A decade on: Follow‐up findings of indigenous children with Chronic suppurative lung disease/bronchiectasis

Abstract

Introduction/Aim. To our knowledge, only one, small prospective longitudinal study of children with chronic suppurative lung disease (CSLD)/bronchiectasis has been published in the current era. We sought to extend this study by evaluating the longer‐term clinical and lung function outcomes and their associated risk factors in Indigenous children and adolescents from Australia, Alaska and New Zealand who participated in our previous CSLD/bronchiectasis studies during 2004‐2010.

Methods. Between 2015‐2018, we evaluated 131/180 (72.8%) children and adolescents from the original studies at a single follow‐up visit. We conducted standardised questionnaires, clinical examination and spirometry, and reviewed medical records and scored available chest computed‐tomography scans.

Results. Participants were seen at a mean age of 12.3 years (standard deviation 2.6), a median of 9.0 years (range 5.0‐13.0) after their original recruitment. With increasing age, rates of acute lower respiratory infections (ALRI) declined, while lung function was mostly within population norms (median forced expiry volume in one‐second [FEV1] was 90% predicted, interquartile range [IQR] 81‐105; forced vital capacity [FVC] of 98% predicted, IQR 85‐114). However, 43/11 (38.7%) reported chronic cough episodes. Their overall global rating judged by symptoms, including ALRI frequency, in last 12 months, examination findings and spirometry (when available) was well (25/123; 20.3%), stable (54/123; 43.9%) or improved (44/123; 35.8%). Multivariable regression models found household tobacco exposure and age at first ALRI‐episode as independent risk factors associated with lower FVC %predicted values.

Conclusion. With clinical care, the respiratory outcomes in late childhood/early adolescence are encouraging for these patient populations at high‐risk of premature mortality. Prospective studies to further inform management throughout the life course are now needed.