Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.

Physical activity lowers the risk for acute respiratory infections:Time for recognition

Physical inactivity is a well-established risk factor for chronic diseases,such as cardiovascular disease,cancer,and diabetes mellitus.There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections(ARIs).ARIs,such as the common cold,influenza,pneumonia,and coronavirus disease 2019(COVID-19),are among the most pervasive diseases on earth and cause widespread morbidity and mortality.Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny.Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness,even after adjusting for other risk factors.The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects,including enhanced surveillance of key immune cells and reduced chronic inflammation.Scientific consensus groups,including those who submitted the Physical Activity Guidelines for Americans,have not yet given this area of research the respect that is due.It is time to add“reduced risk for ARIs”to the“Exercise is Medicine”list of physical activity-related health benefits.

Bacteriological Profile of Acute Respiratory Infections in Children: About a Prospective Study at the Albert Royer Hospital in Dakar

Introduction: Acute Respiratory Infections (ARI) is a global public health priority. It is the leading cause of childhood morbidity and mortality, especially in developing countries. The main objective of this work was to look mainly at the bacteriological aspects of ARI in children in Senegalese hospitals. Methodology: We have been conducted a prospective descriptive mono-centric study over a period of one year (from July 1, 2017 to June 30, 2018) at the Albert Royer National child hospital in Dakar. A multiplex PCR (protein chain reaction) has been performed on nasopharyngeal swabs taken from all patients. This technique (viral RNA transcribed into DNA, then the DNA of the different pathogens is simultaneously amplified in the same tube by PCR Fast-tract®, multiplex). Results: During the study period, 109 patients were included. The hospital prevalence of acute respiratory infections was 3.7%. The mean age was 23.7 months with extremes between 1 month and 144 months. Peaks of consultations were found in the months of August, March and April with 22%, 15.6% and 12.8% respectively. Fever, respiratory distress and pulmonary condensation syndrome were the main signs found in our patients. Bacteriology was positive in 82.6% of samples and the most frequently found bacteria were Streptococcus pneumoniae in 38.5%, Haemophilus influenza b in 32.1% and Moraxella catarrhalis in 25.7%. Pneumonia was the main diagnosis, found in 61 cases, a prevalence of 59.9%. The average length of hospitalization was 10 days. Lethality was 1.8% or 2 cases. Conclusion: Acute Respiratory Infections in children still remains a public health problem in developing countries;children under 5 years of age are the most affected hence the need to strengthen ARI control programs. The identification of germs is indispensable in treatment and epidemiological surveillance in our regions.

Viral Acute Respiratory Infections in Central African Republic Children: Epidemiological and Clinical Aspects

Background: Acute respiratory infections (ARI) are recognized as an important cause of morbidity, mortality, and hospitalization among children in developing countries. Objectives: To identify the respiratory viruses circulating in Central African children before the SARS-COV2 pandemic and to assess the clinical manifestations. Methodology: This is a cross-sectional, descriptive, multicenter study, run from March 1, 2019, to March 31, 2020. Children aged 28 days to 15 year-old, with respiratory symptoms ≤10 days had been included. Nasopharyngeal swabs were taken and sent to the Institute Pasteur in Bangui (WHO National Referral Center for influenza). Virus research was done by cell and molecular culture techniques. Data were recorded and processed with Access 2019 software, then analyzed with STATA version 14 software. Chi-square test and ANOVA test were used to compare proportions at the p 0.05 threshold. Results: Out of 659 children included during the study period, viruses were identified in 231 children, for an overall positivity rate of 35.05% (231/659). Rhinoviruses (RV) and influenza viruses were found in 66.23% and 16.88% respectively. Virus-virus co-infections were found in 10 (10/231) children (4.32%). Children under 5 years of age were more represented (78.60%). The main reasons for consultation were: fever (96.20%), cough (95.45%), runny nose (78.5%), and breathing difficulty (30.50%). ILI (Influenza-Like Illness) was found in 71.02% versus 28.98% of SARI (Severe Acute Respiratory Infection). There was a statistically significant association between age 5 years and severity of acute respiratory infection (p = 0.001). The outcome was known for the 122 children at the CHUPB site with a mortality rate of 17.21% (n = 21). Conclusion: Viral ARI is common in children in Central African Republic. Care givers should think about it in order to reduce the inappropriate prescription of antibiotics.

