Lung function in African infants in the Drakenstein child health study impact of lower respiratory tract illness

Gray, Diane M., Turkovic, Lidija, Willemse, Lauren, Visagie, Ane, Vanker, Aneesa, Stein, Dan J., Sly, Peter D., Hall, Graham L. and Zar, Heather J. (2017) Lung function in African infants in the Drakenstein child health study impact of lower respiratory tract illness. American Journal of Respiratory and Critical Care Medicine, 195 2: 212-220. doi:10.1164/rccm.201601-0188OC

Author Gray, Diane M.
Turkovic, Lidija
Willemse, Lauren
Visagie, Ane
Vanker, Aneesa
Stein, Dan J.
Sly, Peter D.
Hall, Graham L.
Zar, Heather J.
Title Lung function in African infants in the Drakenstein child health study impact of lower respiratory tract illness
Journal name American Journal of Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1535-4970
Publication date 2017-01-15
Year available 2017
Sub-type Article (original research)
DOI 10.1164/rccm.201601-0188OC
Open Access Status Not yet assessed
Volume 195
Issue 2
Start page 212
End page 220
Total pages 9
Place of publication New York, NY United States
Publisher American Thoracic Society
Language eng
Subject 2700 Medicine
2740 Pulmonary and Respiratory Medicine
2706 Critical Care and Intensive Care Medicine
Abstract Rationale: Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness reduces lung function. Objectives: To investigate the impact of early life exposures, including lower respiratory tract illness, on lung function during infancy. Methods: Infants enrolled in the Drakenstein child health study had lung function at 6 weeks and 1 year. Testing during quiet natural sleep included tidal breathing, exhaled nitric oxide, and multiple breath washout measures. Risk factors for impaired lung health were collected longitudinally. Lower respiratory tract illness surveillance was performed and any episode investigated. Measurements and Main Results: Lung function was tested in 648 children at 1 year. One hundred and fifty (29%) infants had a lower respiratory tract illness during the first year of life. Lower respiratory tract illness was independently associated with increased respiratory rate (4%; 95% confidence interval [CI], 1.01-1.08; P = 0.02). Repeat episodes further increased respiratory rate (3%; 95% CI, 1.01-1.05; P = 0.004), decreased tidal volume (21.7 ml; 95% CI, 23.3 to 20.2; P = 0.03), and increased the lung clearance index (0.13 turnovers; 95% CI, 0.04-0.22; P = 0.006) compared with infants without illness. Tobacco smoke exposure, lung function at 6 weeks, infant growth, and prematurity were other independent predictors of lung function at 1 year. Conclusions: Early life lower respiratory tract illness impairs lung function at 1 year, independent of baseline lung function. Preventing early life lower respiratory tract illness is important to optimize lung function and promote respiratory health in childhood.
Keyword Epidemiology
Lung function
Lung growth and development
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
HERDC Pre-Audit
Child Health Research Centre Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 8 times in Scopus Article | Citations
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Created: Fri, 01 Dec 2017, 00:40:51 EST