Asunto(s)
Asma/prevención & control , Necesidades y Demandas de Servicios de Salud , Vacunas contra la Influenza , Asma/epidemiología , Asma/virología , Niño , Preescolar , Humanos , Inmunización/estadística & datos numéricos , Lactante , Gripe Humana/complicaciones , Gripe Humana/prevención & control , Guías de Práctica Clínica como Asunto , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: Although influenza immunization is recommended for children with high-risk medical conditions, the majority of such children do not receive influenza vaccine. This study was designed to measure the burden of influenza among children with asthma and other chronic medical conditions. STUDY DESIGN: We performed a retrospective cohort study of children younger than 15 years with medically treated asthma or other chronic medical conditions enrolled in the Tennessee Medicaid program from 1973 to 1993. We determined rates of hospitalization for acute cardiopulmonary disease, outpatient visits, and antibiotic courses throughout the year. Annual differences between event rates when influenza virus was circulating and event rates during winter months when there was no influenza in the community were used to calculate influenza-attributable morbidity. RESULTS: Influenza accounted for an average of 19, 8, and 2 excess hospitalizations for cardiopulmonary disease yearly per 1000 high-risk children aged <1 year, 1 to <3 years, and 3 to <15 years, respectively. For every 1000 children, an estimated 120 to 200 outpatient visits and 65 to 140 antibiotic courses were attributable to influenza annually. CONCLUSIONS: Children younger than 15 years with asthma and other chronic medical conditions experience substantial morbidity requiring inpatient and outpatient care during influenza season. More effective targeting of this population for annual influenza immunization is warranted.
Asunto(s)
Asma/complicaciones , Costo de Enfermedad , Cardiopatías/complicaciones , Gripe Humana/complicaciones , Enfermedades Pulmonares/complicaciones , Adolescente , Atención Ambulatoria/estadística & datos numéricos , Antibacterianos/uso terapéutico , Asma/epidemiología , Niño , Preescolar , Enfermedad Crónica , Estudios de Cohortes , Utilización de Medicamentos , Femenino , Cardiopatías/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Vacunas contra la Influenza , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Enfermedades Pulmonares/epidemiología , Masculino , Morbilidad , Estudios Retrospectivos , Estaciones del Año , Tennessee/epidemiologíaRESUMEN
Respiratory syncytial virus causes worldwide epidemics of respiratory disease. Of 23 children infected with respiratory syncytial virus, 65% had low serum concentrations of vitamin A during acute illness; these low values were associated with more severe illness. Vitamin A supplementation may have a role in the management of infection with respiratory syncytial virus.