Sociodemographic Factors for Vitamin D Levels in Children with Acute Respiratory Infection

Background and Objectives: Childhood acute respiratory infection is a public health problem with significant morbidity and mortality in developing countries. The present study was to assess the sociodemographic determinants of vitamin D levels in patient with acute respiratory infections (ARIs) receiving care in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Southeast Nigeria. Methodology: This was a cross-sectional study, conducted in Nnewi, Nigeria, on 250 children with ARI. Sociodemographic data were collected and serum vitamin D levels of the subjects were assayed. The association between sociodemographic variables and vitamin D was evaluated using multivariate logistic regression analysis. Results: A total of 250 children with ARI aged 1 - 59 months were enrolled in this study, with slight male preponderance (57.2%). About 60% of the population was less than 2 years. The majority (85.6%) of the subjects had adequate vitamin D levels (≥20 ng/dL). The mean serum vitamin D level in the subjects was (52.2 ± 25.6 ng/mL). Multivariate logistic regression showed that only gender was significantly related to vitamin D levels with males found to have a lower risk of vitamin D deficiency. {OR = 0.05 (0.004 - 0.77)}, p = 0.03. Conclusion: The association between male gender and high levels of vitamin D in acute respiratory infection was significant in this study. Further studies, however, should explore a probable role for vitamin D supplementation in children with ARI.

Demystifying roles of exercise in immune response regulation against acute respiratory infections:A narrative review

The benefits of physical activity and exercise,especially those classified as moderate-to-vigorous activity(MVPA),have been well-established in preventing non-communicable diseases and mental health problems in healthy adults.However,the relationship between physical activity and exercise and the prevention and management of acute respiratory infection(ARI),a global high-burden disease,has been inconclusive.There have been debates and disagreements among scientific publications regarding the relationship between exercise and immune response against the causative agents of ARI.This narrative review aims to explore the theory that sufficiently explains the correlation between exercise,immune response,and ARI.The potential root causes of discrepancies come from research associated with the“open window”hypothesis.The studies have several limitations,and future improvements to address them are urgently needed in the study design,data collection,exercise intervention,subject recruitment,biomarkers for infection and inflammation,nutritional and metabolism status,and in addressing confounding variables.In conclusion,data support the clinical advantages of exercise have a regulatory contribution toward improving the immune response,which in turn potentially protects humans fromARI.However,the hypothesis related to its negative effect must be adopted cautiously.

Carbocysteine as Adjuvant Therapy in Acute Respiratory Tract Infections in Patients without Underlying Chronic Conditions: Systematic Review and Meta-Analysis

Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: Systematic review and meta-analysis. Data sources: An electronic search was conducted across PubMed, Cochrane Library, clinicaltrials.gov, and the European Clinical Trial Register, with the search dated to May 2023. Bibliographic references from other literature reviews and meta-analyses were also reviewed. The search was limited to randomized clinical trials published in any language and year. It was completed by cross-checking the references of the located articles. Methods: Inclusion criteria covered studies assessing systemic or inhaled carbocysteine, regardless of dosing regimen. Concomitant medication use was acceptable if balanced between intervention and control groups. Authors independently extracted data, resolving disagreements through consensus. Methodological quality assessment relied on critical reading of each study. Dichotomous variables were analyzed using odds ratio (OR), and a final effect size was calculated. Statistical significance was established when confidence intervals did not cross the neutral value. Heterogeneity was assessed via the X2 test and I2 index. Results: Out of 318 initially identified studies, 4 met inclusion criteria. The meta-analysis for poor general condition yielded an OR of 0.45 in favor of intervention, p = 0.013, with non-significant heterogeneity. Cough events showed a percentage of 15.8% for carbocysteine vs. 27.2% for placebo. On the seventh day, expectoration rates were 18.37% for carbocysteinevs 33.3% for placebo. Conclusions: The observed clinical benefits align with carbocysteine’s mucoactive and muco-regulatory properties, complemented by anti-inflammatory and antioxidant actions. Carbocysteine stands out among mucolytic agents. In the context of persistent infectious diseases, the study emphasizes the need for further exploration of carbocysteine’s therapeutic potential as an adjunctive treatment for acute respiratory infections. These findings underscore its significance in the evolving landscape of respiratory healthcare.

