Respiratory Diseases In Children Research Articles

Prevalence, risk factors, impact and management of pneumonia among preschool children in Chinese seven cities: a cross-sectional study with interrupted time series analysis

BackgroundPneumonia is a common disease worldwide in preschool children. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of pneumonia among preschool children. We therefore investigated the prevalence of pneumonia among preschool children in Chinese seven representative cities, and explore the possible risk factors of pneumonia on children, with a view to calling the world's attention to childhood pneumonia to reduce the prevalence of childhood pneumonia.MethodsTwo group samples of 63,663 and 52,812 preschool children were recruited from 2011 and 2019 surveys, respectively. Which were derived from the cross-sectional China, Children, Homes, Health (CCHH) study using a multi-stage stratified sampling method. This survey was conducted in kindergartens in seven representative cities. Exclusion criteria were younger than 2 years old or older than 8 years old, non-permanent population, basic information such as gender, date of birth and breast feeding is incomplete. Pneumonia was determined on the basis of parents reported history of clearly diagnosed by the physician. All participants were assessed with a standard questionnaire. Risk factors for pneumonia, and association between pneumonia and other respiratory diseases were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was evaluated by the parents’ reported history of physician diagnosis, longitudinal comparison of risk factors in 2011 and 2019.ResultsIn 2011 and 2019, 31,277 (16,152 boys and 15,125 girls) and 32,016 (16,621 boys and 15,395 girls) preschool children aged at 2–8 of permanent population completed the questionnaire, respectively, and were thus included in the final analysis. The findings showed that the age-adjusted prevalence of pneumonia in children was 32.7% in 2011 and 26.4% in 2019. In 2011, girls (odds ratio [OR] 0.91, 95%CI [confidence interval]0.87–0.96; p = 0.0002), rural (0.85, 0.73–0.99; p = 0.0387), duration of breastfeeding ≥ 6 months(0.83, 0.79–0.88; p < 0.0001), birth weight (g) ≥ 4000 (0.88, 0.80–0.97; p = 0.0125), frequency of putting bedding to sunshine (Often) (0.82, 0.71–0.94; p = 0.0049), cooking fuel type (electricity) (0.87, 0.80–0.94; p = 0.0005), indoor use air-conditioning (0.85, 0.80–0.90; p < 0.0001) were associated with a reduced risk of childhood pneumonia. Age (4–6) (1.11, 1.03–1.20; p = 0.0052), parental smoking (one) (1.12, 1.07–1.18; p < 0.0001), used antibiotics (2.71, 2.52–2.90; p < 0.0001), history of parental allergy (one and two) (1.21, 1.12–1.32; p < 0.0001 and 1.33, 1.04–1.69; p = 0.0203), indoor dampness (1.24, 1.15–1.33; p < 0.0001), home interior decoration (1.11, 1.04–1.19; p = 0.0013), Wall painting materials (Paint) (1.16, 1.04–1.29; p = 0.0084), flooring materials (Laminate / Composite wood) (1.08, 1.02–1.16; p = 0.0126), indoor heating mode(Central heating)(1.18, 1.07–1.30, p = 0.0090), asthma (2.38, 2.17–2.61; p < 0.0001), allergic rhinitis (1.36, 1.25–1.47; p < 0.0001), wheezing (1.64, 1.55–1.74; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (2.53, 2.31–2.78; p < 0.0001), allergic rhinitis (1.41, 1.29–1.53; p < 0.0001) and wheezing (1.64, 1.55–1.74; p < 0.0001). In 2019, girls (0.92, 0.87–0.97; p = 0.0019), duration of breastfeeding ≥ 6 months (0.92, 0.87–0.97; p = 0.0031), used antibiotics (0.22, 0.21–0.24; p < 0.0001), cooking fuel type (Other) (0.40, 0.23–0.63; p = 0.0003), indoor use air-conditioning (0.89, 0.83–0.95; p = 0.0009) were associated with a reduced risk of childhood pneumonia. Urbanisation (Suburb) (1.10, 1.02–1.18; p = 0.0093), premature birth (1.29, 1.08–1.55; p = 0.0051), birth weight (g) < 2500 (1.17, 1.02–1.35; p = 0.0284), parental smoking (1.30, 1.23–1.38; p < 0.0001), history of parental asthma (One) (1.23, 1.03–1.46; p = 0.0202), history of parental allergy (one and two) (1.20, 1.13–1.27; p < 0.0001 and 1.22, 1.08–1.37; p = 0.0014), cooking fuel type (Coal) (1.58, 1.02–2.52; p = 0.0356), indoor dampness (1.16, 1.08–1.24; p < 0.0001), asthma (1.88, 1.64–2.15; p < 0.0001), allergic rhinitis (1.57, 1.45–1.69; p < 0.0001), wheezing (2.43, 2.20–2.68; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (1.96, 1.72–2.25; p < 0.0001), allergic rhinitis (1.60, 1.48–1.73; p < 0.0001) and wheezing (2.49, 2.25–2.75; p < 0.0001).ConclusionsPneumonia is prevalent among preschool children in China, and it affects other childhood respiratory diseases. Although the prevalence of pneumonia in Chinese children shows a decreasing trend in 2019 compared to 2011, a well-established management system is still needed to further reduce the prevalence of pneumonia and reduce the burden of disease in children.

