Bronchiectasis in children from Qikiqtani (Baffin) Region, Nunavut, Canada

Abstract
Rationale: Bronchiectasis not related to cystic fibrosis is common in indigenous populations globally, but it has not been studied in Canadian indigenous children.

Objective: The objective of this study was to describe bronchiectasis in Canadian Inuit children and examine potentially causal factors.

Methods: We described the clinical features of bronchiectasis in Canadian Inuit children residing in the Qikiqtani (Baffin) Region, Nunavut, Canada, by performing a retrospective chart review of children from this region. Patients had computed tomography-confirmed bronchiectasis and were diagnosed at the Children’s Hospital of Eastern Ontario, Ottawa, Canada, the regional tertiary center, between 1998 and 2011.

Measurements and main results: We identified 17 cases of bronchiectasis. We conservatively estimated the prevalence at 202/100,000 children. Bronchiectasis was strongly associated with lower respiratory tract infection (LRTI) in infancy. Reported environmental tobacco smoke exposure and overcrowding in the home appeared to be common. The left lower lobe was the most common lung lobe involved. Haemophilus influenza, Streptococcus, and Streptococcus pneumoniae were commonly isolated. The range of FEV1 values measured during pulmonary function testing was 46-108% predicted.

Conclusions: Previous researchers have reported that Canadian Inuit children have markedly elevated rates of LRTI early in life. Our study suggests that this may lead to long-term pulmonary sequelae. Preventing LRTI in Inuit infants may both prevent acute, severe illness and reduce their risk of developing permanent lung damage.