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Singh RG, Garcia-Campayo V, Green JB, Paton N, Saunders JD, Al-Wahsh H, Crowley DC, Lewis ED, Evans M, Moulin M. Efficacy of a yeast postbiotic on cold/flu symptoms in healthy children: A randomized-controlled trial. Pediatr Res 2024:10.1038/s41390-024-03331-z. [PMID: 38942887 DOI: 10.1038/s41390-024-03331-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/10/2024] [Accepted: 05/27/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Children attending school/daycare are at high risk of acute respiratory tract infections. EpiCorTM postbiotic, derived from yeast fermentate, has been demonstrated to improve immune function in adults, reducing the incidence of cold/flu-like or allergy symptoms. As such, studies are warranted in children as available pharmaceutical options have unwanted side effects. METHODS Two-hundred and fifty-six children aged 4-12 years attending school/daycare were randomized to either EpiCor or Placebo for 84 days during the 2022-2023 flu season in Ontario, Canada. The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) and study diary assessed the incidence and severity of cold/flu symptoms and the use of cold/flu medications. Adverse events were recorded. RESULTS Total CARIFS severity scores, 'sore throat' and 'muscle aches or pains' symptom scores in the EpiCor group were significantly lower compared to Placebo during incidences of cold/flu (P ≤ 0.05). Participants taking Placebo were 1.73 times more likely to use cold/flu medication compared to those receiving EpiCor (P = 0.04). The incidence of cold/flu symptoms was not significantly different between groups. EpiCor was found to be safe and well-tolerated. CONCLUSIONS EpiCor supplementation resulted in significantly lower cold/flu symptom severity and less cold/flu medication usage than Placebo demonstrating a beneficial effect on immune function in children. IMPACT Children are at high risk of acquiring cold/flu infections and safe and efficacious mitigating regimens are lacking. Children supplemented daily with 500 mg EpiCorTM postbiotic derived from yeast fermentate had significantly lower overall cold/flu symptom severity, and severity of sore throat and muscle aches or pains over the 84-day supplementation period. EpiCor supplementation resulted in decreased use of traditional cold/flu medication. Daily supplementation with 500 mg of EpiCor for 84 days was safe and well tolerated by healthy children aged 4-12 years attending school or daycare.
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Affiliation(s)
| | | | | | - Neil Paton
- Cargill Limited c/o Cargill Inc., Wayzata, MN, USA
| | | | | | | | | | - Malkanthi Evans
- KGK Science Inc., London, ON, Canada
- Department of Biochemistry, Western University, London, ON, Canada
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Hu S, Ma R, Shen K, Xin D, Li X, Xu B, Zhao X, Feng Z, Yan Y, Xue Z, Zhang B, Li X, Zheng Y, Zhou H, Wu L, Yang L, Xu H, Shao R, Yin Y, Zhong C, Li H, Cai Q, Xu Y. Efficacy and safety of Qinxiang Qingjie oral solution for the treatment of influenza in children: a randomized, double-blind, multicenter clinical trial. Transl Pediatr 2022; 11:987-1000. [PMID: 35800262 PMCID: PMC9253950 DOI: 10.21037/tp-22-201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Qinxiang Qingjie (QXQJ), an oral solution containing various Chinese herbs, is indicated for pediatric upper respiratory tract infections. The treatment of influenza also shows potential advantages in shortening the duration of illness and improving symptoms. However, there is still a lack of high-quality clinical evidence to support this. The trial was to explore the efficacy and safety of QXQJ for treating pediatric influenza and provide an evidence-based basis for expanding its applicability. METHODS A randomized, double-blind, double-dummy, positive-controlled, multicenter clinical trial was conducted in 14 hospitals in China. Children aged 1-13 years with influenza and "exterior and interior heat syndromes" as defined by traditional Chinese medicine (TCM) were randomly assigned to two groups with 1:1 radio. Children in the test group received QXQJ oral solution and oseltamivir simulant, while the control group received oseltamivir phosphate granules and QXQJ simulant. The duration of treatment was five days, followed by a two-day follow-up period. The primary endpoint was the clinical recovery time. Secondary endpoints included the time to defervescence, incidences of complications and severe or critical influenza, negative conversion rate, improvement of TCM syndromes, and safety profiles of the therapeutics, which mainly contained the adverse clinical events and adverse drug reactions. RESULTS A total of 231 children were randomized to either the QXQJ (n=117) or oseltamivir (n=114) group. The FAS and PPS results showed that both groups experienced a median clinical recovery time of three days (P>0.05). The median time to defervescence of both groups were 36 hours in FAS and PPS (P>0.05), and two groups did not differ in terms of the other secondary endpoints (P>0.05). 14 patients (12.39%) in the QXQJ group and 14 patients (12.50%) in the oseltamivir group reported at least one adverse event, respectively. One serious adverse event occurred in the QXQJ group. There was no significant difference in the incidence of adverse events or adverse drug reactions between the groups. CONCLUSIONS The efficacy of QXQJ oral solution was comparable to that of oseltamivir for treating influenza in children, with an acceptable safety profile. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900021060.
