Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children

Bre Anna Kinghorn, Rosalyn Singleton, Gabrielle B. McCallum, Lisa Bulkow, Keith Grimwood, Leslie Hermann, Anne B. Chang, Gregory Redding

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Introduction: Alaska Native (AN) children from the Yukon Kuskokwim (YK) Delta region have high rates of chronic suppurative lung disease (CSLD), including bronchiectasis. We characterized the clinical progress of an AN adolescent cohort with CSLD/bronchiectasis, and estimated bronchiectasis prevalence trends in this region.

    Methods: The original cohort comprised 41 AN children (originally aged 0.5-8 years) with CSLD/bronchiectasis, recruited between 2005 and 2008, with follow-up in 2015-2016. Clinical assessments, lung function, radiography, medical chart review, and spirometry were obtained. We also conducted data queries of bronchiectasis diagnoses in YK individuals born between 1990 and 2010 to estimate prevalence.

    Results: Thirty-four (83%) of the original cohort aged 7.3-17.6 years were reviewed, of whom 14 (41%) had high-resolution computed tomography (HRCT)-confirmed bronchiectasis, eight (24%) had no evidence of bronchiectasis on HRCT scans, while 12 (35%) had not undergone HRCT scans. Annual lower respiratory tract infection (LRTI) frequency decreased with age, although 27 (79%) still had respiratory symptoms, including all with HRCT-confirmed bronchiectasis, who were also more likely than those without confirmed bronchiectasis to have recent wheeze (80 vs 25%, P = 0.005), auscultatory crackles (60 vs 0%, P < 0.001), and lower mean forced expiratory volume in 1-second/forced vital capacity ratio (73 vs 79%, P = 0.03). The bronchiectasis prevalence for YK AN people born during 2000-2009 was 7 per 1000 births, which was lower than previously reported.

    Conclusion: Despite reduced LRTI frequency, most AN children with CSLD/bronchiectasis had symptoms/signs of underlying lung disease as they entered adolescence. Close clinical follow-up remains essential for managing these patients as they transition to adulthood.

    Original languageEnglish
    Pages (from-to)1662-1669
    Number of pages8
    JournalPediatric Pulmonology
    Volume53
    Issue number12
    Early online date16 Oct 2018
    DOIs
    Publication statusPublished - Dec 2018

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    Bronchiectasis
    Lung Diseases
    Yukon Territory
    Tomography
    Respiratory Tract Infections
    Alaska Natives
    Patient Transfer
    Spirometry
    Vital Capacity
    Respiratory Sounds
    Forced Expiratory Volume
    Population Groups
    Radiography
    Signs and Symptoms
    Parturition

    Cite this

    Kinghorn, B. A., Singleton, R., McCallum, G. B., Bulkow, L., Grimwood, K., Hermann, L., ... Redding, G. (2018). Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children. Pediatric Pulmonology, 53(12), 1662-1669. https://doi.org/10.1002/ppul.24174
    Kinghorn, Bre Anna ; Singleton, Rosalyn ; McCallum, Gabrielle B. ; Bulkow, Lisa ; Grimwood, Keith ; Hermann, Leslie ; Chang, Anne B. ; Redding, Gregory. / Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children. In: Pediatric Pulmonology. 2018 ; Vol. 53, No. 12. pp. 1662-1669.
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    title = "Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children",
    abstract = "Introduction: Alaska Native (AN) children from the Yukon Kuskokwim (YK) Delta region have high rates of chronic suppurative lung disease (CSLD), including bronchiectasis. We characterized the clinical progress of an AN adolescent cohort with CSLD/bronchiectasis, and estimated bronchiectasis prevalence trends in this region. Methods: The original cohort comprised 41 AN children (originally aged 0.5-8 years) with CSLD/bronchiectasis, recruited between 2005 and 2008, with follow-up in 2015-2016. Clinical assessments, lung function, radiography, medical chart review, and spirometry were obtained. We also conducted data queries of bronchiectasis diagnoses in YK individuals born between 1990 and 2010 to estimate prevalence. Results: Thirty-four (83{\%}) of the original cohort aged 7.3-17.6 years were reviewed, of whom 14 (41{\%}) had high-resolution computed tomography (HRCT)-confirmed bronchiectasis, eight (24{\%}) had no evidence of bronchiectasis on HRCT scans, while 12 (35{\%}) had not undergone HRCT scans. Annual lower respiratory tract infection (LRTI) frequency decreased with age, although 27 (79{\%}) still had respiratory symptoms, including all with HRCT-confirmed bronchiectasis, who were also more likely than those without confirmed bronchiectasis to have recent wheeze (80 vs 25{\%}, P = 0.005), auscultatory crackles (60 vs 0{\%}, P < 0.001), and lower mean forced expiratory volume in 1-second/forced vital capacity ratio (73 vs 79{\%}, P = 0.03). The bronchiectasis prevalence for YK AN people born during 2000-2009 was 7 per 1000 births, which was lower than previously reported. Conclusion: Despite reduced LRTI frequency, most AN children with CSLD/bronchiectasis had symptoms/signs of underlying lung disease as they entered adolescence. Close clinical follow-up remains essential for managing these patients as they transition to adulthood.",
    keywords = "adolescent, Alaska Native, asthma bronchiectasis, child, chronic suppurative lung disease, cough, spirometry, wheeze",
    author = "Kinghorn, {Bre Anna} and Rosalyn Singleton and McCallum, {Gabrielle B.} and Lisa Bulkow and Keith Grimwood and Leslie Hermann and Chang, {Anne B.} and Gregory Redding",
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    Kinghorn, BA, Singleton, R, McCallum, GB, Bulkow, L, Grimwood, K, Hermann, L, Chang, AB & Redding, G 2018, 'Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children', Pediatric Pulmonology, vol. 53, no. 12, pp. 1662-1669. https://doi.org/10.1002/ppul.24174

    Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children. / Kinghorn, Bre Anna; Singleton, Rosalyn; McCallum, Gabrielle B.; Bulkow, Lisa; Grimwood, Keith; Hermann, Leslie; Chang, Anne B.; Redding, Gregory.

    In: Pediatric Pulmonology, Vol. 53, No. 12, 12.2018, p. 1662-1669.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska Native children

    AU - Kinghorn, Bre Anna

    AU - Singleton, Rosalyn

    AU - McCallum, Gabrielle B.

    AU - Bulkow, Lisa

    AU - Grimwood, Keith

    AU - Hermann, Leslie

    AU - Chang, Anne B.

    AU - Redding, Gregory

    PY - 2018/12

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    N2 - Introduction: Alaska Native (AN) children from the Yukon Kuskokwim (YK) Delta region have high rates of chronic suppurative lung disease (CSLD), including bronchiectasis. We characterized the clinical progress of an AN adolescent cohort with CSLD/bronchiectasis, and estimated bronchiectasis prevalence trends in this region. Methods: The original cohort comprised 41 AN children (originally aged 0.5-8 years) with CSLD/bronchiectasis, recruited between 2005 and 2008, with follow-up in 2015-2016. Clinical assessments, lung function, radiography, medical chart review, and spirometry were obtained. We also conducted data queries of bronchiectasis diagnoses in YK individuals born between 1990 and 2010 to estimate prevalence. Results: Thirty-four (83%) of the original cohort aged 7.3-17.6 years were reviewed, of whom 14 (41%) had high-resolution computed tomography (HRCT)-confirmed bronchiectasis, eight (24%) had no evidence of bronchiectasis on HRCT scans, while 12 (35%) had not undergone HRCT scans. Annual lower respiratory tract infection (LRTI) frequency decreased with age, although 27 (79%) still had respiratory symptoms, including all with HRCT-confirmed bronchiectasis, who were also more likely than those without confirmed bronchiectasis to have recent wheeze (80 vs 25%, P = 0.005), auscultatory crackles (60 vs 0%, P < 0.001), and lower mean forced expiratory volume in 1-second/forced vital capacity ratio (73 vs 79%, P = 0.03). The bronchiectasis prevalence for YK AN people born during 2000-2009 was 7 per 1000 births, which was lower than previously reported. Conclusion: Despite reduced LRTI frequency, most AN children with CSLD/bronchiectasis had symptoms/signs of underlying lung disease as they entered adolescence. Close clinical follow-up remains essential for managing these patients as they transition to adulthood.

    AB - Introduction: Alaska Native (AN) children from the Yukon Kuskokwim (YK) Delta region have high rates of chronic suppurative lung disease (CSLD), including bronchiectasis. We characterized the clinical progress of an AN adolescent cohort with CSLD/bronchiectasis, and estimated bronchiectasis prevalence trends in this region. Methods: The original cohort comprised 41 AN children (originally aged 0.5-8 years) with CSLD/bronchiectasis, recruited between 2005 and 2008, with follow-up in 2015-2016. Clinical assessments, lung function, radiography, medical chart review, and spirometry were obtained. We also conducted data queries of bronchiectasis diagnoses in YK individuals born between 1990 and 2010 to estimate prevalence. Results: Thirty-four (83%) of the original cohort aged 7.3-17.6 years were reviewed, of whom 14 (41%) had high-resolution computed tomography (HRCT)-confirmed bronchiectasis, eight (24%) had no evidence of bronchiectasis on HRCT scans, while 12 (35%) had not undergone HRCT scans. Annual lower respiratory tract infection (LRTI) frequency decreased with age, although 27 (79%) still had respiratory symptoms, including all with HRCT-confirmed bronchiectasis, who were also more likely than those without confirmed bronchiectasis to have recent wheeze (80 vs 25%, P = 0.005), auscultatory crackles (60 vs 0%, P < 0.001), and lower mean forced expiratory volume in 1-second/forced vital capacity ratio (73 vs 79%, P = 0.03). The bronchiectasis prevalence for YK AN people born during 2000-2009 was 7 per 1000 births, which was lower than previously reported. Conclusion: Despite reduced LRTI frequency, most AN children with CSLD/bronchiectasis had symptoms/signs of underlying lung disease as they entered adolescence. Close clinical follow-up remains essential for managing these patients as they transition to adulthood.

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    KW - Alaska Native

    KW - asthma bronchiectasis

    KW - child

    KW - chronic suppurative lung disease

    KW - cough

    KW - spirometry

    KW - wheeze

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