Treatment Of Acute Respiratory Infections Research Articles

ANALYSIS OF CONSUMER PREFERENCES AND THEIR INFLUENCE ON THE USE OF HOMEOPATHIC MEDICINES IN THE COMPLEX TREATMENT OF ACUTE RESPIRATORY VIRAL INFECTIONS

This article is devoted to the analysis of consumer preferences in the context of treatment of acute respiratory viral infections (ARVI) using homeopathic medicines. The study covers various aspects such as patients' main motivations for choosing homeopathy, their level of satisfaction with the results of treatment, and factors influencing the use of homeopathic remedies in complex therapy. The authors of the article review data from social surveys conducted on Google Forms portal, medical research, and literature reviews to provide a comprehensive overview of current trends in the use of homeopathic remedies in the treatment of acute respiratory infections. Special attention is paid to the influence of sociocultural and educational factors on patients' decision-making regarding treatment choices. The results of the study may be useful for health professionals, pharmacists and public health organizations, helping to better understand consumer preferences for homeopathy and to develop individualized approaches to the treatment of acute respiratory infections. The aim of the study is to analyse consumer preferences in the use of homeopathic medicines in the complex treatment of acute respiratory viral infections. Materials: Questionnaires and Surveys: Development of structured questionnaires to collect information from patients about their preferences, motivations and experiences of using homeopathic medicines for ARVI. The survey was conducted anonymously on Google Forms platform, which allowed systematisation of the data obtained. Internet resources: Analysis of discussions and reviews on medical forums and social networks related to homeopathy and treatment of acute respiratory infections. Methods: Statistical analysis: Processing data from questionnaires using statistical techniques such as frequency and correlation analyses. Qualified interviews: Conducting interviews with patients, doctors to gain a deeper understanding of motivations and experiences of using homeopathic medicines. Systematic literature review: Examining existing scientific articles and publications related to homeopathy and ARVI to obtain additional data and context. Comparative analysis: Comparison of questionnaire results with literature review and interviews to identify trends and influence of consumer preferences on the use of homeopathic medicines. Results. The study found that homeopathic medicines have the potential to be in demand in the comprehensive treatment of acute respiratory infections. Scope of the findings: the results of the study may be useful for health professionals, pharmacists and public health organisations, helping to better understand consumer preferences for homeopathy and to develop individualised approaches to the treatment of ARVI.

IN SILICO STUDY : HERMETIA ILLUCENS BASED ACUTE RESPIRATORY INFECTION TREATMENT

The novel coronavirus is now referred to as severe and critical acute respiratory syndrome coronavirus-2 (SARS-CoV-2). There have been few studies about SARS-CoV-2 co-infection may significantly inhibit the immune system of host, increase antibacterial therapy intolerance, and be harmful to the prognosis of the disease. The highest co infection comes from Streptococcus pneumoniae. Bacterial co-infection in the setting of viral pneumonia is known as major cause of mortality. Therefore, therapeutics such as antibiotics are needed to be able to kill and inhibit these bacteria. In this connection, the inaccurate use of antibiotics causes multi-drug resistant and worsens their immature immune systems. Hermetia illucens contains AMPs and various amino acids that synergistically have the potential to overcome this problem. Research on the use of crude maggot extract as a candidate for acute respiratory infection treatment products is still not available and has never been reported. This study aims to conduct in silico computerized tests related to the potential of maggot extract as antibacterial and anti-inflammatory properties, analyze its interaction with target proteins, bioavailability and ligand toxicity in maggot extract, and docking analysis of ligand-receptor. The results showed that the maggot extract had activity as peptidoglycan glycosyltransferase inhibitor, antibacterial, and anti-inflammatory. A binding affinity of the maggot AMPs ligands (defensin, diptericin, and attacin) to MurC receptor protein Streptococcus pneumoniae is also found. The antibacterial and anti-inflammatory abilities of bioactive maggots have the potential for used as a candidate treatment products for SARS-CoV-2 co-infection with Streptococcus pneumoniae as a biomedical innovation.

