No. of RTI per year, excluding pneumonia
No. of preschool children
No. of primary school children
No. of secondary school children
All patients
HIV (n = 9)
Non-HIV (n = 16)
HIV (n = 10)
Non-HIV (n = 30)
HIV (n = 7)
Non-HIV (n = 24)
HIV (n = 26)
Non-HIV (n = 70)
0
0
0
1
2
0
12
1
14
1
2
0
2
4
5
4
9
8
2–3
5
2
4
11
2
6
11
19
4–10
2
10
2
13
0
2
4
25
>10
0
4
1
0
0
0
1
4
No. of cases of pneumonia
0
6
4
7
0
0
4
13
In the control non-HIV-infected children, the average number of respiratory tract infections (excluding pneumonia) was 3.5 episodes per year (95 % CI: 2.7–4.3) with 6.7 episodes in the preschool children (95 % CI: 4.8–8.6), 3.6 episodes in the primary school children (95 % CI: 2.6–4.5), and 1.2 episodes in the secondary school children (95 % CI: 0.5–1.9). The preschool children had a higher incidence of respiratory tract infections than the primary school children and both these groups had a higher incidence of respiratory tract infections than the secondary school children. The preschool and primary school children usually had 4–10 episodes annually, while the secondary school children had 2–3 episodes annually (Table 1). The incidence of respiratory tract infections (excluding pneumonia) per person-month was significantly lower in HIV-infected children compared with the control group (14 % vs. 29 %, respectively; p < 0.0001), while the incidence of pneumonia was similar (Table 2).
Table 2
The incidence of respiratory tract infections (RTI) in vertically infected children with human immunodeficiency virus (HIV) compared with the control group
No. of RTI per person-month of observation | HIV-infected children (95 % CI) | Control group (95 % CI) | P-value |
|---|---|---|---|
No. of respiratory infections, excluding pneumonia | 44/312; 14 % (0.10–0.18) | 243/840; 29 % (0.26–0.32) | <0.0001 |
No. of pneumonia | 4/312; 1.3 % (0.00–0.03) | 13/840; 1.5 % (0.01–0.03) | NS |
Caregivers of HIV-infected children rated their social conditions as average (12/26; 46.2 %), good (10/26; 38.5 %), or poor (4/26; 15.3 %). The majority of HIV-infected children (17/26; 65.4 %) were exposed to tobacco smoke at home, usually over 20 cigarettes per day. Five out of the 26 children were hospitalized. The primary care physician was informed of the HIV infection in 18/26 children. Four children were routinely treated with antibiotics for each infection; on average, three times per year.
4 Discussion
Respiratory tract infections are a major public health concern and represent a common problem both in healthy and immunocompromised children, particularly in HIV-positive individuals (Mendoza Sanchez et al. 2006). It has been estimated that in the US an adult person suffers from 2 to 4 colds per year, whereas a schoolchild suffers from 6 to 10 colds (Spector 1995; Johnston and Holgate 1996; Winther et al. 1998; Eccles 2005). According to a study conducted in the general child population in Germany, up to eight episodes of respiratory infections per year at pre-school age and four episodes per year at school age should be regarded as normal and does not indicate any kind of immunodeficiency (Grüber et al. 2008). Therefore, respiratory tract infections represent a significant clinical and therapeutic problem and an economic burden (Wat 2004).
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