Acute Respiratory Infection Morbidity Research Articles

Study on 25 (OH) Vitamin D Status in Hospitalizied Children with Acute Respiratory Infections: Preliminary Results

Summary Our study aimed to determine and analyze the serum levels of 25 (OH) vitamin D and parathyroid hormone (PTH) to assess vitamin D deficiency as a risk factor for increased morbidity of acute respiratory infections (ARI) in childhood. The changes in the serum parathormone level were used as a criterion for vitamin D sufficiency since an optimal level of 25 (OH) vitamin D is required for normal PTH values. The study included 87 children divided into four subgroups, respectively – children with acute bronchopneumonia (n=49), children with acute laryngotracheitis (n=11), children with acute bronchiolitis (n=16), and a control group (n=11). Subnormal Vit. D levels were found in the individual groups: in the bronchopneumonia group, 18 children showed evidence of insufficiency; in the group of children with laryngotracheitis, five children showed insufficiency, and one child had Vit.D deficiency; children with acute bronchiolitis showed abnormalities in vit. D levels: seven children with insufficiency and two children - with deficiency. The preliminary results showed that Vit. D status deviations are more common in children with acute respiratory infections than in healthy children.

Modeling a traffic light warning system for acute respiratory infections

The high morbidity of acute respiratory infections constitutes a crucial global health burden. In particular, for SARS-CoV-2, non-pharmaceutical intervention geared to enforce social distancing policies, vaccination, and treatments will remain an essential part of public health policies to mitigate and control disease outbreaks. However, the implementation of mitigation measures directed to increase social distancing when the risk of contagion is a complex enterprise because of the impact of NPI on beliefs, political views, economic issues, and, in general, public perception. The way of implementing these mitigation policies studied in this work is the so-called traffic-light monitoring system that attempts to regulate the application of measures that include restrictions on mobility and the size of meetings, among other non-pharmaceutical strategies. Balanced enforcement and relaxation of measures guided through a traffic-light system that considers public risk perception and economic costs may improve the public health benefit of the policies while reducing their cost. We derive a model for the epidemiological traffic-light policies based on the best response for trigger measures driven by the risk perception of people, instantaneous reproduction number, and the prevalence of a hypothetical acute respiratory infection. With numerical experiments, we evaluate and identify the role of appreciation from a hypothetical controller that could opt for protocols aligned with the cost due to the burden of the underlying disease and the economic cost of implementing measures. As the world faces new acute respiratory outbreaks, our results provide a methodology to evaluate and develop traffic light policies resulting from a delicate balance between health benefits and economic implications.

Effectiveness of handwashing with soap for preventing acute respiratory infections in low-income and middle-income countries: a systematic review and meta-analysis

Acute respiratory infection (ARI) is a leading cause of morbidity and mortality globally, with 83% of ARI mortality occurring in low-income and middle-income countries (LMICs) before the COVID-19 pandemic. We aimed to estimate the effect of interventions promoting handwashing with soap on ARI in LMICs. In our systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, Global Health, and Global Index Medicus for studies of handwashing with soap interventions in LMICs from inception to May 25, 2021. We included randomised and non-randomised controlled studies of interventions conducted in domestic, school, or childcare settings. Interventions promoting hand hygiene methods other than handwashing with soap were excluded, as were interventions in health-care facilities or the workplace. The primary outcome was ARI morbidity arising from any pathogen for participants of any age. Secondary outcomes were lower respiratory infection, upper respiratory infection, influenza confirmed by diagnostic test, COVID-19 confirmed by diagnostic test, and all-cause mortality. We extracted relative risks (RRs), using random-effects meta-analysis to analyse study results, and metaregression to evaluate heterogeneity. We assessed risk of bias in individual studies using an adapted Newcastle-Ottawa scale, and assessed the overall body of evidence using a Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The study is registered with PROSPERO, CRD42021231414. 26 studies with 161 659 participants met inclusion criteria, providing 27 comparisons (21 randomised). Interventions promoting handwashing with soap reduced any ARI compared with no handwashing intervention (RR 0·83 [95% CI 0·76-0·90], I2 88%; 27 comparisons). Interventions also reduced lower respiratory infections (0·78 [0·64-0·94], I2 64%; 12 comparisons) and upper respiratory infections (0·74 [0·59-0·93], I2 91%; seven comparisons), but not test-confirmed influenza (0·94 [0·42-2·11], I2 90%; three comparisons), test-confirmed COVID-19 (no comparisons), or all-cause mortality (prevalence ratio 0·95 [95% CI 0·71-1·27]; one comparison). For ARI, no heterogeneity covariates were significant at p<0·1 and the GRADE rating was moderate certainty evidence. Interventions promoting handwashing with soap can reduce ARI in LMICs, and could help to prevent the large burden of respiratory disease. Bill & Melinda Gates Foundation, Reckitt Global Hygiene Institute, and UK FCDO.

