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Alharbi AS, Al-Hindi MY, Alqwaiee M, Al-Shamrani A, Alharbi S, Yousef A, Alshammary A, Miqdad A, Said Y, Alnemri A, Alahmadi T, Almudeer AH. Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention 2024 updated consensus on the prevention of respiratory syncytial virus. Ann Thorac Med 2024; 19:190-200. [PMID: 39144535 PMCID: PMC11321529 DOI: 10.4103/atm.atm_69_24] [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: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 08/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%-88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.
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Affiliation(s)
- Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Mohammed Y Al-Hindi
- Department of Pediatric, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- Research and Development, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mansour Alqwaiee
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Saleh Alharbi
- Department of Pediatrics, Umm Al Qura University, Makkah, Saudi Arabia
| | - Abdullah Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Aisha Alshammary
- Department of Pediatrics, Alyammamah Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Abeer Miqdad
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Yazan Said
- Department of Pediatrics, King Fahad Specialist Hospital, Ministry of Health, Dammam, Saudi Arabia
| | - Abdulrahman Alnemri
- Department of Pediatrics, College of Medicine, Pediatrics Department, King Saud University, Riyadh, Saudi Arabia
| | - Turki Alahmadi
- Department of Pediatrics, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali Husein Almudeer
- Department of Pediatrics, College of Medicine, Pediatrics Department, King Saud University, Riyadh, Saudi Arabia
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Alharbi A, Yousef A, Zubani A, Alzahrani M, Al-Hindi M, Alharbi S, Alahmadi T, Alabdulkarim H, Kazmierska P, Beuvelet M. Respiratory Syncytial Virus (RSV) Burden in Infants in the Kingdom of Saudi Arabia and the Impact of All-Infant RSV Protection: A Modeling Study. Adv Ther 2024; 41:1419-1435. [PMID: 38356106 PMCID: PMC10960893 DOI: 10.1007/s12325-024-02798-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) represents a considerable burden on the healthcare system and hospital resources. This study explored the impact of universal immunoprophylaxis with long-acting monoclonal antibody (nirsevimab) during infants' first RSV season on RSV-induced health events and related costs in the Kingdom of Saudi Arabia (KSA). METHODS The burden of RSV-induced health events and related costs under the current standard of practice (SoP) and the impact of universal immunoprophylaxis with nirsevimab was estimated using a static decision-analytic model in a cohort of infants experiencing their first RSV season in the KSA. The model estimated hospital admissions (including pediatric intensive care unit [PICU] admissions and mechanical ventilation [MV]), emergency room (ER) visits, primary care (PC) visits, long-term sequelae, and RSV mortality. RESULTS The model estimated that under the current SoP, RSV results in 17,179-19,607 hospitalizations (including 2932-3625 PICU and 172-525 MV admissions), 57,654-191,115 ER visits, 219,053-219,970 PC visits, 14 deaths, 12,884-14,705 cases of recurrent wheezing, and a total cost of SAR 480-619 million. Universal nirsevimab immunoprophylaxis was estimated to avert 58% of hospitalizations (58% PICU admissions, 58% MV episodes), 53% of ER visits, 53% of PC visits, 58% of episodes of recurrent wheezing, 8 deaths, and result in savings of SAR 274-343 million in total healthcare cost. CONCLUSION Compared with current SoP, an nirsevimab immunoprophylaxis strategy in the KSA for all infants during their first RSV season was estimated to dramatically decrease healthcare resource use, and economic burden associated with RSV.
