Episodes Of Respiratory Infections Research Articles

Spontaneous Resolution of an Endobronchial Mass

ABSTRACT Bronchial adenomas are a heterogeneous group of tumors accounting for 5% of primary pulmonary neoplasms. We report the case of a 21-year-old woman with recurrent episodes of lower respiratory tract infections requiring hospitalization since 2008. She was diagnosed with right middle lobe and lower lobe atelectasis and underwent fiber-optic bronchoscopy for further evaluation, which revealed a red, smooth, pedunculated mobile mass in the right bronchus intermedius. The post-bronchoscopy patient had hemoptysis. A review bronchoscopy performed for surgical management surprisingly revealed the disappearance of mass. The patient probably expectorated the mass during the episode of hemoptysis. Such incidence has been reported only once in the literature.

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

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

Quel che resta della prevenzione delle otiti (e infezioni respiratorie): xilitolo e dintorni

Over the years, the prevention of episodes of upper respiratory tract infections and in particular of acute otitis media have always been discussed. A recent randomized controlled clinical trial has re-proposed the evaluation of the efficacy of a natural sugar, xylitol. The results were not favourable as the use of xylitol in children aged 1-5 years did not reduce the frequency of episodes of otitis and upper respiratory tract infection compared to placebo. An opportunity to reflect and discuss the issue of the prophylaxis of “physiological” respiratory infections, which must always be evaluated in relation to the available evidence of efficacy: whether we are talking about drugs or what is called complementary medicine.

The incidence of upper respiratory infections in children is related to the concentration of vanadium in indoor dust aggregates.

It has been reported that the disease-initiated and disease-mediated effects of aerosol pollutants can be related to concentration, site of deposition, duration of exposure, as well as the specific chemical composition of pollutants. To investigate the microelemental composition of dust aggregates in primary schools of Vilnius and determine trace elements related to acute upper respiratory infections among 6-to 11-year-old children. Microelemental analysis of aerosol pollution was performed using dust samples collected in the classrooms of 11 primary schools in Vilnius from 2016 to 2020. Sites included areas of its natural accumulation behind the radiator heaters and from the surface of high cupboards. The concentrations of heavy metals (Pb, W, Sb, Sn, Zr, Zn, Cu, Ni, Mn, Cr, V, and As) in dust samples were analyzed using a SPECTRO XEPOS spectrometer. The annual incidence rates of respiratory diseases in children of each school were calculated based on data from medical records. The mean annual incidence of physician-diagnosed acute upper respiratory infections (J00-J06 according to ICD-10A) among younger school-age children was between 25.1 and 71.3% per school. A significant correlation was found between vanadium concentration and the number of episodes of acute upper respiratory infections during each study year from 2016 to 2020. The lowest was r = 0.67 (p = 0.024), and the highest was r = 0.82 (p = 0.002). The concentration of vanadium in the samples of dust aggregates varied from 12.7 to 52.1 parts per million (ppm). No significant correlations between the other trace elements and the incidence of upper respiratory infections were found, which could be caused by a small number of study schools and relatively low concentrations of other heavy metals found in the samples of indoor dust aggregates. A significant and replicable correlation was found between the concentration of vanadium in the samples of natural dust aggregates collected in primary schools and the incidence of acute upper respiratory infections in children. Monitoring the concentration of heavy metals in the indoor environment can be an important instrument for the prevention and control of respiratory morbidity in children.

Within-episode repeat antibiotic prescriptions in patients with respiratory tract infections: A population-based cohort study

