Infections In Preschool Children Research Articles

Bronchoscopy-guided antimicrobial therapy for cystic fibrosis.

Bronchoscopy-guided antimicrobial therapy for cystic fibrosis.

BASIC INDICATORS OF PHYSICAL DEVELOPMENT IN CHILDREN AGED 5-6 YEARS WITH RECURRENT RESPIRATORY INFECTIONS

Background. Recently, scientific publications on various aspects of the problem of recurrent respiratory infections in preschool children have paid increasing attention to identifying influential factors contributing to frequent episodes of acute respiratory infections (ARI). In particular, these factors include significant deviations in children's physical development from standard values.
 Aim: to find out the relationship between the frequency of ARI episodes in children aged 60-83 months and their basic anthropometric indicators.
 Materials and methods. A total of 71 children (44 boys and 27 girls) aged 60-83 months, undergoing inpatient treatment on ARI, were involved in the clinical study.
 The number of ARI episodes during the previous year of their life was taken into account. Additionally, two integral indices of ARI recurrence, specifically the infection index (InI) and resistance index (RI), were calculated. The basic indicators of physical development were assessed in the children, including: 1) body weight; 2) body length; 3) body surface area; 4) body mass index; 5) chest circumference (CC); 6) integral index of dolichostenomelia. For the comparative analysis of the results obtained, the current standards of physical development indicators for children from the World Health Organization were used. The statistical processing of the digital data was performed with IBM SPSS Statistics 28 licensed software.
 Results. Rank correlation analysis and cross-tabulation did not demonstrate any interdependence between InI and RI, on the one hand, and the anthropometric indicators considered, on the other hand. Meanwhile, there was a very strong direct correlation between InI and RI (ρ=0.983; p<0.001; 95% CI: 0.972-0.989) in the examined children. Linear regression analysis revealed the dependence of InI and RI on CC size (p<0.001). At that, the degree of the impact of CC size on these clinical indices was almost the same, constituting 7.7% and 7.5%, respectively.
 Conclusion. Thus, according to the data obtained, the contribution of СС size to the susceptibility of children aged 60-83 months to recurrent respiratory infections among other potential risk factors is insignificant. However, given the widely recognized diversity of mentioned factors, the result deserves due attention. This should be accounted while developing the final integrated model for predicting the frequency of ARI episodes in preschool children.

SARS-CoV-2 Seroprevalence in a Berlin Kindergarten Environment: A Cross-Sectional Study, September 2021.

SARS-CoV-2 serology may be helpful to retrospectively understand infection dynamics in specific settings including kindergartens. We assessed SARS-CoV-2 seroprevalence in individuals connected to kindergartens in Berlin, Germany in September 2021. Children, staff, and household members from 12 randomly selected kindergartens were interviewed on COVID-19 history and sociodemographic parameters. Blood samples were collected on filter paper. SARS-CoV-2 anti-S and anti-N antibodies were assessed using Roche Elecsys. We assessed seroprevalence and the proportion of so far unrecognized SARS-CoV-2 infections. We included 277 participants, comprising 48 (17.3%) kindergarten children, 37 (13.4%) staff, and 192 (69.3%) household members. SARS-CoV-2 antibodies were present in 65.0%, and 52.7% of all participants were vaccinated. Evidence of previous infection was observed in 16.7% of kindergarten children, 16.2% of staff, and 10.4% of household members. Undiagnosed infections were observed in 12.5%, 5.4%, and 3.6%, respectively. Preceding infections were associated with facemask neglect. In conclusion, two-thirds of our cohort were SARS-CoV-2 seroreactive in September 2021, largely as a result of vaccination in adults. Kindergarten children showed the highest proportion of non-vaccine-induced seropositivity and an increased proportion of previously unrecognized SARS-CoV-2 infection. Silent infections in pre-school children need to be considered when interpreting SARS-CoV-2 infections in the kindergarten context.

Lactoferrin in the Prevention of Recurrent Respiratory Infections in Preschool Children: A Prospective Randomized Study.