The impact of ambient air pollutants on childhood respiratory system disease and the resulting disease burden: a time-series study.

The effects of air pollution on human health have long been a hot topic of research. For respiratory diseases, a large number of studies have proved that air pollution is one of the main causes. The purpose of this study was to investigate the risk of hospitalization of children with respiratory system diseases (CRSD) caused by six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) in Hefei City, and further calculate the disease burden. In the first stage, the generalized additive models were combined with the distributed lag non-linear models to evaluate the impact of air pollution on the inpatients for CRSD in Hefei. In the second stage, this study used the cost-of-illness approach to calculate the attributable number of hospitalizations and the extra disease burden. Overall, all the six kinds of pollutants had the strongest effects on CRSD inpatients within lag10 days. SO2 and CO caused the highest and lowest harm, respectively, and the RR values were SO2 (lag0-5): 1.1 20 (1.053, 1.191), and CO (lag0-6): 1.002 (1.001, 1.003). During the study period (January 1, 2014 to December 30, 2020), the 7-year cumulative burden of disease was 36.19 million CNY under the WHO air pollution standards. In general, we found that six air pollutants were risk factors for CRSD in Hefei City, and create a huge burden of disease.

Key issues in selecting an antibacterial drug for the treatment of acute respiratory infections in children: A review

Аcute respiratory diseases in children remain an urgent problem in pediatric practice. Most respiratory infections are due to viruses, but some may be due to bacterial pathogens or associations. During the pandemic of a coronavirus infection the number of unjustified prescriptions of antibiotics increased, which significantly complicated the situation with drug resistance of microorganisms and changed the strategy for choosing a starting antibacterial drug in children. Under the current circumstances, timely diagnosis of bacterial inflammation and the adequate choice of drug are the key issues in the practice of a pediatrician. On an outpatient basis it is important for a pediatrician to determine the indications timely and empirically prescribe an effective antibacterial drug. In Russia, in recent years, Federal Clinical Guidelines for various nosologies have been approved, defining indications for systemic antibiotic therapy. According to clinical guidelines, amoxicillin is the first-line antibiotic for most bacterial acute respiratory infections. In addition, there are cohorts of children who are expected to have risk factor as drug-resistant organisms and these children are eligible for protected amoxicillin as a first-line medication. The indications for prescribing macrolides and third-generation oral cephalosporins have fundamentally changed. The article presents the defining indications for systemic antibiotic therapy and the features of the choice of the starting antibacterial drug in children with acute respiratory infections.

Increased risk of respiratory and allergic diseases in preschoolers from building envelope dampness exposure: Repeated cross-sectional surveys in multicity China

Building envelope dampness exposure is correlated with children's respiratory and allergic diseases. However, little research has compared the variation in the health impact of dampness exposure across multiple cities from a longitudinal perspective. A cross-sectional survey and a repeated one were conducted in children's residences in six cities: Chongqing, Shanghai, Nanjing, Wuhan, Changsha and Taiyuan, China, in 2010 (Phase I) and 2019 (Phase II). We selected 17,810 preschoolers during Phase I and 26,001 preschoolers during Phase II aged 3–6 years without changing residence since birth in the study. The proportion of residences with building envelope dampness exposure and the prevalence of respiratory and allergic diseases, except allergic rhinitis, in preschoolers significantly declined from Phase I to Phase II. Dampness exposure increased the risk for most childhood respiratory diseases in Phase II, with a 34% greater risk of lifetime-ever asthma in early residences and a 36% greater risk of current eczema in current residences. Most diseases showed a significantly positive exposure-response relationship to the cumulative period of building envelope dampness exposure (p < 0.05). The risk of developing current eczema was approximately 1.35 and 1.73 times higher in children exposed to both early and current dampness in Phase I and Phase II, respectively, than in children who had never been exposed. These findings provide new insights into the respiratory and allergic diseases in Chinese preschoolers because of building envelope dampness exposure over the last decade. The increased risk in Phase II raises concerns about the household's dampness environment.

