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Research ArticleOriginal Research

Respiratory Tract Infections in Children in the Community: Prospective Online Inception Cohort Study

Alastair D. Hay, Emma Anderson, Sue Ingle, Charles Beck and William Hollingworth
The Annals of Family Medicine January 2019, 17 (1) 14-22; DOI: https://doi.org/10.1370/afm.2327
Alastair D. Hay
1Centre for Academic Primary Care, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
3NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, United Kingdom
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  • For correspondence: alastair.hay@bristol.ac.uk
Emma Anderson
2Centre for Child and Adolescent Health, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
3NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, United Kingdom
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Sue Ingle
3NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, United Kingdom
4Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Charles Beck
3NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, United Kingdom
5Field Epidemiology Service, Public Health England, Bristol, United Kingdom
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William Hollingworth
4Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Abstract

PURPOSE Describe the duration of symptoms, proportion of parents seeking primary care consultations, and costs for respiratory tract infections (RTIs) of children in the community.

METHODS Community-based, online, prospective inception cohort study. General practitioners from socioeconomically diverse practices posted study invitations to parents of 10,310 children aged ≥3 months and <15 years.

RESULTS One parent of 485 (4.7%) children in 331 families consented, completed baseline data and symptom diaries, and agreed to medical record review. Compared with nonresponders, responding parent’s children were younger (aged 4 vs 6 years) and less socioeconomically deprived. Between February and July 2016, 206 parents reported 346 new RTIs in 259 children. Among the 197 first RTIs reported per family, it took 23 days for 90% (95% CI, 85%-94%) of children to recover. Median symptom duration was longer: in children with primary care consultations (9 days) vs those without consultations (6 days, P = 0.06); children aged <3 years (11 days) vs >3 years (7 days, P <.01); and among children with reported lower RTI symptoms (12 days) vs those with only upper RTI symptoms (8 days, P <.001). Sixteen (8.1%; 95% CI, 4.7%-12.8%) of 197 children had primary care consultations at least once (total 19 consultations), and a similar proportion had time off school or nursery. Sixty of 188 (32%; 95% CI, 25%-39%) parents reported paying for medications for their child’s illness.

CONCLUSIONS Parents can be advised that RTI symptoms last up to 3 weeks. Policy makers should be aware that parents may seek primary care support in at least 1 in 12 illnesses.

Key words
  • child
  • respiratory tract infections
  • primary health care
  • antibacterial agents
  • Received for publication March 20, 2018.
  • Revision received August 9, 2018.
  • Accepted for publication September 27, 2018.
  • © 2019 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 17 (1)
The Annals of Family Medicine: 17 (1)
Vol. 17, Issue 1
January/February 2019
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Respiratory Tract Infections in Children in the Community: Prospective Online Inception Cohort Study
Alastair D. Hay, Emma Anderson, Sue Ingle, Charles Beck, William Hollingworth
The Annals of Family Medicine Jan 2019, 17 (1) 14-22; DOI: 10.1370/afm.2327

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Respiratory Tract Infections in Children in the Community: Prospective Online Inception Cohort Study
Alastair D. Hay, Emma Anderson, Sue Ingle, Charles Beck, William Hollingworth
The Annals of Family Medicine Jan 2019, 17 (1) 14-22; DOI: 10.1370/afm.2327
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Subjects

  • Domains of illness & health:
    • Acute illness
    • Disease pathophysiology / etiology
  • Person groups:
    • Children's health
  • Methods:
    • Quantitative methods
  • Other research types:
    • Health policy
    • Health services
  • Core values of primary care:
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Keywords

  • child
  • respiratory tract infections
  • primary health care
  • antibacterial agents

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