Antimicrobial stewardship interventions mainly focus on initial antibiotic prescriptions, with few considering within-episode repeat prescriptions. We aimed to describe the magnitude, type and determinants of within-episode repeat antibiotic prescriptions in patients presenting to primary care with respiratory tract infections (RTIs). We conducted a population-based cohort study among 530 sampled English general practices within the Clinical Practice Research Datalink (CPRD). All individuals with a primary care RTI consultation for which an antibiotic was prescribed between March 2018 and February 2022. Main outcome measurement was repeat antibiotic prescriptions within 28 days of a RTI visit stratified by age (children vs. adults) and RTI type (lower vs. upper RTI). Multivariable logistic regression and principal components analyses were used to identify risk factors and patient clusters at risk for within-episode repeat prescriptions. 905,964 RTI episodes with at least one antibiotic prescription were identified. In adults, 19.9% (95% CI 19.3-20.5%) had at least one within-episode repeat prescription for a lower RTI, compared to 10.5% (95% CI 10.3-10.8%) for an upper RTI. In children, this was around 10% irrespective of RTI type. The majority of repeat prescriptions occurred a median of 10 days after the initial prescription and was the same antibiotic class in 48.3% of cases. Frequent RTI related GP visits and prior within-RTI-episode repeat antibiotic prescriptions were main factors associated with repeat prescriptions in both adults and children irrespective of RTI type. Young (<2 years) and older (65+) age were associated with repeat prescriptions. Among those aged 2-64 years, allergic rhinitis, COPD and oral corticosteroids were associated with repeat prescriptions. Repeat within-episode antibiotic use accounts for a significant proportion of all antibiotics prescribed for RTIs, with same class antibiotics unlikely to confer clinical benefit and is therefore a prime target for future antimicrobial stewardship interventions.

Parallels between clinical and genetic characteristics in children with primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) is a rare genetic disorder that leads to chronic inflammatory damage to the airways and auditory organs. This article presents current information and a study aimed at investigating parallels between the course of PCD and clinical and genetic variant of the disease, which contributes to a timely diagnosis and enables personalized treatment approach.The aim of the study was to identify phenotypic characteristics and chronological patterns of PCD course depending on the genotype.Methods. The study was conducted at the Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University (Pirogov Medical University), Ministry of Health of Russia. The study included children with PCD who underwent next generation sequencing (NGS) of the exome.Results. Significant differences were found in the course of PCD based on clinical and genetic characteristics. Children with defects in the genes encoding central pair proteins are characterized by an earlier onset of daily productive cough and recurrent respiratory infections. A similar pattern is typical for patients with defects in the genes encoding the cilia assembly proteins. The first episode of respiratory infection occurs later in patients with defects in the genes encoding dynein handle proteins. Patients who do not have defects in PCD-associated genes are characterized by a late onset of persistent difficulty in nasal breathing, productive cough and respiratory diseases.Conclusion. Identification of clinical and genetic variants of PCD allows prediction of chronological features of the course of the disease.

Epidemiological characteristics and outcome of viral respiratory tract infections in the first year after allogeneic hematopoietic cell transplantation.

Adverse outcomes of viral respiratory tract infections (RTI) have been reported in recipients of allogeneic hematopoietic cell transplantation. Using a laboratory-developed multiparameter PCR in a consecutive series of 242 patients, we found the highest incidence of viral RTI in the pre-engraftment phase. The occurrence of multiple episodes of viral RTI or viral pneumonia was significantly associated with a higher hazard of non-relapse mortality in the first year after transplantation. We observed a 90-day mortality of 19.7% after viral RTI, which was significantly different between patient groups stratified according to the ISI score.

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

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

Two young adults presenting with breathlessness and recurrent chest infection: a major miss!!!

Dyspnea is of multi-factorial etiology, and in young adults, obstructive airway disease is the commonest cause. We are reporting two cases of young adults who presented with breathlessness and recurrent episodes of respiratory tract infections since childhood associated with poor physical development. They were referred to our hospital for an evaluation of suspected lung collapse. The evaluation revealed it to be an unusual case of right lung hypoplasia presenting in the second decade, and which was not associated with any other systemic anomaly in the first case, while the second case was diagnosed as a case of left pulmonary aplasia with right tracheal bronchus and double SVC drainage. The treating physicians should have a high clinical suspicion about developmental pulmonary disorders while treating young patients with recurrent episodes of pneumonia.

