 95%), these patients do not have a true immunologically mediated allergy and they may very likely tolerate the antibiotic upon a new exposure. All patients defined as allergic should be carefully evaluated and their levels of antibiotic allergy risk determined. In cases of suspected penicillin allergy (e.g. those with cutaneous manifestations), skin tests are not necessary before prescribing a beta-lactam antibiotic (amoxicillin) and direct oral administration can be performed in low-risk phenotypes carefully selected according to simple protocols that do not always require a specialist evaluation. The article, based on the recommendations of the WHO Aware Manual, provides current evidence and practical guidance, and fosters a correct interpretation and management of an overestimated problem that does not promote an optimal and judicious antibiotic use.

Bacteria and viruses and their role in the preschool wheeze to asthma transition.

Wheezing is the cardinal symptom of asthma; its presence early in life, mostly caused by viral infections, is a major risk factor for the establishment of persistent or recurrent disease. Early-life wheezing and asthma exacerbations are triggered by common respiratory viruses, mainly rhinoviruses (RV), and to a lesser extent, respiratory syncytial virus, parainfluenza, human metapneumovirus, coronaviruses, adenoviruses, influenza, and bocavirus. The excess presence of bacteria, several of which are part of the microbiome, has also been identified in association with wheezing and acute asthma exacerbations, including haemophilus influenza, streptococcus pneumoniae, moraxella catarrhalis, mycoplasma pneumoniae, and chlamydophila pneumonia. While it is not clear when asthma starts, its characteristics develop over time. Airway remodeling already appears between the ages of 1 and 3 years of age even prior to the presence of atopic inflammation or an asthma diagnosis. The role of genetic defect or variations hampering the airway epithelium in response to environmental stimuli and severe disease morbidity are now considered as major determinants for early structural changes. Repeated viral infections can induce and perpetuate airway hyperresponsiveness. Allergic sensitization, that often precedes infection-induced wheezing, shifts inflammation toward type-2, while common respiratory infections themselves promote type-2 inflammation. Nevertheless, most children who wheeze with viral infections during infancy and during preschool years do not develop persistent asthma. Multiple factors, including illness severity, viral etiology, allergic sensitization, and the exposome, are associated with disease persistence. Here, we summarize current knowledge and developments in infection epidemiology of asthma in children, describing the known impact of each individual agent and mechanisms of transition from recurrent wheeze to asthma.

Lemierre’s syndrome – case report

Introduction: Lemierre’s syndrome or Lemierre’s disease is sepsis caused by tonsillitis. This is a rare disease that occurs during or after pharyngitis, connected with inflammation of the internal jugular vein and subsequent embolic abscesses in the lungs or viscera. It is most common in teenagers and young adults. The incidence of Lemierre’s syndrome is unknown but it is estimated at 1–2.5 cases per million people per year. The most common pathogen responsible for the disease is Fusobacterium necrophorum – from the name of this bacterium, the syndrome is also called necrobacillosis. Before the era of antibiotics, which began in the 1940s with the introduction of penicillin, Lemierre’s syndrome was more common and usually resulted in death after a few weeks. Over time, it became a „forgotten disease”, but nowadays, with the reduction of antibiotic therapy in common upper respiratory tract infections in young adults, the incidence of this syndrome is increasing again. Case report: In this study, the authors present the case of a 44-year-old man who was hospitalized due to life-threatening complications resulting from pharyngitis that had not been treated for about a week. Despite prompt treatment, subsequent complications could not be avoided. Ultimately the patient was saved. Conclusions: The occurrence of Lemierre’s syndrome is associated with a mortality rate of approximately 5–18%, but without proper diagnosis, the mortality rate is much higher. Although this disease is rare, it is worth remembering it, especially in young adults after a throat infection, with neck pain and pulmonary symptoms (abscesses, infiltrates in the lung parenchyma, pleural effusion).

The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection in the Neonatal Period.

