Medical Consultations After Typhoon Haiyan in a Field Hospital in the Philippines

2019 ◽  
Vol 14 (1) ◽  
pp. 34-38
Author(s):  
Julita Gil Cuesta ◽  
Joris Adriaan Frank van Loenhout ◽  
Maria Lourdes de Lara Banquesio ◽  
Masniza Mustaffa ◽  
Debarati Guha-Sapir

ABSTRACTIntroduction and Objectives:Typhoon Haiyan partially destroyed the Ormoc District Hospital in the Philippines. A field hospital was established to replace its outpatient department for 5 weeks. We investigated the reasons for medical consultation in the field hospital.Methods:We described the consultations by sex, age, week, and diagnosis according to the Surveillance in Post-Extreme Emergencies and Disasters system. We compared the number and proportion of upper respiratory tract infections (URTIs) with a control season in 2014.Results:We included 6785 consultations, 55.9% from women. The majority of consultations were communicable diseases (88.2%) followed by noncommunicable (7.1%) and injuries (5.6%). Males suffered more often from injuries than women (66.0% vs 34.0%). Consultations due to injuries decreased from 10.0% in the first to 2.9% in the last week. The most frequent diagnosis over the study period was acute respiratory infections (ARIs) (73.1%), of which 83.0% were children. The number of daily URTIs was higher than in a similar 2014 period.Conclusions:ARI was the most prevalent diagnosis. We recommend ARI treatments being fully accessible after such a disaster. During the first week, injury prevention should focus on adult men. Studies after natural disasters should include control periods to better understand disease distribution, ultimately improving the prioritization in disasters.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Lei ◽  
Lisong Yang ◽  
Cheong Tat Lou ◽  
Fan Yang ◽  
Kin Ian SiTou ◽  
...  

Abstract Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.


2019 ◽  
Author(s):  
Laura K Certain ◽  
Miriam B Barshak

Upper respiratory tract infections are the most common maladies experienced by humankind.1 The majority are caused by respiratory viruses. A Dutch case-controlled study of primary care patients with acute respiratory tract infections found that viruses accounted for 58% of cases; rhinovirus was the most common (24%), followed by influenza virus type A (11%) and corona­viruses (7%). Group A streptococcus (GAS) was responsible for 11%, and 3% of patients had mixed infections. Potential pathogens were detected in 30% of control patients who were free of acute respiratory symptoms; rhinovirus was the most common.2 Given the increasing problem of antibiotic resistance and the increasing awareness of the importance of a healthy microbiome, antibiotic use for upper respiratory infections should be reserved for those patients with clear indications for treatment. A recent study of adult outpatient visits in the United States found that respiratory complaints accounted for 150 antibiotic prescriptions per 1,000 population annually, yet the expected “appropriate” rate would be 45.3 In other words, most antibiotic prescriptions for these complaints are unnecessary. Similarly, a study in the United Kingdom found that general practitioners prescribed antibiotics to about half of all patients presenting with an upper respiratory infection, even though most of these infections are viral.4 This review contains 5 figures, 16 tables, and 82 references. Keywords: infection, airway, sinusitis, otitis media, otitis externa, pharyngitis, epiglottitis, abscess


2018 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Aleksandra Paź ◽  
Magdalena Arimowicz

An estimated 50% of antibiotic prescriptions may be unjustified in the outpatient setting. Viruses are responsible for most acute respiratory tract infections. The viral infections are often self-limiting and only symptomatic treatment remains effective. Bacteria are involved in a small percentage of infections etiology in this area. In the case of a justified or documented suspicion of a bacterial infection, antibiotic therapy may be indicated. Based on the Polish „Recommendations for the management of non-hospital respiratory infections 2016”, the indications, the rules of choice, the appropriate dosing schedules and the therapy duration, in the most frequent upper respiratory tract infections in adults, have been presented. Implementation of the presented recommendations regarding our Polish epidemiological situation, will significantly reduce the tendency to abuse antibiotics, and thus will limit the spread of drug-resistant microorganisms.


2021 ◽  
Vol 28 (6) ◽  
pp. 1
Author(s):  
Gruppo di lettura di Parma

Improving communication in the office reduces the prescription of antibiotics for respiratory infections: the results of an RCT Effective communication with parents in the clinic can reduce inappropriate antibiotic prescriptions in primary care for upper respiratory tract infections (URTI). In this American RCT with a gradual wedge of good methodological quality, the distance training program 'DIALOGUE AROUND RESPIRATORY ILLNESS TREATMENT' (DART QI), allows an overall reduction of 7% in the probability of prescribing antibiotics for URTI between the baseline period and post-surgery.