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Affiliation(s)
- Adel Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah Yousef
- King Fahd University Hospital, Al Khobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal Zubani
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Mohammad Al-Hindi
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
- Research and Development, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Turki Alahmadi
- Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, Rabigh, Saudi Arabia
| | - Hana Alabdulkarim
- Drug Policy and Economics Center, National Guard Health Affairs, Riyadh, Saudi Arabia
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
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Bhader M, Al-Hindi M, Ghaddaf A, Alamoudi A, Abualola A, Kalantan R, AlKhulifi N, Halawani I, Al-Qurashi M. Noninvasive Neurally Adjusted Ventilation versus Nasal Continuous or Intermittent Positive Airway Pressure for Preterm Infants: A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1935. [PMID: 38136137 PMCID: PMC10741611 DOI: 10.3390/children10121935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
The noninvasive neurally adjusted ventilatory assist (NIV-NAVA) is a newly developed noninvasive ventilation technique with promising clinical and ventilatory outcomes for preterm infants. This systematic review and meta-analysis aimed to investigate whether NIV-NAVA has better clinical and ventilatory outcomes than nasal continuous airway pressure (NCPAP) or noninvasive positive pressure ventilation (NIPP) on premature infants. MEDLINE, Embase, and CENTRAL were searched, and randomized controlled trials (RCTs) that compared NIV-NAVA with NCPAP or NIPP for preterm infants (gestational age: <37 weeks) were included. We evaluated the following outcomes in the neonatal intensive care unit: the desaturation rate, failure of noninvasive modality requiring intubation when received as the primary mode or the need for re-intubation after extubation from mechanical ventilation in the secondary mode (weaning), length of stay, and fraction of inspired oxygen. The mean difference and risk ratio were used to represent continuous and dichotomous outcomes, respectively. We included nine RCTs involving 339 preterm infants overall. NIV-NAVA showed similar clinical and ventilatory outcomes to NCPAP or NIPP, except for the maximum diaphragmatic electrical activity. The rate of failure of the noninvasive modality was not statistically different between NIV-NAVA and NCPAP. The pooled estimates for the maximum electrical activity were significantly reduced in NIV-NAVA compared with those in NIPP. The findings suggest that NIV-NAVA may be as safe and effective as NCPAP and NIPP for preterm neonates, particularly those who may not tolerate these alternative noninvasive methods. However, further trials are recommended for greater evidence.
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Affiliation(s)
- Mohammed Bhader
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Mohammed Al-Hindi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
| | - Abdullah Ghaddaf
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Anas Alamoudi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Amal Abualola
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Renad Kalantan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Norah AlKhulifi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Ibrahim Halawani
- College of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia;
| | - Mansour Al-Qurashi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia; (M.A.-H.); (A.G.); (A.A.); (R.K.); (N.A.); (M.A.-Q.)
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
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Alqahtani MH, Alqahtani MF, Asiri M, Alghamdi S, Alshagawi Z, Alzahrani S. Bronchiolitis in Infants; Five Years' Experience of a Teaching Hospital. Infect Drug Resist 2023; 16:5647-5664. [PMID: 37662975 PMCID: PMC10473431 DOI: 10.2147/idr.s385615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Background Bronchiolitis is a clinical syndrome affecting the lower respiratory tract of infants and toddlers <2 years old. Variability in clinical profile and response to therapy in children with Bronchiolitis calls for studying the different clinical aspects of local patient population. Aim The goal of our study is to determine the clinical presentation, past medical history, hospitalization course and prognosis in children below two years of age who have been hospitalized in King Fahad University Hospital over the last five years. Materials and Methods A retrospective chart review based on electronic health records of all Bronchiolitis-related hospitalization of infants and toddlers below two years of age, covering the period between January 1, 2015, to April 26, 2020. Results Out of a total of 446 children <2 years of age, 202 were female (45.4%), and 243 were male (54.6%). Although the length of hospital stay was almost equal between the sexes, there was a significant (p-value=0.01) increase in length of intensive care unit stay among females compared to males. Furthermore, there was a significant prolongation in the duration of ventilator usage among females (p value = 0.062). Out of fifty-five patients admitted to the ICU, 83.63% of them were 12 months of age and below. Conclusion Our results show a significant increase in length of ICU and ventilator use among females compared to males. It also shows that infants younger than 12 months account for most ICU admissions. These findings, among many others, may help pediatricians formulate a better diagnostic and therapeutic pathways.