Prevalence of Diminished Vitamin D and Association between Vitamin D-Levels and Morbidity by Acute Respiratory Infections (ARI) among Hospital Staff in Northern Bavaria during a Seasonal Flu Epidemic

Although vitamin D is known to have an influence on the immune system, the impact of a low level on the susceptibility to ARI is not very clear. So the aim of this study was to investigate the prevalence of diminished vitamin D in adult workers and the relationship between vitamin D-levels and the morbidity of acute respiratory infections (ARI) during the influenza epidemic in the first quarter of 2018 (Q1/2018) in Germany. Included were 60 employees of a hospital in northern Bavaria

Опыт применения азоксимера бромида для профилактики острых респираторных заболеваний и COVID-19 у взрослых из группы повышенного риска инфицирования (медицинских работников «красной зоны»): метаанализ контролируемых клинических исследований

Aim: meta-analysis of the clinical trials with the use of Azoximer bromide for the prevention of acute respiratory infections (ARI) and the novel coronavirus infection COVID-19 to systematically assess the epidemiological effectiveness of Azoximer bromide in adults at a higher risk of contracting the infection — the "red zone" healthcare workers. Patients and Methods: the search for clinical trials of Azoximer bromide was performed in the Russian-language and international sources. To identify controlled trials, the authors used such electronic databases as PubMed, Embase, Cochrane Library, eLIBRARY.RU, Scientific Electronic Library, and CyberLeninka. The following keywords were used for conducting the search: Azoximer bromide, respiratory tract infection, COVID-19, prevention, and adults (through May 2022), heathcare workers, medical personnel. Also, clinical trial reports on the use of medications containing Azoximer bromide as the main active ingredient were requested from the manufacturing companies. Publications and reports were selected based on the eligibility criteria. In particular, the assessment included such a parameter as ARI and COVID-19 morbidity. Pointwise estimates of effects were found for conducting meta-analysis which were calculated using odds ratios (OR). Results: out of the total 64 publications and reports involving over 5060 adults, three clinical trials using Azoximer bromide were selected. These trials had a relatively uniform design and matched the eligibility criteria. The selected trials included 1141 adults 18–69 years old. The treatment group comprised 718 subjects who received Azoximer bromide, and the control group included 423 individuals. The use of Azoximer bromide had the effect of reducing morbidity associated with ARI and COVID-19 in the groups at a higher risk of contracting infection (healthcare workers). For the subjects receiving Azoximer bromide, an OR of not getting sick from ARI and COVID-19 was 3.02 (95% confidence interval (CI) 2.14–3.89); in the control group an OR of not getting sick from COVID-19 was 2.65 (95% CI 1.53–3.77). The authors noted that Azoximer bromide had a good safety profile in all trials. Conclusion: the epidemiological effectiveness of Azoximer bromide was demonstrated in the groups at a higher risk of contracting the infection (healthcare workers), as proven by the significant reduction of ARI and COVID-19 morbidity. Thus, this drug can be recommended for the prevention of the studied infections during seasonal epidemics. KEYWORDS: acute respiratory infections, COVID-19, meta-analysis, Azoximer bromide, healthcare workers. FOR CITATION: Omarova Kh.G., Ploskireva A.A., Agarkova I.A., Gorelov A.V. Experience with the use of Azoximer bromide for the prevention of acute respiratory infections and COVID-19 in adults from the group with a higher risk of contracting the infection ("red zone" healthcare workers): meta-analysis of controlled clinical trials. Russian Medical Inquiry. 2022;6(11):635–642 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-11-635-642.

