International Journal of Environmental Research and Public Health

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9 pages, 1053 KiB

Open AccessArticle

Health Effects of the Asthma Care Program under the Universal Coverage Scheme in Children and Young Adults in Thailand

by Phatthanawilai Namuenhong Inmai, Tippawan Liabsuetrakul, Nao Ichihara, Hiroyuki Yamamoto, Jutatip Thungthong, Virasakdi Chongsuvivatwong and Hiroaki Miyata

Int. J. Environ. Res. Public Health 2022, 19(7), 4130; https://doi.org/10.3390/ijerph19074130 - 31 Mar 2022

Cited by 1 | Viewed by 2588

Abstract

This study aimed to evaluate the effect of the asthma care program available under the Universal Coverage Scheme (UCS) in Thailand on hospital admissions per 100,000 population, its regional and seasonal variation, readmission within 28 days, and the asthma-specific fatality rate of patients [...] Read more.

This study aimed to evaluate the effect of the asthma care program available under the Universal Coverage Scheme (UCS) in Thailand on hospital admissions per 100,000 population, its regional and seasonal variation, readmission within 28 days, and the asthma-specific fatality rate of patients aged 0–29 years in 2009–2016 compared with those in 2007–2008. A retrospective study was conducted using data sources from the UCS register and in-patient databases from the National Health Security Office (NHSO), Thailand. Hospital admissions per 100,000 population was the highest among those aged 0–4 years, but the trends decreased from 470.8 to 288.1 per 100,000 population in 2010–2014. The hospital admission rates were high in Southern Thailand and common in rainy seasons. The readmission rates within 28 days slightly decreased in all age groups in 2016 compared to those in 2007. The case fatality rate of patients aged 20–29 years decreased from 0.40% in 2007 to 0.34% in 2016. The readmission rate within 28 days and case fatality rate were the highest in patients aged 20–29 years. In conclusion, the asthma hospital admission, readmission, and case fatality rates declined over time along with the investment in the asthma care program under the UCS in Thailand. The highest hospital admission rates in patients aged 0–4 years and the readmission and case fatality rates in patients aged 20–29 years should be given more attention. Recordings of individual service utilization data in asthma patients, including quality of care provided, should be monitored to improve the asthma care system. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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13 pages, 1034 KiB

Open AccessArticle

The Effect of Outdoor Aeroallergens on Asthma Hospitalizations in Children in North-Western Tuscany, Italy

by Maria Di Cicco, Ester Del Tufo, Salvatore Fasola, Serena Gracci, Maria Giovanna Marchi, Luca Fibbi, Giovanna Cilluffo, Giuliana Ferrante, Diego G. Peroni and Stefania La Grutta

Int. J. Environ. Res. Public Health 2022, 19(6), 3586; https://doi.org/10.3390/ijerph19063586 - 17 Mar 2022

Cited by 6 | Viewed by 2449

Abstract

Few data are currently available on the effects of aeroallergens in triggering respiratory symptoms in children. To evaluate the potential effects of daily outdoor aeroallergens loads on childhood admissions, in this case-crossover study, we analyzed data from 85 children hospitalized at the University [...] Read more.

Few data are currently available on the effects of aeroallergens in triggering respiratory symptoms in children. To evaluate the potential effects of daily outdoor aeroallergens loads on childhood admissions, in this case-crossover study, we analyzed data from 85 children hospitalized at the University Hospital of Pisa, Italy, for asthma or asthma-like symptoms without respiratory infection, between 2010 and 2019. Data were linked to outdoor allergens, temperature, nitrogen dioxide, and relative humidity observed during the same period. A 10-grains/m³ increase in the total aeroallergen concentration was associated with an increased risk of admission at lag 0 (OR = 1.054, 95% CI: 1.011–1.098), with a smaller effect at lag 1 (OR = 1.037, 95% CI: 1.008–1.067) and lag 2 (OR = 1.021, 95% CI: 1.003–1.039). Trends to larger effects were observed in children with sensitization to one or more aeroallergens (OR = 1.085, 95% CI: 1.004–1.173 at lag 0), in males (OR = 1.069, 95% CI: 1.009–1.132 at lag 0) and in older children (OR = 1.065, 95% CI: 1.007–1.127 at lag 0). Our study shows an association between increased outdoor allergens loads and asthma or asthma-like symptoms in children up to at least two days prior to hospitalization, suggesting that tracking aeroallergen counts may be useful to improve the management of respiratory allergic diseases. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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19 pages, 420 KiB

