International Journal of Respiratory Medicine

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Screening score to identify people prone to respiratory tract infections in the community.

Background: Respiratory tract infections (RTIs) are a major cause of morbidity in society. A proportion of the general population suffers more often from recurrent and severe RTI compared to the vast majority. We aim to identify those in the population at risk for recurrent RTI with the help of a questionnaire-derived score. Method: A population-based study, termed the Airway Infection Susceptibility (AWIS) study, was conducted between December 2011 and March 2013 in South Baden, Germany. From a total of 69, 695 individuals approached via mail 12, 839 individuals in the age range of 18 to 70 years completed the screening questionnaire. A predefined RTI-score was calculated as a weighted sum of relevant questionnaire items. Regression models were used to assess the association of potential risk factors and co-morbidities with the score. The score was prospectively validated among 1459 individuals who reported their monthly RTI prevalence in three consecutive winterspring seasons using a summary measure. Results: Repeated severe or long lasting RTIs during adulthood were reported by 12% and 18% of the study participants. The RTI-score correlated positively with female sex, younger age, and frequent contact to children, smoking status, and obesity as well as a number of co-morbidities, most strongly asthma and chronic obstructive pulmonary disease. The monthly prevalence of most RTI symptom categories in the subsequent infection seasons approximately doubled between the low to medium and quintupled between the low to high baseline score category. Bronchitis was reported by 2.3%, 11.6%, and 19.4% of individuals in the low, medium, and high baseline category, respectively. Furthermore, 33.7% of the high baseline score group compared to only 6.4% of the low score group reported significant infection related impairments of their daily activities. Conclusion: The RTI-score applied in this study helps to identify adults in the community prone to RTI who might benefit from preventive measures.

Author(s): Alexandra Nieters*, Susanne Weber, Magdeldin Elgizouli, Livia Maccioni, Stefan Wolfrum,Jacques T. Tshiang, Ilona Geist, Hans-Hartmut Peter, Werner Vach