Machine learning in predicting severe acute respiratory infection outbreaks / Aprendizado de máquina na previsão de surtos de síndrome respiratória aguda grave / Aprendizaje automático en la predicción de brotes de síndrome respiratorio agudo grave

Abstract: Severe acute respiratory infection (SARI) outbreaks occur annually, with seasonal peaks varying among geographic regions. Case notification is important to prepare healthcare networks for patient attendance and hospitalization. Thus, health managers need adequate resource planning tools for SARI seasons. This study aims to predict SARI outbreaks based on models generated with machine learning using SARI hospitalization notification data. In this study, data from the reporting of SARI hospitalization cases in Brazil from 2013 to 2020 were used, excluding SARI cases caused by COVID-19. These data were prepared to feed a neural network configured to generate predictive models for time series. The neural network was implemented with a pipeline tool. Models were generated for the five Brazilian regions and validated for different years of SARI outbreaks. By using neural networks, it was possible to generate predictive models for SARI peaks, volume of cases per season, and for the beginning of the pre-epidemic period, with good weekly incidence correlation (R2 = 0.97; 95%CI: 0.95-0.98, for the 2019 season in the Southeastern Brazil). The predictive models achieved a good prediction of the volume of reported cases of SARI; accordingly, 9,936 cases were observed in 2019 in Southern Brazil, and the prediction made by the models showed a median of 9,405 (95%CI: 9,105-9,738). The identification of the period of occurrence of a SARI outbreak is possible using predictive models generated with neural networks and algorithms that employ time series.

Resumo: Surtos de síndrome respiratória aguda grave (SRAG) ocorrem anualmente, com picos sazonais variando entre regiões geográficas. A notificação dos casos é importante para preparar as redes de atenção à saúde para o atendimento e internação dos pacientes. Portanto, os gestores de saúde precisam ter ferramentas adequadas de planejamento de recursos para as temporadas de SRAG. Este estudo tem como objetivo prever surtos de SRAG com base em modelos gerados com aprendizado de máquina usando dados de internação por SRAG. Foram incluídos dados sobre casos de hospitalização por SRAG no Brasil de 2013 a 2020, excluindo os casos causados pela COVID-19. Estes dados foram preparados para alimentar uma rede neural configurada para gerar modelos preditivos para séries temporais. A rede neural foi implementada com uma ferramenta de pipeline. Os modelos foram gerados para as cinco regiões brasileiras e validados para diferentes anos de surtos de SRAG. Com o uso de redes neurais, foi possível gerar modelos preditivos para picos de SRAG, volume de casos por temporada e para o início do período pré-epidêmico, com boa correlação de incidência semanal (R2 = 0,97; IC95%: 0,95-0,98, para a temporada de 2019 na Região Sudeste). Os modelos preditivos obtiveram uma boa previsão do volume de casos notificados de SRAG; dessa forma, foram observados 9.936 casos em 2019 na Região Sul, e a previsão feita pelos modelos mostrou uma mediana de 9.405 (IC95%: 9.105-9.738). A identificação do período de ocorrência de um surto de SRAG é possível por meio de modelos preditivos gerados com o uso de redes neurais e algoritmos que aplicam séries temporais.

Resumen: Brotes de síndrome respiratorio agudo grave (SRAG) ocurren todos los años, con picos estacionales que varían entre regiones geográficas. La notificación de los casos es importante para preparar las redes de atención a la salud para el cuidado y hospitalización de los pacientes. Por lo tanto, los gestores de salud deben tener herramientas adecuadas de planificación de recursos para las temporadas de SRAG. Este estudio tiene el objetivo de predecir brotes de SRAG con base en modelos generados con aprendizaje automático utilizando datos de hospitalización por SRAG. Se incluyeron datos sobre casos de hospitalización por SRAG en Brasil desde 2013 hasta 2020, salvo los casos causados por la COVID-19. Se prepararon estos datos para alimentar una red neural configurada para generar modelos predictivos para series temporales. Se implementó la red neural con una herramienta de canalización. Se generaron los modelos para las cinco regiones brasileñas y se validaron para diferentes años de brotes de SRAG. Con el uso de redes neurales, se pudo generar modelos predictivos para los picos de SRAG, el volumen de casos por temporada y para el inicio del periodo pre-epidémico, con una buena correlación de incidencia semanal (R2 = 0,97; IC95%: 0,95-0,98, para la temporada de 2019 en la Región Sudeste). Los modelos predictivos tuvieron una buena predicción del volumen de casos notificados de SRAG; así, se observaron 9.936 casos en 2019 en la Región Sur, y la predicción de los modelos mostró una mediana de 9.405 (IC95%: 9.105-9.738). La identificación del periodo de ocurrencia de un brote de SRAG es posible a través de modelos predictivos generados con el uso de redes neurales y algoritmos que aplican series temporales.

Investigation of viral etiology with sever acute respiratory infection of hospitalized patients in Guangdong Province from 2019 to 2021 / 公共卫生与预防医学

Objective To investigate the infection status and epidemiological characteristics of viral pathogens in hospitalized patients with severe acute respiratory infection (SARI) in Guangdong Province from 2019 to 2021, so as to provide reference for clinical diagnosis and prevention. Methods The respiratory tract samples of SARI patients collected from 2019 to 2021 were detected and analyzed for respiratory syncytial virus (RSV), adenovirus (ADV), human rhinovirus/enterovirus (HRV/EV), human metapneumonic virus (HMPV) and other common respiratory viruses using Luminex respiratory multi-pathogen detection technology. Results A total of 1 948 influenza-negative cases were collected, of which 24.28 % were positive detection of virus infection. HRV/EV was the highest (10.32%), followed by RSV (4.31%). The detection rates were statistically significantly different among different age groups (χ2=176.186，P2=0.042，P>0.05). The detection peaks of RSV were mainly concentrated in summer and autumn, while HMPV was prevalent in winter, and HRV/EV and ADV had no obvious seasonality. Mixed infection was found in 39 samples, and the mixed infection rate was 2.00%. In the mixed infection cases, HPIV and HRV/EV combined infection was the most common. Conclusion HRV/EV, RSV, HMPV and ADV are predominant viral pathogens in SARI influenza-negative hospitalized cases in Guangdong Province from 2019 to 2021. It is recommended to strengthen the surveillance of SARI cases in children under 5 years old.