Few studies have evaluated the effect of bovine lactoferrin (bLf) on reducing respiratory infections in preschool children. This randomized controlled trial evaluated the effect of bLf in preschool children with recurrent respiratory infections. Participants were randomly assigned bLf (n = 25) or control (n = 25). Outcomes included respiratory infection episodes (RIEs), symptom duration, school absence and medication. Fifty children aged 4.2 ± 0.1 years were included. During the active 4-month phase, median number of RIEs was reduced by 50% in the bLf group [1-episode, interquartile range (IQR): 0-2] vs. control (2, IQR: 1-3; p = 0.02). The proportion of participants with >3 RIEs was significantly lower in bLf (n = 1, 4%) vs. control (n = 7, 28%) with 80% lower odds of upper RIEs in the bLf arm (odds ratio: 0.20, 95% CI:0.06-0.74, p = 0.015). The duration of symptoms (3 vs. 6, p = 0.009) and days absent from school (3 vs. 6, p = 0.15) were lower in the active arm. Over the 2-month follow-up, no significant differences were observed between groups for infection episodes, symptom duration or school absence. However, bLf-treated children received significantly less corticosteroids over the entire 6-month study period (32% vs. 60%; p = 0.047). bLf supplementation significantly reduced the frequency and duration of RIEs in children with decreased corticosteroid use.

The Association between Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Respiratory Tract Infections in Preschool Children: A Wuhan Cohort Study.

This study investigates the association between prenatal exposure to per- and polyfluoroalkyl substances (PFASs) and the incidence and frequency of respiratory tract infections (RTIs) in preschool children. We selected 527 mother-infant pairs from Wuhan Healthy Baby Cohort (WHBC), China. Ten PFASs were measured in umbilical cord serum, and we collected data on common RTIs in preschool children aged 4 years through a questionnaire. Associations of single PFASs with the incidence and frequency of RTIs were analyzed via Logistic regression and Poisson regression, while the collective effect was assessed by weighted quantile sum (WQS) regression. Furthermore, stratified and interaction analyses were performed to evaluate if there were sex-specific associations. We found a positive correlation between perfluorododecanoic acid (PFDoDA) and the incidence of tonsillitis, with several PFASs also showing positive associations with its frequency. Moreover, perfluorotridecanoic acid (PFTrDA) showed a positive link with the frequency of common cold. The results of WQS regression revealed that after adjusting for other covariates, PFASs mixture showed a positive association with the incidence of tonsillitis, the frequency of common cold, and episodes. In particular, perfluoroundecanoic acid (PFUnDA), PFDoDA, PFTrDA, perfluorodecanoic acid (PFDA) and 8:2 chlorinated polyfluorinated ether sulfonic acid (8:2 Cl-PFESA) had the most significant impact on this combined effect. The results suggest that both single and mixed exposures to PFASs may cause RTIs in preschool children. However, there was no statistically significant interaction between different PFASs and sex.

Changes in the microbiota of the upper airways and intestine in the treatment of acute respiratory infections in preschool children

Introduction. The microbiota of the upper airways and intestine in preschool children is directly involved in protecting the growing body from acute respiratory infections (ARI), which are the most common infections in children, about 65% of them turn into recurrent respiratory infections (RRI). Aim. To establish changes in the microbiota of the upper airways and intestine in the treatment of ARI in preschool children.
 Materials and methods. The study involved sixty 1–6 year (Me = 3.38 years) frequently ill children. They were divided into 3 groups depending on the chosen treatment lasting 90 days. Children of group 1 (n = 20) underwent nutrition correction. Children of group 2 (n = 20) received additional probiotics. Children of group 3 (n = 20) received both nutritional correction and probiotics at the prescribed doses. Before and after treatment, the composition of the microbiota of the oropharyngeal zone and intestine was determined by genetic sequencing of the V3–V4 region of the 16S ribosomal RNA gene, followed by bioinformatic analysis. 
 Results. Significant differences were found mainly in the relative content of Firmicutes in the microbiota of patients treated. The content of Firmicutes in the microbiota of children receiving probiotics against the background of nutrition correction (30%) was significantly higher than in patients with nutrition correction (26.91%) and in children receiving only probiotics (25.95%). In patients of different groups, after treatment, a decrease in the content of Proteobacteria in the microbiota of the oropharyngeal zone was revealed. A significant decrease in the relative content of Bacteroidota (by more than 3 times) in 95% of patients, and a decrease in Proteobacteria (by more than 4.5 times) in 100% of patients was also found in the intestinal microbiota of group 3 patients treated with probiotics. In addition, there was a significant increase in the Firmicutes microbiota from 21.97% to 30.07% in 85% of patients, and an increase in the content of Actinobacteriota from 1.9% to 5.7% in 95% of patients. The relative content of undifferentiated microbiota after therapy was also significantly higher (70.08%) than before treatment (58.40%) in 85% of patients.

