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Respiratory Exacerbations in Indigenous Children from Two Countries with Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis

Redding, Gregory J., Singleton, Rosalyn J., Valery, Patricia C., Williams, Hayley, Grimwood, Keith, Morris, Peter S., Torzillo, Paul J., McCallum, Gabrielle B., Chikoyak, Lori, Holman, Robert C. and Chang, Anne B. (2014). Respiratory Exacerbations in Indigenous Children from Two Countries with Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis. Chest,146(3):762-774.

Document type: Journal Article
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IRMA ID 11436xPUB3
Title Respiratory Exacerbations in Indigenous Children from Two Countries with Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis
Author Redding, Gregory J.
Singleton, Rosalyn J.
Valery, Patricia C.
Williams, Hayley
Grimwood, Keith
Morris, Peter S.
Torzillo, Paul J.
McCallum, Gabrielle B.
Chikoyak, Lori
Holman, Robert C.
Chang, Anne B.
Journal Name Chest
Publication Date 2014
Volume Number 146
Issue Number 3
ISSN 0012-3692   (check CDU catalogue  open catalogue search in new window)
Start Page 762
End Page 774
Total Pages 13
Place of Publication United States of America
Publisher American College of Chest Physicians
HERDC Category C1 - Journal Article (DIISR)
Abstract
BACKGROUND
: Acute respiratory exacerbations (AREs) cause morbidity and lung function decline in children with chronic suppurative lung disease (CSLD) and bronchiectasis. In a prospective longitudinal cohort study, we determined the patterns of AREs and factors related to increased risks for AREs in children with CSLD/bronchiectasis.
METHODS:
Ninety-three indigenous children aged 0.5 to 8 years with CSLD/bronchiectasis in Australia (n = 57) and Alaska (n = 36) during 2004 to 2009 were followed for > 3 years. Standardized parent interviews, physical examinations, and medical record reviews were undertaken at enrollment and every 3 to 6 months thereafter.
RESULTS:
Ninety-three children experienced 280 AREs (median = 2, range = 0-11 per child) during the 3-year period; 91 (32%) were associated with pneumonia, and 43 (15%) resulted in hospitalization. Of the 93 children, 69 (74%) experienced more than two AREs over the 3-year period, and 28 (30%) had more than one ARE in each study year. The frequency of AREs declined significantly over each year of follow-up. Factors associated with recurrent (two or more) AREs included age < 3 years, ARE-related hospitalization in the first year of life, and pneumonia or hospitalization for ARE in the year preceding enrollment. Factors associated with hospitalizations for AREs in the first year of study included age < 3 years, female caregiver education, and regular use of bronchodilators.
CONCLUSIONS:
AREs are common in children with CSLD/bronchiectasis, but with clinical care and time AREs occur less frequently. All children with CSLD/bronchiectasis require comprehensive care; however, treatment strategies may differ for these patients based on their changing risks for AREs during each year of care.

DOI http://dx.doi.org/10.1378/chest.14-0126   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Description for Link Link to publisher's version
URL http://journal.publications.chestnet.org/article.aspx?articleid=1870142
 
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