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Affiliation(s)
- Siyuan Hu
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Rong Ma
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Kunling Shen
- Department of Respiratory Medicine, Beijing Children’s Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children’s Health, Beijing, China
- Department of Pediatrics, Shenzhen Children’s Hospital, Shenzhen, China
| | - Deli Xin
- Department of Tropical Medicine Research, Beijing Friendship Hospital, Capital Medical University, Beijing Tropical Medicine Research Institute, Beijing, China
| | - Xinmin Li
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Baoping Xu
- Department of Respiratory Medicine, Beijing Children’s Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children’s Health, Beijing, China
| | - Xiaobing Zhao
- Department of Medical Affairs, Maternity and Child Health Care of Zaozhuang, Zaozhuang, China
| | - Ziwei Feng
- Department of Pediatrics, Luohe Hospital of Traditional Chinese Medicine, Luohe, China
| | - Yongbin Yan
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zheng Xue
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Baoqing Zhang
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xueming Li
- Department of Pediatrics, Handan Hospital of Traditional Chinese Medicine, Handan, China
| | - Yanmei Zheng
- Department of Pediatrics, Taiyuan Maternity and Child Health Care Hospital, Taiyuan, China
| | - Hongxia Zhou
- Department of Pediatrics, Maternal and Child Health Care Hospital of Yuncheng, Yuncheng, China
| | - Liqun Wu
- Department of Pediatrics, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Lili Yang
- Department of Pediatrics, Changzhi People’s Hospital, Changzhi, China
| | - Hua Xu
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Rongchang Shao
- Department of Pediatrics, Ezhou Central Hospital, Ezhou, China
| | - Yong Yin
- Department of Respiratory, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengliang Zhong
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Han Li
- Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Qiuhan Cai
- Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yaqian Xu
- Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Teoh L, Chatfield MD, Acworth JP, McCallum GB, Chang AB. How Does the Canadian Acute Respiratory Illness and Flu Scale Relate to Other Scales in Pediatric Asthma Exacerbations? J Asthma 2021; 59:1590-1596. [PMID: 34156320 DOI: 10.1080/02770903.2021.1946823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: In children with asthma exacerbations, we evaluated the relationship between Canadian Acute Respiratory Illness and Flu Scale (CARIFS) scores and (a) Asthma Diary Scale (ADS) scores for 14 days; (b) Pediatric Asthma Caregiver's Quality of Life (QoL) Questionnaire (PACQLQ) scores on days 1, 7 and 14; (c) viral detection. We hypothesized that in children with acute asthma, CARIFS scores correlate with ADS and PACQLQ scores over time and that viruses have little impact on CARIFS scores.Methods: In children aged 2-16 years who presented with acute asthma to the Emergency Departments of 2 hospitals, we documented the clinical history, examination, asthma severity at baseline and on presentation. Eighteen respiratory pathogens were determined by PCR on nasopharyngeal aspirate (NPA) collected on recruitment. The parent(s) recorded their child's daily CARIFS and ADS and weekly PACQLQ for 14 days. We used Spearman's correlation to relate the scores of 108 children.Results: CARIFS scores correlated well with ADS scores throughout 14 days (rs ranged 0.30-0.67). CARIFS and PACQLQ scores correlated -0.28, -0.14 and -0.44 on days 1, 7 and 14 respectively. There was no significant difference in CARIFS scores between children whose NPAs were PCR virus-positive or -negative over 14 days.Conclusions: CARIFS and ADS scores correlated well as a disease severity measure during the recovery period in children with acute asthma and this was not influenced by the virus state. The ADS may be used as an alternative in selected situations. The CARIFS reflects different aspects to acute asthma severity and QoL.