Determinants of acute respiratory infection among under-five children in rural Ethiopia

IntroductionIn low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia.MethodsA cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection.ResultsThe total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631–2.887), mother’s no education (AOR = 2.050,95% CI: 1.017–4.133), mother’s Primary education (AOR = 2.387, 95% CI:1.176–4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578–2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210–0.314), mothers not working (AOR = 0.773, 95% CI:0.630–0.948), not stunted (AOR = 0.663, 95% CI: 0.552–0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395–2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI.ConclusionsChildhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.

Distance from Healthcare Facilities Is Associated with Increased Morbidity of Acute Infection in Pediatric Patients in Matiari, Pakistan.

The relationship between environmental factors and child health is not well understood in rural Pakistan. This study characterized the environmental factors related to the morbidity of acute respiratory infections (ARIs), diarrhea, and growth using geographical information systems (GIS) technology. Anthropometric, address and disease prevalence data were collected through the SEEM (Study of Environmental Enteropathy and Malnutrition) study in Matiari, Pakistan. Publicly available map data were used to compile coordinates of healthcare facilities. A Pearson correlation coefficient (r) was used to calculate the correlation between distance from healthcare facilities and participant growth and morbidity. Other continuous variables influencing these outcomes were analyzed using a random forest regression model. In this study of 416 children, we found that participants living closer to secondary hospitals had a lower prevalence of ARI (r = 0.154, p < 0.010) and diarrhea (r = 0.228, p < 0.001) as well as participants living closer to Maternal Health Centers (MHCs): ARI (r = 0.185, p < 0.002) and diarrhea (r = 0.223, p < 0.001) compared to those living near primary facilities. Our random forest model showed that distance has high variable importance in the context of disease prevalence. Our results indicated that participants closer to more basic healthcare facilities reported a higher prevalence of both diarrhea and ARI than those near more urban facilities, highlighting potential public policy gaps in ameliorating rural health.

Study of respiratory disease pattern in children aged 2 months-5 years admitted in a tertiary care hospital

Background: Acute respiratory infections (ARI) is one of the leading causes of under 5 mortality globally and in India. India accounts for 20% of deaths globally due to pneumonia. Reviewing the prevalence and profile of pneumonia admissions in a tertiary care hospital will reflect the burden in the community and thereby help to plan optimal use of resources and adopting proper preventive measures. Aim of study was to identify prevalence, various risk factors involved, morbidity and mortality of acute respiratory infections in children 2 months to 5 years old.Methods: A prospective observational study conducted at a tertiary care teaching hospital of southern Tamil Nadu, India over a period of 18 months (January 2016 to June 2017). All cases between the age group of 2 months to 5 years admitted to Paediatric department were included in the study. Demographic and clinical features were recorded. Statistical analysis was done using SPSS version 22.0.Results: A total of 2793 children were included, of which the prevalence of acute respiratory infection was 10.95% (306 children). Pneumonia was the most common diagnosis (38.5%) followed by bronchiolitis (15.3%). Mortality rate was 5.9% among the ARI cases. There was a significant influence of exclusive breast feeding and malnutrition over the morbidity and mortality of ARI cases.Conclusions: Identifying ARI cases with risk factors for developing severe and very severe pneumonia and children with risk factors for high mortality need to be referred to tertiary care centres as early as possible for better outcome.

