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