Background
Methods
Data sources and search strategy
Study selection and inclusion/exclusion criteria
Data extraction
Assessment of methodical quality and risk of bias
Statistics
Results
Included studies
Studies | Country | Setting | Time of recruit-ment | Data assess-ment | Study population: Number of females | Age in study sample (years1) | Inclusion (IN) / Exclusion (EX) criteria | Out-come |
---|---|---|---|---|---|---|---|---|
Boyce 2019 [20] | Malawi | 57 health facilities with 250 health surveillance assistants for integrated community case management | n.r. | prospectively | 987 children ♀52% | Ø23.4 months | IN: first 4 children, aged 2–59 months, presenting to the health surveillance assistants for an initial consultation of their current illness EX: severely ill children who needed urgent referral to a health facility | Pre |
Cazzato 2001 [21] | Italy | 35 family paediatricians in Southern Italy | 04–06/1998 | prospectively | 9917 children ♀50% | < 12: ≤2: 40.5% 3–6: 33.5% 7–12: 26% | IN: every patient-doctor contact on an index-day of the week over a 3-month period | Pre |
Giannattasio 2014 [22] | Italy | 3 primary care paediatric practices in Naples | 12/2011–01/2012 | prospectively | 284 patients 188 consultations due to symptoms ♀ 54% | Ø 4.8 0–2: 25% 3–5: 36% 6–8: 20% 9–11: 13% 12–14: 6% | IN: all children aged 0–14 years observed in the index days | Pre |
Hall 2017 [23] | Australia | 1 Aboriginal-owned and operated comprehensive primary health-care service | 02/2013–10/2015 | prospectively | 121 children ♀ 49% | 0: 32.8% 1: 26.7% 2: 16.1% 3–4: 24.4% Ø18.4 months | IN: children presenting for any reason, aged < 5 years, registered at the healthcare service and parent willing/able to complete study requirements EX: family was planning to move from the area in the following 12 months | Pre |
Harnden 2006 [24] | UK | 18 general practices | 10/2001–05/2005 | prospectively | 172 patients ♀ 45% | Ø 9.1 (positive pertussis serology) – 9.8 (negative pertussis serology) | IN: children, aged 5–16 years, with cough ≥14 days EX: refused blood sample | Aet Prog |
Krishnan 2019 [25] | USA | 1 predominantly suburban, academic paediatric faculty practice | 1 year | retrospectively | 560 consultations ♀ 47% | 19 days - 18 years Ø 6.6 < 2: 18% 2–5: 41% | IN: children with completed electronic health record cough template | Aet |
Leconte 2011 [26] | Belgium | 36 primary care practices | 02–03/2006 | prospectively | 345 patients | n.r. | IN: all consulting children aged 5–17 years | Pre |
Mash 2012 [27] | South Africa | 83 primary care clinics, 17 mobile clinics, 12 community health centres; nurse-led with support from doctors | 1 year | prospectively | 5545 reasons for encounter | < 1–14 | IN: all ambulatory patients aged 0–14 years seen by health workers | Pre |
Molony 2016 [28] | Ireland | 1 large general practice with 4 GPs in a primary healthcare centre in North Cork | 10/2010–10/2014 | retrospectively | 5100 patients 52,572 consultations 70,489 RFE | n.r. | IN: doctor-patient face-to-face encounters (children aged < 7 years) on all working days and 146 non-working days with a documentation of diagnostic code in the electronic medical record EX: contacts with practice nurse/ practice’s administrative team, telephone or ‘out-of-hours’ contacts | Pre |
UK | 1 general practice with 3 GPs | 1 year | prospectively | 707 patients 4467 consultations ♀ 51.3% | n.r. | IN: new patient-initiated consultations with symptoms not presented to any doctor in the previous 12 months, children aged 0–14 years EX: doctor-initiated consultations | Pre | |
Movsowitz 1987 [31] | South Africa | 1 private paediatric practice in Cape Town | 1984–1985 | prospectively | 256 patients | 3 months −15 years | IN: patients with cough > 3 weeks | Aet |