Factors associated with respiratory morbidity in the first year of life

Abstract Objectives: To investigate the association between socioeconomic and nutritional factors with respiratory morbidity in the first year of life in different regions of Brazil. Methodology: A nested case-control study within a randomized field trial was conducted in three capital cities (Porto Alegre, Manaus, and Salvador), representing different macro-regions of the country. Cases were defined as children with a reported previous diagnosis of asthma, bronchiolitis, or pneumonia. Corresponding controls were matched by age and sex in a 2:1 ratio, selected consecutively from the original cohort, resulting in a sample of 222 children. Bivariate analyses were performed to assess the association between sociodemographic and nutritional variables with respiratory morbidity outcomes, calculating odds ratios (OR) and their respective confidence intervals (95% CI). Values of p < 0.05 were considered significant. Potential confounding factors were adjusted through multivariate analysis (logistic regression). Results: Maternal smoking and breastfeeding for less than six months showed a significant association and increased risk of respiratory disease (OR=2.12 and 2.05, respectively). Children born in the Southern region of Brazil also demonstrated a higher association and risk of respiratory morbidity. The consumption of ultra-processed foods did not show a significant association or increased risk of respiratory disease. Conclusions: Maternal smoking, breastfeeding for less than six months, and being born in the Southern region of Brazil are risk factors for the development of respiratory morbidity in the first year of life. The consumption of ultra-processed foods does not appear to pose a risk, but it was prevalent in more than 80% of the population, limiting its discriminatory power of analysis.

Identificación de agentes virales en niños con infección respiratoria aguda

Introducción: Las infecciones respiratorias agudas representan un problema de salud en niños, con elevadas cifras de morbilidad y elevado índice de mortalidad. Objetivo: Determinar la circulación de virus respiratorios en niños ingresados con diagnóstico de infección respiratoria aguda, negativos para COVID-19. Métodos: Estudio observacional descriptivo en 119 niños con infección respiratoria aguda, entre 0 y 6 años e ingreso hospitalario entre octubre de 2021-abril de 2022. Se tomaron muestras de exudado nasofaríngeo para estudio virológico (reacción en cadena de la polimerasa en tiempo real). Las variables estudiadas fueron: edad, sexo, diagnóstico clínico, período de ocurrencia y aislamiento de virus respiratorios. Resultados: Predominó el sexo femenino con 51 % y la edad correspondiente al período neonatal con 50 %, seguidos por lactantes entre 1 y 11 meses (40 %), solo 10 % entre 1 y 6 años de edad. Resultaron positivas 42 % de las muestras con predominio del CoV229E (78 %); se aislaron otros virus como influenza A (6 %), sincitial respiratorio (6 %), CoVOC43 (2 %) y rinovirus (2 %). El CoV229E fue frecuente en pacientes con infección respiratoria aguda alta (48,7 %), seguido de infección respiratoria aguda grave (20,5 %) y bronquiolitis (28,2 %). Se detectó coinfección viral solo en infección respiratoria aguda grave, específicamente por IFA/CoV229E (4 %) y CoV229E/bocavirus (2 %). Conclusiones: Se destaca la importancia de la biología molecular para el aislamiento viral. El coronavirus CoV229E tiene relevancia en los casos de infección respiratoria aguda alta y grave principalmente en los menores de 1 año.

Introduction: Acute respiratory infections represent a health problem in children, with high morbidity and high mortality rates. Objective: To determine the circulation of respiratory viruses in children admitted with a diagnosis of acute respiratory infection, negative to COVID-19. Methods: Descriptive observational study in 119 children with acute respiratory infection, in the ages from 0 to 6, and with hospital admission in the period from October 2021 to April 2022. Nasopharyngeal exudate samples were taken for virological study (real-time polymerase chain reaction). The variables studied were: age, sex, clinical diagnosis, period of occurrence and isolation of respiratory viruses. Results: The female sex predominated with 51% and the age corresponding to the neonatal period with 50 %, followed by infants between 1 and 11 months (40%), and only 10% in the ages from 1 to 6 years. 42 % of the samples with a predominance of CoV229E (78%) were positive; other viruses such as influenza A (6 %), respiratory syncytial (6 %), CoVOC43 (2%) and rhinovirus (2%) were isolated. CoV229E was common in patients with high acute respiratory infection (48.7%), followed by severe acute respiratory infection (20.5%) and bronchiolitis (28.2%). Viral co-infection was detected only in severe acute respiratory infection, specifically by IFA/CoV229E (4%) and CoV229E/bocavirus (2%). Conclusions: The importance of molecular biology for viral isolation is highlighted. The Coronavirus CoV229E has relevance in cases of acute high and severe respiratory infection mainly in children under 1 year old.

Morbilidad por infecciones respiratorias agudas altas en menores de 5 años / Morbidity from acute upper respiratory infections in children under 5 years of age / Morbidade de infecções respiratórias superiores agudas em crianças menores de 5 anos de idade

RESUMEN Introducción: las infecciones respiratorias agudas (IRA) constituyen la causa más frecuente en las consultas de pediatría. Objetivo: caracterizar el comportamiento de la morbilidad por infecciones respiratorias altas en menores de 5 años, en el servicio de respiratorio del Hospital Pediátrico Docente "General Luis Ángel Milanés Tamayo, desde enero a marzo de 2019. Métodos: se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 172 niños que ingresaron en este periodo y la muestra después de aplicados los criterios de inclusión y exclusión quedó conformada por 74 niños. El procesamiento de los datos se realizó mediante el programa EPIDAT versión 3.1, como procesador de texto, se utilizaron los métodos teóricos, empíricos y estadísticos. Resultados: predominaron los niños menores de 1 año (51,3%), el sexo masculino(64,8%), la estadía hospitalaria fue generalmente menos de 3 días(64,8%) la procedencia urbana (67,5%), la rinofaringitis aguda como la IRAA más frecuente (74,3%) y la exposición al humo pasivo como principal factor predisponente(56,7%). Conclusiones: se concluyó que en el estudio predominaron los niños menores de 1 año, el sexo masculino , la estadía hospitalaria fue generalmente menos de 3 días, la procedencia urbana, la rinofaringitis aguda como la IRAA más frecuente , la exposición al humo pasivo como principal factor de riesgo asociado.