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Affiliation(s)
- Mohammad Hussain Alqahtani
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
| | - Mohammad Faraj Alqahtani
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
| | - Mohammed Asiri
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
| | - Saad Alghamdi
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
| | - Ziyad Alshagawi
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
| | - Saleh Alzahrani
- Pediatrics Department, Imam Abdulrahman Bin Faisal University King Fahd Hospital of the University, Al Khobar, Saudia Arabia
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Kelabi HM, Alharbi AS, Alshamrani AS, Baqais K, Alenazi AM, Alqwaiee MM. Impact of COVID-19 Pandemic on Respiratory Syncytial Virus (RSV) Prophylaxis Program: A Tertiary-Care Center Experience. Cureus 2023; 15:e42563. [PMID: 37637610 PMCID: PMC10460243 DOI: 10.7759/cureus.42563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES The purpose of this investigation was to evaluate the effects of the COVID-19 pandemic on the respiratory syncytial virus (RSV) prevention program at our institution across three time frames: 2019-2020, 2020-2021, and 2021-2022. METHODS We carried out a descriptive, single-site observational study spanning four years, from June 2019 to June 2022. Our study included patients in our institution's RSV program who met our enrollment criteria. We collected information about the number of children receiving immunoprophylaxis, immunoprophylaxis doses, and RSV risk factors. RESULTS The number of patients receiving immunoprophylaxis dropped across the three periods, from 315 patients in the first period (2019-2020) to 176 in the second period (2020-2021), and further decreased to 128 in the third period (2021-2022). Following the COVID-19 pandemic, there was a 50% reduction in the number of patients receiving immunoprophylaxis. The proportion of RSV-infected patients remained relatively similar in the first and second periods (2.86% and 2.27%, respectively) but increased in the third period (5.47%). In the first period, most patients (60.32%) received seven doses, 11.75% got four to six doses, and 27.95% received three doses or fewer. The second period saw 59.66% of patients receiving four to six doses and 40.34% receiving three doses or fewer. In the third period, a mere 9.38% received four to five doses, while 90.63% got three doses or fewer. CONCLUSIONS While preventative measures associated with COVID-19 may have helped reduce the number of RSV cases, the pandemic seems to have caused a significant decrease in the number of children receiving immunoprophylaxis and the doses of immunoprophylaxis. More extensive, multicenter research is needed to understand the impact of the COVID-19 pandemic on RSV immunoprophylaxis, its activity, and seasonal patterns fully.
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Affiliation(s)
- Hamza M Kelabi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Adel S Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Abdullah S Alshamrani
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Khaled Baqais
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Ayed M Alenazi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Mansour M Alqwaiee
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
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Osman S, Alaa Adeen A, Hetta O, Alsiraihi A, Bader M, Aloufi A, Abushouk A, Al-Hindi MY. Epidemiology and Risk Factor Analysis of Children with Bronchiolitis Admitted to the Intensive Care Unit at a Tertiary Care Center in Saudi Arabia. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040646. [PMID: 37189894 DOI: 10.3390/children10040646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
Bronchiolitis is a leading cause of hospitalization worldwide for children aged ≤2 years. Few studies have compared general ward and pediatric intensive care unit (PICU) admissions, particularly in Saudi Arabia. This retrospective cohort study aimed to compare the demographic and clinical characteristics of children with bronchiolitis admitted to the general ward with those admitted to the PICU. Children (≤6 years) previously diagnosed with bronchiolitis and admitted to the PICU or general ward at a tertiary center in Saudi Arabia between May 2016 and May 2021 were included. Multiplex polymerase chain reaction was used to identify respiratory viruses. Of the 417 patients enrolled, 67 (16.06%) were admitted to the PICU. The PICU group was younger (median, 2 months; interquartile range [IQR], 1-5 months) vs. (6 months; IQR, 2.65-13.25 months). There was a dramatic reduction in bronchiolitis admissions during the COVID-19 pandemic. The most common causative virus was respiratory syncytial virus (RSV) (54.9%). In the multivariate regression analysis, hypoxia, hyperinflation on X-ray, and non-RSV bronchiolitis were independently associated with PICU admission. However, a higher chronological age and cough were protective. Children with Down syndrome, immunodeficiency, or neuromuscular disorders, and intermediate preterm infants (29-33 weeks of gestation) are at a high risk of PICU admission (adjusted odds ratio: 2.4, 7.1, 2.9, and 2.9; p = 0.037, 0.046, 0.033, and 0.029, respectively). Bronchiolitis is still one of the leading causes of PICU admission. Particular attention should be paid to preventive measures, especially in the post-COVID-19 era, targeting high-risk groups.
