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Table 2 Case-control and follow-up studies examining the effects of childhood pneumonia upon adult lung function

From: Long-term effects of pneumonia in young children

Study Type of study Country Year(s) of inception Year(s) of study Source of diagnosis No. with pneumonia No. with pneumonia studied (%) No. without pneumonia studied Ages (years) Median follow-up (years) Main findings
Tennant et al. [30]a Case-control (done in adolescence and again in adulthood) UK 1947 1961–62,
1996–98
Doctor or study team diagnosis of severe lower respiratory illness before 5 yrs of age 167 167 (100) 85 14
49–51
14
50
Severe lower respiratory illness before age 5 yrs was independently associated with lower FEVl at 14 yrs of age (p = 0.004) and a greater overall decline in FEV1 between 14 to 51 yrs of age (p = 0.047).
Mok & Simpson [31]b Case-control UK 1971–74 1978–81 Infants hospitalised with CXR documented 51 51 (100) 51c 7.20 ± 0.44d 7 Ongoing respiratory symptoms in the previous year were significantly higher in the pneumonia group than controls. This included wheeze (p < 0.01), chest infections (p < 0.001), using medications (p < 0.001) and school missed from respiratory illness (p < 0.01). Study also had 102 children hospitalised with bronchiolitis and 44 with bronchitis. Compared with controls, those with bronchiolitis had significantly lower FEV1 (p < 0.05), but not FVC values. Although findings were similar in pneumonia group, the difference was not statistically significant.
Eastham et al. [19]b Controlled follow-up study UK 1995–98 NR Clinical with CXR confirmation aged 5–16 yrs 159 103 (65) 248e NR 5.6
(4.4–7.4)e
Pneumonia is independent risk factor for persistent cough (OR 2.9 [95% CI 1.45, 5.71; p = 0.02) and asthma (OR 4.8 [95% CI 1.43, 16.34]) in cases with non-atopic parents. Compared to controls, cases with pneumonia and atopic parents had significantly lower FEV1% pred (−7.0%; 95% CI −10.5, −3.21; p < 0.001) and FVC % pred (−4.4%; 95% CI −8.0, −0.78; p = 0.017).
Pulchalski et al. [32]b,f Case-control Gambia 1992–94 NR Children aged <5 yrs with severe pneumonia 190g 68 (36) 67h 12–14 13 No significant difference found between cases and controls. 14 of the 83 traced had died of whom 78% died within days to weeks of discharge.
Piippo-Savolainen et al. [33]f Case-control Finland 1981–82 2000 CXR-confirmed hospitalised children aged 1–24 mths 44 34 (77) 45 18–21 17 No significant difference between groups for lung function, diagnosis of asthma, or prolonged cough in last 12 mths. Study also enrolled infants with bronchiolitis (n = 53) group that significantly differed from controls for asthma symptoms (OR 5.07 [95% CI 1.66, 15.50]) and abnormal lung function (OR 4.13 [95% CI 1.36, 12.51]).
Wesley et al. [21]b,f Follow-up of hospitalised cohort South Africa (‘Black children’) NR NR CXR-confirmed, aged 6–119 mths, but most were from virus or measles NR 62 0 NR 7 40% had persistent respiratory symptoms (wheeze or cough), 34% with abnormal lung function (8% with obstruction, 16% undefined).
Kycler et al. [20]b Follow-up of hospitalised cohort Poland NKi NKi   55 49 (89) 0 NR (2–10)e 44 of 55 had spirometry: 35% restrictive pattern, 17% airway obstruction. 13% of cohort were rehospitalised for respiratory illness, 35% had exercise limitation.
Chang et al. [34]b Follow-up of hospitalised cohort Australia (Aboriginal children) 2000–01 2001–02 Clinical with CXR confirmation (alveolar changes) aged <14 yrs 109 88 (81) 0 NR 1 37.5% with persistent CXR abnormality or respiratory symptoms, 62.5% without these features.
  1. CI, confidence interval; CXR, chest radiograph; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; OR, odds ratio; NK, not known; NR, not reported; pred, predicted; UK, United Kingdom
  2. asevere lower respiratory tract infection according to maternal report, family physician or study team
  3. bIncluded in review by Thomson et al. [17]
  4. cControls from same gender and class as index child
  5. dMean ± Standard Deviation
  6. eRange
  7. fIncluded in review by Edmonds et al. [18]
  8. gOnly 83 of the 190 cases could be traced
  9. hGender and age matched controls
  10. iUnable to obtain article in Polish (data from abstract)