Лінійний регресійний аналіз впливу біоелементів на частоту гострих респіраторних інфекцій у дітей дошкільного віку

Purpose - to identify the bioelements having the most significant impact on the susceptibility of preschool children to frequent episodes of acute respiratory infections (ARI). Materials and methods. A total of 30 children (14 boys and 16 girls) aged 1-6 years, undergoing inpatient treatment on ARI, were involved in the clinical study. Two integral indicators of acute respiratory infections recurrence, i.e. the infection index and the resistance index, were taken into account for each patient. The children were tested by X-ray fluorescence analysis of 17 bioelements in their hair - Zn, Fe, Cu, Se, Mn, Cr, Co, Br, Ni, Rb, Sr, Sn, Pb, Ca, K, S, and Cl. The statistical processing of the obtained digital material was performed with IBM SPSS Statistics 28 licensed software. A linear regression analysis with stepwise involvement of predictors was applied. Results. In preschool children, there is a moderate negative correlation between hair Rb content and the calculated resistance index (ρ=-0.405; p=0.026; 95% CI: (-0.674)-(-0.042)), according to which lower concentrations of this bioelement are associated with more frequent episodes of ARI. Additionally, Rb has a statistically significant pairwise relationship with several other bioelements studied and the ratios between them. Rb was demonstrated to be directly and most closely correlated with K (ρ=0.842; p&lt;0.001; 95% CI: 0.678-0.926). A prognostic model of the resistance index was obtained, using the linear regression analysis of independent factors. The formula of the prognostic model included only one of the factors studied - the ratio of Mn/Cr content in hair. The informativeness of the mentioned model was 24.9%, which is a quite significant value, taking into consideration a broad range of known predictors for recurrent respiratory infections. Conclusions. The findings are complementary to the available scientific data on the participation of the bioelements in providing resistance to frequent ARI in preschool children. It is planned to continue examining the status of particular bioelements in combination with other potential predictors of recurrent respiratory infections. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the authors.

Large spontaneous lung hernia—a case report

Abstract Intercostal lung hernias can be results of trauma or surgery. True spontaneous lung hernias thought to be a result of sudden acute increase in intrathoracic pressures are extremely rare. Only 51 cases have been reported in literature over the past four-and-half decades. We report a case of spontaneous chest wall posterior-lateral lung herniation that developed in a 73-year-old following severe coughing and straining during an episode of lower respiratory tract infection. Herein we present the unusual findings in the case and outline the pathophysiology of the problem and management options available.

The clinical impact of serious respiratory disease in children under the age of two years during the 2021-2022 bronchiolitis season in England, Scotland and Ireland.

Interventions introduced to reduce the spread of SARS-CoV-2 led to a widespread reduction in childhood infections. However, from spring 2021 onwards the United Kingdom and Ireland experienced an unusual out-of-season epidemic of respiratory disease. We conducted a prospective observational study (BronchStart), enrolling children 0-23 months of age presenting with bronchiolitis, lower respiratory tract infection or first episode of wheeze to 59 Emergency Departments across England, Scotland and Ireland from May 2021 to April 2022. We combined testing data with national admissions datasets to infer the impact of respiratory syncytial virus (RSV) disease. The BronchStart study collected data on 17,899 presentations for 17,164 children. Risk factors for admission and escalation of care included prematurity and congenital heart disease, but most admissions were for previously healthy term-born children. Of those aged 0-11 months who were admitted and tested for RSV, 1,907/3,912 (48.7%) tested positive. We estimate that every year in England and Scotland 28,561 (95% confidence interval 27,637-29,486) infants are admitted with RSV infection. RSV infection was the main cause of hospitalisations in this cohort, but 51.3% of admissions in infants were not associated with the virus. The majority of admissions were in previously healthy term-born infants.

Prevention of the Seasonal Spread of Arvi Among Early Children

Acute respiratory viral infections (ARVI) are widespread infectious diseases, cause significant economic damage and therefore are not only a serious medical, but also the most important socio-economic problem for humanity. This group of diseases accounts for up to 90% of all infectious morbidity. Mostly children and people over 60 years of age fall ill - the so-called risk groups for the incidence of ARVI. Every adult suffers from influenza or other acute respiratory viral infections on average 2-4 times a year, a schoolchild - 4-5 times, a preschool child - 6 times, a child of the first year of life has from 2 to 12 episodes of acute respiratory viral infections. The polyetiology of ARVI pathogens and the variability of viruses involved in the epidemic process, complications after an illness, necessitate the search for new diagnostic methods and optimization of treatment and preventive measures. Modern approaches to the treatment of influenza and acute respiratory viral infections of other etiologies are reduced to the use of complex drugs that combine antiviral, immunomodulatory, symptomatic and pathogenetic effects.