ABSTRACT Introduction: acute respiratory infections (ARI) are the most frequent cause in paediatric consultations. Objective: to characterize the behavior of morbidity due to upper respiratory infections in children under 5 years of age, in the respiratory service of the Pediatric Teaching Hospital "General Luis Ángel Milanés Tamayo", from January to March 2019. Methods: an observational, descriptive and cross-sectional study was conducted. The universe consisted of 172 children who entered in this period and the sample after applying the inclusion and exclusion criteria was made up of 74 children. The data processing was carried out using the EPIDAT version 3.1 program, as a word processor, theoretical, empirical and statistical methods were used. Results: children under 1 year of age (51.3%), male sex (64.8%), hospital stay was generally less than 3 days (64.8%) urban origin (67.5%), acute rhinopharyngitis as the most frequent HAA (74.3%) and exposure to secondhand smoke as the main predisposing factor (56.7%). Conclusions: it was concluded that in the study predominated children under 1 year, the male sex, the hospital stay was generally less than 3 days, urban origin, acute rhinopharyngitis as the most frequent HAIS, exposure to passive smoke as the main associated risk factor.

RESUMO Introdução: infecções respiratórias agudas (RV) são a causa mais frequente em consultas pediátricas. Objetivo: caracterizar o comportamento da morbidade devido a infecções respiratórias superiores em crianças menores de 5 anos, no serviço respiratório do Hospital Universitário Pediátrico "General Luis Ángel Milanés Tamayo", de janeiro a março de 2019. Métodos: foi realizado um estudo observacional, descritivo e transversal. O universo era composto por 172 crianças que ingressaram nesse período e a amostra após a aplicação dos critérios de inclusão e exclusão foi composta por 74 crianças. O processamento dos dados foi realizado utilizando-se o programa EPIDAT versão 3.1, como processador de texto, métodos teóricos, empíricos e estatísticos. Resultados: crianças menores de 1 ano (51,3%), sexo masculino (64,8%), internação hospitalar foi geralmente inferior a 3 dias (64,8%) origem urbana (67,5%), rinofaringite aguda como a HAA mais frequente (74,3%) e exposiçãoao fumo de segunda mão como principal fator predisponente (56,7%). Conclusões: concluiu-se que no estudo predominaram as crianças menores de 1 ano, o sexo masculino, a internação hospitalar foi geralmente inferior a 3 dias, origem urbana, rinofaringite aguda como o HAIS mais frequente, exposição à fumaça passiva como principal fator de risco associado.

Clinical Profile of COVID-19 Illness in Children—Experience from a Tertiary Care Hospital

Objective To detail clinical profle and outcome in children infected with SARS-CoV-2. Methods This retrospective study was undertaken at a tertiary care pediatric teaching hospital in Northern India. The data on clinical characteristics and outcome of children (<18 y) with COVID-19 illness from April 2020–October 2020 were reviewed and analyzed. Results A total of 2919 children with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness were tested for novel COVID-19 virus in the fu emergency (n=1744), severe acute respiratory infection (SARI) ward (n=825), and non-COVID area (n=350) of the hospital. 8.73% (255/2919) children tested positive for SARS-CoV-2 infection. Of the 255 positive cases, 144 (56.47%) were managed on an outpatient basis and 100 (59 boys) required admission in COVID ward. The mortality rate of patients with SARS-CoV-2 was 11.4% (29/255). Majority of children admitted with COVID-19 had severe to critical illness due to the presence of malnutrition and underlying comorbidities. Conclusions Children of all age groups were susceptible to COVID-19 illness with a slight male preponderance. Amongst infected, two-third were asymptomatic or had mild symptoms that required outpatient management and home isolation. The adverse outcomes were more commonly seen in infants and children>10 y of age with malnutrition and comorbid illness.

Association of temperament type and mother's emotional state with acute respiratory infection in children / 南方医科大学学报

OBJECTIVE@#To explore the correlation of temperament type and mother's emotional state with acute respiratory tract infections in children so as to provide evidence for comprehensive treatment of the infections.@*METHODS@#A total of 200 children aged between 3 and 6 were enrolled in this study from two kindergartens of Guangzhou and Hengyang. The mothers were invited to complete a questionnaire of the children's general information followed by assessment using children's temperament scale and the Depression-Anxiety-Stress Scale.@*RESULTS@#The total incidence of acute respiratory infection was significantly higher in children with a hard- to-raise temperament than the easy- to-raise children (P < 0.05); the incidences of acute rhinitis, acute pharyngitis, acute laryngitis and acute bronchitis were all significantly higher in the hard-to-raise children (P < 0.05). A significant positive correlation was identified between the total number of episodes of acute respiratory tract infection in children and their mothers' stress and anxiety levels (P < 0.01). Acute rhinitis and acute tracheitis in the children were both positively correlated with the mothers' stress scores (P < 0.05), while acute pharyngitis and acute laryngitis were positively correlated with the mothers' anxiety scores (P < 0.05), while acute bronchitis was positively correlated with the mothers' stress and anxiety scores (P < 0.05). Multiple linear regression analysis with the factors influencing the types of acute respiratory tract infections in children as the independent variables suggested that the easy-to-raise type of temperament was a protective factor against acute rhinitis in children (P < 0.05), while mothers' anxiety was a risk factor of acute laryngitis in children (P < 0.05); the mothers' stress was a risk factor for acute bronchitis in children (P < 0.05).@*CONCLUSION@#Acute respiratory tract infection in children is closely related to the temperament type of the children and the emotional state of the mothers, which are important therapeutic targets in comprehensive interventions of acute respiratory tract infection in children.

Analysis of the prevalence of common respiratory pathogens in children in Beijing in 2020 / 中华微生物学和免疫学杂志

