Characteristics of acute respiratory infections and healthcare-seeking behaviors among a community population in Kunming from 2023 to 2025

Objective To investigate the status of acute respiratory infections (ARI) and healthcare-seeking behavior characteristics among a community population after the COVID-19 pandemic, and to provide evidence for optimizing prevention and control strategies for respiratory infectious diseases.Methods A prospective cohort study was conducted. From February to April 2023, a community-based cohort was established in Majie Subdistrict, Xishan District, Kunming City, Yunnan Province. A total of 1774 participants were recruited. Five follow-up surveys were conducted from April 2023 to April 2025. Data on ARI occurrence, clinical symptoms, and healthcare-seeking behaviors were collected through face-to-face structured questionnaires. ARI was defined based on self-reported acute respiratory symptoms. Healthcare-seeking behaviors included self-medication, visiting medical institutions, and no treatment. 1411 participants attending ≥3 follow-ups without missing two consecutive follow-ups were finally included in the analyses. Results Among the 1411 participants, 1183 reported experiencing ARI during the study period, with a cumulative incidence of 83.84% (95%CI: 81.82%-85.73%) and an overall incidence density of 136518 per 100000 person-years (95%CI: 132218-140923 per 100000 person-years). A total of 64.28% (907/1411) experienced ≥2 episodes of infection. Age-specific differences were observed in the frequency of ARI episodes. Among all age groups, children aged 0-5 years old had the highest proportion of recurrent infections (≥4 episodes), exceeding 50%. ARI symptoms in children aged 0-5 years old were mainly characterized by cough, nasal congestion/runny nose, and fever, whereas chest pain and dyspnea were relatively more common among older adults. After experiencing ARI, self-medication was the most common healthcare-seeking behavior, accounting for 68.22%, while only 29.44% of participants sought care at medical institutions. Among individuals aged ≥75 years old, more than 80% either self-medicated or received no treatment. Children under 5 years old had the highest proportion of visits to medical institutions (39.22%), though still less than half. Conclusion From April 2023 to April 2025, the cumulative incidence of ARI among the community population in Kunming was relatively high, and healthcare-seeking behaviors varied among age groups. The findings indicate that greater attention should be paid to populations at higher risk of severe outcomes following ARI, particularly children and older adults. Health education and public awareness campaigns should be strengthened to improve timely healthcare-seeking awareness after symptom onset and encourage standardized medical consultation during the early stage of illness, thereby reducing disease progression and the occurrence of adverse outcomes.