Central lung Inflammatory Myofibroblastic Tumor after aspergillosis and total occlusion of the left pulmonary artery

Inflammatory Myofibroblastic Tumor (IMT) is an exceptionally uncommon benign tumor. We present a 54-year-old man with IMT, frequent episodes of respiratory infections, aspergillosis, and hemoptysis, who has received 23 years of conservative treatment. A successful left intrapericardial pneumonectomy was performed. During chest closure, the left atrial auricle lesion caused a massive hemorrhage owing to contact with the staplers of the left pulmonary artery stapler line. The bleeding was immediately controlled. One year after surgery, the patient has fully recovered and no adverse events or relapses have occurred.

Supracardiac Total Anomalous Pulmonary Venous Connection in Adolescence.

Background Supracardiac total anomalous pulmonary communication (TAPVC) constitutes a rare congenital cardiac anomaly. Most babies with supracardiac TAPVC are diagnosed in infancy and undergo complete surgical repair during infancy. Delayed presentation of supracardiac TAPVC is rare, and the surgical outcomes are not well known. This retrospective study was conducted to determine the presentation and surgical outcome of supracardiac TAPVC among adolescents, which constitutes an extremely rare subgroup of TAPVC. Methodology This retrospective analysis was conducted among 15 adolescent patients with supracardiac TAPVC who underwent surgical repair in the cardiothoracic surgery department of a tertiary care center in India. This study aimed to assess the intraoperative, postoperative, immediate, early, and late outcomes of adolescent patients with supracardiac TAPVC who had undergone surgical repair between 2010 and 2014 in a tertiary care center in India. Results The study included 15 patients with a diagnosis of isolated supracardiac TAPVC. A mild degree of cyanosis was present in eight patients, recurrent episodes of lower respiratory tract infections were present in five patients, and dyspnea (New York Heart Association I/II) was noted in 12 patients. Mean oxygen saturation was 92% (range = 85-93%), and mean pulmonary artery pressure was 24 mmHg (range = 15-50 mmHg). After median stenotomy, a wide anastomosis was made between the common pulmonary venous chamber and the posterior wall of the left atrium. A fenestration was made in the Dacron patch in three patients who had raised pulmonary vascular resistance (PVR) preoperatively. Twelve patients were weaned off cardiopulmonary bypass (CPB) with minimal inotropic support. Three patients who had high preoperative PVR had difficulty in weaning from CPB. The mean CPB and cross-clamp time was 75 ± 12 minutes and 58 ± 9 minutes, respectively. Atrial fibrillation was noted in five (33.3%) patients in the early postoperative period, and three (20%) patients had pulmonary artery hypertensive crises postoperatively. There was no superficial or deep sternal wound infection in the postoperative period. Mild and moderate right ventricular dysfunction was present in four (26.67%) and two (13.3%) patients, respectively, in the postoperative period. On two-dimensional echocardiography during follow-up at the end of one year, there was no gradient across the anastomosis, and pulmonary artery pressure was normal in all patients. Conclusions Surgical repair of supracardiac TAPVC in adolescence has an excellent outcome. Survival of patients with supracardiac TAPVC until adolescence depends on the presence of a dilated vertical vein and a large atrial septal defect facilitating unobstructed pulmonary venous flow. The aim of the surgical repair should be to create a wide anastomosis between the left atrium and the pulmonary venous chamber which should be bigger than the size of the mitral valve orifice indexed to the body surface area as it would amount to no or negligible anastomotic gradient postoperatively.