Respiratory syncytial virus (RSV) is the most common viral respiratory infection in infants. This study aimed to establish the potential changes in the clinical course of RSV in the neonatal period with the onset of the coronavirus disease 2019(COVID-19) pandemic. During the observational study period, newborns diagnosed with community-acquired RSV infection and admitted to the neonatal intensive care unit (NICU) were evaluated. RSV-infected neonates before the COVID-19 pandemic were classified as Group 1, those during the strict isolation period as Group 2, and RSV-infected newborns after the removal of restrictions were classified as Group 3. A total of 208 community-acquired RSV-infected neonates were analyzed. The median age at admission to the NICU was 26 days, and the mean gestational week was 37.2 ± 2.7. The ratio of hospitalized babies with RSV infection to all hospitalized newborns rose after the pandemic significantly (1.9, 1.6, 5.2%; p < 0.001). Following the pandemic, there was an increase in full-term, early-term, and late-preterm cases. Nevertheless, no change was observed in the number of preterm cases (p > 0.05). There was also a statistically significant increase in the need for intubation, noninvasive ventilation (NIV), supplemental oxygen, inhaled bronchodilator drugs, and length of hospital stay in Group 3 after the pandemic (p < 0.001). All these parameters related to more severe RSV infection when the precautions were removed, while there was a milder disease with restrictions during the pandemic in Group 2 (p < 0.001). However, none died due to RSV infection during the study because of timely supportive care. Following the COVID-19 pandemic, the frequency and severity of RSV infection in newborns have increased, and it can result in a serious clinical picture even in full-term babies with no comorbidities. Attention to strict contact precautions, particularly in newborns, who are a more vulnerable population after the pandemic, may play an important role in any future outbreak. · The course of neonatal RSV infection has changed after the pandemic.. · A statistically significant increase was observed in the need of intubation in newborns with RSV.. · The strict precautions during the pandemic also helped to prevent the transmission of RSV..

Long COVID Definition, Symptoms, Risk Factors, Epidemiology and Autoimmunity: A Narrative Review

The virus called SARS-CoV-2 emerged in 2019 and quickly spread worldwide, causing COVID-19. It has greatly impacted on everyday life, healthcare systems, and the global economy. In order to save as many lives as possible, precautions such as social distancing, quarantine, and testing policies were implemented, and effective vaccines were developed. A growing amount of data collected worldwide allowed the characterization of this new disease, which turned out to be more complex than other common respiratory tract infections. An increasing number of convalescents presented with a variety of nonspecific symptoms emerging after the acute infection. This possible new global health problem was identified and labelled as long COVID. Since then, a great effort has been made by clinicians and the scientific community to understand the underlying mechanisms and to develop preventive measures and effective treatment. The role of autoimmunity induced by SARS-CoV-2 infection in the development of long COVID is discussed in this review. We aim to deliver a description of several conditions with an autoimmune background observed in COVID-19 convalescents, including Guillain-Barré syndrome, antiphospholipid syndrome and related thrombosis, and Kawasaki disease highlighting a relationship between SARS-CoV-2 infection and the development of autoimmunity. However, further studies are required to determine its true clinical significance.

Epidemiological shifts in bronchiolitis patterns and impact of the COVID-19: A two-season comparative study.

Bronchiolitis is a common lower respiratory tract infection (LRTI) affecting infants and young children. Respiratory syncytial virus (RSV) has historically been the primary causative agent, but other viruses also contribute to the LRTI epidemiology. Recent changes in epidemiology and clinical patterns due to the coronavirus disease 2019 (COVID-19) pandemic have raised concerns. This study aims to analyze the impact of the pandemic on bronchiolitis epidemiology and severity. Two consecutive bronchiolitis seasons (October 2021 to March 2022 and October 2022 to March 2023) were compared. Data on viral agents, hospitalization duration, clinical severity, and respiratory support requirements were collected from pediatric patients at San Marco Hospital, University of Catania. In the 2021-2022 season, RSV was the predominant virus (40%), followed by other viruses, with mild clinical outcomes. In the 2022-2023 season, RSV remained prevalent (58.7%), but other viruses, including rhinovirus (RV) and influenza, showed a significant increase (p < .05) in bronchiolitis cases and severity. Notably, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season, contrary to the previous year. The COVID-19 pandemic appears to have shifted the epidemiological landscape of bronchiolitis, with a peak incidence in November instead of January/February. Non-RSV viruses (RV, influenza A and B, as well as metapneumovirus) have gained prominence, possibly due to viral competition and reduced pandemic-related restrictions. Traditionally, RSV has been the primary pathogen responsible for most bronchiolitis cases. Nonetheless, the findings of this study indicate a shifting landscape in bronchiolitis etiology, with RSV gradually diminishing in its role. Contrary to the previous year, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season.

Improving the antibiotic duration of therapy with the implementation of antimicrobial lanyard cards and education in a regional hospital

AbstractBackgroundThere is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.AimThe project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.MethodA retrospective pre‐ and post‐implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.ResultsFor all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).ConclusionThe introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.

Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand.

