Tracheobronchial foreign body aspiration in children in Soweto, South Africa: A retrospective descriptive study

Main Article Content

A Moola
C Verwey
T Mabaso
K Mopeli
A Withers
J Loveland
N Patel
Z Dangor

Abstract





Background. Airway foreign bodies are a common cause of accidental death in children. Tracheobronchial foreign body aspiration (FBA) can result in severe immediate and long-term complications if the foreign body is not identified and removed. Little is known about the burden of tracheobronchial FBA in the Soweto area, south of Johannesburg, South Africa.
Objectives. To describe the burden and clinical characteristics of tracheobronchial FBA in hospitalised children in a tertiary-level hospital in Johannesburg.


Methods. This was a retrospective, single-centre, descriptive study of children aged <10 years who presented to Chris Hani Baragwanath Academic Hospital from 1 January 2011 to 31 December 2020. Children with FBA were identified from the paediatric pulmonology and paediatric surgery databases using the relevant International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), codes (T17.4 and T17.5). Clinical and radiological data were extracted from medical records and the databases.
Results. Forty-seven children with FBA were identified during the study period. Overall, the incidence of FBA among children aged <10 years of age was 1.42 per 100 000 person-years (95.0% confidence interval 1.04 - 1.88). FBA occurred more commonly in males (66.0%; n=31), and the mean (standard deviation) age at presentation was 68 (28.2) months. Most of the children (42.6%) were in the 7 - <10-year age group, followed by the 5 - <7-year age group (27.7%). Chronic respiratory symptoms were reported in one-third of the children, and a history of witnessed FBA was reported in only 59.6% of cases. Inorganic foreign bodies (n=29; 61.7%) were aspirated more commonly than organic foreign bodies; these included metal objects such as pins or springs (21.3%), toy parts (17.0%), pen or pencil lids/ stoppers (12.8%) and plastic objects (6.4%).
Conclusion. Our study highlights the fact that tracheobronchial FBA is prevalent in school-aged children, and public safety campaigns targeted at this age group are warranted. Furthermore, to prevent sequelae, a high index of suspicion in required in children with respiratory symptoms that fail to respond to appropriate therapy.





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1.
Moola A, Verwey C, Mabaso T, Mopeli K, Withers A, Loveland J, et al. Tracheobronchial foreign body aspiration in children in Soweto, South Africa: A retrospective descriptive study. Afr J Thoracic Crit Care Med [Internet]. 2024 Jul. 4 [cited 2024 Jul. 18];30(2):e1145. Available from: https://samajournals.co.za/index.php/ajtccm/article/view/1145
Section
Original Research: Articles

How to Cite

1.
Moola A, Verwey C, Mabaso T, Mopeli K, Withers A, Loveland J, et al. Tracheobronchial foreign body aspiration in children in Soweto, South Africa: A retrospective descriptive study. Afr J Thoracic Crit Care Med [Internet]. 2024 Jul. 4 [cited 2024 Jul. 18];30(2):e1145. Available from: https://samajournals.co.za/index.php/ajtccm/article/view/1145

References

Concepcion E. Pediatric airway foreign body. Medscape, 27 April 2021. https:// emedicine.medscape.com/article/1001253-overview#a6 (accessed 16 February 2023).

Cramer N, Jabbour N, Tavarez M, Roger S. Foreign body aspiration. Last updated 31 July 2023. In: StatPearls. Treaure Island, Fla: StatPearls Publishing. https://www.ncbi.nlm.nih. gov/books/NBK531480/ (accessed 5 October 2023).

