Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
National AIDS Control Committee, Epidemiological Surveillance, Evaluation and Research Unit, Yaounde, Cameroon.
PLoS One. 2020 Apr 24;15(4):e0231816. doi: 10.1371/journal.pone.0231816. eCollection 2020.
Existing evidence on the relationship between childhood lower respiratory tract infections (LRTI) and the subsequent atopy development is controversial. We aimed to investigate an association between viral LRTI at <5 years and the development of atopy at > 2 years.
We conducted a search at Embase, Pubmed, Web of Science, and Global Index Medicus. We collected data from the included articles. We estimated the odds ratio and the 95% confidence intervals with a random effect model. We determined factors associated with atopy development after childhood LRTI using univariate and multivariate meta-regression analyses. We recorded this systematic review at PROSPERO with the number CRD42018116955.
We included 24 studies. There was no relationship between viral LRTI at <5 years and skin prick test-diagnosed-atopy (OR = 1.2, [95% CI = 0.7-2.0]), unknown diagnosed-atopy (OR = 0.7, [95% CI = 0.4-1.3]), atopic dermatitis (OR = 1.2, [95% CI = 0.9-1.6]), hyperreactivity to pollen (OR = 0.8, [95% CI = 0.3-2.7]), food (OR = 0.8, [95% CI = 0.3-2.5]), or house dust mite (OR = 1.1, [95% CI = 0.6-2.2]). Although not confirmed in all studies with a symmetric distribution of the 23 confounding factors investigated, the overall analyses showed that there was a relationship between childhood viral LRTI at < 5 years and serum test diagnosed-atopy (OR = 2.0, [95% CI = 1.0-4.1]), allergic rhinoconjunctivitis (OR = 1.7, [95% CI = 1.1-2.9]), hyperreactivity diagnosed by serum tests with food (OR = 5.3, [1.7-16.7]) or inhaled allergens (OR = 4.2, [95% CI = 2.1-8.5]), or furred animals (OR = 0.6, [95% CI = 0.5-0.9]).
These results suggest that there is no association between viral LRTI at < 5 years and the majority of categories of atopy studied during this work. These results, however, are not confirmed for the remaining categories of atopy and more particularly those diagnosed by serum tests. There is a real need to develop more accurate atopy diagnostic tools.
目前关于儿童下呼吸道感染（LRTI）与随后特应性发展之间关系的证据存在争议。我们旨在调查<5 岁时病毒 LRTI 与>2 岁时特应性发展之间的关联。
我们在 Embase、Pubmed、Web of Science 和全球医学索引中进行了检索。我们从纳入的文章中收集数据。我们使用随机效应模型估计了比值比和 95%置信区间。我们使用单变量和多变量荟萃回归分析确定了儿童 LRTI 后特应性发展的相关因素。我们在 PROSPERO 中记录了这个系统综述，编号为 CRD42018116955。
我们纳入了 24 项研究。<5 岁时病毒性 LRTI 与皮肤点刺试验诊断的特应性（OR=1.2，[95%CI=0.7-2.0]）、未知诊断的特应性（OR=0.7，[95%CI=0.4-1.3]）、特应性皮炎（OR=1.2，[95%CI=0.9-1.6]）、花粉超敏反应（OR=0.8，[95%CI=0.3-2.7]）、食物超敏反应（OR=0.8，[95%CI=0.3-2.5]）或屋尘螨超敏反应（OR=1.1，[95%CI=0.6-2.2]）之间没有关系。尽管并非所有研究都以调查的 23 个混杂因素的对称分布来证实，但总体分析表明，<5 岁时儿童病毒性 LRTI 与血清学试验诊断的特应性（OR=2.0，[95%CI=1.0-4.1]）、过敏性鼻结膜炎（OR=1.7，[95%CI=1.1-2.9]）、血清学试验诊断的食物超敏反应（OR=5.3，[1.7-16.7]）或吸入性过敏原超敏反应（OR=4.2，[95%CI=2.1-8.5]）、或有毛动物超敏反应（OR=0.6，[95%CI=0.5-0.9]）之间存在关系。
这些结果表明，<5 岁时的病毒性 LRTI 与本研究期间研究的大多数特应性类别之间没有关联。然而，对于其余的特应性类别，特别是那些通过血清学试验诊断的特应性类别，这些结果并未得到证实。因此，确实需要开发更准确的特应性诊断工具。