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Affiliation(s)
- Sara Osman
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
| | - Abdulqader Alaa Adeen
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
| | - Omar Hetta
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
| | - Abdulaziz Alsiraihi
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
| | - Mahmoud Bader
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
| | - Alwaleed Aloufi
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
| | - Amir Abushouk
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Mohammed Yasir Al-Hindi
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
- Research Office, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah 22384, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia
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Hon KL, Leung AKC, Wong AHC, Dudi A, Leung KKY. Respiratory Syncytial Virus is the Most Common Causative Agent of Viral Bronchiolitis in Young Children: An Updated Review. Curr Pediatr Rev 2023; 19:139-149. [PMID: 35950255 DOI: 10.2174/1573396318666220810161945] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Viral bronchiolitis is a common condition and a leading cause of hospitalization in young children. OBJECTIVE This article provides readers with an update on the evaluation, diagnosis, and treatment of viral bronchiolitis, primarily due to RSV. METHODS A PubMed search was conducted in December 2021 in Clinical Queries using the key terms "acute bronchiolitis" OR "respiratory syncytial virus infection". The search included clinical trials, randomized controlled trials, case control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to children and English literature. The information retrieved from the above search was used in the compilation of this article. RESULTS Respiratory syncytial virus (RSV) is the most common viral bronchiolitis in young children. Other viruses such as human rhinovirus and coronavirus could be etiological agents. Diagnosis is based on clinical manifestation. Viral testing is useful only for cohort and quarantine purposes. Cochrane evidence-based reviews have been performed on most treatment modalities for RSV and viral bronchiolitis. Treatment for viral bronchiolitis is mainly symptomatic support. Beta-agonists are frequently used despite the lack of evidence that they reduce hospital admissions or length of stay. Nebulized racemic epinephrine, hypertonic saline and corticosteroids are generally not effective. Passive immunoprophylaxis with a monoclonal antibody against RSV, when given intramuscularly and monthly during winter, is effective in preventing severe RSV bronchiolitis in high-risk children who are born prematurely and in children under 2 years with chronic lung disease or hemodynamically significant congenital heart disease. Vaccines for RSV bronchiolitis are being developed. Children with viral bronchiolitis in early life are at increased risk of developing asthma later in childhood. CONCLUSION Viral bronchiolitis is common. No current pharmacologic treatment or novel therapy has been proven to improve outcomes compared to supportive treatment. Viral bronchiolitis in early life predisposes asthma development later in childhood.
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Affiliation(s)
- Kam L Hon
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, and The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Amrita Dudi
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
| | - Karen K Y Leung
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
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Al-Eyadhy A, Almazyad M, Hasan G, Almuhaideb Q, AbuDujain N, Alhaboob AAN, Alfawaz F, Alshenaifi S, Alfayez F, Aljebrin Y, Alsohime F, Alabdulhafid M, Temsah MH. The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience. J Infect Chemother 2022; 29:20-25. [PMID: 36103948 PMCID: PMC9464359 DOI: 10.1016/j.jiac.2022.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Objectives To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.
