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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Association between early viral lower respiratory tract infections and subsequent asthma development
Sebastien Kenmoe, Etienne Atenguena Okobalemba, Guy Roussel Takuissu, Jean Thierry Ebogo-Belobo, Martin Gael Oyono, Jeannette Nina Magoudjou-Pekam, Ginette Irma Kame-Ngasse, Jean Bosco Taya-Fokou, Chris Andre Mbongue Mikangue, Raoul Kenfack-Momo, Donatien Serge Mbaga, Arnol Bowo-Ngandji, Cyprien Kengne-Ndé, Seraphine Nkie Esemu, Richard Njouom, Lucy Ndip
Sebastien Kenmoe, Seraphine Nkie Esemu, Lucy Ndip, Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
Sebastien Kenmoe, Richard Njouom, Department of Virology, Centre Pasteur of Cameroon, Yaounde 00237, Cameroon
Etienne Atenguena Okobalemba, Faculty of Medicine and Biomedical Science, The University of Yaounde I, Yaounde 00237, Cameroon
Guy Roussel Takuissu, Centre of Research in Food, Food Security and Nutrition, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
Jean Thierry Ebogo-Belobo, Ginette Irma Kame-Ngasse, Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
Martin Gael Oyono, Laboratory of Parasitology and Ecology, The University of Yaounde I, Yaounde 00237, Cameroon
Jeannette Nina Magoudjou-Pekam, Raoul Kenfack-Momo, Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
Jean Bosco Taya-Fokou, Chris Andre Mbongue Mikangue, Donatien Serge Mbaga, Arnol Bowo-Ngandji, Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
Cyprien Kengne-Ndé, Epidemiological Surveillance, Evaluation and Research Unit, National Aids Control Committee, Douala 00237, Cameroon
Author contributions: Kenmoe S, Ndip L, and Njouom R were responsible for conception and design of the study as well as project administration; Kenmoe S, Atenguena Okobalemba E, Takuissu GR, Ebogo-Belobo JT, Oyono MG, Magoudjou-Pekam JN, Kame-Ngasse GI, Taya-Fokou JB, Mbongue Mikangue CA, Kenfack-Momo R, Fall A, Mbaga DS, Bowo-Ngandji A, Kengne-Nde C, and Esemu SN were responsible for the data curation and interpretation of results; Kengne-Nde C and Kenmoe S were responsible for statistical analysis; Kenmoe S, Ndip L, and Njouom R were responsible for the project supervision; Kenmoe S wrote the original draft; All authors critically reviewed the first draft and approved the final version of the paper for submission and have read and approved the final manuscript.
Supported by the European Union (EDCTP2 Programme), No. TMA2019PF-2705.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Sebastien Kenmoe, PhD, Assistant Lecturer, Department of Microbiology and Parasitology, University of Buea, Molyko to Buea Town Rd, Buea 00237, Cameroon.
sebastien.kenmoe@ubuea.cm
Received: November 30, 2021
Peer-review started: November 30, 2021
First decision: April 19, 2022
Revised: April 25, 2022
Accepted: June 16, 2022
Article in press: June 16, 2022
Published online: July 9, 2022
Processing time: 218 Days and 15.2 Hours
BACKGROUND
The association between hospitalization for human respiratory syncytial virus (HRSV) bronchiolitis in early childhood and subsequent asthma is well established. The long-term prognosis for non-bronchiolitis lower respiratory tract infections (LRTI) caused by viruses different from HRSV and rhinovirus, on the other hand, has received less interest.
AIM
To investigate the relationship between infant LRTI and later asthma and examine the influence of confounding factors.
METHODS
The PubMed and Global Index Medicus bibliographic databases were used to search for articles published up to October 2021 for this systematic review. We included cohort studies comparing the incidence of asthma between patients with and without LRTI at ≤ 2 years regardless of the virus responsible. The meta-analysis was performed using the random effects model. Sources of heterogeneity were assessed by stratified analyses.
RESULTS
This review included 15 articles (18 unique studies) that met the inclusion criteria. LRTIs at ≤ 2 years were associated with an increased risk of subsequent asthma up to 20 years [odds ratio (OR) = 5.0, 95%CI: 3.3-7.5], with doctor-diagnosed asthma (OR = 5.3, 95%CI: 3.3-8.6), current asthma (OR = 5.4, 95%CI: 2.7-10.6), and current medication for asthma (OR = 1.2, 95%CI: 0.7-3.9). Our overall estimates were not affected by publication bias (P = 0.671), but there was significant heterogeneity [I2 = 58.8% (30.6-75.5)]. Compared to studies with hospitalized controls without LRTI, those with ambulatory controls had a significantly higher strength of association between LRTIs and subsequent asthma. The strength of the association between LRTIs and later asthma varied significantly by country and age at the time of the interview. The sensitivity analyses including only studies with similar proportions of confounding factors (gender, age at LRTI development, age at interview, gestational age, birth weight, weight, height, smoking exposure, crowding, family history of atopy, and family history of asthma) between cases and controls did not alter the overall estimates.
CONCLUSION
Regardless of the causative virus and confounding factors, viral LRTIs in children < 2 years are associated with an increased risk of developing a subsequent asthma. Parents and pediatricians should be informed of this risk.
Core Tip: The results of this meta-analysis confirmed that viral lower respiratory tract infections (LRTIs) in children < 2 years increase the risk of developing asthma later until the age of 20 years. This indicates that pediatricians and parents should be vigilant with anticipating asthma preventive measures in children with viral LRTIs in childhood.
