The risk of hospitalization for respiratory tract infection (RTI) in children who are treated with high-dose IVIG in Kawasaki Disease: a nationwide population-based matched cohort study.

BACKGROUND: Kawasaki disease (KD) is an immune-mediated systemic vasculitis, and infection plays an important role in the pathophysiology of KD. The susceptibility to infectious disease in patients with KD remains largely unclear. This study aimed to investigate the risk of respiratory tract infection (RTI)-related hospitalizations in children with KD. METHODS: Data from the Taiwanese National Health Insurance Research Database was analyzed. We excluded patients with history of congenital abnormality, allergic diseases, or hospitalization history. Children with KD were selected as KD group and age- and sex-matched non-KD patients were selected as control group with 1:4 ratio. Both cohorts were tracked for one year to investigate the incidences of RTI-related hospitalizations. Cox regression hazard model was used to adjust for confounding factors and calculate the adjusted hazard ratio (aHR). RESULTS: Between January 1996 and December 2012, 4,973 patients with KD were identified as the KD group and 19,683 patients were enrolled as the control group. An obviously reduced risk of RTI-related hospitalizations was observed in KD patients (aHR: 0.75, 95% CI [0.66-0.85]). The decreased risk persisted through the first six-months follow-up period with a peak protection in 3-6 months (aHR: 0.49, 95% CI [0.37-0.64]). CONCLUSIONS: KD patients had approximately half reduction of risk for RTI-related hospitalizations. The protective effects persisted for at least six months. Further studies are warranted to elucidate the entire mechanism and investigate the influences of intravenous immunoglobulin.

Seroprevalence of Helicobacter pylori and Hepatitis A Virus among Children in Rural Central Taiwan.

Helicobacter pylori and hepatitis A virus (HAV) are thought to have similar routes of transmission and epidemiology. This study investigated the seroprevalence of these 2 pathogens among children in rural, central Taiwan. Serum samples were collected from 856 children between 2010 and 2012 and levels of anti-HAV and anti-H. pylori antibodies were measured by ELISA. Questionnaires were used to investigate possible risk factors. The overall H. pylori and HAV infection rates were 6% and 0.8%, respectively. There was a significant difference in H. pylori infection rates (P value=0.008), but not HAV infection rates, between different age groups. H. pylori infection rates were significantly higher in children whose mothers had lower education levels. In contrast, HAV infection rates were significantly higher in children whose fathers had lower education levels. The risk of HAV infection was also 14.20-fold higher in children whose family members had traveled to China or Southeast Asia. No significant correlation was found between H. pylori and HAV seropositivity. The seroprevalences of H. pylori and HAV were low in rural central Taiwan. Universal HAV vaccination is highly recommended to prevent outbreak due to low seroprevalence.