Respiratory Diseases In Children Research Articles

Assessment of respiratory function in children after kidney transplantation.

Severe respiratory complications following kidney transplantation have been reported, yet remain poorly understood in the pediatric population. This study aimed to document respiratory disease in this population. At annual follow-ups, patients completed a respiratory symptoms questionnaire and underwent pulmonary function tests (PFTs). We defined respiratory disease in children when they had clinical disorders and/or PFT abnormalities. Among 236 children included, 110 (41%) exhibited respiratory involvement: 59 (53%) had only clinical disorders, 38 (35%) had only PFT abnormalities, and 13 (12%) had both. Of those with PFT abnormalities, 15 (7%) had obstructive impairment, 12 (6%) had restrictive impairment, and 30 (24%) showed decreased lung diffusion capacity for carbon monoxide (DLCO)/transfer coefficient for carbon monoxide (KCO). In the multivariate analysis, being over 3.5years of age at the time of transplantation was associated with a reduced risk of respiratory involvement (OR 0.30, CI [0.14; 0.63], p = 0.002), such as induction with basiliximab (OR 0.39, CI [0.17; 0.90], p = 0.03). Conversely, history of immune deficiency, male gender, positive PCR for BK virus and diastolic hypertension were associated with an increased risk (OR 5.96, CI [2.15; 16.51], p = 0.0006, OR 1.97, CI [1.03; 3.77], p = 0.04, OR 3.77, CI [1.14; 12.52], p = 0.03 and OR 2.21, CI [1.13; 4.32], p = 0.02, respectively). Bronchial lesions, such as bronchiectasis, were predominantly observed on tomography. Given the risk of irreversible lung damage, we recommend systematic clinical and functional respiratory monitoring in case of respiratory symptoms, recurrent lower respiratory tract infections, and risk factors in their follow-up.

PREVALÊNCIA DE DOENÇAS RESPIRATÓRIAS EM CRIANÇAS: IMPACTOS SAZONAIS E ESTRATÉGIAS DE PREVENÇÃO

Introduction: The prevalence of respiratory diseases among pediatric populations constitutes a substantial public health concern, shaped by inherent biological susceptibilities and environmental determinants. Temporal variations critically influence the occurrence and severity of these diseases. Material and Methods: In this study, recent literature on respiratory diseases in children was analyzed, focusing on seasonal factors, environmental impacts, and prevention strategies such as vaccination, hygiene, and indoor air pollution control. Results and discussion: Respiratory diseases, such as Influenza, Bronchiolitis, and Asthma, demonstrated higher incidence during periods of low temperatures and high humidity. In colder months, increased viral transmission was associated with prolonged stays in enclosed spaces. Conversely, in tropical climates, rainy periods heightened risks due to factors related to humidity and mold exposure. Vaccination, hygiene practices, and improved ventilation in indoor environments showed significant reductions in severe cases. Seasonality has a direct impact on the dynamics of respiratory diseases. It is essential to adopt and promote measures such as awareness campaigns, vaccination, and reductions in indoor air pollution. However, the implementation of these strategies is limited by socioeconomic barriers. Conclusion: Seasonal impacts and the adoption of preventive measures are fundamental to reducing the prevalence of respiratory diseases in children, allowing for an improvement in their quality of life.

Risk factors for complications of Mycoplasma pneumoniae pneumonia in hospitalized children in China: a systematic review and meta-analysis

BackgroundMycoplasma pneumoniae pneumonia (MPP) is a common respiratory disease in children. Some patients may develop long-term respiratory issues such as chronic cough and wheezing due to complications. These complications increase the health burden for children with MPP, highlighting the need to understand their risk factors in order to improve disease prognosis. This study aims to assess the risk factors for complications in hospitalized children with MPP in China.MethodsA comprehensive review of Chinese and English databases was conducted up to April 2024 to retrieve studies focusing on complications in hospitalized children with MPP. Pooled effect sizes were calculated using random-effects or fixed-effects models. Statistical analyses were performed using R software and RevMan 5.3.ResultsThis meta-analysis encompassed a total of 17 studies. We analyzed multiple risk factors associated with complications, including prolonged fever (OR: 3.79, aOR: 1.64), pleural effusion (OR: 3.71, aOR: 6.70), extensive lung infiltration (OR: 5.52, aOR: 3.57), ≥ 2/3 consolidation in a single lung lobe (OR: 4.29, aOR: 4.52), right upper lung lesion (OR: 4.84, aOR: 3.57), extrapulmonary manifestations (OR: 3.20, aOR: 1.89), hypoxemia (OR: 7.58, aOR: 12.43), delayed administration of glucocorticoids (OR: 7.93, aOR: 6.67), and delayed administration of macrolides (OR: 2.75, aOR: 3.84).ConclusionHospitalized children with SMPP and RMPP may have a higher risk of complications, and it is important to identify risk factors early and provide appropriate treatment to minimize complications. The current level of evidence is relatively low and may not accurately reflect the actual clinical situation in China. Further high-quality studies are needed to validate and clarify these findings.Trial registrationOur protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42024534397).