Clinical Effect of Yinhuang Qingfei Capsules in Treatment of Asymptomatic and Mild/Common Severe Acute Respiratory Syndrome Coronavirus 2 Infection:An Analysis of 242 Cases

[Objectives]To investigate the clinical effect of Yinhuang Qingfei capsules in the treatment of asymptomatic and mild/common severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.[Methods]A total of 362 patients with SARS-CoV-2 infection were divided into the treatment group with 242 patients and control group with 120 patients according to their treatment regimen.The patients in the control group were given standard treatment regimen and those in the treatment group were given Yinhuang Qingfei capsules in addition to the treatment in the control group.The two groups were observed in terms of average length of hospital stay,mean time for nucleic acid clearance,TCM syndrome score,and progression to severe/critical illness,and clinical outcome was compared between the two groups.[Results]There was a significant difference in the overall response rate between the treatment group and the control group[97.52%(236/242)vs 95.00%(114/120),P<0.05].Compared with the control group,the treatment group had significantly shorter length of hospital stay and time for nucleic acid clearance(P<0.05).After 7 days of treatment,both groups had a significant change in TCM syndrome score,and there was a significant difference in TCM syndrome score between the two groups(P<0.05);after 15 days of treatment,both groups had a TCM syndrome score of 0.Progression to severe/critical illness was not observed in either group.[Conclusions]Compared with the standard treatment regimen alone,standard treatment regimen combined with Yinhuang Qingfei capsules can effectively shorten the length of hospital stay and time for nucleic acid clearance and improve TCM symptoms in patients with asymptomatic and mild/common SARS-CoV-2 infection.

Virus profile in children with acute respiratory infections with various severities in Beijing, China

Background Acute respiratory infection （ARI） is one of the most common infectious diseases in infants and young children globally.This study aimed to determine the virus profile in children with ARI presenting with different severities.Methods Clinical specimens collected from children with ARI in Beijing from September 2010 to March 2011 were investigated for 18 respiratory viruses using an xTAG Respiratory Viral Panel Fast （RVP Fast） assay.The Pearson chisquare analysis was used to identify statistical significance.Results Of 270 cases from three groups of ARI patients,including Out-patients,In-patients and patients in the intensive care unit （ICU）,viruses were detected in 176 （65.2％） specimens with the RVP Fast assay.The viral detection rate from the Out-patients group （50.0％） was significantly lower than that from the In-patients （71.1％） and ICU-patients （74.4％） groups.The virus distribution was different between the Out-patients group and the other hospitalized groups,while the virus detection rate and distribution characteristics were similar between the In-patients and ICU-patients groups.The coinfection rates of the Out-patients group,the In-patients group,and the ICU-patients group were 15.6％,50.0％ and 35.8％,respectively.In addition to respiratory syncytial virus （RSV） and adenovirus （ADV）,human rhinovirus （HRV） was frequently detected from children with serious illnesses,followed by human metapneumovirus （hMPV）,human bocavirus （HBoV） and coronaviruses.Parainfluenza virus 3 （PIV3） was detected in children with lower respiratory illness,but rarely from those with serious illnesses in the ICU-patient group.Conclusion In addition to so-called common respiratory viruses,virus detection in children with ARI should include those thoucht to be uncommon respiratory viruses,especially when there are severe ARI-related clinical illnesses.

Parainfluenza Virus Types 1, 2, and 3 in Pediatric Patients with Acute Respiratory Infections in Beijing During 2004 to 2012

Background： Although human parainfluenza virus （HPIV） has been determined as an important viral cause of acute respiratory infections （ARIs） in infants and young children, data on long-term investigation are still lacking to disclose the infection pattern of HPIV in China. Methods： Nasopharyngeal aspirates were collected from 25,773 hospitalized pediatric patients with ARIs from January 2004 through December 2012 for respiratory virus screen by direct immuno-fluorescence assay. Results： Out of these specimens, 1675 （6.50%, 1675/25,773） showed HPIV positive, including 261 （1.01%, 261/25,773） for HPIVI, 28 （0.11%, 28/25,773） for HPIV2, and 1388 （5.39%, 1388/25373） for HPIV3, 2 of the samples were positive for both HPIV1 and HPIV3, and 36 were co-detected with other viruses. The positive rates of HPIVs were higher in those younger than 3 years old. HPIV3 was detected from all age groups, predominantly from patients under 3 years of age, and the highest frequency was found in those 6 months to 1-year old （352/4077, 8.63%）. HPlV3 was the dominant type in each of the years detected between May and July. HPIV1 showed a peak in every odd year, mainly in August or September. HPIV was detected most frequently from patients with upper respiratory infection （12.49%, 157/1257）, followed by bronchitis （ 11.13%, 176/2479）, asthma （9.31%, 43/462）, bronchiolitis （5.91%, 150/2536）, pneumonia （6.06%, 1034/17,068）, and those with underlying diseases （1.0%, 15/1506）. HPIV3 is the dominant type in these six disease groups referred above, especially in the asthma group. Conclusions： HPIV is one of the important viral causes of ARIs in infants and young children in Beijing based on the data from the hospitalized children covering a 9-year term. HPIV3 is the predominant type in all these years and in most of the disease groups. HPIVs with different types show different seasonality.