P361 Psychological and physical impact of coughing in patients with cystic fibrosis (CF)

Cough is a leading symptom in CF patients and has influence on everyday life of the patients. Our aim is to find out what is the psychological and physical impact of the cough on everyday activities in CF patients in the Institute for Respiratory Diseases in Children, Skopje, Republic of North Macedonia.

Childhood secondhand smoke exposure and respiratory disease mortality among never-smokers: the Japan collaborative cohort study for evaluation of cancer risk.

The main source of secondhand smoke (SHS) exposure during childhood occurs at home due to close family members who smoke. This study examined the association between childhood SHS exposure and the risk of respiratory disease mortality among non-smoking adults. Data from 44233 never-smoking Japanese men and women aged 40-79years who participated in the JACC study between 1988 and 1990 were analyzed. The Cox proportional hazards model was used to calculate hazard ratios and 95% confidence intervals of respiratory disease mortality according to the number of smoking family members during childhood. Subdistribution HRs (SHRs) were calculated as a competing risk analysis. A total of 735 deaths from respiratory diseases were documented in a median follow-up of 19.2years. Living with three or more smoking family members during childhood was associated with a higher risk of respiratory disease mortality in adulthood among women; multivariable SHR compared with participants with no family member smokers during childhood was 1.60 (1.01-2.54) for participants with three or more family members who smoked during their childhood. SHS exposure from three or more family members during childhood was associated with an increased risk of respiratory disease-related mortality in adulthood.

Elevated Neutrophil-to-Lymphocyte Ratio Is Associated with Severe Asthma Exacerbation in Children.

Asthma is the most common chronic respiratory disease in children. The neutrophil-to-lymphocyte ratio (NLR) is a marker of a chronic inflammatory state; however, data on the association of NLR with acute asthma exacerbations in children is lacking. In this cross-sectional study, between 2016 and 2021, children aged 2-18 years who were referred to the emergency department (ED) due to asthma exacerbation, were included. NLR, calculated from complete blood count upon arrival, was assessed as a continuous variable and was classified into four groups according to quartiles. The association between severity parameters and NLR quartiles was examined. A total of 831 ED visits for asthma exacerbation were included in the study. The median NLR was 1.6, 3.8, 6.7, and 12.9 in quartiles 1-4, respectively (p < 0.001). Demographic parameters, background diseases, and chronic medications were similar between the quartiles. Higher heart rate, body temperature, systolic blood pressure, and respiratory rate were observed in the higher NLR quartiles, as well as lower oxygen saturation. Higher urgency scale and higher rates of intravenous magnesium sulfate were observed in the higher NLR quartiles, with higher admission rates and prolonged hospitalizations. In summary, NLR upon admission is associated with the severity of asthma exacerbation and higher chances of hospitalization among children in the ED.

Is it time to end race and ethnicity adjustment for pediatric pulmonary function tests?

The continued inclusion of race in spirometry reference equations is a topic of intense debate for adult lung function, but less discussion has focused on implications for children. Obtaining accurate estimates of children's lung function is an important component of the diagnosis of childhood respiratory illnesses, including asthma, cystic fibrosis, and interstitial lung disease. Given the higher burden among racial/ethnic minorities for many respiratory illnesses, it is critical to avoid racial bias in interpreting lung function. We recommend against the continued use of race-specific reference equations for a number of reasons. The original reference populations used to develop the equations were comprised of children with restricted racial diversity, relatively small sample sizes, and likely included some unhealthy children. Moreover, there is no scientific justification for innate racial differences in lung function, as there is no clear physiological or genetic explanation for the disparities. Alternatively, many environmental factors harm lung development, including allergens from pests, asbestos, lead, prenatal smoking, and air pollution, as well as preterm birth and childhood respiratory illnesses, which are all more common among minority racial groups. Race-neutral equations may provide a temporary solution, but still rely on the racial diversity of the reference populations used to build them. Ultimately researchers must uncover the underlying factors truly driving racial differences in lung function.

