Mehran Mosley, MD FAAP

Publication Details

• Multicenter Brochiectasis Study: A Collaborative International Study of Bronchiectasis in Indigenous Children

  Rosalyn Singleton, Gregory Redding, Patricia Valery, Anne Chang, Mehran Mosley, Lori Pruitt, Mary Jackson. Multicenter Brochiectasis Study: A Collaborative International Study of Bronchiectasis in Indigenous Children.

  Background: Bronchiectasis still contributes to the high burden of respiratory disease in indigenous children worldwide. The risk factors associated with progression to bronchiectasis, the clinical course and optimal treatment are not known. The high rates of bronchiectasis among indigenous populations has led to the first collaborative international study (Aboriginal and Torres Strait Island, New Zealand Pacific Island, Maori and Alaskan Native people). The aims of the Observational study are to: (1) define the clinical course of chronic moist cough with or without infiltrates, and bronchiectasis; (2) identify the risk factors associated with progression to bronchiectasis. The Australians are also conducting an Interventional study to evaluate maintenance azithromycin (30 mg/kg once a week) compared to placebo on the prevention of pulmonary exacerbations. Methods The Observational study design is identical in the participating countries: a prospective cohort study (2005-2010) of Indigenous children aged 6 months to 8 years with bronchiectasis or chronic moist cough. Primary outcomes are: number and rate of pulmonary exacerbations and progression of radiologic findings. Results: The study has started in all sites; to date 64 children have been enrolled (29 children in Alaska); we expect to identify 100-150 eligible children. Participants have high rates of nasopharyngeal carriage with pneumococcus, H. influenzae, and M. catarrhalis Conclusions: This will be the first study to prospectively document the clinical course of chronic moist cough and bronchiectasis in indigenous children. The clinical trial will provide critical information about the benefits and risks of maintenance antibiotic treatment. The project has the potential to improve health outcomes for children with bronchiectasis worldwide