Analysis of the primary incidence of conscript military personnel of the Navy and Russian Ground Forces over the last 10 years (2010–2019)

The purpose of the study is to analyze the primary incidence of conscript military personnel of the Navy and Ground Forces over the last 10 years from 2010–2019.Methodology. We conducted a selective statistical analysis of medical reports on the health status of personnel and the activities of the medical service in the form of 3/MED of military units, in which served about 80% of the total number of conscript military personnel of the Navy and Russian Ground Forces. The primary incidence of conscript military personnel was correlated with the chapters of the International Classification of Diseases, 10 th revision (ICD-10).Results and their discussion. The average annual incidence rate of conscript military personnel for the Navy amounted to 1143,4–59,1‰, of the Ground Forces was higher at the level of trends — 1345,9–86,1‰. The dynamics of the primary incidence of conscript military personnel of the Navy showed a decrease in data, the Ground Forces — resembled an inverted U-curve with maximum rates in 2013–2014. The leading chapters of diseases of the primary incidence of the Russian Navy and the Army were respiratory diseases (X chapter), skin and subcutaneous tissue diseases (XII chapter), some infectious and parasitic diseases (chapter I), digestive diseases (XI chapter) and bone disease -muscular system and connective tissue (XIII chapter). The total contribution of these classes to the structure was 83,9 and 84,5%, respectively. Indicators of primary morbidity of acute respiratory infections of the upper respiratory tract (J00–J06), infections of the skin and subcutaneous tissue (L00–L08), and other acute lower respiratory infections were of a different significance for the conscripts of the Russian Navy and the Ground Forces of rank 1–6 respiratory tract (J20–J22), flu and pneumonia (J10–J18), diseases of the esophagus, stomach and duodenum (K20–K31) and viral infections characterized by lesions of the skin and mucous membranes (B00–B09). The distinctive features of the primary morbidity of military personnel of the Navy and Ground Forces by disease classes and leading nosologies are revealed. The total contribution of the listed nosologies (groups in chapters) to the structure was 71,3 and 73,2%, respectively.

Current Issues of Empirical Therapy of Severe Bacterial Community-Acquired Pneumonia During the Season of Respiratory Viral Infections

Progredient growth of morbidity and mortality of patients with community-acquired pneumonia (CAP) requires optimization of treatment including antibacterial therapy. Implementation of molecular-genetic methods of diagnostics of viral and viral-bacterial infections in clinical practice has significantly augmented the conception of etiology of community-acquired pneumonia. Seasonal fluctuation of CAP prevalence corresponds with growth of morbidity of acute respiratory infections and influenza which contribute to the etiological structure of CAP by increasing the risk of infection caused by staphylococci. The synergy between influenza A virus and S.aureus has been shown; it is associated with an increase of virus replication in the presence of specific staphylococcal proteases and the ability of viruses to increase adhesion of S.aureusin the respiratory tract, to decrease phagocytosis of S.aureus by macrophages/neutrophils and production of antimicrobial peptides, as well as to increase the probability of secondary bacterial co-infection. Therefore, the most important requirement for the empiric therapy agents of CAP is high streptococcal and staphylococcal activity. According to the current guidelines on antimicrobial therapy of severe CAP, antipneumococcic cephalosporins, macrolides, and fluoroquinolones are the basic treatment agents, but none of them have the combined high antistaphylococcal and antipneumococcal activity inherent in ceftaroline. The advantages of ceftaroline over ceftriaxone and levofloxacin in terms of the probability of reaching target concentrations for clinically relevant pharmacokinetic/pharmacodynamic parameters are shown. Meta-analysis of randomized clinical trials showed the higher clinical efficacy of ceftaroline in comparison to ceftriaxone with similar adverse event rate. Summarized analysis of antibiotic susceptibility data, pharmacokinetic/pharmacodynamic and clinical data, as well as negative epidemiological trends confirms the necessity of optimization of antimicrobial therapy of CAP for implementation of ceftaroline advantages against pneumococci and staphylococci in comparison to other β-lactams. Therefore, empiric treatment with ceftaroline is the most rational option for the therapy of CAP in critically ill patients during the season of respiratory viral infection.