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Affiliation(s)
- Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Assiut Faculty of Medicine, Assiut University, Egypt; Pediatric Critical Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Ali A N Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fahad Alfayez
- College of Medicine, King Saud University, Saudi Arabia
| | | | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Al-Hindi MY, Almahdi BH, Alasmari DA, Alwagdani RK, Hunjur WM, Khalel AF, AlQurashi MA. Screening for Neurodevelopmental Delay for Preterm Very Low Birth Weight Infants at Tertiary Care Center in Saudi Arabia. Cureus 2021; 13:e20092. [PMID: 34877230 PMCID: PMC8642145 DOI: 10.7759/cureus.20092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/29/2022] Open
Abstract
Background Preterm infants are more susceptible to death, short-term complications, and long-term complications such as neurodevelopmental impairments. However, definitive assessment tools are not available in a resource-limited setting. Hence a screening tool is needed the Arabic-speaking population. Method Infants born at a gestational age of <32 weeks or a very low birth weight (VLBW) of less than 1500 g were recruited into a cross-sectional study. We identified infants (n = 61) admitted to the neonatal ICU at King Abdulaziz Medical City and reached 18 up to 24 months of corrected gestational age (CGA). The developmental assessment was done at 18, 20, 22, and 24 CGAs using the Ages and Stages Questionnaire third edition - Arabic version (ASQ3-A). The primary outcomes are early detection rate of neurodevelopmental delay (NDD), defined as a delay in one or more of the following: communication, gross motor, fine motor, problem-solving, and personal-social skills as per ASQ3-A. Results Sixty-one out of 92 eligible infants (36 excluded) completed the sufficient assessment. Twenty-six infants (42.6%) had at least one NDD in one of the following domains: communication skills: (11.5%), gross motor: (11.5%), fine motor: (19.7%), problem-solving skills: twelve infants (19.7%), and personal-social skills: twenty infants (23%). Perinatal events and periventricular leukomalacia (PVL) were significant independent predictors for the NDD. Conclusion This single-center study in Saudi Arabia screened preterm, VLBW infants based on ASQ3-A, twenty infants (42.6%) had an abnormal NDD at a corrected age of 18-24 months. Perinatal events and PVL were independent predictors of NDD. We recommend that all preterm VLBW infants in Saudi Arabia be evaluated by a neurodevelopmental screening tool, ASQ3-A, especially in resource-limited settings to start early intervention. Also, more extensive multicenter studies are to be carried out with definitive diagnostic tools to have a national benchmark for the long-term neurodevelopmental impairment.
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Affiliation(s)
- Mohammed Y Al-Hindi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Research Office, King Abdullah International Medical Research Center, Jeddah, SAU.,Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU
| | - Bashaer H Almahdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Dinah A Alasmari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Raghad K Alwagdani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Wujud M Hunjur
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdullah F Khalel
- Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU
| | - Mansour A AlQurashi
- Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Research Office, King Abdullah International Medical Research Center, Jeddah, SAU
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10
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Al Shamrani A, AlShammari A, AlAlkami H, AlShanwani J, Alharbi AS. When is asthma not guilty? Int J Pediatr Adolesc Med 2021; 8:203-211. [PMID: 34401444 PMCID: PMC8356124 DOI: 10.1016/j.ijpam.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/12/2020] [Accepted: 10/18/2020] [Indexed: 11/20/2022]
Abstract
Asthma is a common childhood condition. Its prevalence in Saudi Arabia is high, increasing, and could exceed 20% at the current trajectory. Asthma is a syndrome with different clinical presentations and phenotypes. Many conditions are often misdiagnosed as asthma because they share the same symptoms, particularly coughing and shortness of breath; physical findings, such as wheezing; radiological findings, such as hyperinflation on chest X-ray; or even responses to asthma therapies, as in some patients with bronchiolitis. When treating the younger age group (>5 years old), there should be a high degree of suspicion of alternative causes when evaluating patients presenting with clinical features suggestive of asthma or patients who do not respond well to asthma therapies. This study will highlight common conditions that may mimic asthma and, as a result of incorrect treatment, unnecessarily expose patients to steroids and other therapies for extended periods. Furthermore, we seek to alert healthcare providers to common symptoms and signs that suggest a cause other than asthma and suggest when to refer the patient to subspecialists.
