Adult outcomes of childhood bronchiectasis

• Published in: International Journal of Circumpolar Health
• Main Authors: Dawn Sibanda, Rosalyn Singleton, John Clark, Christine Desnoyers, Ellen Hodges, Gretchen Day, Gregory Redding
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2020
• Subjects: chronic lung disease; bronchiectasis; adolescence; indigenous; native american; transition; Arctic medicine. Tropical medicine; RC955-962; Arctic; Yukon; Circumpolar Health; International Journal of Circumpolar Health; Kuskokwim; Alaska
• Online Access: https://doi.org/10.1080/22423982.2020.1731059; https://doaj.org/article/949341e45db54e40bbc8b10a6559b173

Recent literature has highlighted the importance of transition from paediatric to adult care for children with chronic conditions. Non-cystic fibrosis bronchiectasis is an important cause of respiratory morbidity in low-income countries and in indigenous children from affluent countries; however, there is little information about adult outcomes of childhood bronchiectasis. We reviewed the clinical course of 31 Alaska Native adults 20–40 years of age from Alaska’s Yukon Kuskokwim Delta with childhood bronchiectasis. In patients with chronic suppurative lung disease, a diagnosis of bronchiectasis was made at a median age of 4.5 years by computerised tomography (68%), bronchogram (26%), and radiographs (6%). The patients had a median of 75 lifetime respiratory ambulatory visits and 4.5 hospitalisations. As children, 6 (19%) experienced developmental delay; as adults 9 (29%) experienced mental illness or handicap. Four (13%) patients were deceased, four (13%) had severe pulmonary impairment in adulthood, 17 (54%) had persistent or intermittent respiratory symptoms, and seven (23%) were asymptomatic. In adulthood, only five were seen by adult pulmonologists and most had no documentation of a bronchiectasis diagnosis. Lack of provider continuity, remote location and co-morbidities can contribute to increased adult morbidity. Improving the transition to adult care starting in adolescence and educating adult providers may improve care of adults with childhood bronchiectasis.