Prevalence of Acute Respiratory Infection (ARI) and Its Different Correlates among Under-five Children of a Slum of Kolkata

Background: ARI is a major cause of morbidity and mortality of the most vulnerable age group; the under-fives. Previous studies had already identified different risk factors of ARI in slums; however, the findings are hard to generalize as there is diversity among slum populations. Moreover Kolkata (M Corp.) has second highest proportion (29.6%) of slum households among million plus cities in India which necessitates studying the ARI morbidity among under-fives of slums of Kolkata. Objective: To find out the prevalence of ARI and its different correlates among under-fives of a slum of Kolkata. Methods: A cross-sectional study was conducted in the month of May, 2015 among under-fives of the Bagbazar slum area of Kolkata. Total enumeration of under-five children residing in the selected slum was done and sample size came to 68. Data were collected by house to house visit. Chi-square test was applied for statistical significance. Results: Prevalence of ARI was 66.2% among the under-five children studied. Prevalence was higher for males (74.4%). Highest prevalence (100%) was noted among infants. Ventilation, over-crowding, type of family, parenteral smoking, type of cooking fuel used, location of kitchen and presence of symptoms of ARI among mothers were found to be significantly associated with ARI among under-fives (p &lt;0.05). Conclusion: The present study showed a very high prevalence of ARI among under-five children of Bagbazar slum area and also identified many correlates of such a high prevalence.

Features of formation of the military personnel’s morbidity of acute respiratory infections of the upper respiratory tract

The article sets out the views on the causes of the incidence of various categories of military personnel with acute respiratory infections of the upper respiratory tract (hereinafter – ARI URT), as having the greatest military and epidemiological significance for almost all military contingents.According to the results of a study of literature data, two groups of reasons for the formation of the incidence of acute respiratory infections of the airborne diseases are identified: external (associated with the exposure of military personnel to specific factors of military service) and internal (associated with the characteristics of individual susceptibility to this group of infections).Based on the results of a retrospective epidemiological analysis of the incidence of military servicemen on conscription, the development features of the epidemic process of ARI URT in military units and compounds are shown.According to the results of a retrospective epidemiological analysis of the incidence rate of cadets at the S.M. Kirov Military Medical Academy for 2011-2017 and a comparative analysis of the reversal rate for completed cases, the presence and relatively stable proportion of military personnel exposed to frequent ARI diseases of the airborne diseases throughout the entire 6-year period has been shown period of study.The results of a combined socio-psychological study in groups of often and rarely ill cadets are shown, showing individual signs and psychological characteristics, according to which individual military personnel can be assigned to the risk contingents of increased susceptibility to ARI URT for the purpose of organizing personalized sanitary-antipyretic (preventive) measures.

Use of modeling in the study of economic burden of influenza in the elderly population in Central and Eastern European countries

The economic burden of the incidence of influenza and ARI requires careful study, since annually about 15% of the world's population suffers from these diseases. In addition, the flu can cause complications that are dangerous to human life and health, especially those at risk. The elderly population belongs precisely to this group, therefore we have chosen to analyze the economic burden of this category of population. According to the international classification, this group of diseases is divided into the following types:&#x0D; &#x0D; Influenza-like illness (ILI);&#x0D; &#x0D; – Acute respiratory infection (ARI);&#x0D; – Severe acute respiratory infections (SARI);&#x0D; – Severe Acute Respiratory Syndrome (SARS).&#x0D; The aim of the work was to develop a model for systematization flows of patients and treatment costs in assessing the economic burden of influenza and ARI morbidity in the elderly peoples in Central and Eastern Europe. The model was developed in cooperation with the Syreon Institute, Hungary. The study involved Hungary, Poland, the Czech Republic, Romania, Ukraine and Kazakhstan.&#x0D; The structure of the model is based on the assumption of a flow of patients. The principle of the model was as follows: in order to assess the economic burden of the disease in a certain period of time, it is necessary to quantify (1) the number of patients, and (2) the costs of health care and treatment. The cost of treatment is different in each case, patients should be divided into relatively homogeneous groups. Since the quantity and quality of the epidemiological data on influenza and related diseases is rather heterogeneous in different countries, WHO offers certain objects of influenza research, taken as a basis for constructing such a model. According to this classification of influenza and WHO definition, the central structure of our model was formed by acute respiratory infections (ARI), representing outpatient cases and severe acute respiratory infections (SARI), representing inpatient cases.&#x0D; The next stage of the research was the study of the cost structure and the principles of collecting expenditure data. The economic burden of influenza in the elderly populations has been analyzed based on the type of health system. In older people, it is difficult to establish a link between influenza and complications of chronic diseases and other acute medical conditions (eg, acute coronary syndrome). This analysis does not include estimates of the economic impact of influenza on other co-morbidities and long-term chronic effects associated with complications of influenza. Since the population of 60+ or 65+ is a risk group and is a numerical group, the cost of treatment in the event of complications and hospitalization will increase cost for the patient and for the medical institution. However, in this case indirect costs is missing, such as paying a sick list. Direct medical cost were subject to analysis. The proposed methodology allows you to objectively assess the costs of treatment and calculate the economic burden, taking into account the type and health system.