New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years. We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions. We observed that border closure to most people, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type-1. Partial border relaxations through quarantine-free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022. Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.

Understanding the use and outcomes of high-flow nasal cannula among infants admitted to Canadian hospitals with bronchiolitis (CanFLO): a protocol for a multicentre, retrospective cohort study

IntroductionBronchiolitis is the most common viral lower respiratory tract infection in children under 2 years of age. Respiratory support with high-flow nasal cannula (HFNC) is increasingly used in this patient...

Mumps treatment by quacks in Pakistan: A neglected danger to public health.

Dear Editor, In this letter, we aim to draw attention to mumps treatment through pseudo therapies by quacks in Pakistan. Our goal is to raise awareness and promote the prevention of mistreatment. Pakistan has seen an unprecedented rise in mumps outbreaks after the COVID-19 pandemic. From 1 January to 31 December 2022, a total of 19,444 mumps cases had been recorded from all provinces of the country. [1] Mumps is a common childhood respiratory infection caused by a paramyxovirus. It can be transmitted through direct contact and droplet spread. Symptoms include swelling of the parotid gland, which occurs in 60-70% of infections and 95% of patients with symptoms. [2] The swelling progresses over 2-3 days and persists for about a week. Sometimes mumps can lead to later complications such as epididymal-orchitis, oophoritis, meningitis, encephalitis, thyroiditis, unilateral deafness, spontaneous abortion, pancreatitis or infertility. Mumps is benign, resolving on its own, requiring only symptomatic relief by proven medical therapies. [3] Unfortunately, in Pakistan, especially in rural areas, people seek pseudo therapies for various diseases including Mumps from quacks which are found in a significant number of over 600,000 in the country. [4] The harmful effects of such malpractices include abandonment and delays in effective medical treatment, emergence of complications, psychological-physical traumas, and financial burden. [5] For treating Mumps, these mal practitioners offer the "massage" of the parotid gland, which involves rotating the index finger from the centre of the gland towards the outside while blowing on the patient's face. [6] These methods are not scientifically proven and may even be harmful. According to a study, non-medical interventions like acupuncture have also proved to be futile and of no advantage. [7] People often attribute the recovery to the quack's treatment, increasing their trust in these practitioners and propagation of false beliefs. These quacks often charge significant amounts of money, further exploiting their patients. We urge physicians, public health workers and the general public to prioritise the prevention and control of mumps outbreaks. This will require proactive education to address the misinformation surrounding mumps and quack treatments. Furthermore, research is needed to determine the frequency of mumps complications later in life, which may be associated with these ongoing practices for many years. Finally, the government should take stern action against quack practitioners, and the public needs to be better informed about the harms. ---Continue

BI-LAMINATED ORAL DISINTEGRATING FILM FOR SYMPTOMATIC TREATMENT OF VIRAL NASOPHARYNGITIS: FORMULATION, CHARACTERIZATION, TASTE MASKING, AND STABILITY STUDIES

Objective: Nasopharyngitis (NP) is one of the most common upper respiratory tract infections (URTIs) brought on by viral infections and requires symptomatic treatment. In this study, a new approach to delivering drugs was developed, which is a bi-laminated oral disintegrating film (ODF) containing dextromethorphan hydrobromide (DEX), phenylephrine hydrochloride (PE), and methylcobalamin (MeCbl) to support the symptomatic treatment of NP. Yet, the extreme bitterness of DEX and PE required a taste-masking technique before ODF formulation to enhance patient compliance. Methods: Various complexing agents were tried at different ratios to mask the bitter taste of the drug(s). DEX-PE ODFs were formulated using the solvent casting procedure. A 31.21 full factorial design was performed to characterize DEX-PE ODFs, where the effects of polymer grade and plasticizer type were evaluated on the disintegration time (DT) and the percentage of drugs released after 10 min (Q10). Results: Complexation with maltodextrin (MD) and ion exchange resin (Kyron T-314) could successfully mask the bitter taste at a ratio of 1:2:2 of drugs, MD, and Kyron T-314, respectively. The ODF optimized formula (F4) recorded the least DT (5±0.5 s) and highest Q10 (96.7±2.1%) and (97.4±1.9%) for DEX and PE, respectively. F4 was then combined with the second film layer containing MeCbl to develop the bi-laminated ODF (B1), which was later evaluated and subjected to stability studies. Conclusion: In conclusion, a taste-masked, bi-laminated ODF could be successfully developed for the symptomatic treatment of NP.