Open AccessArticle

Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach

by Valentina Fainardi, Carlo Caffarelli, Barbara Maria Bergamini, Loretta Biserna, Paolo Bottau, Elena Corinaldesi, Arianna Dondi, Martina Fornaro, Battista Guidi, Francesca Lombardi, Maria Sole Magistrali, Elisabetta Marastoni, Alessandra Piccorossi, Maurizio Poloni, Sylvie Tagliati, Francesca Vaienti, Cristina Venturelli, Giampaolo Ricci, Susanna Esposito and on behalf of the Emilia-Romagna Asthma (ERA) Study Group

Int. J. Environ. Res. Public Health 2021, 18(23), 12775; https://doi.org/10.3390/ijerph182312775 - 3 Dec 2021

Cited by 9 | Viewed by 4587

Abstract

Bronchial asthma is the most frequent chronic disease in children and affects up to 20% of the pediatric population, depending on the geographical area. Asthma symptoms vary over time and in intensity, and acute asthma attack can resolve spontaneously or in response to [...] Read more.

Bronchial asthma is the most frequent chronic disease in children and affects up to 20% of the pediatric population, depending on the geographical area. Asthma symptoms vary over time and in intensity, and acute asthma attack can resolve spontaneously or in response to therapy. The aim of this project was to define the care pathway for pediatric patients who come to the primary care pediatrician or Emergency Room with acute asthmatic access. The project was developed in the awareness that for the management of these patients, broad coordination of interventions in the pre-hospital phase and the promotion of timely and appropriate assistance modalities with the involvement of all health professionals involved are important. Through the application of the RAND method, which obliges to discuss the statements derived from the guidelines, there was a clear increase in the concordance in the behavior on the management of acute asthma between primary care pediatricians and hospital pediatricians. The RAND method was found to be useful for the selection of good practices forming the basis of an evidence-based approach, and the results obtained form the basis for further interventions that allow optimizing the care of the child with acute asthma attack at the family and pediatric level. An important point of union between the primary care pediatrician and the specialist hospital pediatrician was the need to share spirometric data, also including the use of new technologies such as teleconsultation. Monitoring the progress of asthma through spirometry could allow the pediatrician in the area to intervene early by modifying the maintenance therapy and help the patient to achieve good control of the disease. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

11 pages, 363 KiB

Open AccessArticle

Infant Nasopharyngeal Microbiota Subphenotypes and Early Childhood Lung Function: Evidence from a Rural Ghanaian Pregnancy Cohort

by Kathryn Dubowski, Seyram Kaali, Darby Jack, Rebecca Kyerewaa Dwommoh Prah, Jose C. Clemente, Theresa Tawiah, Mohammed Mujtaba, Louisa Iddrisu, Daniel Carrión, Dennis Gyasi Konadu, Oscar Agyei, Francis Mensah Kornu, Samuel Osei-Owusu, Alison G. Lee and Kwaku Poku Asante

Int. J. Environ. Res. Public Health 2021, 18(14), 7276; https://doi.org/10.3390/ijerph18147276 - 7 Jul 2021

Cited by 2 | Viewed by 2367

Abstract

Early life respiratory microbiota may increase risk for future pulmonary disease. Associations between respiratory microbiota and lung health in children from low- and middle-income countries are not well-described. Leveraging the Ghana Randomized Air Pollution and Health Study (GRAPHS) prospective pregnancy cohort in Kintampo, [...] Read more.