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Affiliation(s)
- Laurel Teoh
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason P Acworth
- Emergency Medicine Department, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital and Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Shapiro D, Bodinayake CK, Nagahawatte A, Devasiri V, Kurukulasooriya R, Hsiang J, Nicholson B, De Silva AD, Østbye T, Reller ME, Woods CW, Tillekeratne LG. Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka. Am J Trop Med Hyg 2017; 97:88-96. [PMID: 28719323 PMCID: PMC5508919 DOI: 10.4269/ajtmh.17-0032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/08/2017] [Indexed: 11/07/2022] Open
Abstract
In tropical and subtropical settings, the epidemiology of viral acute respiratory tract infections varies widely between countries. We determined the etiology, seasonality, and clinical presentation of viral acute respiratory tract infections among outpatients in southern Sri Lanka. From March 2013 to January 2015, we enrolled outpatients presenting with influenza-like illness (ILI). Nasal/nasopharyngeal samples were tested in duplicate using antigen-based rapid influenza testing and multiplex polymerase chain reaction (PCR) for respiratory viruses. Monthly proportion positive was calculated for each virus. Bivariable and multivariable logistic regression were used to identify associations between sociodemographic/clinical information and viral detection. Of 571 subjects, most (470, 82.3%) were ≥ 5 years of age and 53.1% were male. A respiratory virus was detected by PCR in 63.6% (N = 363). Common viral etiologies included influenza (223, 39%), human enterovirus/rhinovirus (HEV/HRV, 14.5%), respiratory syncytial virus (RSV, 4.2%), and human metapneumovirus (hMPV, 3.9%). Both ILI and influenza showed clear seasonal variation, with peaks from March to June each year. RSV and hMPV activity peaked from May to July, whereas HEV/HRV was seen year-round. Patients with respiratory viruses detected were more likely to report pain with breathing (odds ratio [OR] = 2.60, P = 0.003), anorexia (OR = 2.29, P < 0.001), and fatigue (OR = 2.00, P = 0.002) compared with patients with no respiratory viruses detected. ILI showed clear seasonal variation in southern Sri Lanka, with most activity during March to June; peak activity was largely due to influenza. Targeted infection prevention activities such as influenza vaccination in January-February may have a large public health impact in this region.
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Affiliation(s)
- David Shapiro
- Department of Pediatrics, Duke University, Durham, North Carolina
| | | | - Ajith Nagahawatte
- Department of Microbiology, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka
| | - Vasantha Devasiri
- Department of Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka
| | | | - Jeremy Hsiang
- Durham Veterans Affairs Medical Center, Durham, North Carolina
| | | | | | - Truls Østbye
- Duke Global Health Institute, Durham, North Carolina
- Department of Community and Family Medicine, Duke University, Durham, North Carolina
| | - Megan E. Reller
- Department of Medicine, Duke University, Durham, North Carolina
| | - Christopher W. Woods
- Duke Global Health Institute, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
| | - L. Gayani Tillekeratne
- Duke Global Health Institute, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
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Su G, Chen X, Liu Z, Yang L, Zhang L, Stålsby Lundborg C, Wen Z, Guo X, Qin X, Liang J, Liu X. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children. Cochrane Database Syst Rev 2016; 12:CD011958. [PMID: 27905672 PMCID: PMC6463872 DOI: 10.1002/14651858.cd011958.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. OBJECTIVES To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk ratio (RR) or odds ratio (OR) to analyse dichotomous data, both with 95% confidence intervals (CIs). MAIN RESULTS We identified 6080 records: 3352 from English language databases, 2724 from Chinese databases, and four from other sources. Following initial screening and deduplication, we obtained 120 full-text papers for assessment. Of these, 21 were not RCTs; 55 did not meet the inclusion criteria because: participants were aged over 14 years; definition was not included for recurrent or frequent episodes;Astragalus preparation was not an intervention; Astragalus preparation was in the formula but was not the sole agent; the Astragalus preparation was not administered orally; or Astragalus was used for treatment rather than prevention of ARTI. A further 44 studies were excluded because they were not placebo-controlled, although other inclusion criteria were fulfilled.No RCTs met our inclusion criteria. AUTHORS' CONCLUSIONS We found insufficient evidence to enable assessment of the effectiveness and safety of oral Astragalus as a sole intervention to prevent frequent ARTIs in children aged up to 14 years.