Objective:To investigate the changes in epidemiological characteristics of common respiratory pathogens in children in Beijing during COVID-19 epidemic.Methods:A total of 9 728 serum samples were collected from cases of acute respiratory infections in Beijing Children′s Hospital from January 2020 to December 2020. Indirect immunofluorescence antibody test was performed to detect IgM antibodies against eight common respiratory pathogens and the test results were statistically analyzed. The eight common respiratory pathogens were influenza virus A (FluA), influenza virus B (FluB), respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV), Mycoplasma pneumoniae ( Mp), Chlamydia pneumoniae ( Cp) and Legionella pneumophila ( Lp). Results:The detection rate of respiratory pathogens in 9 728 cases was 41.71% (4 058/9 728) and respiratory viruses (FluA, FluB, RSV, ADV and PIV) accounted for 46.18%(2 343/5 074)of all detected pathogens. Mp, FluB and FluA accounted for 84.73%(4 299/5 074)of all detected pathogens, and the detection rates were 24.27% (2 361/9 728), 11.49% (1 118/9 728) and 8.43% (820/9 728), respectively. There were 846 cases positive for two kinds of pathogens, and the most common co-infection was Mp and FluB. The detection rates in male and female were 37.56% (2 089/5 562) and 47.26% (1 969/4 166), respectively. There were significant differences in the total detection rate and the positive rates of PIV and Mp between different sexes ( P<0.05). The detection rate in school-age children (6-12 years old) was the highest (52.26%, 1 535/2 937). The detection rates of respiratory pathogens in different months ranged from 30.12% (203/674) to 49.81% (268/538) with higher rates in autumn and winter [42.45% (1 304/3 072) and 43.29% (1 618/3 738)]. The detection rates of FluA and FluB were higher in summer [11.46% (195/1 701)] and winter [14.63% (547/3738)], respectively. Most of RSV infection occurred in summer [1.35% (23/1 701)], and Mp could be detected all year round, especially in winter and spring [27.21% (1 017/3 738) and 25.64% (312/1 217)]. The detection rate of respiratory pathogens in outpatient group was higher than that in inpatient group [46.48% (1 583/3 406) vs 39.15% (2 475/6 322)]. The detection rate in severe cases was 26.10% (71/272). The detection rates of total pathogens, FluB and Mp were higher in outpatients than in inpatients and the differences were statistically significant ( P<0.05). The detection rates of FluA, PIV and ADV were higher in inpatients than in outpatients and the differences were statistically significant ( P<0.05). The detection rates of total pathogens, FluB and Mp in mild cases were significantly higher than those in severe cases and the differences were statistically significant ( P<0.05). The detection rate of RSV in severe cases was significantly higher than that in mild cases and the difference was statistically significant ( P<0.05). Conclusions:The protective measures taken during the period of regular prevention and control of COVID-19 epidemic could better prevent the spread of respiratory viruses, having a certain impact on the population susceptible to respiratory pathogens and typical seasonal patterns, but had little effect on the prevention and control of Mp. New protective measures needed to be studied to prevent Mp infection in children during epidemical season.

Infecciones respiratorias agudas virales en pacientes menores de 5 años hospitalizados / Viral acute respiratory infections in hospitalized patients under 5 years

Introducción: Los virus constituyen las causas más frecuentes de infección respiratoria aguda, aunque el diagnóstico causal suele ser empírico dada la complejidad de su aislamiento. Objetivo: Caracterizar a pacientes menores de 5 años de edad con infecciones respiratorias agudas, según variables epidemiológicas, clínicas e imagenológicas. Métodos: Se efectuó una investigación descriptiva y transversal de 171 pacientes con infecciones respiratorias agudas y aislamiento viral mediante exudado nasofaríngeo profundo, egresados del Servicio de Neonatología del Hospital Docente Infantil Sur Antonio María Béguez César de Santiago de Cuba, desde el 2014 hasta el 2016, para lo cual se realizaron cálculos de frecuencias y porcentajes. Resultados: Predominaron los lactantes (57,9 %), el sexo masculino y los afectados con diagnósticos de neumonía (40,9 %) y bronquiolitis (28,0 %) por virus sincitial respiratorio y rinovirus. La supresión precoz de lactancia materna y tabaquismo fueron los factores de riesgo prevalentes. Tanto la fiebre como la tos y las secreciones nasales resultaron preponderantes, e infrecuentes las complicaciones. La consolidación alveolar prevaleció en pacientes con neumonía. Conclusiones: Se caracterizó epidemiológica y clínicamente a los pacientes con virus respiratorios y se evidenció discordancia con el predominio del patrón de infiltrado alveolar descrito en la bibliografía médica consultada.

Introduction: Viruses constitute the most frequent causes in acute respiratory infection, although the causal diagnosis is usually empiric given the complexity of its isolation. Objective: To characterize patients under 5 years with acute respiratory infections, according to epidemiological, clinical and imaging variables. Methods: A descriptive and cross-sectional investigation of 171 patients with acute respiratory infections and viral isolation was carried out by means of deep nasopharyngeal swab. They were discharged from the Neonatology Service of Antonio María Béguez César Southern Children Teaching Hospital in Santiago de Cuba, from 2014 to 2016, for which calculations of frequencies and percentages were carried out. Results: There was a prevalence of infants (57.9 %), the male sex and those affected patients with diagnosis of pneumonia (40.9 %) and bronchiolitis (28.0 %) due to respiratory syncytial virus and rhinovirus. The early suppression of breast feeding and nicotine addiction were the prevalent risk factors. Both fever and cough and the nasal secretions were preponderant, and the complications were infrequent. The alveolar consolidation prevailed in patients with pneumonia. Conclusions: Patients with respiratory virus were clinically and epidemiologically characterized and conflict with the pattern prevalence of alveolar infiltrates described in the consulted medical literature was evidenced.

Vulnerabilidad de la Covid-19 por estratificación epidemiológica en policlínicos de Arroyo Naranjo, La Habana / Covid-19 vulnerability due to epidemiological stratification at community clinics in Arroyo Naranjo, Havana

Introducción: El SARS-CoV-2 es un coronavirus nuevo poco conocido, su puerta de entrada es la respiratoria. La vulnerabilidad espacial establece grados de riesgos para contraer la enfermedad, esto permite aplicar intervenciones radicales y diferentes, necesarias para enfrentar la pandemia. Objetivo: Determinar la vulnerabilidad espacial de la Covid-19 en policlínicos de Arroyo Naranjo, La Habana. Método: Se realizó un estudio descriptivo y transversal. Las siete áreas de salud del municipio Arroyo Naranjo. Con una población territorial. Se estudiaron adultos de 60 años y más, casos positivos y mortalidad por Covid-19, con infección respiratoria aguda, sintomatología y vulnerabilidad espacial. Los policlínicos se estratificaron en contextos vulnerables, medianamente vulnerables y menos vulnerables. La estratificación epidemiológica se realizó mediante el método de indicadores con ponderación fija, establecidos según criterios de expertos. Los datos se obtuvieron del departamento de estadística de los policlínicos y de la pesquisa diaria. Resultados: Los policlínicos estratificados como de contexto menos vulnerable fueron Capri, Managua y Eléctrico; mientras que como contexto medianamente vulnerable fueron Los Pinos, Mantilla y Grimau y de contexto vulnerable resultó el policlínico Párraga. Conclusiones: Existieron contextos vulnerables en el territorio, con una influencia negativa de los indicadores no bien controlados que favorecen la aparición de la Covid-19, lo que expresa el peligro de contraer la enfermedad o de un rebrote(AU)

