title: Long-term morbidity from severe pneumonia in early childhood in The Gambia, West Africa: a follow-up study.
abstract: OBJECTIVE
  To assess long-term outcomes in severe early childhood pneumonia in The Gambia.
  
  
  METHODS
  Observational cohort study of children hospitalised with severe pneumonia between 1992 and 1994 compared to age, sex, and neighbourhood-matched controls on measures of current general and pulmonary health.
  
  
  RESULTS
  Of 83 children successfully traced, 68 of the 69 alive at follow-up agreed to participate. Thirteen per cent of cases and 4% of controls had lung disease clinically or on spirometry. Another 16 (13%) participants had abnormal spirometry but did not meet the American Thoracic Society technical criteria (formally 'inconclusive'). Odds ratios of lung disease among childhood pneumonia cases were 2.93 (95%CI 0.69-12.48, P = 0.1468) with inconclusives omitted; 2.53 (95%CI 0.61-10.59, P = 0.2033) with inconclusives included as normal; and 2.83 (95%CI 1.09-7.36, P = 0.0334) with inconclusives included as lung disease. Among deceased cases, most deaths were reported within weeks of discharge, suggesting a possible connection between admission and subsequent death.
  
  
  CONCLUSIONS
  These African data, while not conclusive, add to previous data suggesting a link between severe early childhood pneumonia and later chronic lung disease. While larger-scale research is needed, increased awareness of possible long-term morbidity in children with severe pneumonia is warranted to limit its impact and optimise long-term health.
authors.affiliation: University Health Network, University of Toronto, Toronto, Ontario, Canada. lisa.puchalskiritchie@utoronto.ca
authors.forename: L M
authors.initials: LM
authors.lastname: Puchalski Ritchie
authors.forename: S R C
authors.initials: SR
authors.lastname: Howie
authors.forename: T
authors.initials: T
authors.lastname: Arenovich
authors.forename: Y B
authors.initials: YB
authors.lastname: Cheung
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: S
authors.initials: S
authors.lastname: Moore
authors.forename: R A
authors.initials: RA
authors.lastname: Adegbola