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Risk Factors for Chronic Cough in Young Children: A Cohort Study
Yin To Au-Yeung1, Anne B Chang1,2,3, Keith Grimwood4,5,6
1Australian Center for Health Services Innovation@ Centre for Healthcare Transformation, Queensland University of Technology, South Brisbane, QLD, Australia.
Insights
Young children attending childcare while sick are at higher risk for developing chronic cough. Factors like prematurity and prior wheezing also predict persistent cough in this age group.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Public Health
Background:
- Chronic cough in young children lacks extensive predictor data.
- Childcare attendance is a potential factor in cough development.
Purpose of the Study:
- To identify factors predicting chronic cough in children under six.
- To specifically investigate the role of childcare attendance.
Main Methods:
- Secondary analysis of a prospective cohort study.
- Followed 362 children (<6 years) presenting with cough for 28 days.
- Used logistic regression to identify predictors of persistent cough.
Main Results:
- 26.2% of children developed chronic cough.
- Predictors included: young age (<12 months), prematurity, medical conditions, prior wheeze, and childcare attendance.
- Continuing childcare while ill strongly predicted chronic cough (aOR=12.9).
Conclusions:
- Gestational age, medical history, wheezing, and childcare are significant risk factors for chronic cough.
- Parents should limit childcare for sick children.
- Childcare facilities need to enhance infection prevention measures.
Abstract:
Background and Objective: Data on the predictors of chronic cough development in young children are scarce. Our primary objective was to examine the factors associated with young children developing a chronic cough, with a focus on childcare attendance. Methods: A secondary analysis of data collected in a prospective cohort study of children presenting to three emergency departments and three primary healthcare centers in southeast Queensland, Australia. Eligible children where those aged <6-years presenting with cough and without known underlying chronic lung disease other than asthma. Children were followed for 4 weeks to ascertain cough duration. The primary outcome was persistent cough at day-28. Logistic regression models were undertaken to identify independent predictors of chronic cough including sensitivity analyses that accounted for children with unknown cough status at day-28. Results: In 362 children, 95 (26.2%) were classified as having chronic cough. In models that included only children for whom cough status was known at day-28, symptom duration at enrolment, age <12 months [adjusted odds ratio (aOR) 4.5, 95% confidence interval (CI) 1.1, 18.7], gestational age (aOR 3.2, 95%CI 1.4, 7.9), underlying medical conditions (aOR 2.6, 95% CI 1.3, 5.5), a history of wheeze (aOR 2.6, 95% CI 1.4, 4.8) and childcare attendance (aOR 2.3, 95% CI 1.2, 4.4) were independent predictors of chronic cough. Amongst childcare attendees only, 64 (29.8%) had chronic cough at day-28. The strongest predictor of chronic cough amongst childcare attendees was continued attendance at childcare during their illness (aOR = 12.9, 95% CI 3.9, 43.3). Conclusion: Gestational age, underlying medical conditions, prior wheeze and childcare attendance are risk factors for chronic cough in young children. Parents/careers need to be aware of the risks associated with their child continuing to attend childcare whilst unwell and childcare centers should reinforce prevention measures in their facilities.
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