Longitudinal study of quality of life among children with acute respiratory infection and cough

Lovie-Toon, Yolanda; Chang, Anne B.; Newcombe, Peter; Vagenas, Dimitrios; Anderson‐James, Sophie; Drescher, Benjamin J.; Otim, Michael; O’Grady, Kerry-Ann

doi:10.1007/s11136-017-1779-y

Cited by 15 publications

(25 citation statements)

References 34 publications

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“…The most common diagnoses at time of presentation for these children were upper respiratory tract infections (64%), conditions other than those specifically described in Table 1 (11%) and in 12% a diagnosis was not documented in the medical record. Our previous studies indicate children with cough may have multiple presentations to healthcare providers for their cough before presenting to an emergency department (8,34). This reflects parental concern that the cough is not resolving and also the impact on parent and child health-related quality of life, particularly given financial concerns, cough severity and whether cough is occurring during the day, at night or both (8).…”

Section: Discussionmentioning

confidence: 98%

“…Our previous studies indicate children with cough may have multiple presentations to healthcare providers for their cough before presenting to an emergency department (8,34). This reflects parental concern that the cough is not resolving and also the impact on parent and child health-related quality of life, particularly given financial concerns, cough severity and whether cough is occurring during the day, at night or both (8). That the majority had a diagnosis of upper respiratory tract infection highlights the need for parents and healthcare providers to be aware that a third of children presenting with more than 2-weeks of cough may develop chronic cough and seek appropriate review at the 4-weeks timepoint.…”

Section: Discussionmentioning

confidence: 99%

“…However, the sensitivity analyses did not substantially change our findings. It is plausible that loss to follow-up would be more likely in children whose cough has stopped, particularly given the known burden of cough on families (8,35)and that parents in the study were informed at enrolment that if their child had persistent cough at day-28 they would be reviewed by a pediatrician over the following weeks (19).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, chronic cough post ARI is important and knowing, at the point of the acute presentation, who are at risk of developing chronic cough will be clinically useful to clinicians and parents. Intervening early in the transitional stage from acute to chronic cough improves cough outcomes (7), and may reduce the burden on families (8) and the healthcare sector (2). However, although primary-care studies have reported 10% of children with an ARI are still coughing after day-25 (9), there are little data on the predictors of chronic cough in children.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Chronic Cough in Young Children: A Cohort Study

et al. 2020

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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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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Chronic Cough in Young Children: A Cohort Study

et al. 2020

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“…This was evident in that at any timepoint during an ARIwC episode, no more than 20% of parent/guardians reported not being worried about the amount of money spent on their child's cough illness. Being worried about the amount of money spent on a child's ARIwC illness has been reported to negatively impact quality of life (41). This stresses the importance of recognizing the impact of monetary costs on families, as the emotional and social stress of managing an illness in a child may be heightened by the economic burden.…”

Section: Discussionmentioning

confidence: 99%

The Cost of Acute Respiratory Infections With Cough Among Urban Aboriginal and Torres Strait Islander Children

et al. 2018

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Introduction: Acute respiratory infections with cough (ARIwC) contribute considerably to childhood morbidity, yet few studies have examined the cost of these illnesses among Australian children. Moreover, of the few studies that have, none are inclusive of Aboriginal and/or Torres Strait Islander children, despite this population experiencing a greater burden of respiratory illnesses. This study aimed to determine the costs of ARIwC among urban Aboriginal and/or Torres Strait Islander children from the perspective of caretakers, the public healthcare system, and employers.Methods: This cost of illness study used data collected from Aboriginal and/or Torres Strait Islander children aged <5 years enrolled in a 12 month prospective cohort study conducted through an urban primary healthcare clinic in Queensland, Australia. Illness-related resource use was collected for each episode of ARIwC reported, and costed at market rates. Linear regression was used to (a) examine cost per episode by season of illness onset and cough duration and (b) examine cost per month of observation by baseline child and family characteristics.Results: During the study period, a total of 264 episodes of ARIwC were reported among 138 children. The total mean cost was estimated to be $AU252 per non-hospitalized episode (95%CI 169–334). Caretakers, the public healthcare system and employers incurred 44, 39, and 17% of costs per episode, respectively. After accounting for months of completed follow-ups, the total mean cost per child per year was estimated to be $991 (95%CI 514–1468). Winter episodes and episodes resulting in chronic cough were associated with significantly higher costs per episode. A prior history of wheezing, connections to traditional lands and parent/guardian belief that antibiotics should be given until symptoms resolved were associated with significantly higher cost per child month of observation.Conclusion: The cost of ARIwC in this predominantly disadvantaged population is substantial, particularly for caretakers and this needs to be considered in both clinical management and public health initiatives. The importance of cultural factors on health and burden of illness should not be overlooked. Further research into the prevention of chronic cough may play an important role in reducing the economic burden of pediatric respiratory infections.

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Medication and healthcare use, parent knowledge and cough in children: A cohort study

Cheng¹,

Mackie²,

Chang

et al. 2021

Pediatric Pulmonology

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IntroductionCough is an important contributor to the health burden of children and their families. There are limited data describing healthcare utilization and medication use over the course of a cough illness beyond the initial presentation. Our primary objective was to describe medication and healthcare use in children with a respiratory illness with cough as a symptom over the course of the illness.MethodsA cohort study of children aged less than 15‐years presenting to three primary healthcare centers and three emergency departments with a cough illness between July 7, 2015 and October 6, 2018. Children with immunosuppression, known chronic lung diseases (except asthma) and those requiring hospitalization at screening were excluded. The primary outcomes were cough‐related frequency and type of healthcare seeking and medication use up to 28 days following enrolment.ResultsData for 465 children were analyzed; median age 2.2‐years (interquartile range = 1.1–5.3). Cough at Day 28 persisted in 117 children (25.2%). Overall, 436 (94%) children received medications in the week before and/or 4 weeks following enrolment. Half with upper respiratory tract infections were prescribed antibiotics. Among children with no diagnosis of asthma, reactive airways disease or croup (n = 404), 16.8% were given steroids. Fifty‐eight percent of children sought healthcare at least once before their baseline presentation (median = 1, range = 0–20) and 49.7% had at least one further presentation in the following 28 days.ConclusionsHigh healthcare utilization, inappropriate medication use, and suboptimal parent knowledge regarding cough suggests targeted education is needed to improve management and reduce cough burden.

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Longitudinal study of quality of life among children with acute respiratory infection and cough

Cited by 15 publications

References 34 publications

Risk Factors for Chronic Cough in Young Children: A Cohort Study

Risk Factors for Chronic Cough in Young Children: A Cohort Study

The Cost of Acute Respiratory Infections With Cough Among Urban Aboriginal and Torres Strait Islander Children

Medication and healthcare use, parent knowledge and cough in children: A cohort study

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