Improvement of air quality has a positive impact on lung growth, particularly during puberty

<b>Improving air quality has a positive impact on lung growth, particularly during puberty. We need studies to address the impact of co-exposure to air pollutants and PM_2.5, and in lower-income countries with higher burden of childhood respiratory illness.</b>https://bit.ly/3YTiFyW

Clinical efficacy of Rajanyadi Choornam in Allergic Respiratory Disease in Children

Allergic Respiratory Disease (ARD) is a frequent atopic condition manifesting through allergic rhino conjunctivitis and asthma, affecting up to 40% of the population world-wide. Though not viewed as a life-threatening condition, it is also recognized to impose a significant burden to the quality of life of sufferers and their caretakers. It is apparent from epidemiology studies that the Allergic Respiratory Disease in younger children below the age of 5 years is a relatively common problem. Many conventional managements provide only symptomatic relief resulting in recurrence of the disease. At the same time Ayurveda, aims at the elimination of the disease from its root cause rather than providing only a symptomatic relief that may cause recurrence of the condition. Rajanyadi Choornam is one such herbal formulation mentioned in the classics which would enhance the status of digestive fire (Grahani Deepanam Sreshtam) and helps in proper channelization of Vata (Vataanulomana), providing considerable relief to symptoms. A total of 32 children of age group 2-5 years satisfying the inclusion criteria were included in the study. The participants were given Rajanyadi Choornam in a dose of 2.5 gm twice daily with 5 ml of Madhu and Ghritam taken in unequal quantities. The severity of clinical symptoms and blood parameters (serum IgE, AEC) were assessed after 45 days of intervention. For clinical evaluation data regarding the severity of symptoms were collected and laboratory investigations like Serum Total IgE, AEC were done in the children both before and after drug intervention. The results were analysed statistically and reduction of symptoms was statistically significant.

Мукоактивные средства в терапии респираторных заболеваний у детей

Мукоактивные средства в терапии респираторных заболеваний у детей

The role of antioxidant enzymes in the development of respiratory diseases in children

Background. Redox reactions are an important part of metabolism and are necessary both for replenishing energy needs and for delivering and utilizing oxygen. In the progression of bronchopulmonary pathology, an important role belongs to the excess amount of various compounds accumulated as a result of activation of lipid peroxidation, which leads to disruption of the membrane structure, lipid metabolism and toxic effects on cells and tissues of various organs and systems. The article summarizes current knowledge about the role of antioxidant enzymes in the pathogenesis of community-acquired pneumonia and non-obstructive bronchitis in children. They are of key importance in the stabilization of oxidative stress in the respiratory system pathology. A regulatory role in the antioxidant defense system of the enzyme superoxide dismutase (SOD) has been shown.Design and methods. The study involved 68 children (10–16 years old): 37 children with bronchitis, 31 with community-acquired pneumonia and 25 healthy children. Blood samples were taken for the subsequent SOD level determination.Results. A significant decrease in the SOD level and a low rate of normalization of its parameters in children with pneumonia were revealed. In children with bronchitis, the initial change in the SOD level was less significant, with a higher rate of its recovery.Conclusion. A significant SOD decrease in pneumonia indicates decompensation of oxidative stress processes in this group.

Associations between residential greenness and asthma and allergic rhinitis in children: A systematic review and meta-analysis

Several studies suggested that residential greenness was associated with childhood asthma and allergic rhinitis. However, associations were inconsistent and it's still limited for the meta-analyses of associations in these studies. Here we aimed to provide state-of-the-art evidence for associations of residential greenness with asthma and allergic rhinitis in childhood. We systematically reviewed the relevant studies from five databases since database inception to December 2020 and meta-analyzed associations of residential greenness with childhood respiratory diseases from 23 original articles. Our meta-analyses indicated that childhood asthma was negatively associated with normalized difference vegetation index (NDVI) within 100m of residence (pooled OR, 95%CI: 0.88, 0.83-0.93), but had no significant association with greenness within 500m of residence (1.10, 0.99-1.23). NDVI within the 500m of residence had significant and positive associations with allergic rhinitis among 6-8-years-old children (1.21, 1.07-1.38), but was not significantly associated with allergic rhinitis among 9-12-years-old children (1.02, 0.93-1.12). Similar associations were found in sensitivity analyses. Our findings indicate that residential greenness could have significant effects on preschoolers’ asthma and allergic rhinitis. However, effect directions on asthma and allergic rhinitis are inconsistent among different study populations and among studies using different indicators of residential greenness.