JanahiIA,KhanS,ChandraP,etal.Anewclinicalalgorithmscoringformanagementof suspected foreign body aspiration in children. BMC Pulm Med 2017;17(1):61. https:// doi.org/10.1186/s12890-017-0406-6

Lea E, Nawaf H, Yoav T, Elvin S, Ze’ev Z, Amir K. Diagnostic evaluation of foreign body aspiration in children: A prospective study. J Pediatric Surg 2005;40(7):1122-1127. https://doi.org/10.1016/j.jpedsurg.2005.03.049

Ding G, Wu B, Vinturache A, Cai C, Lu M, Gu H. Tracheobronchial foreign body aspiration in children: A retrospective single-center cross-sectional study. Medicine (Baltimore) 2020;99(22):e20480. https://doi.org/10.1097/MD.0000000000020480

Mathew RP, Liang TIH, Kabeer A, Patel V, Low G. Clinical presentation, diagnosis and management of aerodigestive tract foreign bodies in the paediatric population: Part 2. SA J Radiol 2021;25(1):2027. https://doi.org/10.4102/sajr.v25i1.2027

Rodríguez H, Passali GC, Gregori D, et al. Management of foreign bodies in the airway and oesophagus. Int J Pediatr Otorhinolaryngol 2012;76(Suppl 1):S84-S91. https://doi. org/10.1016/j.ijporl.2012.02.010

Karaaslan E, Yildiz T. Management of anesthesia and complications in children with tracheobronchial foreign body aspiration. Pak J Med Sci 2019;35(6):1592-1597. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC6861508/ (accessed 12 February 2023).

Sultan TA, van As AB. Review of tracheobronchial foreign body aspiration in the South African paediatric age group. J Thorac Dis 2016;8(12):3787-3796. https://doi. org/10.21037/jtd.2016.12.90

Zanini A, Maistry N, Brisighelli G, et al. The burden of disease and pathology at a rapidly expanding tertiary paediatric surgical unit in South Africa. World J Surg 2021;45(8):2378-2385. https://doi.org/10.1007/s00268-021-06144-x

Salih AM, Alfaki M, Alam-Elhuda DM. Airway foreign bodies: A critical review for a common pediatric emergency. World J Emerg Med 2016;7(1):5-12. https://doi. org/10.5847/wjem.j.1920-8642.2016.01.001

Hughes CA, Baroody FM, Marsh BR. Pediatric tracheobronchial foreign bodies: Historical review from the Johns Hopkins Hospital. Ann Otol Rhinol Laryngol 1996;105(7):555-561. https://doi.org/10.1177/000348949610500712

HochdornA,OliveiraA,LorenzoniG,etal.Monitoringpublicperceptionofhealthrisks in Brazil and Italy: Cross-cultural research on the risk perception of choking in children. Children (Basel) 2021;8(7):541. https://doi.org/10.3390/children8070541

KlingbergS,vanSluijsEM,DraperCE.Parentperspectivesonpreschoolers’movement and dietary behaviours: A qualitative study in Soweto, South Africa. Public Health Nutr 2021;24(12):3637-3647. https://doi.org/10.1017/S1368980020003730

Mahajan JK, Rao SG. Pen cap aspirations: Maneuvering for successful extraction. J Pediatr Intensive Care 2018;7(3):126-128. https://doi.org/10.1055/s-0037-1613672 16. Oğuz F, Citak A, Unüvar E, Sidal M. Airway foreign bodies in childhood. Int J Pediatr

Otorhinolaryngol 2000;52(1):11-16. https://doi.org/10.1016/s0165-5876(99)00283-9 17. Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A. Tracheobronchial foreign-bodies in children: A 7 year retrospective study. Iran J Otorhinolaryngol 2015;27(82):377-385. https://www.ncbi.nlm.nih.gov/pmc/articles/

PMC4639691/ (accessed 16 April 2023).

Ding L, Su S, Chen C, Yao H, Xiao L. Tracheobronchial foreign bodies in children:

Experience from 1,328 patients in China. Front Pediatr 2022;10:873182. https://doi.

org/10.3389/fped.2022.873182

Antón-Pacheco JL, Martín-Alelú R, López M, et al. Foreign body aspiration in children: Treatment timing and related complications. Int J Pediatr Otorhinolaryngol 2021;144:110690. https://doi.org/10.1016/j.ijporl.2021.110690

RuizF.Airwayforeignbodiesinchildren.Airwayforeignbodiesinchildren.UpToDate, 2022. https://www.uptodate.com/contents/airway-foreign-bodies-in-children/print (accessed 7 January 2023).