Child Acute Lower Respiratory Tract Infection in Pediatrics Intensive Care Unit at University Hospital of Brazzaville (Congo)

In order to contribute to reduction of morbidity and mortality due to low acute respiratory infections in pediatrics, the objective of this study was to determine the epidemiological profile and to identify the factors favoring and those associated with the risk of deceased. We reviewed the cases of children aged between 1 and 59 months hospitalized between January and December 2015 in the pediatric intensive care unit of the CHU of Brazzaville and retained those whose diagnosis of discharge was an ALRI. The study variables were: epidemiological, clinical, paraclinic, diagnostic, therapeutic and evolutionary. For 2012 hospitalized children, 400 (19.8%) were hospitalized for an ALRI. There were 235 boys (58.8%) and 165 girls (41.2%) of average age. Infants aged 1 to 11 months were the most affected n = 260 (65%). They were insufficiently immunized with haemophilus influenza B and pneumococcus n = 378 (94.5%);Fully immunized n = 20 (5%), the average delay for consultation after the first symptom was 5.03 ± 3.86 days;Denutrition was rated n = 180 (45%), positive retroviral serology n = 19 cases (4.8%). The main nosological varieties were: bronchiolitis n = 223 (55.7%), pneumonia n = 145 (36.2%). One death was rated n = 65 (16.3%). The mortality determinants were: prematurity, vaccination status and HIV/AIDS infection. The frequency and severity of ALRIs necessitates a strengthened program of integrated management of childhood illnesses, and public health actions targeting the factors that promote and contribute to the risk of death.

Effectiveness and Safety of Jinye Baidu Granules(金叶败毒颗粒)for Acute Upper Respiratory Tract Infection:A Systematic Review and Meta-analysis

To evaluate the effectiveness and safety of Jinye Baidu Granules(金叶败毒颗粒)for acute upper respiratory tract infection(AURTI).Database such as CNKI,Wan-fang,VIP,Sino Med,Web of science,Clinical Trials gov,Medline、EMBASE,CENTRAL,Cochrane Library were retrieved to collect randomized controlled trials(RCTs)on Jinye Baidu Granules(金叶败毒颗粒)in treating AURTI from the estabslishment of the database to March 2019.A total of 2 reviewers independently screened the literature according to the inclusion and exclusion criteria,and extracted material and the quality evaluation of the included studies.Quality evaluation adopted Cochrane Handbook 5.1 evaluation standards and tools.Rev Man5.3 was used to perform Meta-analysis for the adopted study.Finally a total of 4 RCTs involving 636 patients were included.Meta-analysis results showed that:compared with conventional Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine in the treatment of acute upper respiratory tract infection can improve the total effective rate of clinical efficacy[RR=0.13,95%CI(0.06,0.29),P<0.00001],shorten the time of antipyretic time for acute upper respiratory tract infection[MD=–1.22,95%CI(–1.43,–1.00),P<0.00001],shorten the time of pharyngeal pain[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001]and shorten the cough disappear time[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001].There were 2 papers reporting adverse reactions during the study period,and one of them specifically reported diarrhea,nausea,vomiting and stomachache in the experimental group.In the control group:diarrhea,nausea and adverse reactions disappeared after drug withdrawal;the incidence of adverse reactions was 3.92%in the control group and 5.88%in the observation group.There was no significant difference between the 2 groups(P>0.05).Based on existing data and methods,the systematic evaluation showed that,compared with Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine alone could improve the total effective rate of clinical efficacy,reduce the time of fever,sore throat,and the disappearance of cough with less adverse reactions.However,due to the low quality of the included study,large samples,multicenter,randomized,double-blind trials and trials are still needed to randomized controlled trials with reference to the CONSORT standard and the STRICTA statement.