Introduction: SARS-CoV-2 is a little-known new coronavirus, its entry point is the respiratory way. The spatial vulnerability establishes degrees of risks to contract the disease, this allows the application of radical and different interventions, necessary to face the pandemic. Objective: To determine Covid-19 spatial vulnerability at polyclinics in Arroyo Naranjo, Havana. Method: A descriptive and cross-sectional study was carried out in the seven health areas at Arroyo Naranjo municipality, with territorial population. We studied adults aged 60 years and over, positive cases and mortality from Covid-19, with acute respiratory infection, symptoms and spatial vulnerability. The community clinics were stratified into vulnerable, moderately vulnerable and lesser vulnerable contexts. Epidemiological stratification was carried out using the method of indicators with fixed weights, established according to expert criteria. Data were obtained from the statistics department of the clinics and from the daily survey. Results: The community clinics stratified as having less vulnerable context were Capri, Managua and Eléctrico; while Los Pinos, Mantilla and Grimau were a moderately vulnerable context and Párraga clinic resulted as a vulnerable context. Conclusions: There were vulnerable contexts in the territory, with a negative influence of poorly controlled indicators that favor the appearance of Covid-19, which expresses the danger of contracting the disease or a regrowth(AU)

Asociación entre hipoplasia del timo y disminución de inmunoglobulina A / Association between thymus hypoplasia and immunoglobulin A reduction

El sistema inmune madura gradualmente durante la infancia y el nacimiento es un momento crucial para este proceso. El paso por el canal del parto es el primer estímulo que el sistema inmunitario percibe para comenzar así su maduración progresiva. El timo como órgano linfoide primario, es el primero en aparecer entre todos los órganos linfoides; en este órgano ocurre la ontogenia, diferenciación y maduración de los linfocitos T que migran a los órganos linfoides secundarios como linfocitos T inmunocompetentes. La producción de IgA por los linfocitos B es uno de los mecanismos esenciales de respuesta inmune de las mucosas a las que protege en su forma de IgA secretoria. En el Instituto de Hematología e Inmunología, se atendieron en consulta 62 pacientes pediátricos entre uno y cinco años de edad, con antecedentes de infecciones respiratorias agudas frecuentes, con dos o más episodios en un mes, a los que se les diagnosticó por ultrasonografía una disminución del área tímica (hipoplasia). De ellos, 50 por ciento presentó además disminución de la concentración de IgA en suero. Estos resultados sugieren múltiples interrogantes. Consecuentemente, este trabajo tiene como objetivo presentar la asociación hallada entre la disminución del tamaño del timo y la disminución de la concentración en suero de IgA, en un grupo de niños de uno a cinco años, con antecedentes de infecciones respiratorias frecuentes, consultados en el Instituto de Hematología e Inmunología durante un año(AU)

The immune system gradually matures during childhood, and birth is a crucial moment in this process. Transit through the birth canal is the first stimulus perceived by the immune system to start its progressive maturation. The thymus, a primary lymphoid organ as it is, is the first lymphoid organ to appear. It is the site of the ontogeny, differentiation and maturation of the T-lymphocytes migrating to secondary lymphoid organs as immunocompetent T-lymphocytes. IgA production by B-lymphocytes is one of the essential immune response actions performed by mucosas, which they protect in the form of secretory IgA. A study was conducted of 62 pediatric patients aged 1-5 years attending consultation at the Institute of Hematology and Immunology who had a history of frequent acute respiratory infection, with two or more episodes in one month. These patients were ultrasonographically diagnosed with thymus size reduction (hypoplasia). Among them, 50 percent also presented a decrease in serum IgA concentration. These results pose many questions concerning the association between thymus hypoplasia and IgA reduction. The purpose of the study was therefore to present the association found between thymus size reduction and serum IgA concentration decrease in a group of children aged 1-5 years with a history of frequent respiratory infection attending the Institute of Hematology and Immunology during one year(AU)

Epidemiological investigation of pathogen spectrum in elderly patients with acute respiratory infection in Hai'an area / 公共卫生与预防医学

Objective To conduct an epidemiological investigation and analysis of pathogen spectrum infection in elderly patients with acute respiratory infection (ARI) in Hai'an area. Methods The throat swab specimens of 547 elderly patients with ARI collected in our hospital from January 2017 to December 2019 were selected for analysis. The RT-PCR method was used to detect the pathogens in the specimens, and the epidemiological characteristics of each pathogen infection was analyzed. Results The positive detection rate of the 547 specimens was 47.71% (261/547). Among the 261 positive samples, 10 types of respiratory pathogens and mixed infections were detected, mainly including 91 cases of influenza virus (34.87%), 42 cases of enterovirus (16.09%), and 36 cases of rhinovirus (13.79%). March, December, and September were the peak periods of pathogen detection, in which influenza virus was detected the highest in March (48.08%), enterovirus was highest in September (40.00%), and rhinoviruses was detected throughout the year. There was no significant difference in pathogen spectrum characteristics between different gender and age (P>0.05). Conclusion Influenza viruses, enteroviruses, and rhinoviruses are the main pathogens of infection in elderly patients with ARI in Hai’an area. Influenza viruses are high in spring and winter, and enteroviruses are high in autumn.

The mechanism of action of Pudilan Xiaoyan oral liquid against LPS-induced acute respiratory infection in mice based on biological network analysis and metabolomics / 药学学报

This study integrates metabolomics and network pharmacology techniques to systematically analyze the possible mechanism of Pudilan Xiaoyan oral liquid (PDL) in the treatment of acute respiratory infections. GC-MS metabolomics analysis found 8 endogenous metabolites, 3-phosphoglycerate, α-aminoadipate, D-ribulose-5-phosphate, β-mannosylglyceric acid, D-fructose, urea, D-maltose and ornithine in the serum of mice with acute respiratory infection induced by LPS; these substances can be used as biomarkers for PDL use in the treatment of acute respiratory infections. Biological network studies revealed 10 potential targets for intervention by PDL in the glycolysis and pentose phosphate pathways, including GPI, G6PD, H6PD, PFKM, TALDO1, TKT, GAPDH, HK1, PKLR and TPI1. All animal experiments were carried out with approval of the Animal Ethics Committee of Nanjing University of Chinese Medicine. Our findings indicate that the strategy of combining metabolomics and network analysis can provide information on the possible mechanism of PDL in acute respiratory infections, and reveal that PDL may ameliorate the pathological process of acute respiratory infections by regulating disordered metabolic pathways.