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Affiliation(s)
| | - Ayshah AlShammari
- Department of Pediatrics, Prince Sultan Military Medical City, Saudi Arabia
| | - Halima AlAlkami
- Department of Pediatrics, Prince Sultan Military Medical City, Saudi Arabia
| | - Jawaher AlShanwani
- Department of Pediatrics, Prince Sultan Military Medical City, Saudi Arabia
| | - Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Saudi Arabia
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11
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Tang G, Lin J, Zhang Y, Shi Q. The Effects and Safety of Continuous Positive Airway Pressure in Children with Bronchiolitis: A Systematic Review and Meta-Analysis. J Trop Pediatr 2021; 67:6284363. [PMID: 34037790 DOI: 10.1093/tropej/fmaa128] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate the effects and safety of continuous positive airway pressure (CPAP) for initial respiratory management of bronchiolitis. METHODS PubMed, EMBASE, Cochrane Library, CNKI, Wanfang data and CQ VIP were searched until 17 June 2020. Randomized controlled trials (RCTs) which investigated the effect of CPAP for bronchiolitis were included. RESULTS Twenty-seven RCTs met the eligibility criteria. In the comparison of CPAP versus standard oxygen therapy, CPAP can reduce the length of stay (LOS) in hospital, respiratory rate (RR), PaCO2, heart rate, mechanical ventilation and increase PaO2, but the SpO2 and PH were not improved. In the comparison of CPAP versus high-flow nasal cannula, CPAP can reduce treatment failure, but the PICU LOS, Incidence of intubation, RR, Modified Woods Clinical Asthma Score were not decreased. Treatment failure may be less in helmet comparing with the mask though there was no quantitative analysis. CONCLUSION CPAP for the initial respiratory management significantly benefit children with bronchiolitis, the delivery of CPAP by helmet may be a better choice. More high-quality research is needed to confirm the conclusion.
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Affiliation(s)
- Guojing Tang
- Department of Critical Care Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Ministry of Education, Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Jilei Lin
- Department of Respiration Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Ministry of Education, Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yin Zhang
- Department of Respiration Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Ministry of Education, Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Qingxia Shi
- Department of Respiration Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Ministry of Education, Key Laboratory of Child Development and Disorders, Chongqing, China
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12
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Alharbi AS, Alzahrani M, Alodayani AN, Alhindi MY, Alharbi S, Alnemri A. Saudi experts' recommendation for RSV prophylaxis in the era of COVID-19: Consensus from the Saudi Pediatric Pulmonology Association. Saudi Med J 2021; 42:355-362. [PMID: 33795490 PMCID: PMC8128639 DOI: 10.15537/smj.2021.42.4.20200769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/23/2021] [Indexed: 12/24/2022] Open
Abstract
Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and viral pneumonia in pediatrics worldwide. In the Kingdom of Saudi Arabia (KSA), the prevalence of RSV is 23.5% in pediatric patients with acute lower respiratory tract illness. Coronavirus disease (COVID-19) poses critical public health and socioeconomic challenges in KSA. The Saudi Pediatric Pulmonology Association (SPPA), a subsidiary of the Saudi Thoracic Society (STS), developed a task force to determine the potential challenges and barriers to the RSV immunoprophylaxis program during the era of COVID-19 and to compose a practical, nationwide, and multidisciplinary approach to address these challenges. Some of the recommendations to manage these challenges include increasing the number of RSV immunoprophylaxis clinics, drive-thru visits, home-care services, and swift referrals to the RSV immunoprophylaxis program specialists. Additional training is required for healthcare personnel to add RSV immunoprophylaxis to the regular immunization schedule.
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Affiliation(s)
- Adel S. Alharbi
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Adel S. Alharbi, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0001-7974-4026
| | - Mohamed Alzahrani
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
| | - Abdulrahman N. Alodayani
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
| | - Mohamed Y. Alhindi
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
| | - Saleh Alharbi
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Adel S. Alharbi, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0001-7974-4026
| | - Abdulrahman Alnemri
- From the Department of Pediatrics (Alharbi A, Alodayani), Prince Sultan Military Medical City; from the Department of Pediatrics (Alzahrani), Security Forces Hospital; from the Pediatrics Department (Alnemri), College of Medicine, King Saud University, Riyadh; from the Department of Pediatrics (Alhindi), King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard; from the Department of Pediatrics (Alharbi S), Dr. Soliman Fakeeh Hospital, Jeddah; and from the Department of Pediatrics (Alharbi S), Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.
