Paediatric Bronchiectasis in a Resource-Constrained Centre: A Case Series

Authors

  • BP Kuti Obafemi Awolowo University https://orcid.org/0000-0002-4778-4362
  • M Jallow Edward Francis Small Teaching Hospital, Banjul (EFSTH), The Gambia
  • ML Jobarteh Edward Francis Small Teaching Hospital, Banjul (EFSTH), The Gambia

DOI:

https://doi.org/10.30442/ahr.1001-07-226

Abstract

Bronchiectasis denotes fixed and often irreversible dilatation of the bronchial wall caused by persistent inflammation and infection. Children with bronchiectasis in developing countries suffer recurrent hospitalisation and poor quality of life and usually succumb to the condition. These children are poorly recognised, misdiagnosed, and under-reported.

We report five cases of computerised tomography-diagnosed paediatric bronchiectasis managed at the Edward Francis Small Teaching Hospital (EFSTH), Banjul, The Gambia. The ages of the children at presentation ranged from 3 to 14 years, and they all had recurrent chest infections. Four out of the five cases had Pulmonary Tuberculosis, among whom two cases had HIV/TB co-infections, and the only non-TB, non-HIV case had features of Down syndrome with congenital heart lesions. All the cases had growth impairment; digital clubbing was observed in four, and low peripheral oxygen saturation in room air in three of the five children. These cases are reported to increase the index of suspicion among clinicians working in resource-limited settings to consider the diagnosis of bronchiectasis in children with recurrent chest infections. Early diagnosis and prompt management, including appropriate follow-up care, will improve the quality of life of these children and ensure better management outcomes.

References

Dagli E. Non-CF bronchiectasis. In: Eber E and Midulla F (Editors) ERS Handbook Paediatric Respiratory Medicine. European Respiratory Society. 2013; 253-257.

Karadag B, Karakoc F, Ersu R, Kut A, Bakac S, Dagli E. Non-cystic fibrosis bronchiectasis in children: a problem in developing countries. Respiration 2005;72:233–238. https://doi.org/10.1159/000085362.

Edwards EA, Asher MI, Byrnes CA. Paediatric bronchiectasis in the twenty-first century: Experience of a tertiary children's hospital in New Zealand. J Paediatr Child Health 2003;39:111-117. https://doi.org/10.1046/j.1440-1754.2003.00101.x.

Brower KS, Del Vecchio MT, Aronoff SC. The etiologies of non-CF bronchiectasis in childhood: a systematic review of 989 subjects. BMC Pediatr 2014;14:299.10. https://doi.org/1186/s12887-014-0299-y.

Reid L. Reduction in bronchial subdivisions in bronchiectasis. Thorax 1950;5:223–247. https://doi.org/10.1136/thx.5.3.233.

Pizzutto SJ, Hare KM, Upham JW. Bronchiectasis in Children: Current Concepts in Immunology and Microbiology. Front Pediatr 2017;5:123. https://doi.org/10.3389/fped.2017.00123.

Cole PJ. Inflammation: a two-edged sword – the model of bronchiectasis. Eur J Respir Dis Suppl 1986;147:6–15.

King PT. The pathophysiology of bronchiectasis. Int J COPD 2009;4:411–419. https://doi.org/10.1016/j.prrv.2010.10.011.

Grimwood K. Airway microbiology and host defences in paediatric non-CF bronchiectasis. Paediatr Respir Rev 2011;12:111–1118. https://doi.org/10.1016/j.prrv.2010.10.009.

Masekela R, Anderson R, Moodley T, Kitchin OP, Risenga SM, Becker PJ, et al. HIV-related bronchiectasis in children: an emerging spectre in high tuberculosis burden areas. Int J Tuberc Lung Dis 16:114–119. https://doi.org/10.5588/ijtld.11.0244.

Owolabi OA, Jallow AO, Jallow M, Sowe G, Jallow R, Monica D. Genekaha MD, et al. Delay in the diagnosis of pulmonary tuberculosis in The Gambia, West Africa: A cross-sectional study. Int J Infec Dis 2020;101:102-106. https://doi.org/10.1016/j.ijid.2020.09.029.

George M, Amodio J, Lee H. Cystic Lung Disease in Down Syndrome: A Case Report and Literature Review. Case Rep Pediatr. 2016;2016:4048501. https://doi.org/10.1155/2016/4048501.

Dearani JA, Neirotti R, Kohnke EJ, Sinha KK, Cabalka AK, Barnes RD, et al. Improving pediatric cardiac surgical care in developing countries: matching resources to needs. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2010;13:35–43. https://doi.org/10.1053/j.pcsu.2010.02.001.

Laverty A, Jaffe A, Cunningham S. Establishment of a web-based registry for rare (orphan) pediatric lung diseases in the United Kingdom: the BPOLD registry. Pediatr. Pulmonol 2008;43:451–456. https://doi.org/10.1002/ppul.20783.

Zaid AA, Elnazir B, Greally P. A decade of non-cystic fibrosis bronchiectasis 1996-2006. Ir Med J 2010;103:77–79.

Pizzutto SJ, Grimwood K, Bauert P, Schutz KL, Yerkovich ST, Upham JW, et al. Bronchoscopy contributes to the clinical management of indigenous children newly diagnosed with bronchiectasis. Pediatr Pulmonol 2013; 48:67–73. https://doi.org/10.1002/ppul.22544.

Chang AB, Grimwood K, Boyd J, Fortescue R, Powell Z, Kantaret A. Management of children and adolescents with bronchiectasis: summary of the ERS clinical practice guideline. Breathe 2021;17:210105. https://doi.org/10.1183/20734735.0105-2021.

Chalmers JD, Smith MP, McHugh BJ, Doherty C, Govan JR, Hill AT. Short- and long-term antibiotic treatment reduces airway and systemic inflammation in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 2012;186:657–665. https://doi.org/10.1164/rccm.201203-0487OC.

Downloads

Published

2024-03-30

Issue

Section

Case Report