Early life respiratory microbiota may increase risk for future pulmonary disease. Associations between respiratory microbiota and lung health in children from low- and middle-income countries are not well-described. Leveraging the Ghana Randomized Air Pollution and Health Study (GRAPHS) prospective pregnancy cohort in Kintampo, Ghana, we collected nasopharyngeal swabs in 112 asymptomatic children aged median 4.3 months (interquartile range (IQR) 2.9, 7.1) and analyzed 22 common bacterial and viral pathogens with MassTag polymerase chain reaction (PCR). We prospectively followed the cohort and measured lung function at age four years by impulse oscillometry. First, we employed latent class analysis (LCA) to identify nasopharyngeal microbiota (NPM) subphenotypes. Then, we used linear regression to analyze associations between subphenotype assignment and lung function. LCA suggest that a two-class model best described the infant NPM. We identified a higher diversity subphenotype (N = 38, 34%) with more pathogens (median 4; IQR 3.25, 4.75) and a lower diversity subphenotype (N = 74, 66%) with fewer pathogens (median 1; IQR 1, 2). In multivariable linear regression models, the less diverse NPM subphenotype had higher small airway resistance (R5-R20

β

= 17.9%, 95% CI 35.6, 0.23; p = 0.047) compared with the more diverse subphenotype. Further studies are required to understand the role of the microbiota in future lung health. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

Review

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22 pages, 1080 KiB

Open AccessReview

Early Origins of Chronic Obstructive Pulmonary Disease: Prenatal and Early Life Risk Factors

by Michela Deolmi, Nicola Mattia Decarolis, Matteo Motta, Heidi Makrinioti, Valentina Fainardi, Giovanna Pisi and Susanna Esposito

Int. J. Environ. Res. Public Health 2023, 20(3), 2294; https://doi.org/10.3390/ijerph20032294 - 27 Jan 2023

Cited by 18 | Viewed by 4170

Abstract

The main risk factor for chronic obstructive pulmonary disease (COPD) is active smoking. However, a considerable amount of people with COPD never smoked, and increasing evidence suggests that adult lung disease can have its origins in prenatal and early life. This article reviews [...] Read more.

The main risk factor for chronic obstructive pulmonary disease (COPD) is active smoking. However, a considerable amount of people with COPD never smoked, and increasing evidence suggests that adult lung disease can have its origins in prenatal and early life. This article reviews some of the factors that can potentially affect lung development and lung function trajectories throughout the lifespan from genetics and prematurity to respiratory tract infections and childhood asthma. Maternal smoking and air pollution exposure were also analyzed among the environmental factors. The adoption of preventive strategies to avoid these risk factors since the prenatal period may be crucial to prevent, delay the onset or modify the progression of COPD lung disease throughout life. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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8 pages, 744 KiB

Open AccessReview

Impact of COVID-19 in Children with Chronic Lung Diseases

by Valentina Agnese Ferraro, Stefania Zanconato and Silvia Carraro

Int. J. Environ. Res. Public Health 2022, 19(18), 11483; https://doi.org/10.3390/ijerph191811483 - 13 Sep 2022

Cited by 5 | Viewed by 2297

Abstract

Background: since December 2019, the world has become victim of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The aim of our narrative review is to analyze the impact of COVID-19 in children suffering from chronic lung [...] Read more.

Background: since December 2019, the world has become victim of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The aim of our narrative review is to analyze the impact of COVID-19 in children suffering from chronic lung disease (CLD). Methods: we searched the MEDLINE/Pubmed database using the terms “SARS-CoV-2” or “COVID-19” or “Coronavirus Diseases 2019”; AND “chronic lung diseases” or “chronic respiratory diseases” or “asthma” or “cystic fibrosis” or “primary ciliary dyskinesia” or “bronchopulmonary dysplasia”; and limiting the search to the age range 0–18 years. Results and Conclusions: although COVID-19 rarely presents with a severe course in children, CLD may represent a risk factor; especially when already severe or poorly controlled before SARS-CoV-2 infection. On the other hand, typical features of children with CLD (e.g., the accurate adoption of prevention measures, and, in asthmatic patients, the regular use of inhaled corticosteroids and T2 inflammation) might have a role in preventing SARS-CoV-2 infection. Moreover, from a psychological standpoint, the restrictions associated with the pandemic had a profound impact on children and adolescents with CLD. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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16 pages, 1881 KiB