Досвід застосування засобу «Біоплазмікс спрей для горла» в комплексному лікуванні гострих вірусних фарингітів у дітей з атопічним фоном

The problem of therapy of acute respiratory infections in children remains relevant. The most common infectious pathology of the upper respiratory tract in both children and adults is acute viral pharyngitis. Irrational prescribing of antibiotics leads to medication-induced side effects and the spread of resistance of microorganisms to antibiotics in society. Topical application of respiratory probiotics may be an important component in the supportive treatment of acute respiratory infections and reducing antibiotic dependence. The use of probiotics in children with an atopic background is of particular importance due to the possible occurrence of adverse reactions. Purpose - to assess the safety and effectiveness of the local application of Bioplasmix throat spray in the complex treatment of acute viral pharyngitis in children with an atopic background. Materials and methods. 45 children aged 6-18 years with acute viral pharyngitis took part in the study. 2 research groups were formed: the Group I - main (n=25) - received protocol treatment + Bioplasmix throat spray locally and the Group II - comparison (n=20) - only protocol treatment. All patients were assessed for the severity of clinical symptoms (fever, headache, sore throat, scratching, cough) and oropharyngoscopy data (hyperemia, swelling of the mucous membrane of the oropharynx, granularity of the back wall of the pharynx) on the 1st, 2nd, 3rd, 4th, 5th and 7th days of using the product. Results. The use of the local application of Bioplasmix throat spray for acute pharyngitis in children ensures a faster reduction in the severity of the main clinical manifestations and signs of inflammation of the oropharynx. In the Group I, compared to the Group II, there were better indicators of a decrease in the severity of cough (1.2±0.91 points vs. 1.76±0.85 points), a scratching (1.12±0.92 points vs. 1.7±0.86 points), sore throat (1.6±0.81 points vs. 2.23±0.76 points) and hyperemia of the pharynx (1.4±0.7 points vs. 2.1±0.9 points) from the 3rd day, swelling of the pharynx (1.22±0.86 points vs. 1.8±1.04 points) from the 4th day. Adverse reactions were not noted during the use of the local application of Bioplasmix throat spray. Conclusions. Local probiotic therapy is an important component of the complex therapy of acute pharyngitis, the use of bacteria of the genus Bacillus in the form of Bioplasmix throat spray shows a positive effect on the course of acute viral pharyngitis in children, which manifests by a faster decrease in the severity of subjective symptoms of pharyngitis and inflammatory signs of the oropharynx. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Impact of Per Capita Health Expenditure on Child Health Outcomes in Nepal

This paper explores the relationship between child health outcomes and per capita health investment in Nepal, using key indicators such as child mortality rate, stunting, skilled birth attendance, and appropriate treatment for acute respiratory infections. The study utilizes the data primarily from the World Bank and the Ministry of Finance in Nepal. The study adopts quantitative analysis techniques, including correlation and regression analysis, to assess the impact of health investment on child health outcomes. The results show that increased per capita health expenditure is positively correlated with improved child health outcomes which shows linear growth in different variables if compared with the per capita investment done in health. There is a negative correlation between per capita health expenditure and child mortality under 5 years of age and this is evidenced that increased per capita health expenditure reduces the child mortality among under 5 years of children. Thus, the study aims to highlight the importance of allocating resources in policy reforms, capacity building and allocating resources in the health sector. The study also incorporates relevant resources from scholarly articles and academic literature to provide a comprehensive understanding of the topic and support the analysis regarding the relationship between per capita health investment and child health outcomes.

Assessing the relationship between coverage of essential health services and poverty levels in low- and middle-income countries.

Universal health coverage (UHC) aims to provide essential health services and financial protection to all. This study aimed to assess the relationship between the service coverage aspect of universal health coverage and poverty in low- and middle-income countries (LMICs). Using country-level data from 96 LMICs from 1990 to 2017, we employed fixed-effects and random-effects regressions to investigate the association of eight service coverage indicators (inpatient admissions; antenatal care; skilled birth attendance; full immunization; cervical and breast cancer screening rates; diarrhoea and acute respiratory infection treatment rates) with poverty headcount ratios and gaps at the $1.90, $3.20 and $5.50 poverty lines. Missing data were imputed using within-country linear interpolation or extrapolation. One-unit increases in seven service indicators (breast cancer screening being the only one with no significant associations) were associated with reduced poverty headcounts by 2.54, 2.46 and 1.81 percentage points at the $1.90, $3.20 and $5.50 lines, respectively. The corresponding reductions in poverty gaps were 0.99 ($1.90), 1.83 ($3.20) and 1.89 ($5.50) percentage points. Apart from cervical cancer screening, which was only significant in one poverty headcount model ($5.50 line), all other service indicators were significant in either the poverty headcount or gap models at both $1.90 and $3.20 poverty lines. In LMICs, higher service coverage rates are associated with lower incidence and intensity of poverty. Further research is warranted to identify the causal pathways and specific circumstances in which improved health services in LMICs might help to reduce poverty.

