Evaluation of chronic cough in children aged 2 year to 12 years

Abstract

Background: Chronic cough is a common complaint in children which causes distress and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity. Aims and objectives of the study was to evaluate the specific diagnosis and prognosis of chronic cough in children aged 2 to 12 years.Methods: A prospective study was done in 100 children with chronic cough (history of cough >4 weeks) at Narayana Hospital, Nellore. Routine investigations like complete blood count with differential count, Mantoux test, sputum examination, and X ray chest and other investigations like bronchoscopy, HIV, CT scan chest and paranasal sinuses, barium swallow, endoscopy and biopsy whenever needed. Pearson Chi square test carried out to quantify significance difference, p value <0.05, considered significant.Results: The mean duration of chronic cough was 56.27 days (1-5 months). Most of the children belonged to <6 years age with higher boys’ prevalence. Breathlessness and fever noticed in 79% cases; it was found mostly in pneumonia cases as compared to other diagnosis (p=0.001). Sputum production noticed in 4, which found to be bronchiectasis. 1 case noticed with regurgitation, which is gastro oesphageal reflux disease. History of triggers for the symptoms of cough, wheeze and breathlessness is found to have a significant correlation with asthma (p=0.000). Asthma in 14% of cases, of which 12 were mild persistent and 2 were moderate persistent. Tuberculosis was diagnosed in 14% cases, Pneumonia in 12% cases, and Bronchiectasis in 12 cases. Undernourished children noticed in 56%, maximum number in tuberculosis group. Asthma was associated with pneumonia, mucous plug obstruction and collapse lung. Recurrent pneumonia was associated with airway anomaly, gastro esophageal reflux disease.Conclusions: It should be remembered that a prolonged cough can be indicative of a more serious underlying condition, and always warrants thorough investigation.