Prevalence and Outpatient Clinical Diagnostic Approaches for Common Acute Respiratory Tract Infections in Children Under Five Years of Age: A Cross-Sectional Study.

Acute respiratory tract infections are among the leading causes of child morbidity and mortality worldwide. Although the diagnosis of acute respiratory tract infections requires simple outpatient medical techniques and care, it is still misdiagnosed among primary care physicians, leading to delayed treatment and increased mortality. This study described the prevalence of common acute respiratory tract infections and simple techniques that effectively detect and diagnose children presenting with acute respiratory symptoms to primary healthcare physicians in remote settings. This descriptive cross-sectional study was conducted at the pediatric outpatient clinic of a tertiary hospital in western Uganda in April, May and June 2019. A total of 896 children aged 2-59 months attending the clinic were recruited consecutively into the study and examined for the presence of acute respiratory infection. Participants' sociodemographic and clinical data were collected through history taking and clinical examination using a validated Uganda Ministry of Health Uganda outpatient clinical checklist (FORM 5). The outcome variable was the presence of an acute upper or lower respiratory condition. Data was analyzed using STATA version 13.0 (StataCorp, College Station, USA) and summarized using descriptive statistics. The overall period prevalence of acute respiratory tract infections among children aged 2 to 59 months was 36.9% (36,942 per 100,000 population). Upper respiratory tract infections with a prevalence of 24.8% were more common than lower respiratory tract infections. The most frequent upper respiratory tract infection in this setting was common cold (52%), followed by tonsillopharyngitis (10.7%), while pneumonia (26%) was the most frequent lower respiratory tract infection. Acute respiratory tract infections contribute to the high burden of disease in pediatric outpatient clinics. Simple, affordable, and approved diagnostic clinical techniques that involve physical examination of the upper and lower respiratory systems can precisely diagnose acute respiratory tract infections in resource-limited settings where there is no access to sophisticated diagnostic equipment.

Recurrent Pneumonia in a Child: Identifying an Underlying Pulmonary Sequestration

Abstract Background: Pulmonary sequestration is a rare foregut abnormality, accounting for a small percentage of lung malformations, with intralobar type being more common than extralobar. Clinical Description: A 10-year-old girl presented with recurring symptoms of breathlessness, cough, chest pain, and intermittent fever since 6 months of age. Earlier, she had been hospitalized four times in the past, and even received antitubercular treatment, but without any relief. Evaluation at our hospital revealed a cystic mass in the left lower lung with anomalous feeding vessels, leading to a diagnosis of pulmonary sequestration. Management and Outcomes: Surgical correction in the form of lobar resection and ligation of the feeding vessels was done. The patient’s symptoms significantly improved postoperatively, and there were no complications or recurrence during follow-up. Conclusion: Pulmonary sequestration is a rare abnormality. Misdiagnosis as a common respiratory infection can delay appropriate management. Surgical treatment through lobar resection can dramatically alleviate symptoms.

Hybrid Inception Architecture with Residual Connection: Fine-tuned Inception-ResNet Deep Learning Model for Lung Inflammation Diagnosis from Chest Radiographs

Diagnosing lung inflammation, particularly pneumonia, is of paramount importance for effectively treating and managing the disease. Pneumonia is a common respiratory infection caused by bacteria, viruses, or fungi and can indiscriminately affect people of all ages. As highlighted by the World Health Organization (WHO), this prevalent disease tragically accounts for a substantial 15% of global mortality in children under five years of age. This article presents a comparative study of the Inception-ResNet deep learning model’s performance in diagnosing pneumonia from chest radiographs. The study leverages Mendeley’s chest X-ray images dataset, which contains 5856 2D images, including both Viral and Bacterial Pneumonia X-ray images. The Inception-ResNet model is compared with seven other state-of-the-art convolutional neural networks (CNNs), and the experimental results demonstrate the Inception-ResNet model’s superiority in extracting essential features and saving computation runtime. Furthermore, we examine the impact of transfer learning with fine-tuning in improving the performance of deep convolutional models. This study provides valuable insights into using deep learning models for pneumonia diagnosis and highlights the potential of the Inception-ResNet model in this field. In classification accuracy, Inception-ResNet-V2 showed superior performance compared to other models, including ResNet152V2, MobileNet-V3 (Large and Small), EfficientNetV2 (Large and Small), InceptionV3, and NASNet-Mobile, with substantial margins. It outperformed them by 2.6%, 6.5%, 7.1%, 13%, 16.1%, 3.9%, and 1.6%, respectively, demonstrating its significant advantage in accurate classification.