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Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004–2010
Author(s) -
Dawood Fatimah S.,
Fry Alicia M.,
Goswami Doli,
Sharmeen Amina,
Nahar Kamrun,
Anjali Bilkis Ara,
Rahman Mustafizur,
Brooks W. Abdullah
Publication year - 2016
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23343
Subject(s) - medicine , pediatrics , respiratory sounds , incidence (geometry) , auscultation , asthma , respiratory system , physics , optics
Summary 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. Pediatr Pulmonol. 2016;51:588–595 . © 2015 Wiley Periodicals, Inc.