Healthy Lungs: Trial of an intervention programme in children less than two years of age admitted to hospital with severe lower respiratory tract infection

INTERVENTION: The intervention programme is based on the Cystic Fibrosis model of care for early childhood with regular clinic review for any deviation from normal health and to institute early treatment and/or preventative care. Reviews will be undertaken as a minimum at 1‐3, 6, 9, 12, 15, 18, 21 and 24 months after the day 0 assessment and as required in one of three community centres (Otara, Mangere, Manurewa) staffed by the nominated general practitioner (GP) or nurse practitioner and practice nurse. CONDITION: Lower respiratory infection (LRI) PRIMARY OUTCOME: Evidence of respiratory morbidity at 24 month follow up during a time of stability, as assessed by: ; ‐ Abnormal CXR Brasfield score of 22/25 (25/25 = normal). ; ‐ And/or abnormal clinical examination (defined as clubbing and/or MCIC and/or crackles on auscultation). SECONDARY OUTCOME: All Chest X‐ray changes Bronchiectasis on CT scan Chronic Moist Cough (CMC) on history (defined as daily moist cough for >3 months or 3 or more episodes of moist cough for > 1 month). Estimation by a health economist of the direct health costs of intervention to the public health system. Information will be obtained from hospital and GP records which illustrates readmissions with LRI, medically attended LRI/wheezing episodes/asthma diagnosis. Nasal swab / sputum cultures INCLUSION CRITERIA: Children <2 years age admitted to Counties Manukau District Health Board (CMDHB) with severe LRI (pneumonia and/or bronchiolitis ‐ admission =5 days and/or supplemental oxygen for > 48 hours and/or admission to Intensive care unit, and/or consolidation on CXR) between 1st Aug 2010 & 31st Oct 2011.