Effect of hygiene interventions on acute respiratory infections in childcare, school and domestic settings in low- and middle-income countries: a systematic review.

Acute respiratory infections (ARIs) disproportionately affect those living in low- and middle-income countries (LMICs). We aimed to determine whether hygiene interventions delivered in childcare, school or domestic settings in LMICs effectively prevent or reduce ARIs. We registered our systematic review with PROSPERO (CRD42017058239) and searched MEDLINE, EMBASE, CENTRAL, and Scopus from inception to 17 October 2017 for randomised controlled trials (RCTs) examining the impact of hygiene interventions on ARI morbidity in adults and children in community-based settings in LMICs. We stratified data into childcare, school and domestic settings and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence quality. We identified 14 cluster RCTs evaluating hand-hygiene interventions in LMICs with considerable heterogeneity in setting, size, intervention delivery and duration. We found reduced ARI-related absenteeism and illness in childcare settings (low- to moderate-quality evidence). In school settings, we found reduced ARI-related absenteeism and laboratory-confirmed influenza (moderate- to high-quality evidence), but no reduction in ARI illness (low-quality evidence). In domestic settings, we found reduced ARI illness and pneumonia amongst children in urban settlements (high-quality evidence) but not in rural settlements (low-quality evidence), and no effect on secondary transmission of influenza in households (moderate-quality evidence). Evidence suggests that hand-hygiene interventions delivered in childcare, school and domestic settings can reduce ARI morbidity, but effectiveness varies according to setting, intervention target and intervention compliance. Further studies are needed to develop, deliver and evaluate targeted and sustainable hygiene interventions in LMICs.

Human metapneumovirus in hospitalized children less than 5 years of age in Pakistan.

Acute respiratory infection (ARI) is the second leading cause of death in children less than 5 years of age worldwide. Human Metapneumovirus (hMPV) is associated with around 5-7% of the total pneumonia admissions in children. The aim of this study was to determine the magnitude of hMPV associated hospitalizations among children, in Karachi, Pakistan. A 3 years prospective study was conducted at the Aga Khan University Hospital (AKUH), from August 2009 to June 2012. Children less than 5 years of age, admitted with ARIs, were enrolled. Throat swabs were collected and tested for hMPV using real-time PCR. Multivariable log binomial regression analysis was performed. Out of 1150 children enrolled, hMPV was detected among 84/1150 (7%). About 87% of the enrolled children presented with cough, followed by fever (73%), nasal congestion (69%) and shortness of breath (68%). Of the hMPV positive subjects, most (56/84, 67%) were less than 12 months of age. The most common diagnosis in hMPV positive infants was pneumonia, followed by asthma and bronchiolitis. HMPV was identified year round, with peaks during February and August. Sore throat was found to be significantly associated with the hMPV infection (Adjusted RR 2.23; 95%CI 1.42-3.52). The proportion of hMPV was higher among hospitalized infants with ARI. Pneumonia was the primary discharge diagnoses of patients who tested positive for hMPV. hMPV could be a target for future vaccine to further decrease the burden of ARI morbidity and possibly mortality in developing countries.

