Wednesday, 27 November 2013

Lower respiratory tract infection (Respiratory Disease) – Bronchitis – The Risk factors

Lower respiratory tract infection
The lower respiratory tract infection are the infection consisting of the trachea (wind pipe), bronchial tubes, the bronchioles, and the lungs, including the bronchitis and pneumonia. According to  The World Health Report 2004 – Changing History(1), in 2002 lower respiratory track infection were still the leading cause of deaths among all infectious diseases, and accounted for 3.9 million deaths worldwide and 6.9% of all deaths that year.
Bronchitis is defined as a condition of an inflammation of the mucous membranes of the bronchi, the larger and medium-sized airways that carry airflow from the trachea into the lung parenchyma(7). Most cases of Bronchitis are as a result of recurrent injure to the airways caused by inhaled irritants and cigarette smoking(6).
A.2. Risk factors
1. Tuberculosis and occupational exposures
In the study to determine the prevalence and predictors of chronic bronchitis, found that the pattern of chronic bronchitis in South Africa suggests a combination of risk factors that includes not only smoking but also tuberculosis, occupational exposures in men and domestic fuel exposure in women. Control of these risk factors requires public health action across a broad front(14).
2. Household income adequacy
In the study to determine the prevalence of chronic bronchitis (CB) and associated risk factors in farm and nonfarm rural residents in Saskatchewan, Canada, found that  increasing household income and reducing smoking could be primary, modifiable determinants of CB prevalence(15).
3. Age, low income, allergic, asthma, geographic location
In the study to determine the prevalence (crude and adjusted) of CB and its associated risk factors in Canadian Aboriginal children and youth six to 14 years of age, found that the prevalence of CB was 3.1% for boys and 2.8% for girls. Other significant risk factors of CB were age (OR 1.38 [95% CI 1.24 to 1.52] for 12 to 14 year olds versus six to eight year olds), income (OR 2.28 [95% CI 2.02 to 2.59] for income category <$25,000⁄year versus ≥$85,000⁄year), allergies (OR 1.96 [95% CI 1.78 to 2.16] for having allergies versus no allergies), asthma (OR 7.61 [ 95% CI 6.91 to 8.37] for having asthma versus no asthma) and location of residence (rural⁄urban and geographical location). A significant two-way interaction between sex and body mass index indicated that the relationship between the prevalence of CB and body mass index was modified by sex(16).
4.  Gender
If you are female, you are at inscreased risk to develop brochitis. In the study to analyze the trend of gender gaps in life expectancy (GGLE) in Japan between 1947 and 2010, and explored the correlations of GGLE with gender mortality ratio and social development indices, found that the increased trend of GGLE in Japan could be partly explained by increased disease-specific mortality ratios (male/female), especially those involving chronic bronchitis and emphysema, diseases of the liver, suicide and cancer. The recent decline of GGLE might imply that Japanese women have been catching up with the lifestyle of men, resulting in similar mortality patterns(17).
5. Influenza vaccination coverges and other risk factors
Other researchers in the study of influenza vaccination coverges, found that Socio-economic factors, such as gender, age, educational level, occupational status and macro-region of residence, affect influenza vaccination coverage rates in the Italian general population. In addition, some chronic medical conditions are an obstacle for vaccination(18)
6. Immunodeficiencies
According to the study by Sheffield Children’s Hospital, Western Bank, Protracted bacterial bronchitis (PBB) is a disease caused by the chronic infection of the conducting airways. In many children the condition appears to be secondary to impaired mucociliary clearance that creates a niche for bacteria to become established, probably in the form of biofilms. In others, immunodeficiencies, which may be subtle, appear to be a factor. PBB causes persistent coughing and disturbed sleep, and affects exercise tolerance, causing significant levels of morbidity(18a).
7. Other risk factors
Accoring to the University of Saskatchewan, in the study to determine the prevalence of chronic bronchitis (CB) and associated risk factors in farm and nonfarm rural residents in Saskatchewan, Canada, showed that The prevalence of CB was 5.3% among farm residents and 6.4% among nonfarm residents. A greater prevalence of CB is associated with household income adequacy, increasing age, allergies, history of lung disease in a parent, exposure to stubble smoke, obesity, prenatal exposure to smoking, and female sex. Smoking interacted with occupational exposure to wood dust and solvents, and allergic reaction to molds(13).
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