Short-term effects of air pollutants on hospitalization for childhood respiratory diseases in Suzhou City: a time-stratified case-crossover study

BackgroundShort-term exposure to air pollution has been demonstrated in previous studies to correlate with respiratory disease (RD) in children. Due to regional heterogeneity, our objective was to explore the correlation between short-term exposure to ambient air pollution and hospital admissions for respiratory ailments in children in Suzhou City from January 1, 2017, to December 31, 2022, alongside assessing the influence of the COVID-19 pandemic on this relationship.MethodsWe collected data on air pollutant levels and hospital admissions for childhood respiratory disease (RD) in Suzhou, China, from 2017 to 2022. We utilized a time-stratified case-crossover design along with a conditional logistic regression model to assess the short-term impacts of air pollutants on RD in children through stratified analysis and sensitivity analysis.ResultsA total of 13,408 children with respiratory diseases were included in the study. The findings revealed significant associations between hospitalization for respiratory diseases in children and exposure to PM2.5, PM10, SO2, NO2, and CO. The maximum effect values (95%CI, best lag days) for each 10 µg/m3 increase in the concentrations of PM2.5, PM10, SO2, and NO2 were as follows: 1.017 (1.003–1.031, lag0-2), 1.015 (1.004–1.026, lag0-2), 1.117 (1.001–1.247, lag0-1), and 1.036 (1.009–1.064, lag0-7). Additionally, the maximum effect value (95%CI, best lag days) for each 1 mg/m3 increase in CO concentration was found to be 1.267 1.017–1.579, lag0-7). Stratified analysis indicated that sex, season of admission, and stage of admission did not modify these correlations significantly; however, differential effects on various age groups and sexes were primarily observed among school-age and older children as well as boys.ConclusionsThe short-term exposure to PM2.5, PM10, SO2, NO2, and CO in Suzhou, China, exhibited a positive correlation with RD hospitalization. Prior to the COVID-19 pandemic, the adverse impacts of air pollutants on hospitalizations for childhood respiratory disease were mitigated compared to the period following the pandemic. Local governments should continue promoting decisions and measures for air pollution prevention and control to reduce further pollutant concentration, which is crucial for public health in reducing the burden of childhood respiratory diseases.

Association between respiratory tract deposited dose of size-segregated PM and FeNO based on individual exposure assessment for Korean children

FeNO (fractional exhaled nitric oxide) is a crucial marker to understand children's respiratory diseases such as asthma, and severity may vary depending on PM diameter and respiratory tract region. This study investigates the relationship between size-segregated respiratory deposited PM dose and FeNO for children. Size-segregated PM (PM1.0, PM1.0–2.5, and PM2.5–10.0) and FeNO were measured for eighty children based on individual exposure assessment in five consecutive days. Individual physical activity was measured by an accelerometer device. Accordingly, a dosimetry model estimated the respiratory deposited dose by PM diameter in the extrathoracic (ET), tracheobronchial (TB), and pulmonary (PUL) regions. A linear mixed model (LMM) with distributed lag non-linear model (DLNM) was used for analysis. The effects of home environment and traffic-related factors were also examined for sensitivity analysis. We found that IQR increases of PM2.5–10.0 and PM1.0 were associated with 15.1 % (95 % CI: 3.5, 28.1) and 15.9 % (95 % CI: 2.7, 30.9) FeNO increase in respiratory Total region in 0–12 h lag. In cumulative lag 0–24 h, PM1.0 was only associated with FeNO increase: 16.6 % (95 % CI: 1.5, 34.1) in total region. No association was observed in lag 12–24 h. PM2.5–10.0 was related to short-term airway inflammation in the upper respiratory tract whereas PM1.0 has a cumulative effect on both the upper and lower respiratory tract. In sensitivity analysis, PM2.5–10.0 was associated with a 0–12 h lag, whereas both PM2.5–10.0 and PM1.0 were associated with a cumulative lag of 0–24 h. Both home environment and traffic-related factors showed a synergetic effect with PM1.0 in short-term exposure and an antagonistic effect with PM2.5–10.0 in long-term exposure. This study highlights that airway inflammation depends on PM sizes, exposure durations, and respiratory tract regions.

