Risk Factors for Chronic Cough in Young Children: A Cohort Study

Yin To Au-Yeung; Anne B Chang; Keith Grimwood; Yolanda Lovie-Toon; Michelle Kaus; Sheree Rablin; Dan Arnold; Jack Roberts; Sarah Parfitt; Jennie Anderson; Maree Toombs; Kerry-Ann F O'Grady

doi:10.3389/fped.2020.00444

Risk Factors for Chronic Cough in Young Children: A Cohort Study

Front Pediatr. 2020 Aug 12:8:444. doi: 10.3389/fped.2020.00444. eCollection 2020.

Authors

Yin To Au-Yeung¹, Anne B Chang^{1

2

3}, Keith Grimwood^{4

5

6}, Yolanda Lovie-Toon¹, Michelle Kaus¹, Sheree Rablin¹, Dan Arnold¹, Jack Roberts¹, Sarah Parfitt¹, Jennie Anderson⁷, Maree Toombs^{8

9}, Kerry-Ann F O'Grady¹

Affiliations

¹ Australian Center for Health Services Innovation@ Centre for Healthcare Transformation, Queensland University of Technology, South Brisbane, QLD, Australia.
² Child Health Division, Menzies School of Health Research, Tiwi, NT, Australia.
³ Department of Respiratory Medicine, Queensland Children's Hospital, South Brisbane, QLD, Australia.
⁴ School of Medicine, Griffith University, Southport, QLD, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
⁶ Department of Paediatrics, Gold Coast Health, Southport, QLD, Australia.
⁷ Caboolture Community Medical, Caboolture, QLD, Australia.
⁸ Carbal Health Services, Toowoomba, QLD, Australia.
⁹ UQ Rural Clinical School, The University of Queensland, Toowoomba, QLD, Australia.

Abstract

Background and Objective: Data on the predictors of chronic cough development in young children are scarce. Our primary objective was to examine the factors associated with young children developing a chronic cough, with a focus on childcare attendance. Methods: A secondary analysis of data collected in a prospective cohort study of children presenting to three emergency departments and three primary healthcare centers in southeast Queensland, Australia. Eligible children where those aged <6-years presenting with cough and without known underlying chronic lung disease other than asthma. Children were followed for 4 weeks to ascertain cough duration. The primary outcome was persistent cough at day-28. Logistic regression models were undertaken to identify independent predictors of chronic cough including sensitivity analyses that accounted for children with unknown cough status at day-28. Results: In 362 children, 95 (26.2%) were classified as having chronic cough. In models that included only children for whom cough status was known at day-28, symptom duration at enrolment, age <12 months [adjusted odds ratio (aOR) 4.5, 95% confidence interval (CI) 1.1, 18.7], gestational age (aOR 3.2, 95%CI 1.4, 7.9), underlying medical conditions (aOR 2.6, 95% CI 1.3, 5.5), a history of wheeze (aOR 2.6, 95% CI 1.4, 4.8) and childcare attendance (aOR 2.3, 95% CI 1.2, 4.4) were independent predictors of chronic cough. Amongst childcare attendees only, 64 (29.8%) had chronic cough at day-28. The strongest predictor of chronic cough amongst childcare attendees was continued attendance at childcare during their illness (aOR = 12.9, 95% CI 3.9, 43.3). Conclusion: Gestational age, underlying medical conditions, prior wheeze and childcare attendance are risk factors for chronic cough in young children. Parents/careers need to be aware of the risks associated with their child continuing to attend childcare whilst unwell and childcare centers should reinforce prevention measures in their facilities.

Keywords: acute respiratory illness; childcare; children; chronic cough; cohort study.