1989 ◽  
Vol 11 (6) ◽  
pp. 180-182
Author(s):  
Richard Hong

Recurrent infections constitute a major challenge to primary care physicians. Primary immunodeficiency or other alterations of the host defense system are extremely rare. In the case of recurrent respiratory infections, particularly of the lungs, a diagnosis will result much more often from ordering a sweat chloride test than a serum immunoglobulin level. RECURRENT RESPIRATORY INFECTIONS The major reason for referral to our clinic for investigation of the immune system is a complaint of too many upper respiratory tract infections. Each respiratory infection in a young child means loss of sleep for child and parents, expenditure of time at the physician's office, and possible loss of income in addition to the expense of medication and office visits. The child is often irritable and his or her misery clouds the home atmosphere. With repeated episodes of this sort each year, it is small wonder that parents want relief. The average number of upper respiratory tract infections experienced by healthy children is approximately 9 to 10 per year. At least 100 viruses can cause the common cold. Accordingly, even when a child has a normal immune system establishing immunity to each virus or virus subtype, it can take many years for a broad enough immunity to develop to diminish the frequency of infection due to newly encountered respiratory viruses.


2015 ◽  
Vol 370 (1675) ◽  
pp. 20140294 ◽  
Author(s):  
Wouter A. A. de Steenhuijsen Piters ◽  
Elisabeth A. M. Sanders ◽  
Debby Bogaert

Respiratory tract infections are a major global health concern, accounting for high morbidity and mortality, especially in young children and elderly individuals. Traditionally, highly common bacterial respiratory tract infections, including otitis media and pneumonia, were thought to be caused by a limited number of pathogens including Streptococcus pneumoniae and Haemophilus influenzae . However, these pathogens are also frequently observed commensal residents of the upper respiratory tract (URT) and form—together with harmless commensal bacteria, viruses and fungi—intricate ecological networks, collectively known as the ‘microbiome’. Analogous to the gut microbiome, the respiratory microbiome at equilibrium is thought to be beneficial to the host by priming the immune system and providing colonization resistance, while an imbalanced ecosystem might predispose to bacterial overgrowth and development of respiratory infections. We postulate that specific ecological perturbations of the bacterial communities in the URT can occur in response to various lifestyle or environmental effectors, leading to diminished colonization resistance, loss of containment of newly acquired or resident pathogens, preluding bacterial overgrowth, ultimately resulting in local or systemic bacterial infections. Here, we review the current body of literature regarding niche-specific upper respiratory microbiota profiles within human hosts and the changes occurring within these profiles that are associated with respiratory infections.


2019 ◽  
pp. 95-99
Author(s):  
E. Р. Merkulova

The article presents data on the prevalence of upper respiratory tract infections in paediatric practice. The following complications may pose health risks: sinusitis, acute suppurative otitis media and chronic tonsillitis. The authors provide statistical data on the prevalence of these complications, a multivariate analysis of the clinical symptoms of the diseases, the main symptoms of which are temperature reaction, leucocytosis, regenerative left shift, increased ESR. Special attention is paid to the choice of antipyretic agents that affect not only the fever, but also the inflammatory reaction of the upper respiratory tract mucosa, which may quickly ease the symptoms of the disease.


1994 ◽  
Vol 15 (5) ◽  
pp. 185-191
Author(s):  
Floyd W. Denny

Acute infections of the upper respiratory tract, including those of the tonsils and pharynx, are the most common affliction of humans; their tendency to occur with much greater frequency in children makes them especially important to the pediatrician. A host of microbial agents can cause these infections, but only a few are responsive to antimicrobial agents. Because of the paucity of definitive laboratory tools that allow easy recognition of the cause of most acute respiratory infections, it is important for the practicing pediatrician to have other methods to aid in the clinical management of children who have these infections. This review will discuss the etiology and epidemiology of acute respiratory infections that involve primarily the tonsils and pharynx, with emphasis on how this knowledge can guide clinicians in their management. The groundwork for this approach will be laid by suggesting a classification of upper respiratory tract infections that involve the tonsils and pharynx. Causative agents will be enumerated and put into perspective. The major factors associated with the occurrence of acute upper respiratory tract infections will be discussed. Finally, treatment of the patient who has tonsillopharyngitis will be presented. Uncomplicated acute tonsillopharyngitis will be emphasized primarily and the role of complications only mentioned.


2017 ◽  
Vol 57 (5) ◽  
pp. 574-579 ◽  
Author(s):  
Zumrut Sahbudak Bal ◽  
Cenk Eraslan ◽  
Elif Bolat ◽  
Gulhadiye Avcu ◽  
Nilgun Kultursay ◽  
...  

Brain abscess is a rare disease in childhood requiring prompt medical and/or surgical treatment. The objective was to review presentation, management, and outcome of brain abscess in children. We reviewed the clinical and radiological features and outcomes of 18 children (10 females, 8 males), with a median age of 48 months (range 1-182), that presented with brain abscesses and admitted to a tertiary pediatric infectious department between December 2010 and January 2017. One (5.5%) patient underwent craniotomy and 14 (77.7%) had burr hole aspirations. The most common localization was the frontal lobe (33.3%). The survival rate was 94.4%, and long-term neurological sequelae affected 27.7% of the patients. Empiric treatment choices require knowledge of common pathogens and local resistance. The most predominant infections were still upper respiratory infections. Clinicians may treat the children with appropriate choice and duration of antibiotic treatment for upper respiratory tract infections.


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