Open AccessReview

Lifelong Lung Sequelae of Prematurity

by Paola Di Filippo, Giulia Dodi, Francesca Ciarelli, Sabrina Di Pillo, Francesco Chiarelli and Marina Attanasi

Int. J. Environ. Res. Public Health 2022, 19(9), 5273; https://doi.org/10.3390/ijerph19095273 - 26 Apr 2022

Cited by 6 | Viewed by 3549

Abstract

The clinical, functional, and structural pattern of chronic lung disease of prematurity has changed enormously in last years, mirroring a better perinatal management and an increasing lung immaturity with the survival of increasingly premature infants. Respiratory symptoms and lung function impairment related to [...] Read more.

The clinical, functional, and structural pattern of chronic lung disease of prematurity has changed enormously in last years, mirroring a better perinatal management and an increasing lung immaturity with the survival of increasingly premature infants. Respiratory symptoms and lung function impairment related to prematurity seem to improve over time, but premature birth increases the likelihood of lung function impairment in late childhood, predisposing to chronic obstructive pulmonary disease (COPD). It is mandatory to identify those individuals born premature who are at risk for developing long-term lung disease through a better awareness of physicians, the use of standardized CT imaging scores, and a more comprehensive periodic lung function evaluation. The aim of this narrative review was to provide a systematic approach to lifelong respiratory symptoms, lung function impairment, and lung structural anomalies in order to better understand the specific role of prematurity on lung health. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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20 pages, 962 KiB

Open AccessReview

The Role of Gut and Lung Microbiota in Susceptibility to Tuberculosis

by Pasquale Comberiati, Maria Di Cicco, Francesco Paravati, Umberto Pelosi, Alessandro Di Gangi, Stefania Arasi, Simona Barni, Davide Caimmi, Carla Mastrorilli, Amelia Licari and Fernanda Chiera

Int. J. Environ. Res. Public Health 2021, 18(22), 12220; https://doi.org/10.3390/ijerph182212220 - 21 Nov 2021

Cited by 20 | Viewed by 4167

Abstract

Tuberculosis is one of the most common infectious diseases and infectious causes of death worldwide. Over the last decades, significant research effort has been directed towards defining the understanding of the pathogenesis of tuberculosis to improve diagnosis and therapeutic options. Emerging scientific evidence [...] Read more.

Tuberculosis is one of the most common infectious diseases and infectious causes of death worldwide. Over the last decades, significant research effort has been directed towards defining the understanding of the pathogenesis of tuberculosis to improve diagnosis and therapeutic options. Emerging scientific evidence indicates a possible role of the human microbiota in the pathophysiology of tuberculosis, response to therapy, clinical outcomes, and post-treatment outcomes. Although human studies on the role of the microbiota in tuberculosis are limited, published data in recent years, both from experimental and clinical studies, suggest that a better understanding of the gut–lung microbiome axis and microbiome–immune crosstalk could shed light on the specific pathogenetic mechanisms of Mycobacterium tuberculosis infection and identify new therapeutic targets. In this review, we address the current knowledge of the host immune responses against Mycobacterium tuberculosis infection, the emerging evidence on how gut and lung microbiota can modulate susceptibility to tuberculosis, the available studies on the possible use of probiotic–antibiotic combination therapy for the treatment of tuberculosis, and the knowledge gaps and future research priorities in this field. Full article

(This article belongs to the Special Issue Chronic Respiratory Diseases and Respiratory Care in Childhood)

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