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Chronic suppurative lung disease in a developing country: impact on child and parent
Anna Marie Nathan1, Ananthan Muthusamy, Surendran Thavagnanam
1Department of Paediatrics, University Malaya, Kuala Lumpur, Malaysia; University Malaya Paediatrics and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia.
Insights
Chronic suppurative lung disease (CSLD) negatively impacts child growth, lung function, and quality of life. Children with cystic fibrosis (CF) showed better growth and parental mental health outcomes compared to other CSLD types.
Area of Science:
- Pediatric Pulmonology
- Child Health Outcomes
- Chronic Lung Disease Research
Background:
- Chronic suppurative lung disease (CSLD) encompasses conditions like bronchiectasis and bronchiolitis obliterans, significantly affecting children's health.
- Assessing the long-term effects of CSLD on pediatric growth, pulmonary function, and overall quality of life is crucial for effective management.
Purpose of the Study:
- To evaluate the impact of CSLD on growth, lung function, and quality of life in affected children.
- To compare outcomes between children with cystic fibrosis (CF) and other CSLD etiologies.
- To assess parental mental health in caregivers of children with CSLD.
Main Methods:
- A cross-sectional study involving 60 children diagnosed with CSLD (including CF, bronchiectasis, and bronchiolitis obliterans).
- Comparison of anthropometric measurements from diagnosis to follow-up, alongside lung function data.
- Administration of the Parent Cough-Specific Quality of Life (PC-QOL) and Depression, Anxiety and Stress (DASS21) questionnaires to parents.
Main Results:
- Children with CF demonstrated improved weight and BMI, unlike those with non-CF CSLD.
- A significant majority (78%) of children exhibited lung function below 80% of predicted values.
- Low PC-QOL scores were reported, with no significant association between exacerbation frequency/cough and QOL.
- Elevated DASS21 scores indicated significant stress (54%) and depression (51%) among parents, with better mental health observed in parents of children with CF.
Conclusions:
- CSLD adversely affects pediatric growth, lung function, and quality of life.
- Children with CF experienced better growth outcomes and had parents with improved mental health compared to other CSLD groups.
- The findings highlight the need for comprehensive support for children with CSLD and their families.
Objectives:
To investigate the impact of chronic suppurative lung disease (CSLD) on growth and lung function in the child as well as quality of life of the child and parent.
Methods:
Cross-sectional study in 60 children with CSLD, bronchiectasis (including cystic fibrosis) and bronchiolitis obliterans. Thirty-five parents were interviewed while the remaining patients' data were collated from medical notes. Anthropometric measurements at first diagnosis and at interview were compared. The most recent lung function was also collected. The Parent Cough-Specific Quality of Life (PC-QOL) and the Depression, Anxiety and Stress (DASS21) questionnaires were administered to parents.
Results:
The median (range) age at diagnosis was 1.3 (0.2-11) years. The median (IQR) duration between anthropometric measurements was 35 (15, 59) months. Children with cystic fibrosis (CF) had improvements both in weight and BMI, whereas children with non-CF CSLD had no improvements in any growth parameter. Seventy-eight percent of children who performed spirometry had values <80% of normal predicted value. PC-QOL scores were low. Frequent exacerbations (more than twice in the past 6 months) and cough (more than 2 days/week) were not associated with significantly lower PC-QOL scores. Seventy-seven percent of interviewed parents had abnormal DASS21 scores with 54% being stressed and 51% being depressed. Mental health was better in parents of children with CF.
Conclusion:
CSLD had a negative impact on growth, lung function, and quality of life. Children with CF had a better outcome in growth as well as better parental mental health compared to children with other etiologies. Pediatr Pulmonol. 2014; 49:435-440. © 2013 Wiley Periodicals, Inc.
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