Rapid detection of Respiratory Pathogens using a Multiplex PCR assay among hospitalized children with Acute Respiratory Infection

Background@#Acute respiratory infection (ARI) is a major cause of morbidity and mortality among children worldwide however, local data on the etiologic diagnosis of ARI are limited. @*Objectives@#To determine the prevalence and the most commonly detected respiratory pathogens using a multiplex PCR assay, known as the Respiratory Panel, among hospitalized children with ARI and compare their clinical and laboratory differences. @*Methods@#This is a cross sectional study of children with ARI who were tested with a multiplex PCR assay. Retrospective chart review was done on these patients admitted from January 2018 to February 2020. @*Results@#There were 47 charts reviewed, mean age was 4.2 years old. Out of 47 patients, 36 (76.6%) tested positive for a pathogen. Respiratory syncytial virus (RSV) being the most common followed by Influenza A/H1-2009 and Human metapneumovirus (hMPV). Two patients had viral co-infections and no bacteria were detected on all subjects. 61.7% patients were started on antibiotics on admission. Fever and cough were the most common sign and symptom, respectively. Normal WBC (68% with neutrophilic predominance) and platelet were detected in 72.3% and 70.2% of patients, respectively; 50% of patients had normal CRP and 60.5% had abnormal findings on chest x-ray. Only the presence of chest x-ray findings was found to have a higher probability of yielding a positive Respiratory Panel p=0.27. @*Conclusion@#Among admitted patients with ARI, 76.6% tested positive for a respiratory pathogen. All were caused by viruses presenting as nonspecific manifestations – fever and cough. Clinical manifestations, CBC and CRP showed no association with the Respiratory Panel result while abnormal chest x-ray had a higher probability of yielding a positive Respiratory Panel result.

Caracterización epidemiológica de las infecciones respiratorias agudas graves. Granma, marzo-mayo de 2020 / Epidemiological characterization of severe acute respiratory infections. Granma, March-May 2020 / Caracterização epidemiológica de infecções respiratórias agudas graves. Granma, março a maio de 2020

RESUMEN Existen pocos estudios acerca de la epidemiología de las infecciones respiratorias agudas graves tanto en la literatura mundial como en el país, los estudios se centran fundamentalmente en la epidemiologia y comportamiento de las IRA sin especificar que ocurre con las formas graves. Con la presente publicación se pretende caracterizar el comportamiento de las infecciones respiratorias agudas graves en la provincia Granma, marzo-mayo 2020. Para ello se realizó un estudio descriptivo, retrospectivo y transversal, teniendo en cuenta las siguientes variables: grupos de edad, sexo, municipio de residencia, antecedentes patológicos personales y diagnóstico. Obteniendo como resultados que el periodo que se describe resultaron hospitalizados 175 pacientes con IRAG. La tasa de incidencia de la provincia fue de 21,4 por 100 mil habitantes. Se notificaron casos en todos los municipios, el 62,9 % de los casos de IRAG se registraron en hombres y los de 65 y más años representaron el mayor porcentaje de casos. Se concluye que Bayamo el municipio de mayor tasa de incidencia, predominó el sexo masculino, las edades de 65 y más años, la hipertensión arterial fue la comorbilidad más referida y dentro de las formas clínicas la bronconeumonía.

ABSTRACT There are few studies on the epidemiology of severe acute respiratory infections in both world literature and the country, studies focus primarily on the epidemiology and behavior of undified IRAs that occur with severe forms. This publication is intended to characterize the behavior of severe acute respiratory infections in Granma province, March-May 2020. For this purpose, a descriptive, retrospective and transversal study was carried out, taking into account the following variables: age groups, sex, municipality of residence, personal pathological history and diagnosis. Obtaining as results that the period described was hospitalized 175 patients with IRAG. The incidence rate of the province was 21.4 per 100 thousand inhabitants. Cases were reported in all municipalities, 62.9% of IRAG cases were recorded in men and those in 65 and over accounted for the highest percentage of cases. It is concluded that Bayamo, the municipality with the highest incidence rate, dominated the male sex, the ages of 65 and older, high blood pressure was the most referred comorability and within the clinical forms bronchopneummony.

RESUMO Há poucos estudos sobre a epidemiologia de infecções respiratórias agudas graves tanto na literatura mundial quanto no país, os estudos focam principalmente na epidemiologia e comportamento de IRAs indignos que ocorrem com formas graves. Esta publicação pretende caracterizar o comportamento de infecções respiratórias agudas graves na província de Granma, março a maio de 2020. Para isso, foi realizado um estudo descritivo, retrospectivo e transversal, levando-se em conta as seguintes variáveis: faixas etárias, sexo, município de residência, histórico patológico pessoal e diagnóstico. Obtendo como resultados que o período descrito foi hospitalizado 175 pacientes com IRAG. A taxa de incidência da província foi de 21,4 por 100 mil habitantes. Os casos foram notificados em todos os municípios, 62,9% dos casos de IRAG foram registrados em homens e aqueles em 65 anos ou mais representaram o maior percentual de casos. Conclui-se que Bayamo, município com maior taxa de incidência, dominou o sexo masculino, com idades a 65 anos ou mais, a pressão alta foi a mais referida comorability e dentro das formas clínicas de broncopneummonia.

Conocimientos y prácticas sobre infección respiratoria aguda en cuidadores de menores de 5 años de dos comunas de Bucaramanga, Colombia / Knowledge and practices on acute respiratory infection in caregivers of children under 5 years of age from two communes in Bucaramanga, Colombia / Conhecimentos e práticas sobre infecção respiratória aguda em cuidadores de crianças com menos de 5 anos de idade de duas comunidades de Bucaramanga, Colômbia

Resumen Objetivo: Describir los conocimientos y las prácticas sobre infección respiratoria aguda por parte de cuidadores de menores de 5 años, de las comunas más pobladas y pobres de Bucaramanga, Colombia, y su asociación con variables sociodemográficas y del contexto. Metodología: Estudio de corte. Se realizó muestreo secuencial de cuidadores de menores de 5 años de edad, usuarios de centros de salud de primer nivel de atención de las comunas más pobres de la capital de Santander. Se realizó entrevista sobre conocimientos y prácticas de prevención y control de infección respiratoria aguda. Se calificaron como adecuados o no, usando lineamientos de la Organización Mundial de la Salud. Se compararon con base en el grupo de mayor prevalencia de conocimientos y prácticas adecuados, y se exploraron asociaciones con las variables sociodemográficas. Resultados: Participaron 403 cuidadores, 92,6 % mujeres, 45,9 % mayores de 24 años. En total, 236 tenían conocimiento adecuado y 286 reportaron prácticas adecuadas de prevención. El análisis multivariado mostró que cuidadores con 25 años o más, y escolaridad de 5 o más años, tienen mayor prevalencia de conocimientos y prácticas adecuados. Conclusión: La edad y el nivel educativo de los cuidadores están asociados a prácticas adecuadas de prevención y control de la infección respiratoria aguda. Estos hallazgos orientan a focalizar la educación en cuidadores jóvenes con baja educación, recomendaciones contempladas en la ruta de promoción de la salud del Modelo de Atención Integral en Salud en Colombia.

