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-Nd��, Seraphine Nkie Esemu, Richard Njouom, Lucy Ndip
Author Information
Sebastien Kenmoe: Department of Microbiology and Parasitology, University of Buea, Buea 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: 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: Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon.
Ginette Irma Kame-Ngasse: Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon.
Jean Bosco Taya-Fokou: Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
Chris Andre Mbongue Mikangue: Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
Raoul Kenfack-Momo: Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon.
Donatien Serge Mbaga: Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
Arnol Bowo-Ngandji: Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
Cyprien Kengne-Nd��: Epidemiological Surveillance, Evaluation and Research Unit, National Aids Control Committee, Douala 00237, Cameroon.
Seraphine Nkie Esemu: Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon.
Richard Njouom: Department of Virology, Centre Pasteur of Cameroon, Yaounde 00237, Cameroon.
Lucy Ndip: Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon.
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 ( = 0.671), but there was significant heterogeneity [ = 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.
