An overview of respiratory tract infections in South Africa

Respiratory tract infections represent a significant global health concern, including high rates of morbidity and mortality. Upper respiratory tract infections (common cold, rhinosinusitis, tonsillitis, laryngitis and otitis media) are usually mild and self-limiting, while lower respiratory tract infections lead to more severe illness (bronchitis, bronchiolitis and pneumonia), and are still one of the top ten leading causes of mortality. In Africa, and other lower-income countries, the burden especially among children under the age of five years is severe. Respiratory tract infections can be differentiated between upper or lower respiratory tract infections. Upper respiratory tract infections have mainly viral origins and can be treated symptomatically. Lower respiratory tract infections involve bronchi, bronchiole and alveoli, with pneumonia the most common presentation. Management of lower respiratory tract infection depends on the underlying cause, severity, and comorbidities. Viral lower respiratory tract infection requires supportive care such as rest, hydration and antipyretics. Antiviral therapy may be considered for confirmed influenza. Bacterial lower respiratory tract infections, particularly community-acquired pneumonia, require empiric antibiotic therapy guided by local antimicrobial guidelines. As accessible frontline health professionals, pharmacists assess symptoms, identify critical warning signs, and facilitate appropriate referrals, thereby ensuring safe and timely patient care. This paper provides an overview of the relevant symptoms and management of upper and lower respiratory tract infections.