Assuntos
Asma/prevenção & controle , Necessidades e Demandas de Serviços de Saúde , Vacinas contra Influenza , Asma/epidemiologia , Asma/virologia , Criança , Pré-Escolar , Humanos , Imunização/estatística & dados numéricos , Lactente , Influenza Humana/complicações , Influenza Humana/prevenção & controle , Guias de Prática Clínica como Assunto , Estados Unidos/epidemiologiaRESUMO
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.
Assuntos
Asma/complicações , Efeitos Psicossociais da Doença , Cardiopatias/complicações , Influenza Humana/complicações , Pneumopatias/complicações , Adolescente , Assistência Ambulatorial/estatística & dados numéricos , Antibacterianos/uso terapêutico , Asma/epidemiologia , Criança , Pré-Escolar , Doença Crônica , Estudos de Coortes , Uso de Medicamentos , Feminino , Cardiopatias/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Vacinas contra Influenza , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Pneumopatias/epidemiologia , Masculino , Morbidade , Estudos Retrospectivos , Estações do Ano , Tennessee/epidemiologiaRESUMO
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.