Prenatal and postnatal decoration in residence are associated with childhood allergies and respiratory diseases: A 10-year repeated retrospective observational study

The previous studies reported inconsistent associations of early residential decoration with childhood allergies and respiratory diseases. In this study, we conducted a 10-year retrospective observational survey among preschoolers from three urban districts in Chongqing of China in 2010 and in 2019, to investigate the associations of the prenatal and postnatal residential decorations with the childhood asthma, allergic rhinitis, eczema, wheeze, rhinitis, and pneumonia. We collected data from 4976 to 3971 of 3-6-year-olds preschoolers in the 2010 and 2019 surveys, respectively. The results showed that proportions of prenatal and postnatal residential decorations in different durations in 2010 were significantly higher than in 2019 (4.1%–19.6% vs. 2.1–5.3%). Except for allergic rhinitis (6.1% vs. 9.5%), prevalences of the studied diseases in 2010 also were significantly higher than in 2019 (for example: asthma: 8.2% vs. 6.1%; wheeze: 17.1% vs. 7.7%; rhinitis: 40.6% vs. 24.0%). In the two-level (district-child) logistic regression analyses, surveys in both 2010 and 2019 revealed that residential renovation and buying new furniture in prenatal and postnatal periods consistently increased odds of most studied diseases (ranges of adjusted odds ratio (AOR): 1.31–1.86). The prenatal decoration exposures had stronger associations with childhood allergies and respiratory diseases than the postnatal decoration exposures. The early residential decoration activities had stronger associations with allergies and respiratory diseases among girls and preschoolers without history of family allergy. Our findings indicate that prenatal and postnatal household decoration behaviors are risk factors for childhood airway diseases and allergies. Girls and children without family history of allergy are vulnerability groups.

Viral loads of parainfluenza virus type 3 and severity of respiratory diseases in children

BackgroundParainfluenza virus type 3 (PIV-3) is one of the common pathogens for respiratory infections in children. Whether viral load of PIV-3 is associated with severity of respiratory diseases in children is not yet known. Our aim was to determine significance of PIV-3 viral load among infected children. MethodsWe conducted a single-center, retrospective study at Tokyo Metropolitan.Children's Medical Center, Japan, from June to August 2021. Hospitalized children were screened with a posterior nasal swab for multiplex PCR, and viral load was subsequently measured from remained samples by real-time PCR. Demographic data were collected from digital charts. PIV-3 positive patients were categorized into mild group with no oxygen demand, moderate group with low-flow oxygen demand and severe group with high-flow nasal cannula oxygen or non-invasive positive pressure ventilation or mechanical ventilation. Viral loads were compared among mild, moderate and severe groups. Results151 patients were positive for PIV-3. We found no statistically significant association among PIV-3 viral load and severity of respiratory diseases (p = 0.35), and no statistically significant association between severity of illness and co-detection of other viruses. In each severity group, relatively high viral load per posterior nasal swab was observed at the time of testing. ConclusionAmong PIV-3 patients, we could not find statistically significant between viral load and their severity, therefore we could not conclude that viral load is a good surrogate marker for clinical severity of PIV-3.

The change in the relationship between temperature and respiratory diseases among children in Guangzhou, China.

Temperature is closely associated with respiratory disease (RD) in children, but few studies have examined whether the relationship between ambient temperature and RD in children changed after the COVID-19 epidemic. The aim of this study was to assess the relationship between temperature and RD in children after the COVID-19 epidemic in Guangzhou, China. We used a distributed lag nonlinearmodel to compare the relationship between temperature and RD among children in Guangzhou from 2018 to 2022. The results showed an S-shaped relationship between temperature and RD in the post-COVID-19 period with a reference minimum risk at a temperature of 21°C and an increasing relative risk (RR) at extremely low temperature (ELT) and extremely high temperature (EHT). The highest RR associated with EHT was 1.935 (95% confidence interval [CI]: 1.314-2.850) at a lag of 0-14days. The on-the-day lag effects were found to be strongest at the lag 0day of EHT with a RR of 1.167 (95% CI: 1.021-1.334). Furthermore, each 1°C increase in post-COVID-19 temperature increased the risk of RD by 8.2% (95% CI: 1.044-1.121). Our study provides evidence that the relationship between temperature and RD in children in Guangzhou changed after the COVID-19 epidemic, and high temperature is more likely to cause RD in children. Relevant government departments and parents should understand the relationship between temperature and RD in children and develop new preventive measures.