Abstract Objective: Describe the knowledge and practices of acute respiratory infection by caregivers of children under 5 years of age from the most populous and poorest communities of Bucaramanga, Colombia, and their association with sociodemographic and context variables. Methodology: Cross-sectional study Sequential sampling of carers of children under 5 years of age, users of first-level health care centers in the poorest communities of the capital of Santander, was carried out. An interview was conducted on knowledge and practices of preventing and controlling acute respiratory infections. Answers were rated as adequate or inadequate, using the World Health Organization's guidelines. They were compared based on the group with the highest prevalence of adequate knowledge and practices, and associations with sociodemographic variables were explored. Results: 403 caregivers participated; 92.6% were women and 45.9% were older than 24. In total, 236 had adequate knowledge and 286 reported adequate prevention practices. The multivariate analysis showed that caregivers aged 25 years and over with a schooling of five or more years have a higher prevalence of adequate knowledge and practices. Conclusions: The age and educational level of caregivers is associated with knowledge of appropriate practices for preventing and controlling acute respiratory infections. These findings guide the focus of education on young carers with a lower level of education, recommendations considered in the promotion of the Comprehensive Health Care Model in Colombia's health route.

Resumo Objetivo: Descrever o conhecimento e as práticas de infecção respiratória aguda dos cuidadores de crianças com menos de 5 anos de idade, das comunidades mais populosas e pobres de Bucaramanga, na Colômbia, e a sua associação com variáveis sociodemográficas e do contexto. Metodologia: Estudo de corte. Foi realizada uma amostragem sequencial de cuidadores de crianças menores de 5 anos, usuários de centros de saúde de primeiro nível de atenção nas comunidades mais pobres da capital do Departamento de Santander. Realizou-se entrevista sobre conhecimentos e práticas de prevenção e controle da infecção respiratória aguda. Classificaram-se como adequados ou não, usando diretrizes da Organização Mundial da Saúde. Compararam-se com base no grupo com maior prevalência de conhecimentos e práticas adequadas, e foram exploradas associações com variáveis sociodemográficas. Resultados: 403 cuidadores participaram, 92,6 % mulheres, 45,9 % com mais de 24 anos. No total, 236 tinham conhecimento adequado e 286 mencionaram práticas de prevenção adequadas. A análise multivariada mostrou que cuidadores com 25 anos ou mais, e escolaridade de 5 anos ou mais, têm maior prevalência de conhecimentos e práticas adequadas. Conclusão: A idade e o nível educativo dos cuidadores estão associados às práticas adequadas para a prevenção e o controle da infecção respiratória aguda. Estes resultados orientam o foco da educação em cuidadores jovens com baixa escolaridade, recomendações consideradas na rota de promoção da saúde do Modelo de Atenção Integral à Saúde na Colômbia.

Validación del Instrumento Diagnóstico Enfermero de infecciones respiratorias agudas en infantes del Hospital Naval General HOSNAG 2017 / Validation of the Nursing Diagnosis Instrument of acute respiratory infections in infants of Naval Hospital HOSNAG 2017

Las infecciones respiratorias agudas (IRA) constituyen la causa más frecuente en las consultas de pediatría, en donde el diagnóstico enfermero juega un papel importante brindando una adecuada atención al usuario, lo cual es posible mediante la aplicación del método científico, denominado Proceso de Atención de Enfermería (PAE). Se establece como objetivo definir el diagnóstico enfermero, categoría diagnóstica, dominios y clases más frecuente de los diagnósticos enfermeros en pacientes pediátricos hospitalizados por infecciones respiratorias agudas en el Hospital Naval General HOSNAG ingresados en el 2017. La muestra estuvo conformada por 10 infantes. Se aplicó la técnica observacional, mediante la elaboración de una tabla de como instrumento, con las siguientes variables: dominios, clases presentes, categoría diagnóstica y tiempo de hospitalización, según la taxonomía II NANDA I. Como resultado se obtuvo que el 40% de los pacientes corresponden a cuadros de neumonía, el 90% de los pacientes tuvo alterado el dominio 11 seguridad-protección, específicamente en la clase 1 infección (100%) y 2 lesión física (100%), donde las etiquetas diagnósticas mayor observadas en los pacientes fueron por riesgo de infección y limpieza de vías aéreas en 100%. Así, es fundamental que el enfermero investigue y conozca las características clínicas de los pacientes, para contribuir en sus cuidados y recuperación(AU)

Acute respiratory infections (ARI) are the most frequent cause in pediatric consultations, where the nursing diagnosis plays an important role in providing adequate attention to the user, which is possible through the application of the scientific method, called the Care Process of Nursing (PAE). The objective is to define the nursing diagnosis, diagnostic category, domains and most frequent classes of nursing diagnoses in pediatric patients hospitalized for acute respiratory infections at Naval General Hospital admitted in 2017. The sample consisted of 10 infants. The observational technique was applied, through the elaboration of a table as an instrument, with the following variables: diagnostic category, domains, classes present, and hospitalization time, according to the II NANDA taxonomy. As a result, it was obtained that 40% of patients correspond to pneumonia, 90% of the patients had altered the domain 11 security-protection, specifically in class 1 infection (100%) and 2 physical lesion (100%), where the major diagnostic labels observed in the patients were due to risk of infection and cleaning of the airways in 100%. Thus, it is essential that the nurse investigate and know the clinical characteristics of the patients, to contribute to their care and recovery(AU)

Programa de infecciones respiratorias agudas en la provincia de Buenos Aires: resultados en 2019 / Program of acute respiratory infections in Buenos Aires province: results in 2019