Viral and Bacterial Etiologies of Acute Respiratory Infections Among Children Under 5 Years in Senegal.

Acute respiratory infections (ARIs) are the leading cause of infectious disease–related morbidity, hospitalization, and morbidity among children worldwide. This study aimed to assess the viral and bacterial causes of ARI morbidity and mortality in children under 5 years in Senegal. Nasopharyngeal samples were collected from children under 5 years who had ARI. Viruses and bacteria were identified using multiplex real-time reverse transcription-polymerase chain reaction and conventional biochemical techniques, respectively. Adenovirus was the most prevalent virus (50%; n = 81), followed by influenza virus (45.68%, n = 74), rhinovirus (40.12%; n = 65), enterovirus (25.31%; n = 41), and respiratory syncytial virus (16.05%; n = 26), whereas Streptococcus pneumoniae (17%; n = 29), Moraxella catarrhalis (15.43%; n = 25), and Haemophilus influenzae (8.02%; n = 13) were the most commonly isolated bacteria. Virus pathogens seem more likely to be more prevalent in our settings and were often associated with bacteria and S. pneumoniae (6%; 16) coinfection.

An experience of vaccination against pneumococcal infection of adults at Krasnoyarsk krai

The aim of the study was to investigate efficacy of specific prevention of pneumococcal infection in high-risk group patients living at Krasnoyarsk krai. Methods. The study involved 12,080 patients with a high risk of pneumococcal infection including patients with chronic lung diseases, chronic heart failure (CHF) and diabetes mellitus. A special questionnaire was developed which included medical history for the previous 1 year and for 1 year after the vaccination. Results. CHF was diagnosed in 41.08% of patients, diabetes was diagnosed in 28.44%, chronic lung diseases were diagnosed in 30.07%; 2.4% of patients had pneumonia. PCV13 vaccine (Prevenar 13) was used in 9,986 patients (82.67%) including 5,070 patients (41.97%) vaccinated against flu and pneumococcus simultaneously. PPV23 (Pneumo-23) vaccine was used in 1,967 patients (16.28%) including 1,181 patients (9.83%) vaccinated against flu and pneumococcus simultaneously. Due to the broad-scale vaccination against pneumococcal infection, exacerbation rate reduced trice, number of hospitalisations related to exacerbations reduced by 11.5 times, morbidity of pneumonia reduced by 4.8 times, morbidity of acute respiratory infections and flu reduced by 6.6 times. Conclusion. The results confirmed high efficacy and safety of 13-valent conjugate pneumococcal vaccine and 23-valent polysaccharide pneumococcal vaccine. The vaccination allowed reducing morbidity of respiratory infection and decrease number of hospitalisations due to exacerbations of chronic diseases.

Метод профилактики острых респираторных инфекций у детей с врожденными пороками сердца

Цель: изучить эффективность и безопасность рекомбинантного липосомального интерферона альфа-2β в профилактике острых респираторных инфекций (ОРИ) у детей с врожденными пороками сердца. Материалы и методы. В предэпидемический период ОРИ 31 ребенку 3–12 лет с врожденными пороками сердца (основная группа) проводили оценку эффективности профилактической программы рекомбинантным липосомальным интерфероном альфа-2β: 250 000 ЕД 1 раз в сутки 2 раза в неделю в течение 1 месяца (методика I). В связи с недостаточной эффективностью в дальнейшем продолжили профилактику по методике II: 250 000 ЕД 2 раза в сутки в течение 3 дней, затем по 250 000 ЕД 1 раз в сутки 2 раза в неделю в течение 1 месяца. Клинико-лабораторное обследование (в том числе оценку уровня лизоцима, лактоферрина и секреторного иммуноглобулина А) проводили до начала профилактического воздействия, на 30, 120, 180-й день. Оценивали удовлетворенность результатами профилактики, побочные явления. Контрольную группу составили 20 здоровых сверстников. Результаты. Исходно у детей с врожденными пороками сердца выявлено снижение в ротоглоточном секрете уровня лизоцима, лактоферрина и секреторного иммуноглобулина А. После профилактической программы по методике I констатировано уменьшение частоты и продолжительности ОРИ и осложнений. Профилактическая программа по методике II продемонстрировала большую эффективность по названным выше показателям. Все дети хорошо переносили профилактическое лечение, побочных эффектов не было. Выводы. Выявлено снижение показателей местного иммунитета у детей с врожденными пороками сердца, что повышает риск заболеваемости ОРИ. Высокая эффективность и безопасность рекомбинантного липосомального интерферона альфа-2β являются основанием для его использования у детей с целью профилактики ОРИ.