Epidemiological and genetic characteristics of respiratory syncytial virus infection in children from Hangzhou after the peak of COVID-19.

Respiratory syncytial virus (RSV) is one of the main pathogens that causes acute lower respiratory tract infection (ARTI) in infants. During the Coronavirus Disease 2019 (COVID-19) pandemic, although strict interventions have been implemented, RSV infection has not decreased. To study the epidemiological and genetic characteristics of RSV circulating in Hangzhou after the peak of COVID-19. A total of 1225 nasopharyngeal swabs were collected from outpatients with ARTIs from July 2021 to January 2022 in The Children's Hospital, Zhejiang University School of Medicine. A total of 267 (21.79%) of the 1225 samples were RSV positive. There was no gender bias. However, an obvious age preference for infection was observed, and children aged 3-6 years were more susceptible, which was very different from previous RSV pandemic seasons. Phylogenetic analysis of 115 sequenced RSV isolates showed that all the RSV-A viruses belong to the ON1 subtype, which could be clustered into three clusters. While all the RSV-B viruses belong to BA9. Further analysis of the mutations highlights the fixation of ten mutations, which should be given extra attention regarding their biological properties. The incidence of RSV infection in preschool children reported in this study is high. Phylogenetic analysis showed that the subtype A ON1 genotype was the dominant strain in Hangzhou from July 2021 to January 2022.

ПРОГНОСТИЧЕСКИЕ ПРЕДИКТОРЫ ТЯЖЕСТИ ТЕЧЕНИЯ КОРОНАВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА

As for adults, the prognostic predictive factors have been established, including some cytokines, associated with the diagnosis, pathogenesis, and severity of the coronavirus infection (COVID-19). However, predictors for the severity of the course of coronavirus infection in children are not well understood. In addition, there is no information on the cytokine profile in preschool children with COVID-19 as yet. The purpose of the research was to create a predictive model based on a comprehensive analysis of cytokine levels, which would then allow predicting the severity of the course of coronavirus infection in preschool children. Materials and methods used: 21 children (47.6% (10/21) boys and 52.4% (11/21) girls) aged 4.0 [3.0; 4.0] y/o with confirmed coronavirus infection (main group) vs. 25 children (44% (11/25) boys and 56% (14/25) girls) of health group I aged 3.0 [2.9; 3.7] y/o (the control group). Depending on the severity of COVID-19, patients of the main group were divided into subgroups: SG1 of 7 children with asymptomatic COVID-19; SG2 of 7 patients with a mild form; and SG3 of 7 cases of moderate form of the disease. In all children, the presence of SARS-CoV-2 in nasopharyngeal and oropharyngeal swabs was detected by PCR. The concentration of cytokines in blood serum was assessed by the flow fluorometry. Results: in children with COVID-19 at the time of admission to the hospital, the serum concentration of IL-1β, IL-2, IL-4, IL-6, IL-8, IP-10, MCP-1, IFN-γ, and TGF-β1 was statistically significantly higher than in the control group (p<0.05). Thus, based on a comprehensive analysis of the levels of IL-1β, IL-2, IL-6, IL-8, IL-12p70, IP-10, and TGF-β1 at the time of admission to the hospital, the prognostic model was developed allowing predicting the severity of COVID-19 in preschool children (Se=1.0 [95% CI 0.99-1.00], Sp=0.98 [95% CI 0.96-0.99], ROC-AUC=1.0 [95% CI 0.99-1.00], p<0.001; R2=0.93). Conclusion: the results of a comprehensive analysis allow us to consider the indicators of IL-1β, IL-2, IL-6, IL-8, IL-12p70, IP-10, and TGF-β1 as predictors for coronavirus infection severity in preschool children.

Knowledge and Practice of Pinworm Infection in Preschool Children, Jiangsu Province, China, 2019-2020.

