Association between semi-quantitative microbial load and respiratory symptoms among Thai military recruits: a prospective cohort study

BackgroundClinicians commonly prescribe antibiotics to prevent major adverse outcomes in children presenting in primary care with cough and respiratory symptoms, despite limited meaningful evidence of impact on these outcomes.AimTo estimate the effect of children’s antibiotic prescribing on adverse outcomes within 30 days of initial consultation.Design and settingSecondary analysis of 8320 children in a multicentre prospective cohort study, aged 3 months to <16 years, presenting in primary care across England with acute cough and other respiratory symptoms.MethodBaseline clinical characteristics and antibiotic prescribing data were collected, and generalised linear models were used to estimate the effect of antibiotic prescribing on adverse outcomes within 30 days (subsequent hospitalisations and reconsultation for deterioration), controlling for clustering and clinicians’ propensity to prescribe antibiotics.ResultsSixty-five (0.8%) children were hospitalised and 350 (4%) reconsulted for deterioration. Clinicians prescribed immediate and delayed antibiotics to 2313 (28%) and 771 (9%), respectively. Compared with no antibiotics, there was no clear evidence that antibiotics reduced hospitalisations (immediate antibiotic risk ratio [RR] 0.83, 95% confidence interval [CI] = 0.47 to 1.45; delayed RR 0.70, 95% CI = 0.26 to 1.90, overall P = 0.44). There was evidence that delayed (rather than immediate) antibiotics reduced reconsultations for deterioration (immediate RR 0.82, 95% CI = 0.65 to 1.07; delayed RR 0.55, 95% CI = 0.34 to 0.88, overall P = 0.024).ConclusionMost children presenting with acute cough and respiratory symptoms in primary care are not at risk of hospitalisation, and antibiotics may not reduce the risk. If an antibiotic is considered, a delayed antibiotic prescription may be preferable as it is likely to reduce reconsultation for deterioration.

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Household Bird Ownership is Associated with Respiratory Illness among Young Children in Urban Bangladesh (CHoBI7 Program)

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0725 ◽

2022 ◽

Author(s):

Tahmina Parvin ◽

Elizabeth D. Thomas ◽

Kelly Endres ◽

Daniel Leung ◽

Bhuyian Sazzadul ◽

...

Keyword(s):

Cohort Study ◽

Young Children ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Odds Ratio ◽

Respiratory Symptoms ◽

Respiratory Illness ◽

Middle Income ◽

The Past ◽

Difficulty Breathing

There is limited evidence on the association between animal ownership and respiratory illness among young children in low- and middle-income countries. In this study, we examined the association between animal ownership and respiratory illness among children younger than 5 years of age enrolled in a prospective cohort study in urban Bangladesh. This prospective cohort study enrolled 884 participants younger than 5 years of age in Dhaka, Bangladesh. At baseline, trained research assistants administered caregivers of children younger than 5 years of age a questionnaire on household animal ownership. Animal ownership was defined as owning chickens, birds other than chickens, cats, and dogs. Respiratory surveillance was conducted monthly for children based on caregiver-reported coughing, rapid breathing, and difficult breathing in the past 2 weeks during the 12-month study period. At baseline, 48% of children (424 of 884) had reports of coughing, 5% (40 of 884) had difficulty breathing, 3% (25 of 884) had rapid breathing, and 49% (431 of 884) had reports of any of these three respiratory symptoms. Seventeen percent of children (151 of 884) resided in a household that owned an animal. Children residing in households reporting bird ownership had a significantly greater odds of coughing (odds ratio, 1.14; 95% CI, 1.02–1.28) and any of the three respiratory symptoms in the past 2 weeks (odds ratio, 1.14; 95% CI, 1.02–1.28). Household bird ownership was associated with respiratory illness in young children. These findings suggest that interventions aiming at reducing young children’s exposure to domestic animals should extend to include birds other than chickens.

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Evaluation of physical screening tests for military recruits – A prospective cohort study

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2017.09.052 ◽

2017 ◽

Vol 20 ◽

pp. S21

Author(s):

Chen Fleischmann ◽

Ran Yanovich ◽

Itay Ketko ◽

Uri Eliyahu ◽

Aharon S Finestone ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Screening Tests ◽

Military Recruits

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Risk factors for clinical stress fractures in male military recruits: A prospective cohort study

Bone ◽

10.1016/j.bone.2005.04.016 ◽

2005 ◽

Vol 37 (2) ◽

pp. 267-273 ◽

Cited By ~ 107

Author(s):

Ville-Valtteri Välimäki ◽

Henrik Alfthan ◽

Eero Lehmuskallio ◽

Eliisa Löyttyniemi ◽

Timo Sahi ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Stress Fractures ◽

Military Recruits

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Incidence of health problems in travelers to Southeast Asia: a prospective cohort study

Journal of Travel Medicine ◽

10.1093/jtm/taz045 ◽

2019 ◽

Vol 26 (7) ◽

Cited By ~ 2

Author(s):

Phimphan Pisutsan ◽

Ngamphol Soonthornworasiri ◽

Wasin Matsee ◽

Weerapong Phumratanaprapin ◽

Suda Punrin ◽

...

Keyword(s):

Cohort Study ◽

Southeast Asia ◽

Prospective Cohort Study ◽

Acute Diarrhea ◽

Prospective Cohort ◽

Respiratory Symptoms ◽

Final Analysis ◽

Health Problems ◽

Rabies Exposure

Abstract Background There are few studies of the incidence of health problems among travelers to Southeast Asia. The current study sought to determine the incidence of self-reported health problems among travelers visiting the region. Methods A prospective questionnaire-based study was conducted among travelers from high-income countries who visited Southeast Asia. Participants were enrolled at time of their pre-travel visit at Mahidol University, Bangkok, Thailand. Travelers were prospectively followed by self-administered questionnaires 2 weeks after arrival, upon return to their home country and 2 weeks after return. Results During January 2018–February 2019, 359 travelers were enrolled in Bangkok, Thailand, and the first questionnaire was administered. Follow-up questionnaires were returned by 191, 96 and 64 participants 2 weeks later, at the end of the trip and 2 weeks after return, respectively. A total of 6094 travel days were included in the final analysis. The incidence of acute diarrhea per month per 1000 travelers was 217 [95% confidence interval (CI), 189–248] episodes; skin problems, 197 (95% CI, 170–227); respiratory symptoms, 133 (95% CI, 111–158); fever, 49 (95% CI, 36–65); and potential rabies exposure, 34 (95% CI, 24–48). The incidence of acute diarrhea episodes per month per 1000 travelers was significantly higher during the first 2 weeks of travel compared with subsequent weeks of travel: 325 (95% CI, 291–362) vs 132 (95% CI, 110–1157) (P < 0.05). The incidence of outpatient visits and hospitalizations per month per 1000 travelers was 49 (95% CI, 36–65) and 5 (95% CI, 2–10), respectively. Conclusions In this prospective cohort study we observed substantial burden of acute diarrhea and skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.

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