LONG-TERM FORECASTING OF INFLUENZA-LIKE ILLNESSES IN RUSSIA

This paper compares the feasible methods for the long-term fore- casting of the incidence rates of influenza-like illnesses (ILI) and acute respira- tory infections (ARI), which is important for strategic management. A litera- ture survey shows that the most appropriate techniques for long-term ILI & ARI morbidity projections are the following well-known statistical methods: simple averaging of observations, point-to-point linear estimates, Serfling-type regres- sion models, autoregressive models such as autoregressive integrated moving average (ARIMA) models, and generalized exponential smoothing using the Holt-Winters approach. Using these methods and official dataon the total number of ILI & ARI cases per week in 2000-2012 in Moscow, St. Petersburg, Novosibirsk, Yekaterinburg, Nizhny Novgorod and Yakutsk, we developed one- year projections and evaluated their accuracy. Different methods yielded the best results, depending on the time series. Generally, it is preferable to use the Serfling model. The Serfling model forecasts almost matched the point- to-point linear estimates. In certain cases, ARIMA outperformed the Serfling model. Simple averaging can ensure a fairly good prediction when the ILI & ARI time series do not exhibit a trend. The results of exponential smoothing were poorer than those of other techniques.

MODERN ASPECTS OF IMPROVING HEALTH IN CHILDREN FROM RISK GROUP OF PERSISTENTLY AND FREQUENTLY FALLING ILL

Aim. To estimate the efficiency of rehabilitation measures by means of using homeopathic remedies for children from the risk group of persistently and frequently falling ill (RGPFFI). Materials and methods. A cohort, prospective, open study was carried out in children from the risk group of persistently and frequently falling ill (RGPFFI). The developed program included observation of five year-old children from the risk group of persistently and frequently falling ill and children who had acute respiratory infection (ARI) during the study. The study involved 222 children. They were divided into 3 groups; rehabilitation measures were presented by antiviral homeopathic drug ocillococcinum combined with vitamins. Children with ARI were administered the drugs corisalium and ocillococcinum. All children underwent clinical screening investigation of skin carotinoid index (SCI). Results. During six months, the number of sick children in first three groups reliably ( p <0,1) reduced as compared to the forth group (the control). While performing rehabilitation measures with homeopathic drug ocillococcinum and vitamins (Multi-tabs Immuno-kids, Vetaron-E, Multi-tabs Intello-kids with Omega 3), percentage of sick children with ARI significantly decreased for 6 months and one year. The efficiency of combined use of ocillococcinum and vitamins is reliably higher ( p <0,02) than their separate application. The obtained data on children’s skin carotinoid content showed that the lowest indices were detected in group 4 (the control) 22,03±1,15 ( p <0,03) where children did not receive antirecurrent therapy (vitamins, antioxidants and homeopathic drug ocillococcinum). At the end of the study, high SCI content in comparison with the first month was noted. Conclusion. The efficiency of rehabilitation measures contributed to decrease in ARI morbidity among children from the risk group of persistently and frequently falling ill when they were administered antiviral homeopathic drugs ocillococcinum and corisalium combined with vitamins. Antioxidant activity was higher in groups 2 and 3 and was preserved till the end of the study. Good tolerance of homeopathic drugs, absence of allergic reactions in pre-school children was detected.