TY - JOUR
T1 - Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004-2010
AU - Dawood, Fatimah S.
AU - Fry, Alicia M.
AU - Goswami, Doli
AU - Sharmeen, Amina
AU - Nahar, Kamrun
AU - Anjali, Bilkis Ara
AU - Rahman, Mustafizur
AU - Brooks, W. Abdullah
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged <5 years in urban Bangladesh. Methods During 2004-2010, respiratory illness surveillance was conducted through weekly home visits. Children with fever or respiratory illness were referred for examination by study physicians including lung auscultation. During 2005-2007, every fifth referred child had nasal washes tested for human metapneumovirus, respiratory syncytial viruses, and influenza and parainfluenza viruses. Results During April 2004-July 2010, 23,609 children were enrolled in surveillance. Of these, 11,912 (50%) were male, median age at enrollment was 20 months (IQR 5-38), and 4,711 (20%) had ≥1 wheezing episode accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at <1 year of age. Among children aged <5 years, incidences of wheezing and wheezing hospitalizations were 2,335/10,000 and 192/10,000 child-years. Twenty-eight percent had recurrent wheezing. Recurrent versus non-recurrent wheezing episodes were more likely to be associated with oxygen saturation <93% (OR 6.9, 95%CI 2.8-17.3), increased work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. Conclusion In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions.
AB - Background Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged <5 years in urban Bangladesh. Methods During 2004-2010, respiratory illness surveillance was conducted through weekly home visits. Children with fever or respiratory illness were referred for examination by study physicians including lung auscultation. During 2005-2007, every fifth referred child had nasal washes tested for human metapneumovirus, respiratory syncytial viruses, and influenza and parainfluenza viruses. Results During April 2004-July 2010, 23,609 children were enrolled in surveillance. Of these, 11,912 (50%) were male, median age at enrollment was 20 months (IQR 5-38), and 4,711 (20%) had ≥1 wheezing episode accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at <1 year of age. Among children aged <5 years, incidences of wheezing and wheezing hospitalizations were 2,335/10,000 and 192/10,000 child-years. Twenty-eight percent had recurrent wheezing. Recurrent versus non-recurrent wheezing episodes were more likely to be associated with oxygen saturation <93% (OR 6.9, 95%CI 2.8-17.3), increased work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. Conclusion In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions.
KW - asthma and early wheeze
KW - epidemiology
KW - infections
KW - international health
KW - pneumonia
KW - viral
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U2 - 10.1002/ppul.23343
DO - 10.1002/ppul.23343
M3 - Article
C2 - 26613245
AN - SCOPUS:84966573811
SN - 8755-6863
VL - 51
SP - 588
EP - 595
JO - Pediatric pulmonology
JF - Pediatric pulmonology
IS - 6
ER -