RESUMEN INTRODUCCIÓN Desde 2002 el Ministerio de Salud de la Provincia de Buenos Aires realiza acciones para disminuir la mortalidad infantil y las internaciones innecesarias por infecciones respiratorias agudas (IRA). A 17 años de la implementación del respectivo Programa, se analizan los datos del Programa en 2019 con el objetivo de evaluar sus resultados. MÉTODOS Se reunieron los datos registrados durante 2019 en toda la Provincia y se analizaron utilizando un software ad hoc. RESULTADOS Se analizaron 161 101 episodios de IRA bajas atendidos entre junio y agosto de 2019, con los siguientes resultados: resolución de 93,7% (97,3% en primer nivel de atención y 92% en segundo nivel; uso de inhalador de dosis medida (IDM) en 87,3%, de nebulizador en 7,4% y mixto en 5,3%; 12,5% en edad de 0-4 meses; 24,5% en 4-6; 22,1% en 7-11 y 40,8% en 12 o más; diagnóstico de síndrome bronquial obstructivo en 94,9%, de neumonía en 3,6% y de ambos en 1,5%; derivación a segundo nivel con uso de IDM en 5,2% y con uso de nebulizador en 8,2%; riesgo de enfermedad de base: 5,2%; madre menor de 17 años: 5,2%; madre con primaria incompleta: 13%; peso de nacimiento menor a 2500 g: 6,3%; fumador en la casa: 33,7%. DISCUSIÓN Hubo mayor resolución de casos en el primer nivel que en el segundo, menor número de internaciones con IDM que con nebulizador, y la sumatoria de riesgos se asoció a incremento de derivaciones y de gravedad.

ABSTRACT INTRODUCTION The Ministry of Health of the Province of Buenos Aires has been carrying out actions since 2002 with the objective of reducing infant mortality and unnecessary hospitalizations due to acute respiratory infections (ARI). Seventeen years after the implementation of the ARI program, an analysis of the 2019 data was performed. METHODS The strategy was focused on nursing and primary care level, including therapeutic test according to clinical score, bronchodilator in a metered-dose inhaler (MDI) and spacer, oxygen according to score, and records since 2004. RESULTS A total of 161,101 episodes of low ARI treated from June to August 2019 were analyzed, with the following results: resolution of 93.7% (97.3% in first level and 92.0% in second level); MDI use in 87.3%, nebulizer in 7.4% and mixed in 5.3%; 12.5% under 4 months of age, 24.5% in 4-6 months, 22.1% in 7-11 months, and 40.8% in 12 months or more; diagnosis of bronchial obstructive syndrome in 94.9%, of pneumonia in 3.6% and of both in 1.5%; referral to Second Level with use of MDI in 5.2% and with use of nebulizer in 8.2%; risk of underlying disease: 5.2%; mother under 17 years old: 5.2%; mother who has not completed elementary school: 13.0%; birth weight less than 2,500 g: 6.3%; smoker in the household: 33.7%. DISCUSSION There was a higher number of cases solved in the first than in the second level of care, lower number of hospitalizations with MDI than with nebulizer, and the sum of risks was associated with a greater number of referrals and greater severity.

Seroprevalencia de anticuerpos anti-Mycoplasma pneumoniae en niños menores de 12 años / Seroprevalence of anti-Mycoplasma pneumoniae antibodies in otherwise healthy children

Resumen: Introducción: La infección por Mycoplasma pneumoniae (Mypn) podría estar ocurriendo a edades más tempranas, debido a fenómenos sociales como concurrencia a centros de cuidado diurno en forma más frecuente y precoz. Objetivo: estimar la prevalencia de anticuerpos anti-Mypn en niños de 0-12 años, y explorar si la edad, asistencia a centro de cuidados diurnos/escuela, hacinamiento o convivencia con niños incrementan el riesgo de seropositividad. Pacientes y Método: Estudio transversal incluyendo niños de 0-12 años de edad que requirieron extracciones de sangre para control, por lo demás sanos. En todos los casos se consignaron las variables mencionadas y se determinó IgG anti-Mypn mediante enzimoinmunoanálisis. Se evaluó la asociación entre predictores y seropositividad en un modelo de regresión logística. Resultados: Se incluyeron 232 pacientes (edad promedio 56,4 ± 40,0 meses). El 56,9% concurría a centro de cuidado diurno/escuela, 63,8% convivían con menores de 12 años y 15,9% presentaban hacinamiento. El 14,6% presentaba anticuerpos anti-Mypn. Los niños seroposi- tivos no mostraron diferencias significativas con aquellos seronegativos en relación a edad (63,1 ± 40,7 vs. 55,4 ± 41,3 meses), escolaridad (64,7% vs 55,5%), hacinamiento (14,7% vs 14,9%), ni con vivencia con menores (64,7% vs 63,6%). La edad tampoco se mostró como predictor independiente de seropositividad en el modelo multivariado. Conclusión: La prevalencia de anticuerpos anti-Mypn fue 14,6%. La edad no fue predictor de seropositividad.

Abstract: Introduction: Mycoplasma pneumoniae (Mypn) infection could be occurring at an earlier age due to social pheno mena such as attending daycare centers more frequently and earlier than decades ago. Objective: to estimate the prevalence of anti-Mypn antibodies in children aged 0-12 years, and to explore whether age, attendance to daycare center/school, overcrowding or the presence of children aged below 12 years in the households increase the risk of seropositivity. Patients and Method: Cross-sectional stu dy including healthy children aged 0-12 years which required blood draws for routine laboratory tests. In all cases, the aforementioned variables were recorded and anti-Mypn IgG was determined by enzyme immunoassay. The association between predictors and seropositivity was assessed in a logistic regression model. Results: We included 232 patients (average age 56.4 ± 40.0 months). 56.9% attended a daycare center/school, 63.8% co-habited with children under 12 years old, and 15.9% lived in overcrowded households. The prevalence of anti-Mypn antibodies was 14.6%. There were no significant differences between seropositive and seronegative children regarding age (63.1 ± 40.7 vs. 55.4 ± 41.3 months), school/day-care attendance (64.7% vs. 55.5%), overcrowding (14.7% vs. 14.9%), or co-habiting with children (64.7% vs. 63.6%). Age was not an independent predictor of seropositivity in the multivariate model. Conclusion: The prevalence of anti-Mypn antibodies in children was 14.6% and age was not a predictor of seropositivity.

Novel Coronavirus Pneumonia Outbreak in 2019: Computed Tomographic Findings in Two Cases

Since the 2019 novel coronavirus (2019-nCoV or officially named by the World Health Organization as COVID-19) outbreak in Wuhan, Hubei Province, China in 2019, there have been a few reports of its imaging findings. Here, we report two confirmed cases of 2019-nCoV pneumonia with chest computed tomography findings of multiple regions of patchy consolidation and ground-glass opacities in both lungs. These findings were characteristically located along the bronchial bundle or subpleural lungs.