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13
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Alharbi AS, Yousef AA, Alharbi SA, Al-Shamrani A, Alqwaiee MM, Almeziny M, Said YS, Alshehri SA, Alotaibi FN, Mosalli R, Alawam KA, Alsaadi MM. Application of aerosol therapy in respiratory diseases in children: A Saudi expert consensus. Ann Thorac Med 2021; 16:188-218. [PMID: 34012486 PMCID: PMC8109687 DOI: 10.4103/atm.atm_74_21] [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: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 11/27/2022] Open
Abstract
The Saudi Pediatric Pulmonology Association (SPPA) is a subsidiary of the Saudi Thoracic Society (STS), which consists of a group of Saudi experts with well-respected academic and clinical backgrounds in the fields of asthma and other respiratory diseases. The SPPA Expert Panel realized the need to draw up a clear, simple to understand, and easy to use guidance regarding the application of different aerosol therapies in respiratory diseases in children, due to the high prevalence and high economic burden of these diseases in Saudi Arabia. This statement was developed based on the available literature, new evidence, and experts' practice to come up with such consensuses about the usage of different aerosol therapies for the management of respiratory diseases in children (asthma and nonasthma) in different patient settings, including outpatient, emergency room, intensive care unit, and inpatient settings. For this purpose, SPPA has initiated and formed a national committee which consists of experts from concerned specialties (pediatric pulmonology, pediatric emergency, clinical pharmacology, pediatric respiratory therapy, as well as pediatric and neonatal intensive care). These committee members are from different healthcare sectors in Saudi Arabia (Ministry of Health, Ministry of Defence, Ministry of Education, and private healthcare sector). In addition to that, this committee is representing different regions in Saudi Arabia (Eastern, Central, and Western region). The subject was divided into several topics which were then assigned to at least two experts. The authors searched the literature according to their own strategies without central literature review. To achieve consensus, draft reports and recommendations were reviewed and voted on by the whole panel.
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Affiliation(s)
- Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Pediatrics, King Fahd Hospital of the University, Khobar, Saudi Arabia
| | - Saleh A. Alharbi
- Department of Pediatrics, Umm Al-Qura University, Mecca, Saudi Arabia
- Department of Pediatrics, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Mansour M. Alqwaiee
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Mohammed Almeziny
- Department of Pharmacy, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yazan S. Said
- Department of Pediatrics, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saleh Ali Alshehri
- Department of Emergency, Pediatric Emergency Division, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Faisal N. Alotaibi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Rafat Mosalli
- Department of Pediatrics, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Pediatrics, International Medical Center, Jeddah, Saudi Arabia
| | - Khaled Ali Alawam
- Department of Respiratory Therapy Sciences, Inaya Medical College, Riyadh, Saudi Arabia
| | - Muslim M. Alsaadi
- Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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14
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Alreshidi NM, Livesley J, Al-Kalaldeh M, Long T. The Impact of a School-based, Nurse-delivered Asthma Health Education Program on Quality of Life, Knowledge, and Attitudes of Saudi Children with Asthma. Compr Child Adolesc Nurs 2020; 45:1-15. [PMID: 33021848 DOI: 10.1080/24694193.2020.1824033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
More than two million people have asthma in Saudi Arabia: 13% aged 6-10 years. Asthma is one of the most common childhood illnesses. Little has been explored about children's ability to learn more about their own asthma in Saudi Arabia. The study was designed to assess the impact of a school-based, nurse-delivered asthma health education program on asthmatic children's knowledge and attitude toward asthma, quality of life, anxiety level, and school absenteeism. A quasi-experimental, non-equivalent group, pretest-posttest design was used. The education program was developed from existing evidence. The Pediatric Asthma Quality of Life Questionnaire, Spence Anxiety Tool, Asthma Knowledge Questionnaire, and Asthma Attitude Questionnaire were employed for data collection. Intervention (n = 130) and control (n = 98) groups were drawn from 10 schools in Ha'il region, Saudi Arabia. Descriptive and inferential statistics were used to examine differences within and between groups. Knowledge of asthma increased significantly more in the intervention group than in the control group. Attitude toward asthma was not changed by the intervention. Anxiety scores reverted to pretest level by posttest II. The intervention group had significantly better total quality of life scores than the control group, and school absenteeism reduced significantly after the delivery of the program. It was concluded that the asthma education program impacted positively on students' knowledge, quality of life, and school attendance. However, asthma education did not change attitudes toward the condition, and the impact on anxiety was not persistent. The results emphasize the benefits of the provision of health education directly to children. Asthma education should be integrated into the Saudi national child health program.