Is an antioxidant-rich or a pro-inflammatory diet during pregnancy associated with allergic and respiratory multimorbidity in children from the ELFE birth cohort?

The antioxidant capacity and the inflammatory potential of diet during pregnancy may represent a prevention opportunity for allergic and respiratory diseases. We aimed to investigate the associations between the antioxidant and the inflammatory potential of maternal diet in the last 3 months of pregnancy with allergic and respiratory diseases in children. Analyses were performed on 9679 mother–child pairs from the ELFE birth cohort. The dietary total antioxidant capacity (DTAC), without coffee, was estimated with the Trolox equivalent antioxidant capacity (TEAC), the total radical trapping antioxidant parameter (TRAP) and the ferric reducing-antioxidant power (FRAP). The inflammatory potential of the maternal diet was assessed by the energy-adjusted dietary inflammatory index (E-DII). Allergic and respiratory diseases in children up to 5·5 years were considered jointly through five allergic and respiratory multimorbidity clusters (‘asymptomatic’ - reference, ‘early wheeze without asthma’, ‘asthma only’, ‘allergies without asthma’ and ‘multi-allergic’). Multinomial logistic regressions were performed and adjusted for main confounders. A diet with a higher antioxidant potential was associated with a lower risk of belonging to the ‘early wheeze without asthma’ cluster (aOR (95 % CI) = 0·95 (0·90, 0·99) per sd of TEAC score). A higher E-DII was associated with a higher risk of belonging to the ‘asthma only’ cluster (aOR (95 % CI) = 1·09 (1·00, 1·19) per sd). No association was found with the ‘allergies without asthma’ or ‘multi-allergic’ clusters. An antioxidant-rich diet during pregnancy was associated with better respiratory health, while a pro-inflammatory diet was associated with poorer respiratory health in children up to 5·5 years, though the associations were weak.

Childhood Respiratory Illnesses Before and After COVID-19 Pandemic Restrictions.

Introduction With the COVID-19 pandemic, multiple studies described a significant drop in common respiratory viruses in children with the lockdown and restrictions. With the lifting of pandemic precautions, we had the ability to observe new patterns of respiratory illnesses in children and emergency department visits. Materials and methods We studied all respiratory nucleic acid amplification test results in emergency patients from a large metropolitan children's hospital from the years 2018 to 2023. The test included adenovirus, coronaviruses HKU1, NL63, 229E, OC43, metapneumovirus, rhinovirus or enterovirus, influenza A and B, parainfluenza virus types 1-4, respiratory syncytial virus, Bordetella pertussis, Bordetella parapertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae. Coronavirus SARS CoV-2 became part of the respiratory panel in November of 2020. We reviewed pediatric emergency department census data to describe the trends before, during, and after COVID-19 pandemic restrictions. Results and conclusions Prior to 2020, there was a median of 1080 tests performed per week with an average positivity rate of 3.7-4.1%. During 2020, this dropped to 486 tests per week with a positivity rate of 1.74%. In 2021, after schools reopened, the median number of tests was 589 per week, with a positivity rate of 4.07%. After schools reopened without masks, the median tests per week were 817, with a positivity rate of 4.71%. Emergency department census data showed a large rebound in 2021 and 2022, with significantly earlier census peaks in these years. Common pediatric respiratory illnesses had an early seasonal spike in the years after the restrictions were lifted, with the most significant being the year in which local schools stopped wearing masks.

Unveiling the hidden power of noncoding RNAs in pediatric respiratory diseases.

