TY - JOUR
T1 - Comparison of First Nations and non-First Nations children's profiles with bronchiectasis over two five-year periods from the Northern Territory, Australia
AU - McCallum, Gabrielle B
AU - Oguoma, Victor M
AU - Versteegh, Lesley A
AU - Wilson, Cate A
AU - Bauert, Paul
AU - Spain, Brian
AU - Chang, Anne B
N1 - Funding Information:
FUNDING/SUPPORT: This study was part of a program of research funded by the National Health and Medical Research Council [Grants 1042601 and 101983]. A. B. C. is supported by the National Health and Medical Research Council practitioner fellowship [APP1154302] the and Children's Hospital Foundation Queensland [Grant 50286].
Funding Information:
FUNDING/SUPPORT: This study was part of a program of research funded by the National Health and Medical Research Council [Grants 1042601 and 101983 ]. A. B. C. is supported by the National Health and Medical Research Council practitioner fellowship [APP1154302] the and Children’s Hospital Foundation Queensland [Grant 50286 ].
Publisher Copyright:
© 2021 American College of Chest Physicians
PY - 2021/10
Y1 - 2021/10
N2 - BACKGROUND: Although the burden of bronchiectasis is globally recognised, there is limited paediatric data particularly on trends over the years. There is also no published data on whether vitamin D deficiency/insufficiency and human T-cell lymphotropic virus type 1 (HTLV-1) infection, both found to relate with severe bronchiectasis in First Nations adults, is also important in children with bronchiectasis.RESEARCH QUESTION: Among children with bronchiectasis, has (a) the clinical and bronchoalveolar lavage (BAL) profiles changed between two 5-year periods (period-1=2007-11, period-2=2012-16); and (b) is vitamin D deficiency/insufficiency and/or HTLV-1 infection associated with radiological severity of bronchiectasis?STUDY DESIGN AND METHODS: We analysed the data from children with bronchiectasis prospectively enrolled at Royal Darwin Hospital, Australia at their first diagnosis i.e. no child was in both time-periods. Data collected include demographics, BAL, bloods and computed tomography chest scan evaluated using the Bhalla and modified Bhalla scores.RESULTS: The median age of the 299 children was 2.2 years (interquartile range 1.5-3.7), 168 (56%) males and most were First Nations (92%). Overall, bronchiectasis was high over time, particularly among First Nations children. In the later period, numbers of non-First Nations more than tripled, but did not reach statistical significance. In period-2 compared to period-1, fewer First Nations children had chronic cough (period-1=61%, period-2=47%, p=0.03), were younger, less likely to have received azithromycin (period-1=42%, period-2=21%, p<0.001) and their BAL had lower Haemophilus influenzae and Moraxella catarrhalis infection. HTLV-1 was not detected and vitamin D deficiency/insufficiency did not correlate with severity of bronchiectasis.INTERPRETATION: Bronchiectasis remains high particularly among First Nations children. Important changes that arguably reflect improvements were present, but overall, profiles remained similar. Although Vitamin D deficiency was uncommon, its role in children with bronchiectasis requires further evaluation. HTLV-1 was non-existent and is unlikely to play any role in First Nations children with bronchiectasis.
AB - BACKGROUND: Although the burden of bronchiectasis is globally recognised, there is limited paediatric data particularly on trends over the years. There is also no published data on whether vitamin D deficiency/insufficiency and human T-cell lymphotropic virus type 1 (HTLV-1) infection, both found to relate with severe bronchiectasis in First Nations adults, is also important in children with bronchiectasis.RESEARCH QUESTION: Among children with bronchiectasis, has (a) the clinical and bronchoalveolar lavage (BAL) profiles changed between two 5-year periods (period-1=2007-11, period-2=2012-16); and (b) is vitamin D deficiency/insufficiency and/or HTLV-1 infection associated with radiological severity of bronchiectasis?STUDY DESIGN AND METHODS: We analysed the data from children with bronchiectasis prospectively enrolled at Royal Darwin Hospital, Australia at their first diagnosis i.e. no child was in both time-periods. Data collected include demographics, BAL, bloods and computed tomography chest scan evaluated using the Bhalla and modified Bhalla scores.RESULTS: The median age of the 299 children was 2.2 years (interquartile range 1.5-3.7), 168 (56%) males and most were First Nations (92%). Overall, bronchiectasis was high over time, particularly among First Nations children. In the later period, numbers of non-First Nations more than tripled, but did not reach statistical significance. In period-2 compared to period-1, fewer First Nations children had chronic cough (period-1=61%, period-2=47%, p=0.03), were younger, less likely to have received azithromycin (period-1=42%, period-2=21%, p<0.001) and their BAL had lower Haemophilus influenzae and Moraxella catarrhalis infection. HTLV-1 was not detected and vitamin D deficiency/insufficiency did not correlate with severity of bronchiectasis.INTERPRETATION: Bronchiectasis remains high particularly among First Nations children. Important changes that arguably reflect improvements were present, but overall, profiles remained similar. Although Vitamin D deficiency was uncommon, its role in children with bronchiectasis requires further evaluation. HTLV-1 was non-existent and is unlikely to play any role in First Nations children with bronchiectasis.
KW - bronchiectasis
KW - children
KW - chronic suppurative lung disease
KW - HTLV-1
KW - vitamin d
UR - http://www.scopus.com/inward/record.url?scp=85115937414&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2021.04.057
DO - 10.1016/j.chest.2021.04.057
M3 - Article
C2 - 33964302
SN - 0012-3692
VL - 160
SP - 1200
EP - 1210
JO - Chest
JF - Chest
IS - 4
ER -