Risk factors of recurrent respiratory infections in early school-age children

Acute respiratory infections (ARIs) annually rank first in the structure of infectious diseases both in Ukraine and worldwide. ARIs are the leading cause of disability and death in preschool children, and with recurrent episodes, they can impact the physical and psychological aspects of children's health, imposing a significant medical burden on families, healthcare systems, and society as a whole. Preventing recurrent respiratory infections (RRIs) can only be achieved through timely intervention in risk factors.Aim: to determine the influence of risk factors on the development of recurrent episodes of acute respiratory infections in children aged 5 to 7 years and to develop preventive measures for their control in primary healthcare settings.Materials and Methods. The authors retrospectively analyzed medical records of 342 children aged 5 to 7 years. The main group included children with RRIs (264), and the control group consisted of children with sporadic illness episodes (78). Results: the incidence of RRIs in children has two peaks at ages 3 and 6, which is likely associated with the commencement of attendance in childcare settings (kindergarten and school). Key prenatal and postnatal, clinical-anamnestic, and social risk factors that increase the likelihood of recurrent respiratory infections in younger school-age children were identified.Conclusions. factors significantly increasing the likelihood of developing RRIs in a child include: ARI episode within the first 6 months of life (OR = 22, 95% CI 11.6 - 41.7), previous pneumonia (OR = 12, 95% CI 3.7 - 40), and the presence of chronic infection foci in the form of tonsillitis (OR = 8.2, 95% CI 4.3 - 15.6), p=0.0001. Primary healthcare practitioners should follow strategies to modify these risk factors and not wait for further depletion of the child's adaptive potential (sanitation of chronic infection foci, promotion of breastfeeding, and tobacco cessation).

The effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children

Background. Recurrent and prolonged course of respiratory infections leads to the formation of chronic foci of inflammation, the persistence of viruses, impaired physical and psychomotor development, and a decrease in the child’s immunity. Given the participation of vitamin D (VD) in the regulation of the body’s immune response, the study of its role in the development and course of recurrent respiratory diseases in children remains re­levant. The purpose is to study the effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children. Materials and methods. We examined 52 children with recurrent respiratory infections aged 4 to 10 years. Children were examined before and after VD supplementation according to the study criteria: the average frequency of acute respiratory infection (ARI) episodes per year, the severity of the clinical manifestations of ARI episode, its average duration, the frequency of antibiotic prescriptions and outpatient visits to the doctor. Results. It was found that at the beginning of the exa­mination, the level of 25(OH)D in the blood serum ranged from 11.1 to 29.9 ng/ml, 22 (42.3 %) children had VD deficiency. An analysis of the frequency of ARI episodes per year showed that children with VD deficiency were ill more often than children with a sufficient level of VD (p &lt; 0.001). According to the results of the study, it was found that VD supplementation contributes to a decrease in the frequency of ARI episodes from 8.7 ± 1.7 to 6.8 ± 1.2 times a year (p &lt; 0.001), a decrease in the average number of symptoms of an episode of acute respiratory infections per year from 5.5 ± 0.5 to 4.5 ± 0.5 and their manifestations from 9.2 to 7.41 points (p &lt; 0.001), a decrease in the duration of ARI episode from 6.0 ± 1.7 to 5.7 ± 1.5 days (p = 0.003), as well as a decrease in the number of outpatient visits from 5 to 4 (p = 0.004) and antibiotic prescriptions from 61 to 38 (p &lt; 0.001). Conclusions. VD supplementation improves the course of respiratory diseases in children. The study was carried out in accordance with the Declaration of Helsinki principles. The study protocol was adopted by the ethics committee of the institution indicated in the work. The informed consent of the children’s parents was obtained.

Microbiological patterns of bacterial infections in tracheostomized children: Reducing uncertainty in continuous care.