Respiratory diseases in children are common health problems that significantly impact their quality of life and health status, and this has its own unique challenges compared to adults. A growing body of research has focused on epigenetic mechanisms that relate with the development of various diseases, such as pediatric respiratory diseases. Noncoding RNAs (ncRNAs), especially long noncoding RNAs, microRNA, and circular RNA, are reported to play a regulatory role in pediatric respiratory diseases whose mutations or aberrant expressions are strongly associated with the development of these diseases. In this review, we mainly discussed the functions of these three ncRNAs in pediatric respiratory diseases.

FREQUENCY OF LOW VITAMIN D LEVELS IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

Background: Asthma is one of the most common chronic respiratory diseases in children and adolescents, and is associated with inflammation and hyper-responsiveness of the airways. Multiple studies have suggested a potential link between lower levels of vitamin D and increased severity & frequency of asthma exacerbations. Objective: To find out the incidence of low vitamin D in children with signs of acute exacerbation. Methods: This was a cross-sectional study conducted at the Pediatrics department of PAEC General Hospital, Islamabad from January, 2023 to March, 2024. 94 pediatric patients aged 5 – 16 years, with clinical diagnosis of asthma according to the Global Initiative for Asthma (GINA) guidelines, and admission with an acute exacerbation of asthma were included into the study. Blood samples were taken for serum vitamin D levels and levels <20ng/ml was considered vitamin D deficiency. Results: Mean age was 10.5 ± 3.2 years. Male and female patients were 58.5% and 41.5%, respectively. The hospitalization rate was slightly higher (60.3%) but the difference was not statistically significant (p=0.18). Mean 25(OH)D levels were significantly lower in patients with severe asthma (12.7 ± 3.5 ng/mL). Vitamin D deficient patients were 58 (61.7%) and insufficient were 25 (26.6%). Conclusion: The findings of this study highlight the importance of vitamin D in pediatric asthma severity and clinical outcomes in children, and role of vitamin D supplementation for prevention of acute episodes.

WTAP Promotes the Excessive Proliferation of Airway Smooth Muscle Cells in Asthma by Enhancing AXIN1 Levels Through the Recognition of YTHDF2.

Asthma is a common chronic respiratory disease in children, the incidence rate of which has increased in recent years. Wilms tumour 1-associated protein (WTAP) is an N6-methyladenosine (m6A) methyltransferase. The purpose of this study was to explore the specific mechanism of WTAP in asthma progression, and clarify the intricate interplay between m6A modifications, WTAP, AXIN1, and their collective impact on airway smooth muscle cells (ASMCs) proliferation in asthma. Platelet-derived growth factor-BB (PDGF-BB)-treated ASMCs were used to establish an asthma model in vitro. The cell phenotype was tested using CCK-8, transwell, and wound healing assays. The expression of the Wnt signalling pathway was detected by western blotting. In addition, the relationship between WTAP/YTDHF2 and AXIN1 was assessed by a double luciferase reporter assay. Actinomycin D treatment and RT‒qPCR assays were performed to determine the mRNA stability of AXIN1. We found that WTAP was significantly increased in PDGF-BB-treated ASMCs. Knockdown of WTAP inhibited the excessive cell viability and migration of ASMCs induced by PDGF-BB. Furthermore, WTAP knockdown increased AXIN1 levels and inhibited the Wnt signalling pathway. Furthermore, WTAP knockdown decreased the m6A levels and enhanced the mRNA stability of AXIN1. WTAP overexpression showed the opposite effect. In addition, YTHDF2 was demonstrated to be the reader that recognizes the WTAP-mediated m6A modification of AXIN1. YTHDF2 knockdown enhanced the mRNA stability of AXIN1 and reversed the effect of WTAP overexpression on PDGF-BB-treated ASMCs. WTAP knockdown inhibited the excessive cell viability and migration of ASMCs by enhancing the m6A levels of AXIN1, which was further recognized by YTHDF2. The upregulation of AXIN1 mediated by the WTAP/YTHDF2 axis further inhibited the Wnt signalling pathway. Our study provides a new method for the treatment of asthma. This work not only deepens our understanding of the molecular underpinnings of asthma but also identifies potential therapeutic targets for the development of novel treatments aimed at inhibiting ASMC proliferation and alleviating asthma symptoms.

