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|Title:||Comparison of First Nations and non-First Nations children's profiles with bronchiectasis over two five-year periods from the Northern Territory, Australia.|
|Authors:||McCallum, Gabrielle B|
Oguoma, Victor M
Versteegh, Lesley A
Wilson, Cate A
Chang, Anne B
|Citation:||Copyright © 2021. Published by Elsevier Inc.|
Chest. 2021 May 5:S0012-3692(21)00865-5. doi: 10.1016/j.chest.2021.04.057.
|Abstract:||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.|
|Click to open Pubmed Article:||https://pubmed-ncbi-nlm-nih-gov.www.ezpdhcs.nt.gov.au/33964302/|
|Appears in Collections:||(a) NT Health Research Collection|
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