Presepsin and procalcitonin as markers of infectious respiratory diseases in children: a protocol for a scoping review of the literature

Background: Presepsin is a new inflammatory marker used in clinical practice for the diagnosis of severe bacterial infections, which might be used in combination or substitution of other classical indexes such as procalcitonin. Presepsin has been studied mainly in specific categories of patients (generally adults, critically ill patients or neutropenic children) to identify severe bacterial infections and to predict the mortality risk, while the role of this marker in discriminating bacterial from viral infections in otherwise healthy children of different age groups is less examined. This scoping review aims to better explore available evidence around the potential role of presepsin in pediatric respiratory infectious diseases, analyzing its ability to distinguish the severity and type of respiratory pathology and comparing it with a classic inflammation index such as procalcitonin. Methods: We started our research in February 2023 in the following bibliographic databases: PubMed, EMBASE, Cochrane and SCOPUS. The main review question will be “What is known about the diagnostic role of presepsin and/or procalcitoninin the differential diagnosis of respiratory tract infection’s severity and etiology?” We will include randomized and non-randomized controlled trials, prospective and retrospective observational studies, performed on children and adolescents (younger than 18 years), hospitalized or not, with a confirmed diagnosis of upper and/or lower respiratory infectious disease. We will include children diagnosed with pneumonia, bronchiolitis, bronchitis, croup, and other types of infectious respiratory diseases. To report our findings, we will follow Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Dissemination: The findings of this review will be published in a peer-reviewed journal and presented in national and international conferences.

Outdoor Air Pollution and Childhood Respiratory Disease: The Role of Oxidative Stress

The leading mechanisms through which air pollutants exert their damaging effects are the promotion of oxidative stress, the induction of an inflammatory response, and the deregulation of the immune system by reducing its ability to limit infectious agents' spreading. This influence starts in the prenatal age and continues during childhood, the most susceptible period of life, due to a lower efficiency of oxidative damage detoxification, a higher metabolic and breathing rate, and enhanced oxygen consumption per unit of body mass. Air pollution is involved in acute disorders like asthma exacerbations and upper and lower respiratory infections, including bronchiolitis, tuberculosis, and pneumoniae. Pollutants can also contribute to the onset of chronic asthma, and they can lead to a deficit in lung function and growth, long-term respiratory damage, and eventually chronic respiratory illness. Air pollution abatement policies, applied in the last decades, are contributing to mitigating air quality issues, but more efforts should be encouraged to improve acute childhood respiratory disease with possible positive long-term effects on lung function. This narrative review aims to summarize the most recent studies on the links between air pollution and childhood respiratory illness.

Racial Disparities and Common Respiratory Infectious Diseases in Children of the United States: A Systematic Review and Meta-Analysis

Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory infectious diseases in children. This study follows the PRISMA flow guidelines for systematic reviews and the standards of meta-analysis for 20 quantitative studies conducted from 2016 to 2022 including 2,184,407 participants. As evidenced from the review, in the U.S., racial disparities are present among children, with Hispanic and Black children carrying the burden of infectious respiratory disease occurrence. Several factors are contributory to these outcomes among Hispanic and Black children, including higher rates of poverty; higher rates of chronic conditions, such as asthma and obesity; and seeking care outside of the home. However, vaccinations can be used to reduce the risk of infection among Black and Hispanic children. Whether a child is very young or a teen, racial disparities are present in occurrence rates of infectious respiratory diseases, with the burden resting among minorities. Therefore, it is important for parents to be aware of the risk of infectious diseases and to be aware of resources, such as vaccines.

Parental Mental Health and Childhood Respiratory Outcomes in a Severe Bronchiolitis Cohort.

Parental mental health conditions appear to contribute to the development of childhood respiratory illness. We investigated the relationship between parental mental health and childhood respiratory illness using data from a 17-center prospective cohort study of infants hospitalized with bronchiolitis between 2011 and 2014 (n = 921). Among 779 (84.6%) participants with self-reported parental mental health history data, 184 (23.6%) had parental history of depression and 155 (19.9%) had anxiety. Multivariable analyses found that both parental history of depression (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.01-1.99) and anxiety (HR 1.28, 95% CI 1.08-1.52) were associated with an increased risk of recurrent wheezing by age 3 years. However, only parental history of anxiety was associated with asthma by age 5 years (odds ratio 1.79, 95% CI 1.25-2.55). Further research on exposure severity, other early life stressors, and effective methods of parental psychosocial support is needed to develop targeted risk factor prevention strategies to reduce the burden of childhood respiratory illness.