Research Progress of Breath Sound Analysis for Common Respiratory Diseases in Children

Breath sounds can reflect the physiological and pathological conditions of the lungs and airways.Due to the differences in acoustic characteristics of breath sounds between healthy children and those with different respiratory diseases,analyzing breath sounds may provide important information for the diagnosis and treatment of respiratory diseases in children.With the development of digital auscultation,children's breath sounds have gradully become a research focus.This article summarizes the recent research progress in breath sound analysis for the diagnosis and treatment of common respiratory diseases in children,offering reference for the research in related fields.

The role of respiratory infections in the formation of airway hyperresponsiveness in children

Airway hyperresponsiveness (AHR) is a heterogeneous and complex disorder characterized by excessive narrowing of the airways in response to various exogenous and endogenous stimuli. This article presents information from the last five years, including 50 publications from PubMed and Google Scholar, on the most common viruses that provoke the development of airway hyperresponsiveness in children, including respiratory syncytial virus, rhinovirus, metapneumovirus, influenza and parainfluenza viruses, SARS-CoV-2 coronavirus, adenovirus, and bocavirus. It describes a number of pathophysiological mechanisms by which viruses damage the respiratory epithelium and lead to the formation of infectious and post-infectious bronchial hypersensitivity. The role of hyperexpression of cytokines and inflammatory mediators in the development of AHR, especially in early childhood, is emphasized. It is shown that the inflammatory process and a balanced immune response are crucial for mitigating the severity of the disease caused by viruses. Understanding the molecular mechanisms of inflammatory reactions and the immune response to acute respiratory viral infections can help develop more effective methods for the prevention and treatment of respiratory diseases in children.

New progress in laboratory detection of respiratory infectious diseases in children

Respiratory infectious disease has become ahead of all the children's diseases, with the trend of continuously increasing global incidence, antimicrobial resistance and simultaneous infection with multiple pathogens. Diagnosis of this disease is mainly based on clinical symptoms and pathogenic detection. However, there are some differences in clinical manifestations, progression and prognosis between pediatric patients and adults, which prompting clinical diagnosis mainly depending on clinical laboratory test. Therefore, fast, convenient and accurate methods are urgently needed to clarify the type of infectious pathogen and carry out differentiated treatment, and reduce the burden on families and public health-care systems in schools. This article aims to elaborate the laboratory methods of children's respiratory infectious diseases and explore the opportunities and challenges, which can provide ideas for prevention, early screening and diagnosis, prognosis and treatment monitoring.

The toxic effects and mechanisms of maternal exposure to Bisphenol F during gestation and lactation on lungs in female offspring mice

Epidemiologic studies suggest that prenatal exposure to bisphenols may increase the risk of respiratory disease in children. Bisphenol F (BPF), a member of the bisphenol family, is widely used in industrial production. However, the potential pulmonary toxic effects and mechanisms of BPF exposure on offspring remain unclear. In this study, maternal mice were exposed to 0, 40, 400, and 4000 μg/kg BPF during gestation and lactation. The results showed that an inflammatory response was observed in lungs of BPF-exposed female offspring mice, characterized by peribronchial inflammatory cell infiltration and an increase in the number of inflammatory cells in BALF. Subsequent transcriptome analysis identified a total of 685 differentially expressed genes (DEGs) were in lungs of female offspring mice exposed to high-dose BPF, with 526 upregulated genes and 159 downregulated genes. Among upregulated DEGs of top 10, most of the upregulated genes were associated with inflammatory responses. In addition, enrichment analysis showed that immunosuppression and oxidative damage were significantly enriched in lungs of female offspring mice, suggesting that BPF could induce immunosuppression and oxidative stress in lungs of female offspring mice. Overall, our findings provide mechanistic insights into the potential pulmonary toxicity associated with BPF exposure during gestation and lactation.

Mycoplasma pneumoniae infection outbreak in Guangzhou, China after COVID-19 pandemic