Respiratory infections are the most frequent cause of hospitalization in tracheostomized children. However, there is a lack of publications to guide their management. The primary objective was to describe the microbiological isolates and their antibiotic susceptibilities of bacterial respiratory infections in a population of tracheostomized children. Retrospective follow-up study of children with tracheostomy seen at a tertiary hospital. Respiratory infection episodes in patients under 18 years of age who had a tracheostomy and bacterial isolation with a count ≥104 Colony Forming Units/mL in tracheal aspirate were included. The study analyzed 328 respiratory infection episodes: 164 tracheobronchitis (50%), 112 nonspecific respiratory episodes (34.1%), and 52 pneumonias (15.9%). The most commonly isolated microorganisms were Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus. The antibiotics that exhibited the highest effectiveness were meropenem (92%), imipenem (87%), and levofloxacin (86%). When hospitalization exceeded 7 days, there was a higher chance of isolating Escherichia coli and Klebsiella pneumoniae (p < 0.001 and p = 0.001, respectively), as well as an increased rate of multidrug resistance (27% vs. 7%, p = 0.035). In 75.3% of cases, the microorganism had been previously isolated in a sample taken 7-30 days before the current one, with a higher frequency observed in the case of P. aeruginosa (95.2%) compared to other microorganisms (65.3%, p < 0.001). Meropenem, imipenem, and levofloxacin provided the most effective coverage for these infections. The risk of multidrug resistance increased with longer hospital stays, especially for E. coli and K. pneumoniae. Recent isolation of P. aeruginosa may justify empirical coverage.

Role of low dose iron intake on acute respiratory tract infection in infants: A longitudinal study

Background: Anaemia and respiratory tract infections are common problems among infants and a complex relationship exists between iron status and infection. Studies on possible role of iron supplementation to prevent respiratory tract infection in healthy infants are needed so that strategies could be made at the community level to reduce its burden. Objectives: To study the effect of iron intake on the incidence of acute respiratory infection (ARI) in healthy infants. Method: A longitudinal study was done in 106 infants at the paediatric department of a teaching hospital, in which infants coming for routine vaccination with haemoglobin levels ≥10g/dl were divided into two groups after computer generated randomization. Group A received 2mg/kg/day of iron for 3 months and Group B received no supplementation. Episodes of respiratory tract infection were recorded. Follow up was done at 4, 8 and 12 weeks and at 6 months for new episodes of ARI. Growth was monitored. Data were analysed using Mann-Whitney U test, Chi square test and Student ‘t’ test via SPSS version 20.0. Results: After 6 months of follow up, mean haemoglobin in the iron supplemented group (12.76±0.63g/dl) was significantly higher than in the non-supplemental group (11.29±0.98g/dl) (p&lt;0.001), when the baseline haemoglobin levels in both groups were comparable. The incidence of ARI was 66% lower in the iron supplemented group compared with the group with no supplementation (IRR=0.34, 95%CI=0.19-0.59, p=0.0001) Conclusions: Iron supplementation in infants improves their haemoglobin status and decreases episodes of ARI in them.

Frequency and Outcome of Acute Respiratory Tract Infection in Exclusive, Partial, and Non-Breastfed Babies

Background: Exclusive breastfeeding provides nutritional and immunological support for the normal growth and development of the infant. Bangladesh is traditionally a breastfed community. The probability of having an acute respiratory infection (ARI) episode was higher for formula-fed infants than fully breastfed infants during the first four months of life. The risks for partially breastfed infants fell between those of formula-fed and fully breastfed infants, suggesting a dose-response effect of breastfeeding on the risk of respiratory infection.&#x0D; Objective: This study compares exclusive, partial, and non-breastfed groups regarding the frequency and outcome of acute respiratory infection. Materials and methods: This cross-sectional comparative study was done at the Department of Pediatrics, Rajshahi Medical College Hospital, from January 2013 to June 2013, a period of six months. A total of 300 cases of infants suffering from ARI were selected. Among them, 100 are each for exclusive breastfed (EBF) babies, partially breastfed babies (PBF), and non-breastfed (NBF) babies. In addition, demographic profile, frequency, severity of attacks, outcomes, and length of hospital stay were assessed.&#x0D; Results: Most EBF babies came to the hospital with a history of one or two attacks of ARI, but PBF and NBF babies had multiple attacks. i.e., two, three, or more attacks. Most of the NBF and PBF have presented with severe attacks (84% and 72%, respectively), whereas only 42% of EBF babies presented with severe attacks; nonetheless, a maximum of 58% of EBF babies present with mild attacks. The severe attack is more frequent in the PBF and NBF groups than in the EBF groups.&#x0D; Conclusion: Frequency, severity, and hospital staying of ARI attacks are found to be more in the PBF and NBF group of babies than in EBF babies. Better outcomes were found in EBF group babies.&#x0D; TAJ 2022; 36: No-1: 135-141