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Affiliation(s)
- Nashi Masnad Alreshidi
- Department of Continuing Education, Nursing Administration in Hail Region, Hail City, Saudi Arabia
| | - Joan Livesley
- School of Health & Society, University of Salford, Salford, UK
| | | | - Tony Long
- Department of Continuing Education, Nursing Administration in Hail Region, Hail City, Saudi Arabia
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15
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Akici N, Aydin V, Donertas B, Alkan A, Akici A. Investigation of injectable drug utilization in primary care: A focus on different age groups in pediatric population. Arch Pediatr 2020; 27:183-188. [PMID: 32331914 DOI: 10.1016/j.arcped.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/31/2019] [Accepted: 03/28/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The suitability of the injectables may vary across different age groups especially for children; therefore, knowledge on their usage patterns is critical in terms of rational pharmacotherapy. This study aimed to investigate pediatric injectable drug utilization in primary care with a focus on different age groups. METHOD By simple sampling method, 100 prescriptions that contained at least one injectable drug were randomly selected for each month of the year in 32 provinces of Turkey (n=38.400). Among these prescriptions, injectable drugs that were for children (<18 years) were analyzed. Patterns of injectable drug utilization were compared according to the pediatric age group of "infants", "children", and "adolescents". RESULTS We identified 5446 patients (14.2%) with a mean age of 7.4±5.2 years and a slight male tendency in distribution (53.8%). The most common indication for these patients was for the respiratory system (65.4%), of which 96.3% were respiratory tract infections. While less pronounced in adolescents than in infants and children, the most commonly prescribed injectable drugs were antibiotics in all age groups (61.5% vs. 78.6% and 79.9%, P<0.0001), which was upheld across all seasons. More than 90% of all prescribed injectable antibiotics consisted of penicillins and cephalosporins; the latter being predominant in infants (67.4%) compared with penicillins in children (53.9%) and adolescents (59.0%). Analgesics and insulin were found to be prescribed more frequently to adolescents than they were to infants and children (P<0.0001 and P<0.0001, respectively). The mean cost of prescription and injectable drugs per encounter was significantly more likely to escalate with increasing age (P<0.0001 and P<0.0001, respectively). CONCLUSION Considering the predominance of antibiotics as well as the substantially higher prescription of third-generation cephalosporins in primary care, which was especially more marked for younger children, our study indicates an inappropriate use of injectable drugs by primary care physicians for managing medical conditions in the pediatric population.
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Affiliation(s)
- N Akici
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - V Aydin
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - B Donertas
- Department of Medical Pharmacology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A Alkan
- Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey
| | - A Akici
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey.
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16
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Paes B, Carbonell-Estrany X. Respiratory syncytial virus prophylaxis for children with chronic lung disease: have we got the criteria right? Expert Rev Anti Infect Ther 2019; 17:211-222. [DOI: 10.1080/14787210.2019.1581062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Bosco Paes
- Department of Pediatrics (Neonatal Division), McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Xavier Carbonell-Estrany
- Hospital Clinic, Institut d’Investigacions Biomediques August Pi Suner (IDIBAPS), Barcelona, Spain
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17
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Al-Moamary MS, Alhaider SA, Alangari AA, Al Ghobain MO, Zeitouni MO, Idrees MM, Alanazi AF, Al-Harbi AS, Yousef AA, Alorainy HS, Al-Hajjaj MS. The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2019; 14:3-48. [PMID: 30745934 PMCID: PMC6341863 DOI: 10.4103/atm.atm_327_18] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This is the fourth version of the updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is now more aligned for different age groups. The guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with integration of recommendations related to biologic agents, evidence-based updates on treatment, and role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.
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Affiliation(s)
- Mohamed S Al-Moamary
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah A Alangari
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed O Al Ghobain
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed O Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majdy M Idrees
- Respiratory Division, Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah F Alanazi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Adel S Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan S Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed S Al-Hajjaj
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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