| [Aims]To explore the influence of recurrent respiratory tract infections(RRTI)on physical development of children,to search for feasible and effective comprehensive interventions for reducing the number of respiratory tract infection recurrence,shortening the disease course,promoting physical development of children,improving the level of K-A-P(Knowledge,Attitude,Practice)in RRTI,feeding and other aspects.[Methods]Children who had physical examination in children’s health clinic of a community health service center in Shanghai Pudong New District were selected as the study subjects.68 RRTI children and 94 non-RRTI children met the inclusion criteria after detailed inquiry of medical history.The 162 children were randomly divided into four groups:RRTI observation group(group A;n=36),RRTI control group(group B;n=32),non-RRTI observation group(group C;n=47)and non-RRTI control group(group D;n=47).The basic conditions including age,sex,birth history,and feeding history had no significant differences between group A and B,or group C and D.During the intervention period(half a year)from March to August 2018,the RRTI observation group and the non-RRTI observation group received comprehensive interventions,which aimed to help parents recognize and treat RRTI correctly,and guide parents about feeding,sleep,outdoor activities and traditional Chinese medicine nursing;the RRTI control group and the non-RRTI control group carried out routine education.During the follow-up period(one year)from September 2018 to August 2019,all four groups of children only undergone regular physical examinations.All children in four groups had physical examination and blood routine examination before and after the intervention and after the follow-up of one year.The indexes of physical development measurement included weight,height(length),arm circumference,subscapular skinfold.We also analyzed the weight for age Z score(WAZ),height for age Z score(HAZ),weight for height Z score(WHZ),arm circumference for age Z sore(ACAZ)and subscapular skinfold for age Z sore(SS AZ);Before and after the interventions and after the follow-up of one year,parents of the RRTI observation group and the non-RRTI observation group participated in the K-A-P questionnaire survey.Based on the data we collected before and after the intervention and after the follow-up of one year,we conducted comparative analyses separately about children’s physical development level,number of anemia cases and hemoglobin concentrations among the four groups,and parents’ K-A-P questionnaire scores between the RRTI observation group and the non-RRTI observation group.Also,comparative analyses were conducted about the number of respiratory tract infection recurrence and average days of each disease course between the RRTI observation group and RRTI control group after the interventions and after the follow-up of one year.[Results]1.Before the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ,the number of anemia cases and hemoglobin concentrations were approximate between RRTI observation group and control group without significant differences(P>0.05).After the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were higher than those in RRTI control group,and the number of anemia cases in RRTI observation group was less than that in RRTI control group,showing significant differences(P<0.01).After the follow-up of one year,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were higher than those in RRTI control group(P<0.01);the number of anemia cases in RRTI observation group was less than that in RRTI control group(P>0.05).2.Before the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ,the number of anemia cases and hemoglobin concentrations were approximate between non-RRTI observation and control groups(P>0.05).After the intervention,WAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in non-RRTI observation group were higher than those in non-RRTI control group.There was no significant difference in HAZ(P>0.05),and there were significant differences in other items(P<0.05);the number of anemia cases in non-RRTI observation group was less than that in non-RRTI control group(P>0.05).After the follow-up of one year,WAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in non-RRTI observation group were higher than those in non-RRTI control group,there was no significant difference in HAZ(P>0.05),and there were significant differences in other items(P<0.05/0.01);no anemia cases were found in both groups.3.Before the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI control group,and the number of anemia cases in RRTI observation group was more than that in non-RRTI control group(P<0.01).After the intervention,WAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI control group,there was significant difference in HAZ and hemoglobin concentrations(P<0.05),and there were no significant differences in other items(P>0.05);the number of anemia cases in RRTI observation group was less than that in non-RRTI control group(P>0.05).After the follow-up of one year,WAZ,HAZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI control group,WHZ in RRTI observation group were slightly higher than that in non-RRTI control group(P>0.05);no anemia cases were found in both groups.4.Before the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI observation group,the number of anemia cases in RRTI observation group was more than that in non-RRTI observation group(P<0.01).After the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI observation group(P<0.01);no anemia cases were observed in two groups.After the follow-up of one year,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were lower than those in non-RRTI observation group(P<0.05/0.01);no anemia cases were observed in both groups.During the period of intervention,the growth of WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were larger than those in non-RRTI observation group(P<0.01);During the period of follow-up,the growth value of WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI observation group were also larger than those in non-RRTI observation group,with significant difference(P<0.05/0.01),except the growth value of WHZ,which had no significant difference(P>0.05).5.Before the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI control group were lower than those in non-RRTI control group,the number of anemia cases in RRTI control group was more than that in non-RRTI control groups(P<0.01).After the intervention,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI control group were still lower than those in non-RRTI control group(P<0.01);the number of anemia cases in RRTI control group was more than that in non-RRTI control group(P>0.05).After the follow-up of one year,WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI control group were lower than those in non-RRTI control group(P<0.01);the number of anemia cases in RRTI control group was more than that in non-RRTI control group(P>0.05).During the period of intervention,the growth value of WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI control group was less than those in non-RRTI control group.There were significant differences in the growth of HAZ,SSAZ(P<0.05/0.01),and there were no significant differences in other items(P>0.05);During the period of follow-up,the growth value of WAZ,HAZ,WHZ,ACAZ,SSAZ and hemoglobin concentrations in RRTI control group were also less than those in non-RRTI control group.There was no significant difference in the growth of HAZ and hemoglobin concentrations(P>0.05),and there were significant differences in other items(P<0.01).6.During the period of intervention and follow-up,the number of respiratory tract infection recurrence and average days of each disease course were fewer in RRTI observation group than those in RRTI control groups(P<0.01).7.Before the intervention,questionnaire scores of parents in RRTI observation group were lower than those in non-RRTI observation group,and the difference was significant(P<0.01);after the intervention,questionnaire scores of parents in RRTI observation group were close to those of non-RRTI observation group(P>0.05).Questionnaire scores of parents in both RRTI observation group and non-RRTI observation group were raised after interventions(P<0.01);the increase of questionnaire scores in the RRTI observation group was larger than that in non-RRTI observation group(P<0.01).After the follow-up of one year,there was no significant difference in questionnaire scores of parents between the RRTI observation group and the non-RRTI observation group(P>0.05),and the questionnaire scores of parents in two observation groups were higher than those after the intervention(P<0.01).[Conclusions]1.The physical development level of RRTI children was obviously lower than that of non-RRTI children,the hemoglobin concentrations of RRTI children was lower than that of non-RRTI children and the number of anemia cases in RRTI observation group was more than that in RRTI control group;K-A-P level of RRTI children’s parents was significantly lower than that of non-RRTI children’s parents.2.Comprehensive interventions obviously decreased the number of respiratory tract infection recurrence and shortened the disease course,promoted the physical development level and the hemoglobin concentrations and reduced anemia cases of children,improved the K-A-P level of parents in RRTI,feeding,etc.These intervention effects persisted in the follow-up phase.3.The physical development level of RRTI children and the K-A-P level of RRTI children’s parents have great potential to be improved after intervention,which is more obvious than the improvement of non-RRTI children.Feasible and effective intervention measures should be implemented as soon as possible.4.Comprehensive interventions aiming to help parents recognize and treat RRTI correctly and guide parents about feeding,sleeping,outdoor activities and traditional Chinese medicine conditioning were efficacious and sustainable. |
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