Abstract:
The substantial decline in the burden of childhood community acquired lower respiratory tract
infections (LRTI) over the last decades is associated with improvements in immunization, nutrition,
socioeconomic, and control of the HIV epidemic (1). However, LRTI remains the commonest
cause of under-5 mortality outside the neonatal period (1). Although most children with LRTI fully
recover, a proportion develop chronic respiratory symptoms and/or sequelae; reasons include host
factors (immunosuppression, poor secretion clearance, airway abnormalities or genetic factors),
infectious causes (TB or adenovirus), and/or adverse environmental factors. Early identification
and management of children at-risk of respiratory sequelae may help to preserve long-term lung
health. However, knowing who and when to investigate is challenging as there is little high-level
evidence to support the timing and extent of investigations required.
Description:
Supplementary Figure 1: Pathway for children that require further investigation.
Supplementary Figure 2: Patterns of lower respiratory tract symptoms over a
12 month period [Adapted Penny ME. Pediatr Infect Dis. (1993) 12:762–3].
Supplementary Figure 3: Infographic demonstrating how airway obstruction by
a foreign body (B) or impairment of muco-ciliary mechanism (C) result in stasis of
secretions and inflammation as compared to normal (A).
Supplementary Figure 4: Managment steps of children with chronic respiratory
symptoms or at-risk of respiratory sequelae.