A systematic review and meta-analysis on nutritional and dietary interventions for the treatment of acute respiratory infection in pediatric patients: An EAACI taskforce.

Acute respiratory infections are a major cause of morbidity and mortality in children worldwide. Dietary and nutritional interventions, including minerals and vitamin supplementation, have been explored as potential treatments for these infections. However, the evidence on their efficacy is limited and inconclusive. This systematic review and meta-analysis aim to provide a comprehensive summary of the available evidence on the effectiveness of dietary and nutritional interventions for treating acute respiratory tract infections in children. A systematic review was conducted according to the PRISMA 2020 guidelines in April 2022 and updated in April 2023. Clinical trials focusing on dietary or nutritional interventions, including supplementations, in children with acute respiratory tract infections were included. The selection of interventions and outcomes was based on biological plausibility. Data were extracted using a standardized form, and the risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta-analysis was performed using random-effect models. A total of 50 studies were included in the review. Four trials were conducted in low, 32 in lower-middle, 12 in upper-middle, and only two in high-income countries. The studies evaluated various dietary interventions, including zinc, vitamin A, vitamin E, vitamin D, and probiotics. The results of individual studies on the efficacy of these interventions were mixed, with some showing positive effects on clinical outcomes such as duration of symptoms, while others showed no significant impact. Meta-analysis was conducted for zinc supplementation in children with pneumonia, and the pooled results suggested a potential limited benefit in terms of reduced hospital length of stay but not time to recovery. Meta-analyses on vitamin D did not show any effect in children with pneumonia. This systematic review fills a critical gap in the literature by synthesizing the available evidence on the efficacy and safety of nutritional or dietary interventions for acute respiratory tract infections in children. The findings indicate no dietary or nutritional intervention can currently be recommended for the routine treatment of respiratory tract infections in children based on single supplement studies. The metanalysis suggests that zinc supplementation might have a beneficial effect on length of hospitalization in children with pneumonia. New studies are needed to establish more conclusive evidence for pediatric acute respiratory diseases especially for children living in a context of high-income countries.

Patterns of antibiotic use for acute respiratory infections in under-three-year-old children in India: A cross-sectional study.

Despite its mostly viral etiology, antibiotics are frequently used to treat acute respiratory infections (ARIs) in children. India is one of the largest global consumers of antibiotics and has one of the highest rates of resistance to antimicrobial treatments. However, the epidemiology of antibiotic treatment among young children in India is poorly understood. Using nationally representative household survey data from the Indian National Family Health Surveys (NFHS) conducted between 2015 and 2016 and 2019 and 2021, we estimated the prevalence of antibiotic use among 17 472 children under the age of three who reported ARI symptoms within two weeks before their mothers were interviewed. To assess the factors associated with antibiotic use for the treatment of ARI symptoms, we used multivariable logistic regression models that included sociodemographic, child-related, household, and health care related characteristics, with results reported on the prevalence difference (PD) scale. We estimated that 18.7% (95% CI = 17.8-19.6) of under-three-year-old (U3) children who exhibited ARI symptoms in the two weeks prior to the survey were given antibiotics as a treatment. The highest prevalence was observed in the southern and northern geographic zones of India. Furthermore, multivariable regression models indicated that children with greater access to health services were more likely to receive antibiotics for ARI treatment, regardless of the type of health care facility (public, private or pharmacy/unregulated). Additionally, the prevalence of antibiotic consumption was higher among children from families with religious affiliations other than Muslim and Hindu backgrounds (i.e. Christian, Sikh, Buddhist/neo-Buddhist, Jain, Jewish, Parsi, no religion and other) (PD = 11.7 (95% CI = 6.3-16.7)) compared to Hindu families and among mothers with a secondary or higher education (PD = 5.8 (95% CI = 1.7-9.9)) compared to mothers lacking formal education. Our findings provide an important baseline for monitoring the use of antibiotics for the treatment of acute respiratory infections, and for designing interventions to mitigate potential misuse among young children in India.