Meta-analysis of the comparison between reduning injection and ribavirin injection for acute upper respiratory tract infection in children

Objective:To systematically evaluate the effectiveness and safety of reduning injection in acute upper respiratory tract infection of children.Methods:Use computer to search PubMed,the Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,Weipu database(VIP)and China Biomedical studies Service System(CBM)for randomized controlled trials(RCT)of acute upper respiratory tract infection in children,and the retrieval time is from their establishment to May,2022.After two researchers independently screened the studies,extracted data and evaluated the risk bias of studies,RevMan5.3 software was used to perform meta-analysis.Results:10 studies in total were included,involving 1466 patients.Results of the meta-analysis:total effective rate[RR=1.12,95%CI(1.07,1.16),P<0.00001],cure time[MD=-1.51,95%CI(-1.71,-1.32),P<0.00001],antipyretic time[MD=-1.32,95%CI(-1.72,-0.92),P<0.00001],disappearing time of nasal obstruction and nose running[MD=-1.04,95%CI(-1.45,-0.62),P<0.00001],disappearing time of cough[MD=-1.35,95%CI(-1.58,-1.13),P<0.00001],disappearing time of throat congestion[MD=-1.36,95%CI(-1.68,-1.03),P<0.00001],disappearing time of sore throat[MD=-1.55,95%CI(-1.74,-1.35),P<0.00001],the incidence of adverse reactions[RR=0.34,95%CI(0.20,0.57),P<0.0001].The differences between two groups in total effective rate,cure time,antipyretic time,disappearing time of nasal obstruction and nose running,disappearing time of cough,disappearing time of throat congestion,disappearing time of sore throat and the incidence of adverse reactions are all statistically significant(P<0.05).The sensitivity analysis demonstrates that three outcomes(total effective rate,cure time and disappearing time of sore throat)have unstable results,while others having stable results.Conclusion:Reduning injection is more effective than ribavirin injection in clinical,and it is better than ribavirin injection at relieving fever,nasal obstruction and nose running,cough and throat congestion.In addition,it’s safer in clinical than ribavirin injection.

ACUPUNCTURE TREATMENT OF 42 CASES OF ACUTE UPPER RESPIRATORY TRACT INFECTION

We made clinical observations on the therapeutic effect of acupuncture on acute upper respiratory tract infection and compared with the effect of paracetamol and Antondine, The result showed that acupuncture therapy could allay fever more rapidly than drugs, so long as the differentiation of syndromes is correct and the acupoint is selected properly.

Association Between Diurnal Temperature Range and Respiratory Tract Infections

Objective This study aimed to assess the association between emergency-room visits for respiratory tract infection （RTI） with diurnal temperature range （DTR）, a weather parameter closely associated with urbanization and global climate change. Methods We conducted a semiparametric time-series analysis to estimate the percentage increase in emergency-room visits for RTI associated with changes in DTR after adjustment for daily weather conditions （temperature and relative humidity） and outdoor air pollution. Results DTR was significantly associated with daily emergency-room visits for RTI. An increase of 1 ~C in the current-day （LO） and in the 2-day moving average （L01） DTR corresponded to a 0.94% [95% confidence interval （CI）, 0.34%-1.55%] and 2.08% （95% CI, 1.24%-2.93%） increase in emergency-room visits for RTI, respectively. Conclusion DTR was associated with increased risk of RTI. More studies are needed to understand the impact of DTR on respiratory health.

ClinicalandExperimentalStudyonTreatmentofAcuteRespiratoryTractInfectionwithShuanghuanglianAerosol（双黄连气雾剂）

Two hundred and two cases of acute respiratory tract infection ( ARI) were treated withShuanghuanglian (SHL) aerosol. In these cases, the majority were virus infection and 64% of them wascaused by the respiratory syncytial virus (RSV) . The virostatic and bacteriostatic test were done in vitro bythe cell culture method and it was shown that SHL could inhibit the RSV, para-influenza virus I - IV and 23kinds of pathogenic bacteria such as Staphylococcus aureus etc. The bacteriostatic effect was positively cor-related to the SHL concentration. Experimental study showed that SHL could enhance the NK cell activity,promote the production of a-interferon and raise the rate of lymphocyte transformation. The controlled obser-vation on SHL preparation with various dosage-forms revealed that the SHL aerosol in treating early ARlshowed better results than that of injections and oral liquid symptomatologically ( P < 0 . 05 ) . The total effec-tive rate was 96% .

Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

Background： Wheezing is common in early childhood and remains an important health concern. The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome. Methods： Infants 〈2 years of age with acute lower respiratory tract infection （ALRTI） who had undergone lung function tests were included in the study. They were assigned to wheeze or no wheeze group based on physical examination. Infants without any respiratory diseases were enrolled as controls. Lung function was measured during the acute phase and 3 months after ALRTI. One-year follow-up for infants with ALRTI was achieved. Results： A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis. Compared with the control and the no wheeze groups, infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time （TPTEF/TE） （20.1 1 6.4% vs. 34.4 ± 6.2% and 26.4 ±8.3%, respectively, P 〈 0.0001） and significantly increased peak tidal expiratory flow （PTEF） （90.7 ± 26.3 ml/s vs. 79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s, respectively, P 〈 0.01）, sReff and Reff. The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume （VPTEF/VE） than the no wheeze infants 3 months after the ALRT1. Moreover, there was a significant inverse relationship between TPTEF/TE, VPTEF/VE, and the recurrence of wheezing and pneumonia. Conclusions： Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

Human adenovirus(HAdV)infection in children with acute respiratory tract infections in Guangzhou,China,2010–2021:a molecular epidemiology study

Background Human adenovirus(HAdV)infection can cause a variety of diseases.It is a major pathogen of pediatric acute respiratory tract infections(ARIs)and can be life-threatening in younger children.We described the epidemiology and subtypes shifting of HAdV among children with ARI in Guangzhou,China.Methods We conducted a retrospective study of 161,079 children diagnosed with acute respiratory illness at the Guangzhou Women and Children’s Medical Center between 2010 and 2021.HAdV specimens were detected by real-time PCR and the hexon gene was used for phylogenetic analysis.Results Before the COVID-19 outbreak in Guangzhou,the annual frequency of adenovirus infection detected during this period ranged from 3.92%to 13.58%,with an epidemic peak every four to fve years.HAdV demonstrated a clear seasonal distribution,with the lowest positivity in March and peaking during summer(July or August)every year.A signifcant increase in HAdV cases was recorded for 2018 and 2019,which coincided with a shift in the dominant HAdV subtype from HAdV-3 to HAdV-7.The latter was associated with a more severe disease compared to HAdV-3.The average mortality proportion for children infected with HAdV from 2016 to 2019 was 0.38%but increased to 20%in severe cases.After COVID-19 emerged,HAdV cases dropped to 2.68%,suggesting that non-pharmaceutical interventions probably reduced the transmission of HAdV in the community.Conclusion Our study provides the foundation for the understanding of the epidemiology of HAdV and its associated risks in children in Southern China.

Clinical characteristics and molecular epidemiology of human metapneumovirus in children with acute lower respiratory tract infections in China, 2017 to 2019: A multicentre prospective observational study

Human metapneumovirus(HMPV) infection is one of the leading causes of hospitalization in young children with acute respiratory illness. In this study, we prospectively collected respiratory tract samples from children who were hospitalized with acute lower respiratory tract infection in six hospitals in China from 2017 to 2019. HMPV was detected in 145 out of 2733 samples(5.3%) from the hospitalized children. The majority of HMPV-positive children were under the age of two(67.6%), with a median age of one year. HMPV can independently cause acute lower respiratory tract infection in young children, while all patients showed mild clinical symptoms. Of all the co-infected patients, HMPV was most commonly detected with enterovirus(EV) or rhinovirus(RhV)(38.0%),followed by respiratory syncytial virus(RSV)(32.0%). The highest detection rate occurred from March to May in both northern and southern China. Out of 145 HMPV positive samples, 48 were successfully typed, of which 36strains were subgrouped into subtypes A2c(75%), eight strains were included in subtype B1(16.7%), and four strains were included in subtype B2(8.3%). Moreover, 16 A2c strains contained 111-nucleotide duplications in the G gene. Twenty-seven complete HMPV genomes were successfully obtained, and 25(92.6%) strains belonged to subtype A2c, whereas one strain was included in subgroup B1 and another was included in subgroup B2. A total of 277 mutations were observed in the complete genomes of 25 A2c strains. All results presented here improve our understanding of clinical characteristics and molecular epidemiology of HMPV infection in children.

A multi-center study on Molecular Epidemiology of Human Respiratory Syncytial Virus from Children with Acute Lower Respiratory Tract Infections in the Mainland of China between 2015 and 2019

Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015–2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A(RSV-A) was the predominant subgroup during this research period except in2016. Totally, 535 sequences of the second hypervariable region(HVR-2) of the G gene were obtained. Combined with182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1(512),NA1(6) and GA5(3), respectively;while 196 RSV-B sequences fell in BA9(193) and SAB4(3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258 Q and H266 L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than10%, while the sequences with T290 I and T312 I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites(296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015–2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.