We conducted a two-year (2019-2020) longitudinal study in Jiangsu Province, China to analyze risk factors of pinworm infection and evaluate the effect of behavior change communication-based (BCC-based) interventions in preschool children. The positive rate of pinworm infection was higher in private preschool (2%) than in public preschool (0.24%). Poor sanitation behaviors were risk factors among private preschool children. BCC-based intervention could improve knowledge and practice and reduce pinworm infection. This study may help fill in gaps in pinworm control. (Am J Public Health. 2022;112(12):1716-1720. https://doi.org/10.2105/AJPH.2022.307067).

SARS-CoV-2 vaccines in children and adolescents: Can immunization prevent hospitalization?

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants of concern can infect people of all ages and can cause severe diseases in children, such as encephalitis, which require intensive care. Therefore, vaccines are urgently required to prevent severe disease in all age groups. We reviewed the safety and efficacy profiles of mRNA vaccines-BNT162b2 and mRNA-1273-demonstrated by clinical trials or observed in the real world. mRNA-1273 is effective in preventing SARS-CoV-2 infection in preschool children (6 months-6 years old). Both BNT162b2 and mRNA-1273 are effective in preventing SARS-CoV-2 infection in school-aged children and adolescents, thereby preventing post-coronavirus disease (COVID) conditions. The common side effects of vaccination are pain at the injection site, fatigue, and headache. Myocarditis and pericarditis are uncommon. Monitoring post-vaccination troponin levels may help prevent severe cardiac events. The SARS-CoV-2 coronavirus mutates its genome to overcome the herd immunity provided by mass vaccinations; therefore, we may need to develop new generations of vaccines, such as those using viral nucleocapsid proteins as antigens. In conclusion, the mRNA vaccines are generally safe and effective in preventing severe diseases and hospitalization among children and adolescents.

Preschool children with asthma during the Covid-19 pandemic: fewer infections, less wheezing

ABSTRACT Introduction: A few studies have already investigated preschool children with asthma during the pandemic. The purpose of the present research was to investigate how preschool children with asthma were affected by the precautionary measures adopted during the pandemic. Methods: Preschool children with asthma aged 18-60 months evaluated in our clinic in March-May 2019, before the Covid-19 pandemic, were included in the study. The lockdown continued during March, April, and May 2020. The questionnaires and asthma symptom control tests for preschool children with asthma in 2019 and 2020 were then evaluated. Results: Sixty-three preschool children with asthma, 37 boys and 26 girls, aged 18-60 months (median 47) were included in the study. The median number of upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs), and the use of antibiotics were significantly lower in 2020 than 2019 (p<.01). The median numbers of the pediatric emergency department (PED) visits and hospitalizations were also lower in 2020 than in 2019 (p<.05). In 2019, 31 children with asthma were well controlled, 28 were partly controlled, and four were uncontrolled, compared to 58 well controlled, four partly controlled, and one uncontrolled in 2020 (p<.01). Conclusion: Preschool children with asthma have been positively affected in terms of pediatric emergency department admission, hospitalization, and asthma symptom control in association with the Covid-19 pandemic and the resulting lockdown measures. This study revealed that wheezing decreased significantly in the absence of respiratory infection in preschool children with asthma. Namely, fewer infections meant less wheezing.