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Affiliation(s)
- Guobin Su
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineDepartment of NephrologyNo 111 Dade RoadYue Xiu DistrictGuangzhouGuangdong ProvinceChina510120
- Karolinska InstitutetGlobal Health ‐ Health Systems and Policy: Medicines, focusing antibiotics, Department of Public Health SciencesTomtebodavägen 18a, Widerströmska HusetStockholmStockholmSweden171 77
| | - Xiankun Chen
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineKey Unit of Methodology in Clinical ResearchGuangzhouGuangdongChina
| | - Zhuangzhu Liu
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineDepartment of NephrologyNo 111 Dade RoadYue Xiu DistrictGuangzhouGuangdong ProvinceChina510120
- Guangdong Provincial Hospital of Chinese MedicineEmergency DepartmentNo 111 Dade RoadGuangzhouGuangdongChina510120
| | - Lihong Yang
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineEvidence‐Based Medicine and Clinical Research Service GroupNo 111 Dade RoadGuangzhouGuangdongChina510120
| | - La Zhang
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineDepartment of NephrologyNo 111 Dade RoadYue Xiu DistrictGuangzhouGuangdong ProvinceChina510120
| | - Cecilia Stålsby Lundborg
- Karolinska InstitutetGlobal Health ‐ Health Systems and Policy: Medicines, focusing antibiotics, Department of Public Health SciencesTomtebodavägen 18a, Widerströmska HusetStockholmStockholmSweden171 77
| | - Zehuai Wen
- Guangdong Provincial Hospital of Chinese MedicineKey Unit of Methodology in Clinical ResearchNo 111 Dade RoadGuangzhouGuangdongChina510120
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineEvidence‐Based Medicine and Clinical Research Service GroupNo 111 Dade RoadGuangzhouGuangdongChina510120
| | - Xindong Qin
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineDepartment of NephrologyNo 111 Dade RoadYue Xiu DistrictGuangzhouGuangdong ProvinceChina510120
| | - Jueyao Liang
- Guangzhou University of Chinese MedicineThe Second Clinical CollegeNo 12 Jichang RoadGuangzhouGuangdongChina510120
| | - Xusheng Liu
- Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital, Guangzhou University of Chinese MedicineDepartment of NephrologyNo 111 Dade RoadYue Xiu DistrictGuangzhouGuangdong ProvinceChina510120
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Nathan AM, Zaki R, Rozario R, Dhania N, Mohd Hamirudin SNS, Eg KP, Kee SY, Teh C, Jabar KA, Westerhout C, Thavagnanam S, de Bruyne J. Cross cultural translation, adaptation and reliability of the Malay version of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS). Health Qual Life Outcomes 2015; 13:139. [PMID: 26338016 PMCID: PMC4559942 DOI: 10.1186/s12955-015-0336-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/26/2015] [Indexed: 05/28/2023] Open
Abstract
Background The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) is a parent-proxy questionnaire that assesses severity of acute respiratory infections in children. The aim was to (a) perform a cross-cultural adaptation and (b) prove that the Malay CARIFS is a reliable tool. Findings The CARIFS underwent forward and backward translations as recommended by international guidelines. A pilot study was performed on the harmonised version and the final version of the Malay version of CARIFS was produced. A test-retest, 1 h apart, was then performed on parents with children less than 13 years old, admitted with a respiratory tract infection. Parents of children with asthma and who were not eloquent in Malay, were excluded. The data was analysed for consistency (Cronbach’s alpha) and reliability (test-retest co-efficient). Thirty-three parents were recruited. Children were aged median (IQR) 6 (2.8, 13.3) months with a male: female ratio of 22:11 and 88 % were Malays. Parents were interviewed at median (IQR) 6 (3, 11.5) days of admission. The Cronbach’s α coefficient was 0.70 for all items. The test–retest reliability analysis had a minimum and maximum intraclass correlation coefficient of 0.63 and 0.97 respectively. Clinically, the longer patients were admitted, the lower the severity score (r = −0.35, p < 0.05), indicating that they were getting better. Conclusion The Malay version of CARIFS is a valid and reliable tool to determine severity of respiratory illness in children. Parent-centred questionnaires are useful and should be an adjunct to other methods, in monitoring response to treatment. Electronic supplementary material The online version of this article (doi:10.1186/s12955-015-0336-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Marie Nathan
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia. .,University Malaya Paediatric and Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Rafdzah Zaki
- Department of Social & Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Rachael Rozario
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Nurul Dhania
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | | | - Kah Peng Eg
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia. .,University Malaya Paediatric and Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Sze Ying Kee
- Department of Paediatrics, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Cindy Teh
- Department of Microbiology, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Kartini Abdul Jabar
- Department of Microbiology, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Caroline Westerhout
- Department of Biomedical Imaging, University Malaya Medical Centre, 50603, Kuala Lumpur, Malaysia.
| | - Surendran Thavagnanam
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia. .,University Malaya Paediatric and Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Jessie de Bruyne
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia. .,University Malaya Paediatric and Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia.
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