Late Breaking Abstract - Prevalence of chronic wet cough and PBB in Aboriginal children

Abstract

Background: Protracted bacterial bronchitis (PBB) is characterised by chronic wet cough and if left untreated can lead to chronic suppurative lung disease (CSLD). Aboriginal children suffer a disproportionate burden of CSLD. Chronic wet cough is the earliest symptom of CSLD, yet there is no prevalence community data in any setting. The ERS statement on PBB recommended collection of prospective data to identify disease burden and understand its natural history. Aim: To determine prevalence of chronic wet cough and PBB in young Aboriginal children. Methods: A whole population, prospective study. Aboriginal children, 0-7 years were assessed for chronic wet cough by paediatric respiratory clinicians at 2 time points over a 1-month period from July 2018-April 2019 in 4 remote communities in northern Western Australia. Families were first given culturally appropriate lung health information about chronic wet cough. Clinical assessment and parent report of cough character and duration were recorded. Children were followed up one month later where parents were unsure about cough duration or reported short duration. A medical record audit 6-weeks later determined those children with chronic wet cough who had PBB (based on response to antibiotics). Results: 191/203 children (mean age 3.5y, SD 2) were enrolled. 28 were not seen at visit-2, 21/191 (11.0%) had chronic wet cough (mean age 2.9y, SD 2.2) with at least 71.4% having PBB. Discussion: This first ever community study on chronic wet cough and PBB showed that these conditions are prevalent in northern Western Australian communities. Longitudinal follow up and culture appropriate health interventions are required to reduce the burden of future lung disease.