Prevalence and risk factors of recurrent respiratory tract infections in preschool children: a systematic review and meta-analysis

Abstract

OBJECTIVE: To evaluate the prevalence and risk factors for recurrent respiratory tract infections in preschool children. METHODS: Studies on RRTIs in preschool children were retrieved from PubMed, Cochrane Library, Embase, Web of Science, CBM, CNKI, Wanfang, and VIP databases up to October 2025. Data was analyzed using Stata 15.0. RESULTS: Ten studies involving 15,271 preschoolers were included. Meta-analysis showed that the overall prevalence was 24.14% [95% CI (0.23,0.33)].A total of 11 risk factors for RRTIs in preschool children were identified, including: asthma I² = 93.8%) [OR = 3.84, 95% CI (1.97, 7.47), P < 0.001], allergy(I² = 0) [OR = 2.27, 95% CI (2.06, 2.51), P < 0.001], dietary bias I² = 65%) [OR = 2.10, 95% CI (1.37, 3.24), P = 0.001], smoking co-resident(I² = 42.7%) [OR = 1.83, 95% CI (1.44, 2.32), P < 0.001], low parental education level(I² = 0) [OR = 3.17, 95% CI (1.76, 5.69), P < 0.001], initial use of antibiotics < 6 months(I² = 0) [OR = 1.70, 95% CI (1.50, 1.93), P < 0.001], maternal BMI per 3 kg/m² increment(I² = 0) [OR = 1.18, 95% CI (1.08, 1.28), P < 0.001], and breastfeeding duration < 6 months(I² = 0) [OR = 1.26, 95% CI (1.12, 1.42), P < 0.001]. CONCLUSION: The high prevalence (24.14%) of RRTIs in preschool children and the risk factors identified provide evidence for targeted prevention and intervention strategies.