ERYTHROCYTIC AND THROMBOCYTIC INDICATORS IN PRESCHOOL CHILDREN SUFFERING FROM RECURRENT RESPIRATORY INFECTIONS

Anemia is both a significant cause of frequent acute respiratory infections in preschool children and a complication of these infections. While, it is quite often accompanied by deterioration of immunity functioning. Moreover, there has been reported that acute respiratory infections can combine with thrombocytosis in children of different ages. It is also important to focus vision to the relationship between particular indicators of immune status, the acute respiratory infections occurrence, and the expression degree of undifferentiated connective tissue dysplasia. The study is aimed to assess the erythrocytic and thrombocytic indicators in preschool children having the different anamnestic occurrence rate of acute respiratory infections and the different expression degree of particular signs of undifferentiated connective tissue dysplasia. Materials and Methods. Seventy-six children (43 boys and 33 girls) aged from one to six years old, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. A wide range of erythrocytic and thrombocytic parameters was taken into consideration. Two markers of acute respiratory infections recurrence (infectious index, resistance index) and dolichostenomelia integral indicator were calculated for each child as well.&#x0D; The statistical processing of the obtained primary digital material was performed by IBM SPSS Statistics&#x0D; 26 licensed program. Results. Such indicators as blood haemoglobin concentration, mean corpuscle haemoglobin concentration, mean cell volume, platelet number, thrombocytocrit, microcytic anaemia factor and volume haemoglobin distribution width factor (coefficient of variation) were statistically lower in the children of the younger age group compared to the older children. The microcytic anaemia factor was lower than its reference values in 40 (52,63 %) patients, and erythrocyte hypochromia was diagnosed in 48 (63.16%) clinical cases. Conclusion. The higher infectious index values in preschool children have been found against the background of the lower mean cell haemoglobin and mean cell volume. The volume haemoglobin distribution width factor (coefficient of variation) and the microcytic anaemia factor among the examined patients are in inverse correlation with the infectious index. There is linear regression dependence between the infectious index on the erythrocyte anisocytosis index and the mean cell volume. The studied integral indicators of acute respiratory infections occurrence among the children do not demonstrate a statistically significant relationship between the platelet parameters and the dolichostenomelia integral indicator.

Incidence of acute respiratory infections in preschool children in an outpatient setting before and during Covid-19 pandemic in Lombardy Region, Italy

IntroductionThe incidence of acute respiratory tract infections (ARTIs) in children is difficult to estimate because they are typically treated in outpatient settings and the majority of epidemiological data originate from hospital settings and refer to the most severe illnesses. Therefore, the incidence of ARTIs in a real-world setting remains largely unexplored. Therefore, this study aims to estimate the incidence of ARTIs, upper respiratory tract infections (URTIs), and lower respiratory tract infections (LRTIs) in children aged 0–5 years in an outpatient setting.MethodsThis prospective cohort study was conducted in Lombardy, Italy, from October 1st, 2019, to March 31st, 2021, before and during the COVID-19 pandemic that began in March 2020. Caucasian healthy children aged 0–5 years were recruited from 69 Family Pediatricians (FP) and followed-up in an outpatient setting. Data were collected whenever a child was referred to FP and ARTI was diagnosed (Covid-19 related ARTI were excluded). The primary outcome was an estimate of the incidence of ARTIs. The incidence of ARTIs in different age groups and the effect of the COVID-19 pandemic on the incidence of ARTIs were secondary outcomes.ResultsWe enrolled 484 children, 249 male (51.8%), mean age of 2.39 ± 1.68 years. The mean estimated incidence of ARTIs was 12.1/100 children × 30 days (95% CIs: 9.5–12.9), with the highest value observed in infants aged 1–12 months (24.9/100 children × 30 days; 95% CIs: 17.6–28.9). The mean estimated incidence of URTIs was higher than that of LRTIs (8.3 – CIs: 7.6–8.9 vs 3.8/100 children × 30 days – CIs: 6.4–4.3, respectively). The comparison of ARTIs, which occurred in the pre-pandemic winter, to those measured during the COVID-19 pandemic, revealed an impressive 82.1% drop in the incidence rate (CIs: 77.8–85.7).ConclusionsThis study showed that infants aged 1–12 months are more likely to develop ARTIs than older children and that COVID-19 pandemic has dramatically altered the epidemiology of ARTIs in children aged 0–5 years.

Association between intestinal helminthic infections and anaemia status in preschool children in the district Skardu of Pakistan.

To evaluate the frequency of parasitic infections and to assess the relation between intestinal helminth infection and the anaemia status of pre-school children. The community-based cross-sectional study was conducted in Skardu, Pakistan, from August 2016 to January 2017, and comprised pre-school children of either gender. Demographical data was collected using a structured questionnaire. Stool samples were collected and examined for the presence and differentiation of ova / larvae of different intestinal helminths under microscope at the pathology department of a local healthcare facility. Blood haemoglobin was measured from blood samples and anaemia was defined as blood Hb <11g/dL. Data was analysed using SPSS 22. Of the 300 paediatric subjects, 169 (56.3%) were males and 131 (43.7%) females. The overall mean age of the sample was 36±16 months. Of the total, 161(53.67%) were found infected. Among the infected, 93(31%) were males and 68(22.67%) were females (p=0.10). Among those who were infection-free, 46(15.3%) children were anaemic. Prevalence of helminthic infections in pre-school children in Skardu was found to be high. The public health problem needs to be addressed for the healthy development of children.

Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe—results from the PED-MERMAIDS multicentre case–control study

BackgroundBoth pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to...

RETROSPECTIVE ANALYSIS OF PREDICTOR OF RECURRENT RESPIRATORY INFECTIONS IN PRESCHOOL CHILDREN

Among the current trends in the systemic prevention of recurrent respiratory infections in preschool children is the differentiated detection and clustering of the most significant ante- and prenatal factors associated with frequent acute respiratory infections. Thus, a comprehensive retrospective investigation of such factors in terms of their association with the integral indicators of acute respiratory infections recurrence in preschool children is exceptionally relevant. The study of particular manifestations of undifferentiated connective tissue dysplasia during recurrent respiratory infections is of great clinical and social relevance. This study research aims at determining the levels of inter-dependency between recurrence indicators of acute respiratory infections in preschool children and ante- and prenatal predictors analyzed retrospectively. Fifty-one children (24 boys and 27 girls) aged 1 to 6 years old, undergoing inpatient treatment for acute respiratory infection, were involved in the clinical study. Two markers of acute respiratory infection recurrence (infection index, resistance index) and dolichostenomelia integral indicator, which is used as the marker of external signs of connective tissue undifferentiated dysplasia, were calculated for each child. In addition, the retrospective analysis of 67 ante- and prenatal factors directly related to the children were examined. The statistical processing of the obtained digital material was performed by IBM SPSS Statistics 26 licensed software. Only non-parametric statistics methods were applied in the purpose.&#x0D; The first stage of investigating the inter-dependency between the acute respiratory infections frequency, the particular manifestations of undifferentiated connective tissue dysplasia, on the one hand, and the ante- and prenatal predictors, on the other hand, was carried out. The results obtained provided the grounds for the further research in the outlined direction involving the higher number of patients and using the more sensitive statistical methods. The higher infectious index values in the preschool children correlate with the following factors as lower initial overall age of their parents, smaller number of their mothers’ previous pregnancies, larger mothers’ body weight at the beginning of pregnancies, longer deliveries, lower Apgar scores in the newborns and no vaccination for tuberculosis. The resistance index values in the examined children increase with the simultaneous decreasing in the haemoglobin concentration in the mothers’ blood just before the deliveries and in cases of no vaccination in newborns for tuberculosis. The dolichostenomelia integral indicator in the patients aged from 1 to 6 years directly correlates with their age as well as with such retrospectively studied predictors as the newborns body mass index, the presence of foetoplacental insufficiency and the total number of complications caused by connective tissue dysplasia in their mothers during the pregnancies and deliveries.

Effect of Daily Bacillus subtilis DE111 Intake on GastrointestinalHealth and Respiratory Infections in Children Attending Day-care: ARandomised, Parallel, Double-blind, Placebo-controlled Study

Children beginning preschool typically have an increased prevalence of gastrointestinal and respiratory infections. This study aimed to evaluate safety and efficacy of the probiotic Bacillus subtilis DE111® in gastrointestinal health and respiratory infections in preschool children. In a randomised, parallel, double-blind placebo-controlled study 102 day-care attending children aged 2-6 years received B. subtilis DE111® (1 × 109 CFU) or placebo once a day for 8 weeks. Participant diaries were completed by parents and evaluated by investigators to follow the incidence and duration of indicators of gastrointestinal health and respiratory infections as well as any adverse events. Saliva samples were collected at baseline and completion of the intervention to measure sIgA levels. A significant reduction in duration of vomiting (2 days vs. 14 days, p=0.045), duration of hard stools (0 days vs 15 days, p=0.044), and duration of overall gastrointestinal discomfort (18 days vs. 48 days, p=0.0499) was seen. No difference in incidence of respiratory infection was observed (41.3% probiotic vs 36.2% placebo, p=0.60). A statistically significant increase of sIgA levels was observed in the placebo group (1.37-fold, p<0.01), but not in the probiotic group (1.05-fold, p=0.61). Overall, data suggests intake of the probiotic B. subtilis DE111® is safe for use in children and supports a healthy gastrointestinal tract with a reduced duration of vomiting, hard stools and overall gastrointestinal discomfort.

