Modern Pediatrics. Ukraine. (2023). 7(135): 23-32. doi: 10.15574/SP.2023.135.23
Voloshin O. M.^1,2, Marushko Yu. V.¹, Savchenko I. I.², Osychniuk L. M.^2
1Bogomolets National Medical University, Kyiv, Ukraine
²Luhansk State Medical University, Rivne, Ukraine

For citation: Voloshin OM, Marushko YuV, Savchenko II, Osychniuk LM. (2023). Family risk factors in the recurrent course of acute respiratory infections in children aged 2-5 years. Modern Pediatrics. Ukraine. 7(135): 23-32. doi: 10.15574/SP.2023.135.23.
Article received: Aug 15, 2023. Accepted for publication: Nov 18, 2023.

Purpose – to find out the influence degree of particular family risk factors on the propensity of preschool children to the recurrent course of acute respiratory infections (ARI).
Materials and methods. A total of 237 children (128 boys and 109 girls) aged 2-5 years, undergoing inpatient treatment on ARI, were involved in the clinical study. Initially, the number of ARI episodes were taken into account for the examined children during the previous year of their lives as well as the presence or absence of 19 potential family risk factors associated with recurrent respiratory infections (RRI). In addition, 2 integral indices of ARI recurrence – the infection index (InI) and the resistance index (RI) – were calculated. The statistical processing of the digital material obtained was performed using IBM SPSS Statistics 28 licensed software. The odds ratio (OR) was calculated by crosstabulation. Besides, the Kaplan-Meier method with adjusted indicators was applied for statistical analysis.
Results. The studied integral indicators of ARI recurrent course – InI and RI – are inversely correlated with the majority of the considered family risk factors, and the degree of connection strength for InI and RI is approximately the same. Almost 50% of the examined risk factors for RRI, specifically 9 out of 19, rise the chance of children belonging to a group with more frequent episodes of ARI. The most significant RRI risk factors were as follows: 1) mother’s and father’s susceptibility to RRI during their preschool age (OR=3.529; p<0.001; 95% CI: 1.791-6.954); 2) the presence of other children in family who have or had a tendency to RRI (OR=2.945; p=0.009; 95% CI: 1.292-6.717); 3) mother’s susceptibility to RRI during her preschool age (OR=2.742; p<0.001; 95% CI: 1.495-5.029); 4) maternal full-time employment at work during the previous year (OR=2.364; p=0.005; 95% CI: 1.287-4.342); 5) maternal and paternal secondary education (OR=2.333; p=0.031; 95% CI: 1.069-5.095).
Conclusions. The prevalence of reported RRI risk factors among preschool children does not correlate with their significance in contributing to more frequent episodes of ARI. The Kaplan-Meier method makes it possible to determine the average and median age of children when the frequency of ARI episodes reaches the established threshold level under the influence of the considered risk factors for RRI. The results obtained substantiate the reasonability of using combined statistical methods to detect the most significant RRI risk factors and their combinations in preschool children.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children.
No conflict of interests was declared by the authors.
Keywords: preschool children, recurrent respiratory infections, family risk factors, odds ratio.

REFERENCES

1. Allinson J, Chaturvedi N, Wong A et al. (2023). Early childhood lower respiratory tract infection and premature adult death from respiratory disease in Great Britain: a national birth cohort study. The Lancet: 401. https://doi.org/10.1016/S0140-6736(23)00131-9; PMid:36898396

2. Ameli F, Brocchetti F, Mignosi S, Tosca MA, Gallo F, Ciprandi G. (2020). Recurrent respiratory infections in children: a study in clinical practice. Acta Biomedica. 91(4): e2020179. doi: 10.23750/abm.v91i4.8585.

3. Asyiroh H, Setyoningrum RA, Fatmaningrum W, Utomo B. (2021). Risk Factors of Recurrent Upper Respiratory Tract Infection in Children Aged 3-60 Months at Primary Healthcare Centers (Puskemas) in Gresik. Jurnal Respirasi. 7(1): 8-13. https://doi.org/10.20473/jr.v7-I.1.2021.8-13

4. Ballarini S, Rossi GA, Principi N, Esposito S. (2021). Dysbiosis in Pediatrics Is Associated with Respiratory Infections: Is There a Place for Bacterial-Derived Products? Microorganisms. 9(2): 448. https://doi.org/10.3390/microorganisms9020448; PMid:33671586 PMCid:PMC7926342

5. Biezen R, Brijnath B, Grando D, Mazza D. (2017). Management of respiratory tract infections in young children – A qualitative study of primary care providers' perspectives. NPJ Primary Care Respiratory Medicine. 27: 15. https://doi.org/10.1038/s41533-017-0018-x; PMid:28258279 PMCid:PMC5434780