Edukasi Pencegahan ISPA pada Anak Oleh Keluarga di Puskesmas Simpang Kawat Kota Jambi

Acute Respiratory Infection (ARI) is a common disease with mild to severe manifestations. Symptoms include fever, cough, and often sore throat, runny nose. ARI usually lasts more than 14 days. Puskesmas Simpang Kawat Jambi City experienced an increase in cases of Acute Respiratory Infection (ARI) in children in August-September 2022 as many as 20-25 cases per month. The purpose of this service is to educate the prevention of children's ARI in families. The methods in this community service are lectures, demonstrations and leaflets. The time of community service was held on December 22, 2022. Participants followed the community service with enthusiasm which was attended by 14 participants and at the end of the material evaluation there were 10 participants. The results of the community service increased knowledge where 5 participants could answer 5 question items, namely the definition of ARI in children, the causes of ARI, 5 out of 9 signs of symptoms of children's ARI, 4 out of 6 prevention of ARI in children, and 4 out of 11 ARI treatments in children while at the beginning of education 3 participants knew the definition of ARI, 3 participants knew the cause of ARI from germs, 3 participants knew the symptoms of ARI were only cough and cold, 3 participants knew the prevention of ARI by wearing masks, 2 participants knew the treatment of ARI by taking cough and cold medicine. The results of this community service are expected to be applied in the form of providing information in the form of education and demonstrations on a scheduled basis so that family knowledge is increasing.

Use of antibiotics, in a pediatric hospital, for respiratory infection and diarrheal disease

The World Health Organization (WHO) reports an increasing unjustified use of antibiotics in the treatment of Acute Respiratory Infections (ARI) and Acute Diarrheal Diseases (ADD) in children under five years of age. This has generated problems such as polypharmacy and the inappropriate use of antibiotics; characterized by incorrect dosage, use in viral infections, prescription inconsistent with clinical guidelines. To analyze the prescription of antibiotics, their diagnostic-therapeutic congruence, as well as the correct filling of the medical prescription, in a tertiary level hospital in Mexico. Observational, descriptive cross-sectional study. The electronic medical prescriptions made during the period January-December 2017 with a clinical diagnosis of ARI and EDA were analyzed. Of a total of 21,446 boys and girls under five years of age, 10,233 prescriptions were issued for the treatment of ARI and ADD diagnoses. 80% of the prescriptions complied with the items indicated in the electronic file. The prescription of antibiotics showed a prudent use of antibiotics both in the management of acute diarrheal diseases and in the management of acute respiratory diseases. Diagnostic-therapeutic congruence was found in most of the cases in the prescriptions analyzed.

Pemberdayaan Masyarakat Dan Keluarga Dalam Pencegahan Dan Penanganan Awal Ispa Pada Bayi Dan Balita Di Ampenan, Kota Mataram

Acute Respiratory Infection (ARI) is a health problem in developed and developing countries. This is due to the high morbidity and mortality rates due to ARI among children under five. ARI is included in the top 10 disease category in NTB with the highest number of visits, that is 174,213 (NTB Health Profile, 2020). In general, there are 3 risk factors for ARI,that is environmental factors, individual child factors and behavioral factors. Behavioral factors can be changed by increasing knowledge in the family. Observations in Karang Ujung Village show the lack of family knowledge about ARIs, how to prevent and treat them early. Therefore, it is important to conduct socialization through community and family empowerment activities in the prevention and early treatment of ARI in infants and toddlers in Karang Ujung Village. Activities are carried out in 3 stages, as follows: 1) identification of the number of infant and toddlers; 2) socialization, and 3) evaluation. The number of mothers with infant and toddlers who participated in community activities was 25 people. The results of the evaluation show that mothers of infants and toddlers have an understanding of ARI, how to prevent and early treat when a child has a cough. It is hoped that the people of Karang Ujung Village can immediately take preventive measures to prevent the occurrence of ARI in infants and toddlers and in the event of ARI disease in their families

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.

Correspondence study on the overuse of antibiotics in the treatment of acute respiratory infections in the United States

Correspondence study on the overuse of antibiotics in the treatment of acute respiratory infections in the United States

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

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

Impact of the use of multiplex PCR on etiological diagnosis and treatment of acute respiratory infections in a private hospital of the north of the country.