The Association Between Environmental Lead Exposure and Recurrent Respiratory Infections in Children Aged 3–7 Years in Shenyang, China

To investigate the lead exposure levels, and the effect of blood lead level (BLL) on recurrent respiratory infections in children aged 3-7 years in Shenyang. A case-control study including 78 children with recurrent respiratory infections and 141 controls was performed. Venous blood was obtained for BLL, and a questionnaire was completed. The BLL was significantly higher in children with recurrent respiratory infections than that in the control group [Median (IQR): 2.56 (1.29-6.19) vs 1.99 (0.90-5.92) µg/dL, P=0.029]. Children with BLL ≥1.95 µg/dL were more likely to be suffering from recurrent respiratory infections (OR=2.328, 95%CI=1.228-4.413) than those with BLL <1.95 µg/dL. High lead level can increase the risk of respiratory infections in preschool children.

Association between prenatal exposure to perfluoroalkyl substances and respiratory tract infections in preschool children

BackgroundPrenatal exposure to perfluoroalkyl substances (PFAS) is considered to affect adversely the immune function. However, the effect of prenatal PFAS exposure on respiratory tract infections (RTIs) in children is unclear. Thus, we evaluated whether cord blood PFAS levels were associated with RTI in the first 5 years of life. MethodsThe Shanghai Prenatal Cohort is an on-going birth cohort, which included all the mothers during pregnancy. Children were followed by paediatricians once a year after birth. The levels of 10 PFAS in cord blood were tested using liquid chromatography-mass spectrometry. RTIs were diagnosed based on face-to-face interviews with the parents and review of medical records. Immunoglobulin G (IgG) and immunoglobulin E (IgE) levels, as biomarkers of humoral immunity, were assessed using enzyme-linked immunosorbent assay at age 5 years. Multivariable logistic and linear regression models were applied to study the association between prenatal PFAS exposure and RTIs. ResultsA total of 743 children completed the follow-up, 344 of them had detail information of cord blood PFAS, IgG, and IgE concentrations. Eight PFAS were detected in more than 90% of the cord blood samples, except for perfluoroheptanoic acid (PFHpA) and perfluorooctane sulfonamide (FOSA). During the 5-year follow-up period, the frequency of RTIs increased with age, reaching a peak at age 4. Moreover, 20.6% of the children were diagnosed with recurrent RTIs. Children with recurrent RTIs had higher prenatal perfluorobutane sulfonic acid (PFBS) concentration. Higher prenatal PFBS concentration was positively associated with total RTI frequency (β = 6.05, 95% CI [0.84, 11.26]) in first 5 years of life and negatively associated with IgG level (β = −0.82, 95% CI [-1.67, −0.01]) at age 5. ConclusionsChildren with higher prenatal PFBS were more vulnerable to RTIs in early life, which may be attributed to immunosuppression of IgG production. These findings need to be further verified in larger prospective studies.

Risk Factors for Otitis Media in Children Referred to Abuzar Hospital in Ahvaz: A Case-Control Study.

IntroductionOtitis media is one of the most common causes of infection in preschool children. The most damaging complication of otitis media is temporary or permanent hearing loss. This study aimed to determine the important risk factors for otitis media.MethodsIn this case-control study, 625 children aged six months to seven years were examined from winter to spring 2020, and 53 children with otitis media were allocated to the case group and the same number to the control group. The chi-square test was used to identify the risk factors affecting otitis media, and the risk factors were compared between the case and control groups. Logistic regression was used to investigate the relationship between the incidence of otitis media and risk factors.ResultsBivariate analysis revealed the following primary risk factors for otitis media: using pacifiers or bottle feeding, working mother, seasonal rhinitis, allergic rhinitis, tonsillopharyngitis, rhinorrhea, and adenoid hypertrophy (P<0.05). In logistic regression analysis, using pacifiers or bottle feeding (odds ratio [OR]=0.156, P=0.000), working mother (OR=0.226, P=0.000), seasonal rhinitis (OR=0.175, P=0.000), allergic rhinitis (OR=5.20, P=0.000) and adenoid hypertrophy (OR=1.57, P=0.000) were identified as the most important risk factors.ConclusionAdenoid hypertrophy and allergic rhinitis increased the risk of otitis media more than the other risk factors. Therefore, pediatricians should increase their awareness of the existence of these risk factors in a patient, and take the appropriate diagnostic steps and implement therapeutic care to prevent language and speech complications.