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GP consultations for respiratory tract infections in children aged <5 years: a retrospective cohort study 2016-2023
Kimberley A Foley1, Dougal S Hargreaves2,3, Alex Bottle4
1Department of Primary Care and Public Health, Imperial College London, London, UK k.foley@imperial.ac.uk.
Insights
GP consultation rates for children's respiratory infections decreased post-pandemic, but bacterial infections like tonsillitis and strep A rose significantly. These concerning trends in pediatric respiratory tract infections require ongoing monitoring.
Area of Science:
- Pediatric Health
- Infectious Diseases
- General Practice
Background:
- Post-COVID-19 pandemic, changes in pediatric respiratory tract infection (RTI) consultations with general practitioners (GPs) are not well understood.
- Understanding these shifts is crucial for public health and healthcare resource allocation.
Purpose of the Study:
- To analyze trends in GP consultation rates for RTIs in children under 5 years old.
- To compare post-pandemic consultation data (2021-2023) with pre-pandemic periods (2016-2020).
Main Methods:
- A population-based retrospective cohort study was conducted.
- Electronic health records of children under 5 years old from April 2016 to March 2023 were analyzed.
- Monthly GP consultation rates for RTIs were compared between post-pandemic and pre-pandemic periods.
Main Results:
- Overall monthly GP consultations for pediatric RTIs were 16.8% lower in 2021/22 and 15% lower in 2022/23 compared to pre-pandemic levels.
- While winter peaks were less pronounced initially, the 2022/23 winter peak for 3-4 year olds exceeded previous years by 43.3%, coinciding with a Group A Streptococcus outbreak.
- A significant increase (around 60%) in tonsillitis, Streptococcus A, and bacterial ear infections was observed across all age groups.
Conclusions:
- GP consultations for pediatric RTIs have decreased since the lifting of COVID-19 restrictions.
- A notable and concerning rise in specific bacterial infections, including tonsillitis and Streptococcus A, warrants close monitoring in young children.
Background:
Little is known about how GP consultation rates for children's respiratory tract infections (RTIs) have changed since the COVID-19 pandemic restrictions lifted.
Aim:
To describe changes in GP consultation rates for RTIs in children aged <5 years from 2016 to 2023.
Design & Setting:
A population-based retrospective cohort study using electronic health records from primary care practices across England.
Method:
All children aged <5 years registered with a general practice in the Clinical Practice Research Datalink Aurum database from April 2016 to March 2023 were included. Monthly GP consultation rates for RTIs from April 2021 to March 2023 were compared with the corresponding months during pre-pandemic years (April 2016 to February 2020).
Results:
There were 3 226 285 GP consultations for RTIs among 2 894 539 children. Pre-pandemic, mean monthly consultation rates ranged from lows in August to highs in November (from 2368 to 8682 per 100 000 children, respectively). Following the pandemic lockdowns in 2020, monthly rates in 2021/2022 peaked in June and October at 5152 and 5942 per 100 000 children, respectively, but the winter peak was less marked than pre-pandemic and mean monthly rates were 16.8% lower (95% confidence interval [CI] = - 13.4 to - 19.6). In 2022/2023, after all restrictions were lifted, rates remained around 15% below pre-pandemic years, but the winter peak for children aged 3-4 years was 8615 per 100 000 children, exceeding mean pre-pandemic winter peaks of 6011 per 100 000 children. This was an increase of 43.3% and coincided with a streptococcal group A outbreak. Across all ages there was a sharp increase (from 1486 to 2370 per 100 000 children, around 60%) in tonsillitis, Streptococcus A, and bacterial ear infections.
Conclusion:
This study shows reductions in GP consultations for RTIs in children aged <5 years since the lifting of COVID- 19 pandemic restrictions. Of concern is a sharp rise in tonsillitis, Streptococcus A, and bacterial ear infections that should be monitored.
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