Diseases of the respiratory system represent one of the leading causes of medical care and antibiotic prescriptions. Currently, new technologies are used for the diagnosis of respiratory diseases of viral origin, such as the FilmArray Respiratory Panel®, approved in 2012 by the FDA. The purpose of this study was to identify the correlation between the diagnosis and treatment of respiratory tract infections and the result of the polymerase chain reaction test for respiratory viruses. The study is of a retrospective, cross-sectional, descriptive type. One-hundred and thirty-four patients who underwent a viral panel for respiratory viruses, which was positive for one or more viruses, were included. For all cases, the positive results of said test and the treatment received by patients were analyzed. Of the patients who underwent nasopharyngeal aspirate during hospitalization, 58 % received antibiotic treatment at admission, 13 % received combined treatment (antibiotic + antiviral), 27 % of the patients received symptomatic treatment since admission and 2 % did it with antivirals. After receiving a positive result for respiratory viruses, 38 % continued with antibiotics, 30 % with antibiotics and antivirals, 13.8 % were managed only with antivirals and 18.2 % with symptomatic treatment. Despite the global alert regarding antimicrobial resistance, patients continue to be treated with antibiotics, due to a situation that we ignore, but that is believed to be influenced by several factors.

EVALUATION OF A MOTHER'S KNOWLEDGE AND PRACTICE INTERVENTION PROGRAM FOR ACUTE RESPIRATORY INFECTIONS IN INDIAN CHILDREN

Acute respiratory Infection (ARI) causes approximately 3.9 million deaths yearly in children under ve years of age. In developing countries, where malnutrition is prevalent, and indoor air pollution is high, pneumonia is the leading cause of death. A structured questionnaire is used to collect data from 205 mothers. In addition, their practice regarding identifying, managing, and treating ARI is suboptimal due to inadequate knowledge about the signs and symptoms, prevalence, causes, diagnosis, and treatment of ARI. A signicant correlation is found between education and age, whereas a signicant correlation is found between joint family status and knowledge. The study highlights the importance of health education for mothers and suggests that nursing personnel can be crucial in counseling mothers in hospital and community settings

A cute respiratory viral infections in children: how to improve the quality of treatment

The issues of improving the quality of treatment of children with acute respiratory infections combined with minimization of the adverse effects and reduction of polypragmasy are high on the agenda. The safety and efficacy of therapy are the key quality criteria, which allows to use complex bioregulatory drugs with antiviral, anti-inflammatory and immunomodulatory effects in the combination therapy of acute respiratory infections in children. The article presents clinical cases of effective treatment of acute respiratory infections using bioregulatory therapy. Clinical case 1: a 3-year-old child, general condition of moderate severity during initial presentation, rise of body temperature up to 38.4 ºС, catarrhal manifestations. Diagnosis: J00 – ARVI, acute nasopharyngitis. Clinical case 2: a 5-year-old child, complaints of fever up to 38.3 ºС, nasal breathing difficulty (especially at night) reported, nasal discharge, wet cough with difficulty in expectoration of sputum. Diagnosis: J00, J35.2, J35.8 – ARVI, grade 2 pharyngeal tonsil hypertrophy, adenoiditis. Clinical case 3: a 12-year-old child, complaints of fever for 3 days (temperature 38.3–38.7 ºС). General condition of moderate severity due to intoxication syndrome, hyperthermia. Complaints of sore throat that was exacerbated by eating. Pharyngoscopy showed hyperemic, enlarged, edematous palatine tonsils, yellowish overlays located in lacunae. Diagnosis: J03.9 Acute tonsillitis, unspecified? All patients were prescribed combination bioregulatory therapy with a high compliance profile, good tolerance and absence of side effects. This therapy contributed to the reduction of polypragmasy and the prevention of recurrent upper respiratory infections.

A Review on Human Metapneumovirus and Human Bocavirus Associated with Acute Respiratory Tract Infections

One of the significant causes of morbidity and mortality among young children in developing nations is acute respiratory tract infections (ARTIs). It is also highly contagious, widely prevalent, and transmissible from person to person. It risks young children, the elderly, and those with immune system disorders. Acute respiratory infections are thought to cause 2.6 million child deaths annually worldwide, according to the World Health Organization (WHO) [1]. Infections in children with human metapneumovirus (hMPV) and bocavirus (HBoV) are linked to a high prevalence of ARTIs. It has been determined that hMPV is the second-leading cause of infant bronchiolitis, after the respiratory syncytial virus (RSV), of upper and lower respiratory tract infections. Although HBoV was first discovered in children's airways, the high detection rates of other viral pathogens and the discovery of HBoV in stool raise doubts about the virus's significance in respiratory tract infections. According to the published literature, only a few studies have identified ARTIs or demonstrated the importance of early diagnosis and treatment of ARTIs. This review article aims to thoroughly explain the aetiology, epidemiology, clinical characteristics, diagnostic approaches, and management of hMPV and HBoV.

Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 3. Expansion of population coverage of key interventions

BackgroundThis is the third in a series of 10 articles describing the Curamericas/Guatemala Maternal and Child Health Project, 2011–2015, and its effectiveness in improving the health and well-being of 15,327 children younger than 5 years of age and 32,330 women of reproductive age in the Department of Huehuetenango in180 communities that make up the municipalities of San Sebastian Coatán, Santa Eulalia, and San Miguel Acatán. The Project combined the Census-Based, Impact-Oriented (CBIO) Approach with the Care Group Approach and the Community Birthing Center (Casa Materna Rural) Approach. This combined approach we refer to as CBIO+. The Project trained women volunteers every two weeks (in Care Groups) to provide health education to neighboring households. Messages focused on the promotion of maternal and newborn health, nutrition, prevention and treatment of acute respiratory infection and diarrhea in children, and immunizations.MethodsHousehold knowledge, practice and coverage (KPC) surveys were executed at baseline in January 2011 and at endline in June 2015 to measure changes in levels of knowledge of danger signs, key household practices (such as Essential Newborn Care and handwashing), and health service utilization (such as antenatal care and care seeking for a child with signs of pneumonia) in two separate Project Areas (Area A with 41 months and Area B with 20 months of full intervention implementation).ResultsFor the 24 indicators of the interventions under the Project’s control, statistically significant improvements were observed for 21 in Area A and 19 in Area B. However, for some of the interventions that required support from the government's Extension of Coverage Program (immunization, family planning, and vitamin A administration) no improvements were noted because of the cessation of the program by the government after Project implementation began. In both Areas A and B one-half of the indicators improved by at least two-fold.ConclusionThis community-based Project has been effective in quickly achieving marked improvements in indicators for interventions that are important for the health of mothers and children. These achievements are notable in view of the challenging context in which the Project was implemented.

Respiratory culture organism isolation and test characteristics in children with tracheostomies with and without acute respiratory infection.

Among children with tracheostomies, little is known about how respiratory culture results differ between states with and without acute respiratory infections (ARI), or the overall test performance of respiratory cultures. To determine the association of respiratory culture organism isolation with diagnosis of ARI in children with tracheostomies, and assess test characteristics of respiratory cultures in the diagnosis of bacterial ARI (bARI). This single-center, retrospective cohort study included respiratory cultures of children with tracheostomies obtained between 2010 and 2018. The primary predictor was ARI diagnosis code at the time of culture; the primary outcomes were respiratory culture organism isolation and species identified. Generalized estimating equations were used to assess for association between ARI diagnosis and isolation of any organism while controlling for potential confounders and accounting for within-patient clustering. A multinomial logistic regression equation assessed for association with specific species. Test characteristics were calculated using bARI diagnosis as the reference standard. Among 3578 respiratory cultures from 533 children (median 4 cultures/child, interquartile range (IQR): 1-9), 25.9% were obtained during ARI and 17.2% had ≥1 organism. Children with ARI diagnosis had higher odds of organism identification (adjusted odds ratio 1.29, 95% confidence interval [CI] 1.16-1.44). When controlling for covariates, ARI was associated with isolation of Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Streptococcus pyogenes. Test characteristics revealed a 24.3% sensitivity, 85.2% specificity, 36.5% positive predictive value, and 76.3% negative predictive value in screening for bARI. The utility of respiratory culture testing to screen for, diagnose, and direct treatment of ARI in children with tracheostomies is limited.

Resolution of the Expert Council on the use of the anti-inflammatory drug ammonium glycyrrhizinate in the treatment of acute respiratory infections and allergic diseases of the respiratory tract

In June 2022, within the XI International Educational Consensus on Respiratory Medicine in Pediatrics, an expert council on the anti-inflammatory agent ammonium glycyrrhizinate in treating acute respiratory infections and allergic diseases of the respiratory tract was held in Vladimir. The resolution of the Expert Council is presented. Based on these studies, experts recommend the use of ammonium glycyrrhizinate in patients with acute respiratory tract infection (including COVID-19); in the rehabilitation period of patients who recovered from the new coronavirus infection with lung involvement; patients with recurrent obstructive bronchitis, including those at high risk of bronchial asthma; patients with allergic rhinitis; patients with mild to moderate asthma.