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.

Study 2 - Five to ten year outcomes of children with CSLD

The specific research objectives in this study are to evaluate long term clinical outcomes of Indigenous children with CSLD to:
a.    determine predictors of clinical outcomes (e.g. recurrent acute lower respiratory infections and lung function);
b.    determine which children are most likely to benefit from maintenance azithromycin and how long these beneficial effects persist; and
c.    define the clinical significance of azithromycin on macrolide-resistant respiratory pathogens present in nasal swabs.

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 findings

• Study one is ongoing
• The frequency of lower respiratory tract infection in Alaskan native children decreased with age, however most children still had respiratory symptoms as they entered adolescence, highlighting the need for close clinical follow-up.
• The frequency of acute lower respiratory tract infection in Indigenous decreased with age and lung function was mostly within population norms. The respiratory outcomes are encouraging and clinical care needs to be informed as these children progress to adulthood.

Publications from the study

Pediatric Pulmonology 2018 53,1662-1669. doi.org/10.1002/ppul.24174

Pediatric Pulmonology 2020 55, 975-85. doi 10.1002/ppul.24696.