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Improvements in lung function of a pediatric cystic fibrosis population in a developing country
Brenda M Morrow1, Andrew C Argent, Heather J Zar
1School of Child and Adolescent Health, University of Cape Town (UCT), Cape Town, WC, South Africa. brenda.morrow@uct.ac.za
Insights
Pediatric cystic fibrosis patients in South Africa showed a 20% improvement in pulmonary function over eight years. This progress in lung function for children with cystic fibrosis highlights enhanced medical care.
Area of Science:
- Pulmonology
- Pediatrics
- Medical Research
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, primarily the lungs.
- Pulmonary function decline is a major concern in pediatric CF management.
- Optimizing care for CF patients is crucial for long-term outcomes.
Purpose of the Study:
- To assess changes in pulmonary function among pediatric cystic fibrosis patients.
- To document the evolution of lung function over an 8-year period (1999-2006).
- To evaluate the impact of care improvements in a South African CF population.
Main Methods:
- Retrospective analysis of medical records for pediatric CF patients.
- Inclusion of spirometry results at 3-month intervals.
- Comparison of pulmonary function data between 1999 and 2006.
Main Results:
- Significant improvement in pulmonary function tests (PFTs) observed over 8 years.
- Forced expiratory volume in 1 second (FEV1) increased from 61% to 81% predicted.
- Forced vital capacity (FVC) and average expiratory flow also showed marked increases.
Conclusions:
- Pulmonary function in pediatric CF patients improved by approximately 20% over the study period.
- Increased azithromycin use correlated with improved lung function.
- Enhanced clinical management likely contributed to better outcomes for South African children with CF.
Objective:
To document the change in pulmonary function of a pediatric cystic fibrosis population managed at the Red Cross War Memorial Children's Hospital, Cape Town, South Africa, between January 1999 and December 2006.
Methods:
Retrospective review of the medical records and best spirometry results within 3-monthly intervals.
Results:
A total of 1,139 pulmonary function tests from 79 patients showed a significant improvement over the 8 years studied. When comparing the first quarter of 1999 with the last quarter of 2006, 78 pulmonary function tests were performed on 65 patients with equal patient numbers in both groups and similar in terms of gender, age, age at diagnosis, ethnicity, cystic fibrosis genotype and number of patients colonized with either Staphylococcus aureus or Pseudomonas aeruginosa. In 2006, 15 patients (38.5%) were on azithromycin treatment compared to one (2.6%) patient in 1999 (p = 0.0003). Median (interquartile range) forced expiratory volume in 1 second, forced vital capacity, and average expiratory flow between 25 and 75% of forced vital capacity increased from 61% (51-73), 63% (52-89), and 40% (27-57), predicted in the first quarter of 1999, to 81% (69-100, p = 0.004), 82% (70-98, p = 0.007), and 62% (41-87, p = 0.01), predicted during the last quarter of 2006, respectively.
Conclusions:
Pulmonary function tests increased by 20% over 8 years in comparable patient groups. This likely reflects improved care of South African children with cystic fibrosis.
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