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