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Free Content Long-term morbidity from severe pneumonia in early childhood in The Gambia, West Africa: a follow-up study

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Abstract:

OBJECTIVE: To assess long-term outcomes in severe early childhood pneumonia in The Gambia.

DESIGN: Observational cohort study of children hospitalised with severe pneumonia between 1992 and 1994 compared to age, sex, and neighbourhood-matched controls on measures of current general and pulmonary health.

RESULTS: Of 83 children successfully traced, 68 of the 69 alive at follow-up agreed to participate. Thirteen per cent of cases and 4% of controls had lung disease clinically or on spirometry. Another 16 (13%) participants had abnormal spirometry but did not meet the American Thoracic Society technical criteria (formally ‘inconclusive’). Odds ratios of lung disease among childhood pneumonia cases were 2.93 (95%CI 0.69–12.48, P = 0.1468) with inconclusives omitted; 2.53 (95%CI 0.61–10.59, P = 0.2033) with inconclusives included as normal; and 2.83 (95%CI 1.09–7.36, P = 0.0334) with inconclusives included as lung disease. Among deceased cases, most deaths were reported within weeks of discharge, suggesting a possible connection between admission and subsequent death.

CONCLUSION: These African data, while not conclusive, add to previous data suggesting a link between severe early childhood pneumonia and later chronic lung disease. While larger-scale research is needed, increased awareness of possible long-term morbidity in children with severe pneumonia is warranted to limit its impact and optimise long-term health.

Keywords: childhood pneumonia; chronic lung disease; follow-up

Document Type: Regular Paper

Affiliations: 1: University Health Network, University of Toronto, Toronto, Ontario, Canada; and Bacterial Diseases Programme, Medical Research Council Laboratories, Fajara, The Gambia 2: Bacterial Diseases Programme, Medical Research Council Laboratories, Fajara, The Gambia 3: Center for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada 4: Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK 5: Department of Child and Adolescent Health, World Health Organization, Geneva, Switzerland 6: Nutrition Programme, Medical Research Council Laboratories, Fajara, The Gambia

Publication date: 2009-04-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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