Use of Chest Radiography Examination as a Probe for Pneumococcal Conjugate Vaccine Impact on Lower Respiratory Tract Infections in Young Children

2019 ◽  
Vol 71 (1) ◽  
pp. 177-187 ◽  
Author(s):  
Shalom Ben-Shimol ◽  
Ron Dagan ◽  
Noga Givon-Lavi ◽  
Dekel Avital ◽  
Jacob Bar-Ziv ◽  
...  
Keyword(s):  
Young Children ◽  
Respiratory Tract ◽  
Conjugate Vaccine ◽  
Chest Radiography ◽  
Pneumococcal Conjugate Vaccine ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
World Health ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Abstract Background Community-acquired alveolar pneumonia (CAAP) is considered a bacterial disease, mainly pneumococcal. CAAP rates markedly declined following 7- and 13-valent pneumococcal conjugate vaccine (PCV) introductions worldwide. In contrast, non-CAAP lower respiratory tract infections (NA-LRIs) are generally not considered pneumococcal diseases. We assessed CAAP, NA-LRIs, and overall visits with chest radiograph (CXR) examination rates in the pediatric emergency room in southern Israel before and after PCV implementation. Methods This was an ongoing, prospective observational study. Our hospital serves a captive population of approximately 75 000 children aged <5 years, enabling incidence calculation. PCV7 and PCV13 were implemented in Israel in July 2009 and November 2010, respectively. All CXRs were analyzed according to the World Health Organization Standardization of Interpretation. We calculated CAAP, NA-LRI, and CXR examinations annual incidences from 2004 to 2017 and incidence rate ratios comparing the PCV13 (2014–2017) with the pre-PCV (2004–2008) periods. Results Overall, 72 746 CXR examinations were recorded: 14% CAAP and 86% NA-LRI. CAAP, NA-LRI, and CXR examination visit rates declined by 49%, 34%, and 37%, respectively. This pattern was seen in Jewish and Bedouin children (the 2 ethnically distinct populations), with steeper declines observed among Jewish children and children aged >12 months. Conclusions PCV7/PCV13 implementation resulted in a marked decline in CAAP and overall visits with CXR examination rates in young children. Overall, approximately 14 750 hospital visits with CXR were prevented annually per 100 000 population aged <5 years. These findings suggest that although NA-LRIs are usually not considered pneumococcal, many can be prevented by PCVs. Pneumococcal conjugate vaccine (PCV7/PCV13) implementation resulted in significant declines in community-acquired alveolar pneumonia (CAAP) and overall chest radiography examination rates in young children. Although non-CAAP lower respiratory tract infections are usually not considered pneumococcal, many can be prevented by PCVs.

Low to Medium WU-Virus Titers in Young Children with Lower Respiratory Tract Infections

Intervirology ◽  
2008 ◽  
Vol 51 (6) ◽  
pp. 444-446 ◽  
Author(s):  
Michael Kleines ◽  
Simone Scheithauer ◽  
Meike Hengst ◽  
Dagmar Honnef ◽  
Klaus Ritter ◽  
...  
Keyword(s):  
Young Children ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

scholarly journals An Overview of Antivirals for Treating Lower Respiratory Tract Infections

2021 ◽  
Vol 66 (1) ◽  
Author(s):  
Alicia Elvira Cruz Jiménez ◽  
Liliana Quintanar Vera ◽  
J. Armando Lujan-Montelongo
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
World Health ◽  
High Morbidity ◽  
Lower Respiratory Tract Infections ◽  
Viral Pathogens ◽  
El Sistema ◽  
Health Organization ◽  
Tract Infections

Abstract. Covid-19 has resulted in a worldwide epidemic (pandemic) with high morbidity and mortality, which has generated efforts in various areas of research looking for safe and effective treatments to combat the virus that generates this disease: SARS-CoV-2. However, several viruses have been emerged/adapted in the last few decades, also affecting the respiratory system. According to the world health organization (WHO), lower respiratory tract infections (LRTIs) are one of the leading causes of death worldwide, and viruses are playing important roles as the cause of these infections. In contrast to the vast repertoire of antibiotics that exist to treat bacteria-caused LRTIs, there are a very few antivirals approved for the treatment of virus-caused LRTIs, whose approach consists mainly of drug reuse. This minireview deals on the main viral pathogens that cause LRTIs and some of the most relevant antivirals to counter them (available drugs and molecules in research/clinical trials), with concise comments of their mechanism of action.   Resumen. Covid-19 ha resultado en una epidemia mundial (pandemia) con alta morbilidad y mortalidad, lo que ha generado esfuerzos en diversas áreas de investigación en la búsqueda de tratamientos seguros y eficaces para combatir el virus que genera esta enfermedad: el SARS-CoV-2. Sin embargo, un número de virus han surgido o se han adaptado en las últimas décadas, que también afectan el sistema respiratorio. Según la Organización Mundial de la Salud (OMS), las infecciones en vías respiratorias inferiores (LRTIs, por sus siglas en inglés) son una de las principales causas de muerte a nivel mundial, siendo los virus de los principales patógenos causantes de estas infecciones. En contraste con el repertorio amplio de antibióticos que existen para tratar LRTIs causadas por bacterias, existen muy pocos antivirales aprobados para su tratamiento, cuyo enfoque consiste principalmente en la reutilización de fármacos. Este ensayo consiste en una breve revisión de los principales agentes virales que causan LRTIs y de los antivirales más relevantes para combatir los virus que las causan (tanto fármacos disponibles como moléculas en fases de investigación o clínicas), con comentarios concisos sobre su mecanismo de acción.

Lower Respiratory Tract Infections in Children in a Well-vaccinated South African Birth Cohort: Spectrum of Disease and Risk Factors

2019 ◽  
Vol 69 (9) ◽  
pp. 1588-1596 ◽  
Author(s):  
David M le Roux ◽  
Mark P Nicol ◽  
Landon Myer ◽  
Aneesa Vanker ◽  
Jacob A M Stadler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Birth Cohort ◽  
Maternal Smoking ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
World Health ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
Substantial Morbidity

Abstract Background Childhood lower respiratory tract infections (LRTIs) cause substantial morbidity and under-5 child mortality. The epidemiology of LRTI is changing in low- and middle-income countries with expanding access to conjugate vaccines, yet there are few data on the incidence and risk factors for LRTI in these settings. Methods A prospective birth cohort enrolled mother–infant pairs in 2 communities near Cape Town, South Africa. Active surveillance for LRTI was performed for the first 2 years of life over 4 respiratory seasons. Comprehensive data collection of risk factors was done through 2 years of life. World Health Organization definitions were used to classify clinical LRTI and chest radiographs. Results From March 2012 to February 2017, 1143 children were enrolled and followed until 2 years of age. Thirty-two percent of children were exposed to antenatal maternal smoking; 15% were born at low birth weights. Seven hundred ninety-five LRTI events occurred in 429 children by February 2017; incidence of LRTI was 0.51 and 0.25 episodes per child-year in the first and second years of life, respectively. Human immunodeficiency virus (HIV)–exposed, uninfected infants (vs HIV-unexposed infants) were at increased risk of hospitalized LRTI in the first 6 months of life. In regression models, male sex, low birth weight, and maternal smoking were independent risk factors for both ambulatory and hospitalized LRTI; delayed or incomplete vaccination was associated with hospitalized LRTI. Conclusions LRTI incidence was high in the first year of life, with substantial morbidity. Strategies to ameliorate harmful exposures are needed to reduce LRTI burden in vulnerable populations.

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