The LOTUS study is an extension of previous bronchiolitis and chronic suppurative lung disease (CSLD) (includes non-cystic fibrosis bronchiectasis) studies. This research project is being conducted over three year and is split into two studies (study-1 and study-2). 

The study is being conducted in the Northern Territory (Australia), Alaska and in New Zealand. The Australian arm is being run in Darwin, Maningrida, Wadeye, Wurrumiyanga, and the APY Lands.

Study-1 Long term consequences of children hospitalised with bronchiolitis

The specific research objectives in this study are to evaluate long term outcomes of Indigenous children previously hospitalised or treated in the community for bronchiolitis so as to: 
a.    determine risk factors (demographic, medical and microbiological) for the development of Chronic  Suppurative Lung Disease (CSLD); and
b.    identify possible intervention points that may prevent future lung disease.

The overall aim of this research is to identify interventional targets that can improve lung health and the management of respiratory diseases in Indigenous children. In doing so, lung disease may be detected early and possibly prevented.

Study- 2 Five to ten year outcomes of Indigenous children with Bronchiectasis (BE)

This study aims to evaluate long term clinical outcomes of Indigenous children previously enrolled in our BE studies.

The specific research objectives are to:

(a) determine predictors of clinical outcomes (recurrent ALRI and lung function);

(b) determine characteristics of children most likely to benefit from maintenance azithromycin and determine how long these beneficial effects persist; and

(c) define the clinical significance of azithromycin on macrolide-resistant respiratory pathogens present in nasal swabs.

The long term consequences of respiratory disease are a major issue among Indigenous children in remote communities. For the first time, study-1 will provide novel data on identifying point of care interventions for Indigenous children after hospitalisation for bronchiolitis, to improve long term respiratory outcomes and prevent subsequent development of CSLD.

Study-2 will help improve our understanding of predictors relating to clinical outcomes of children with CSLD. This long term follow-up will also provide important clinical data on the optimal duration of maintenance azithromycin, as well as the importance of acquiring antibiotic resistant pathogens on a patient-level.

The studies will also direct future interventions and management pathways. This research program will work closely with families and health departments to translate the research findings into meaningful outcomes (evidence based guidelines and culturally appropriate educational resources).