BackgroundsMycoplasma pneumoniae (M. pneumoniae) is a common pathogen causing respiratory diseases in children. This study aimed to characterize epidemiological and disease severity shifts of M. pneumoniae: infections in Guangzhou, China during and after the coronavirus disease 2019 (COVID-19) pandemic.MethodsThroat swab samples were obtained from 5405 hospitalized patients with symptoms of acute respiratory infections to detect M. pneumoniae. Differences in epidemiological and clinical characteristics of M. pneumoniae: infections were investigated during 2020–2022 and after COVID-19 pandemic (2023).ResultsM. pneumoniae were detected in 849 (15.6%, 849/5405) patients. The highest annual positive rate was 29.4% (754/2570) in 2023, followed by 5.3% (72/1367) in 2022, 1.2% (12/1015) in 2021, and 2.0% (11/553) in 2020, with significantly increasing annual prevalence from 2020 to 2023. M. pneumoniae incidence peaked between July and December post-COVID-19 pandemic in 2023, with the highest monthly positive rate (56.4%, 165/293). Clinical characteristics and outcomes of patients with M. pneumoniae did not vary between periods during and after COVID-19 pandemic except that patients with M. pneumoniae post-COVID-19 pandemic were more likely to develop fever. Patients with severe M. pneumoniae pneumonia (SMPP) were more likely to develop respiratory complications, myocardial damage, and gastrointestinal dysfunction than those with non-SMPP. Patients with SMPP had lower lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, B cells, and higher IL-4, IL-6, IL-10 levels than those with non-SMPP. Bronchoalveolar lavage fluid specimens from infected patients were obtained to identify macrolide resistance mutations. Macrolide-resistant M. pneumoniae (MRMP) proportion in 2023 was 91.1% (215/236).ConclusionOutbreaks of M. pneumoniae: occurred in Guangzhou, China in 2023 upon Non-pharmaceutical interventions easing. Despite the increasing incidence of M. pneumoniae, the disease severity remained similar during and after the COVID-19 pandemic.

Progress in Research into the Effectiveness of Pulmonary Rehabilitation in Children with Asthma - A Narrative Review.

Asthma is the most common chronic respiratory disease in children. It has a serious impact on children's physical and mental health. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory disease, whose major components include breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases, the main components of which are breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation can improve the physical and mental condition of patients with chronic respiratory diseases and promote healthy behaviors. However, there is little research on pulmonary rehabilitation in children with asthma. This review comprehensively evaluated the effect of pulmonary rehabilitation in children with asthma at home and abroad, aiming to provide reference for clinical research on pulmonary rehabilitation in children with asthma.

Aspergillus-sensitized asthma in children.

Asthma is the most common chronic respiratory disease in childhood. Aspergillus fumigatus sensitivity may be involved in the pathogenesis of asthma by leading to different clinical presentations. To investigate the demographic, clinical, laboratory, and radiological characteristics of A. fumigatus sensitivity in childhood asthma and identify associated risk factors and diagnostic parameters. A total of 259 children with asthma were included in the study, 7 (2.7%) with allergic bronchopulmonary aspergillosis (ABPA), 84 (32.4%) with A. fumigatus-sensitized asthma (Af-SA), and 168 (64.9%) with A. fumigatus-unsensitized asthma (Af-UA). Aspergillus sensitivity was associated with early asthma onset and longer asthma duration. Total IgE level and asthma severity are highest in ABPA and higher in Af-SA. Absolute eosinophil count was higher, and FEV1 was lower in Af-SA and ABPA. Aspergillus fumigatus was associated with greater odds of being male (odds ratio [OR], 2.45), having atopic dermatitis (OR, 3.159), Alternaria sensitivity (OR, 10.37), and longer asthma duration (OR, 1.266). The best cut-off values for detecting A. fumigatus positivity were 363.5 IU/mL for total IgE and 455 cells/μL for absolute eosinophil count. In Af-SA compared to Af-UA, centrilobular nodules and peribronchial thickening were more common, and the bronchoarterial ratio was higher. Aspergillus sensitivity is a strong allergic stimulus in asthma, leading to laboratory, structural, clinical, and functional consequences. Af-SA is a distinct asthma endotype independent of ABPA that is characterized by increased risk of severe clinical presentations and impaired lung function.

Analysis of asthma incidence and mortality rates among children aged 0–14 in 204 countries from 1990 to 2019