6. Chernyshova LI. (2018). Recurrent respiratory diseases in children: the physician's action algorithm (lecture). Sovremennaya pediatriya. 3: 92-97. https://doi.org/10.15574/SP.2018.91.92

7. De Benedictis FM, Bush A. (2018). Recurrent lower respiratory tract infections in children. British Medical Journal. 362: k2698. https://doi.org/10.1136/bmj.k2698; PMid:30002015

8. Etrhuni S, Omar R, Hadid I. (2020). Risk factors of acute respiratory infections in children in Tripoli, Libya. Ibnosina Journal of Medicine and Biomedical Sciences. 12(3): 200-207. https://doi.org/10.4103/ijmbs.ijmbs_77_20

9. Fathmawati F, Rauf S, Indraswari BW. (2021). Factors related with the incidence of acute respiratory infections in toddlers in Sleman, Yogyakarta, Indonesia: Evidence from the Sleman Health and Demographic Surveillance System. PLoS ONE 16(9): e0257881. https://doi.org/10.1371/journal.pone.0257881; PMid:34559864 PMCid:PMC8462707

10. Kansen HM, Lebbink MA, Mul J et al. (2020). Risk factors for atopic diseases and recurrent respiratory tract infections in children. Pediatric Pulmonology. 55: 3168-3179. https://doi.org/10.1002/ppul.25042; PMid:32841506 PMCid:PMC7589449

11. Marengo RL, Ciceran A, Del Río Navarro BE. (2017). Upper Respiratory Tract Infections in Children and Adults: Burden and Management. European Medical Journal Respiratory. 5 (14): 22-28. https://doi.org/10.33590/emjrespir/10313231

12. Nagaraju K, Shah R, Ganapathy S et al. (2021). Practical Approach for the Diagnosis, Prevention, and Management of Recurrent Upper Respiratory Tract Infection in Children: Report from an Expert Closed-group Discussion. Pediatric Infectious Disease. 3: 105-112. https://doi.org/10.5005/jp-journals-10081-1321

13. Ostrzyżek-Przeździecka K, Panczyk M, Bronikowski M, Gasior JS, Feleszko W. (2023). Association of low physical activity with higher respiratory tract infections frequency among pre-school children. Pediatric Research. 94 (2): 594-602. https://doi.org/10.1038/s41390-022-02436-7; PMid:36690745

14. Pedro CR, Freitas PP, Papoila AL et al. (2017). Respiratory diseases in children attending kindergartens: Health-related variables and mothers' psychological, parental, and marital functioning. Health psychology open. 4 (2): 2055102917724334. https://doi.org/10.1177/2055102917724334; PMid:29379614 PMCid:PMC5779923

15. Schaad UB, Esposito S, Razi CH. (2016). Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide. Archives of Pediatric Infectious Diseases. 4(1): e31039. https://doi.org/10.5812/pedinfect.31039

16. Voloshin OM, Marushko YuV, Savchenko II. (2023). А bootstrap analysis of immune status in preschool children suffering from recurrent respiratory infections. Modern Pediatrics. Ukraine. 3: 13-21. https://doi.org/10.15574/SP.2023.131.13

17. Voloshin OM, Marushko YuV. (2021). Retrospective analysis of predictor of recurrent respiratory infections in preschool children. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 21 (2): 28-33. doi: 10.31718/2077-1096.21.2.28.; https://doi.org/10.31718/2077-1096.21.2.28

18. Wang X, Li X, Jin C et al. (2021). Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children. Frontiers in Pediatrics. 9: 756217. https://doi.org/10.3389/fped.2021.756217; PMid:35004539 PMCid:PMC8740126

19. Yunitawati D, Khairunnisa M, Latifah L. (2023). Maternal Characteristics as Predictors of the Incidence of Acute Upper Respiratory Infection in Children Under Five Years Old in Indonesia. Proceedings of the 1st International Conference for Health Research – BRIN (ICHR 2022). https://doi.org/10.2991/978-94-6463-112-8_46

20. Zhou B, Niu W, Liu F et al. (2021). Risk factors for recurrent respiratory tract infection in preschool-aged children. Pediatrsc Research. 90: 223-231. https://doi.org/10.1038/s41390-020-01233-4; PMid:33173178

21. Zuccotti GV, Mameli C. (2015). Respiratory infections and immunostimulants in childhood: an update. Journal of Pediatric and Neonatal Individualized Medicine. 4(2): e040218. doi: 10.7363/040218.