Acute bronchiolitis in infants: epidemiology, diagnosis and management
DOI:
https://doi.org/10.5281/zenodo.22137060Keywords:
bronchiolitis, respiratory syncytial virus, infant, hospitalization, Brazil, ParaguayAbstract
Introduction: Acute bronchiolitis is the most common lower respiratory tract infection in the first year of life and the leading cause of infant hospitalization; respiratory syncytial virus accounts for 60% to 80% of cases. The aim was to gather evidence available through May 2024 on the epidemiology, diagnosis, treatment and prevention of bronchiolitis, with emphasis on Brazil and Paraguay. Materials and methods: Narrative review of evidence available through May 2024. Results: In 2019 an estimated 33 million episodes of lower respiratory infection due to respiratory syncytial virus occurred worldwide in children under five years, with 3.6 million hospitalizations and about 101 400 attributable deaths, more than 95% in low- and middle-income countries; the burden concentrates in the first six months of life and in preterm infants. Diagnosis is clinical and does not require virological testing or chest radiography. Treatment is supportive: hydration and oxygen therapy; bronchodilators, corticosteroids and antibiotics are not recommended. Data from Brazil and Paraguay confirm predominance in infants under one year, a winter peak, and the weight of prematurity, comorbidities, low socioeconomic level and lack of exclusive breastfeeding. Conclusions: Prevention has changed with the long-acting monoclonal antibody and maternal vaccine against respiratory syncytial virus; in Brazil and Paraguay the challenge is implementation: aligning practice with evidence, strengthening breastfeeding promotion and preparing for equitable introduction of the new immunization tools.References
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Copyright (c) 2024 Renata Cialdine Silveira, Renato Corrêa Estrela, Silvio Moreira Neto, Júlia Gabriela Benítez (Autor/a)
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