Objective Asthma is a common chronic respiratory disease in children. Understanding incidence and mortality trends is crucial for prevention and intervention strategies. Methods Data from the Global Burden of Disease (GBD) study were used to analyze asthma incidence and mortality trends among children aged 0–14 in 204 countries from 1990 to 2019. The 30-year trends were calculated using the Estimated Annual Percentage Change (EAPC). Results Globally, pediatric asthma cases increased from 18,857,697 in 1990 to 20,191,786 in 2019. Incidence rates for children <5, 5–9, and 10–14 years are 1509.36, 980.25, and 586.95 per 100,000, respectively. Over 30 years, pediatric asthma mortality rates significantly decreased from 1.59 to 0.51 per 100,000, with minimal gender differences. High-income North America, Tropical Latin America, and the Caribbean show the highest incidence rates at 3203.2, 2493.83, and 2314.8 per 100,000. The USA, Puerto Rico, and Haiti have the highest national rates at 3357.17, 2695.30, and 2605.38 per 100,000. Regions with higher Sociodemographic Index levels tend to have higher incidence rates. Pediatric asthma prevalence varies by region and age group. Conclusion Our study of asthma incidence and mortality rates among children aged 0–14 across 204 countries from 1990 to 2019 reveals significant global disparities. These findings underscore the influence of socioeconomic and environmental factors on asthma prevalence and outcomes.

The Burden of Respiratory Disease in Childhood

Respiratory disease is an acute or chronic illness affecting the airways and other structures of the lungs. Asthma, bronchitis, pneumonia, pulmonary hypertension, allergic rhinitis, and sinusitis are the most common respiratory diseases which affect children. Respiratory disease strains health-care resources due to the doctor and hospital visits and the cost of treatment. Further, it can significantly impact on child’s health and is a fundamental cause of missed school days, limitations of activities, and social interaction. The prevalence of respiratory diseases in children increased significantly over the last decade, possibly because of different exposure to indoor and outdoor pollution, lifestyle, and respiratory infection. Certain risk factors appear to predispose children to develop respiratory disease, including genetic predisposition and exposure to environmental triggers. This article discusses the burden, prevalence, risk factors, and treatment associated with a pediatric respiratory disorder.

Psychometric evaluation of the Chinese version of the febrile convulsion knowledge scale for parents/caregivers: translation and validation study

BackgroundFever is one of the most common clinical symptoms of respiratory diseases in children. Once the child has a fever, parents and caregivers are mainly concerned that the child may have a febrile convulsion. A lack of cognitive ability not only leads to anxiety but also aggravates or delays the time of children’s medical treatment and even seriously affects the prognosis because of improper management of fever patients.Therefore, it is necessary to clarify the degree of mastery of knowledge related to febrile convulsions, implement targeted guidance and health education, and ensure that parents and caregivers receive correct and reasonable first aid treatment. The purpose of this study was to translate the Febrile Convulsion Knowledge Scale for Parents/Caregivers into Chinese and to verify its reliability and validity for Chinese parents and caregivers of children.MethodsThe Brislin traditional translation model was used to translate the Febrile Convulsion Knowledge Scale for Parents/Caregivers from English to Chinese, following authorization from the original author of the scale. This involved literal translation, back translation, and cultural adaptation. A convenience sampling method was used to select 402 parents and caregivers of children in the pediatric ward and pediatric infusion clinic of a Grade III hospital in Liaoning Province. The item analysis method was employed to assess item differentiation, while the Delphi method was used to analyze content validity. Scale reliability was evaluated through the calculation of internal consistency and test-retest reliability. Exploratory and confirmatory factor analyses were conducted to explore and verify the underlying factor structure and scale validity.ResultsThe Chinese version of the Febrile Convulsion Knowledge Scale for Parents/Caregivers consists of 3 dimensions and 8 items. The Cronbach’s alpha coefficient was 0.828, with each dimension having coefficients of 0.806, 0.720, and 0.702. The split-half reliability and test-retest reliability were 0.716 and 0.790, respectively. The Chinese version has good reliability. Exploratory factor analysis revealed that the Bartlett sphericity test was 394.52 (p < 0.001) and that the KMO value was 0.802 > 0.600, indicating suitability for factor analysis. Principal component analysis and orthogonal rotation of maximum variance were performed on the data, and items with a load greater than 0.40 within a single factor were selected for inclusion. The resulting three-factor structure explained 70.78% of the total variance. All model fitting indices were within the acceptable range, indicating the good structural validity of the Chinese version. The results of both exploratory and confirmatory factor analyses support this conclusion.ConclusionsThe Chinese version of the Febrile Convulsion Knowledge Scale for Parents/Caregivers has good reliability and validity. It can be used as a tool for clinical pediatric nurses to evaluate the knowledge of parents and caregivers of children with febrile convulsion and provide the basis for the design and implementation of targeted training plans according to the results obtained from the Chinese scale.