NAMCS Schappert 1999 [32] | USA | 195 office-based paediatricians | 01/1995–12/1996 | prospectively | 92,888 consultations ♀ 49.5% | < 15: 89.6% 15–24 6.2% 25–44: 2.5% 45–64: 1.1% | IN: office visits to non-federally employed paediatricians occurring during a randomly assigned 1-week reporting period EX: telephone contacts and visits made outside the physician’s office, visits to government-operated facilities and hospital-based outpatient departments | Pre |
Nizami 1997 [33] | Pakistan | 65 GPs and 29 paediatricians in Karachi | 04–12/1992 | prospectively | 2433 consultations | n.r. | IN: children aged < 5 years | Pre |
Njalsson 1992 [34] | Iceland | 12 rural and 4 urban primary care health centres | 01–12/1988 | prospectively | 67,746 RFE | 0–14 | IN: all contacts with children aged 0–14 years, including prescriptions, follow-up visits, tests, procedures and administrative visits | Pre |
SESAM 2 Study Frese 2011 [35] | Germany | 209 GPs in the federal state of Saxony | 10/1999–09/2000 | prospectively | 805 patients 1196 RFE | 0–4: 13.3% 5–9: 14.7% 10–14: 20.8% 15–19: 51.2% | IN: randomly selected children, aged 0- ≤ 19 years, presenting in general practice (tenth consultation of the consultation hour) previously known to the practitioner EX: house calls, patients already included in SESAM 2 study | Pre |
Simoes 1997 [36] | Ethiopia | 3 primary health centres with 6 outpatient clinic nurses | 3 weeks in August | prospectively | 449 patients ♀ 54% | 2–11 months: 36% | IN: any sick child, aged 2 months – 5 years, presenting during study hours | Pre |
TRANSITION Okkes 2002 [37] | Netherlands | 54 family physicians in 23 locations in the Netherlands | 1985–1995 | prospectively | 3371 episodes of care | n.r. | IN: episode data for all face-to-face encounters with paediatricians’ listed patients, aged 0–14 years, including encounters for prevention | Aet |
Usherwood 1991 [38] | UK | 1 general practice in Scotland | 12/1986–01/1988 | prospectively | 466 consultations (including 147 home visits) | n.r. | IN: all health centre consultations of children, aged 2–13 years | Pre |
Vinson 1993 [39] | USA, Canada | 44 primary care practices in the Ambulatory Sentinel Practice Network (ASPN) | 10/1990–01/1991 | prospectively | 1398 patients ♀ 47% | infancy - ≤14 Ø 4,8 | IN: children aged 0–14 years with cough ≤1 month | Aet |
Assessment of methodical quality and risk of bias
Prevalence
Aetiologies
Study Study population | Vinson 1993 1398 patients | TRANSITION Okkes 2002 3371 episodes of care | Krishnan 2019 560 consultations | Harnden 2006 172 patients | Movsowitz 1987 256 patients |
---|---|---|---|---|---|
Duration of cough Aetiology | acute | all durations of cough | subacute/chronic | ||
≤1 month | ≥2 weeks | > 3 weeks | |||
Upper respiratory tract infection | n = 873 62.4% [59.8; 65] viral: 35% (n = 494) bacterial: 27% (n = 379) | n = 1294 38.4% [36.7; 40.1] | n = 241 43% [38.9; 47.3] | n.r. | n = 71 27.7% [22.4; 33.7] (recurrent upper respiratory tract infection including bronchiolitis and bronchopneumonia) |
Asthma | n = 129 9.2% [7.8; 10.9} | n = 100 3% [2.4; 3.6] | n = 101 18% [15; 21.5] | n.r. | n = 129 50.4% [44.1; 56.7] |
Pertussis | n.r. | n = 34 1% [0.7; 1.4] | n.r. | n = 64 37,2% [30.1; 44.9] | n = 56 21.9% [17.1; 27.5] |
Bronchitis / bronchiolitis | n = 465 33.3% [30.8; 35.6] | n = 757 22.5% [21.1; 23.9] (acute bronchitis / bronchiolitis) | n = 28 5% [3.4; 7.2] | n.r. | n.r. |
Pharyngitis | n.r. | n.r. | n = 45 8% [6; 10.7] | n.r. | n.r. |
Sinusitis | n.r. | n = 55 1.6% [1.2; 2.1] | n = 45 8% [6; 10.7] | n.r. | n.r. |
Laryngitis / tracheitis | n.r. | n = 245 7.3% [6.4; 8.2] | n.r. | n.r. | n.r. |
Croup | n = 30 2.1% [1.5; 3.1] | n.r. | n = 45 8% [6; 10.7%] | n.r. | n.r. |
Pneumonia | n = 78 5.6% [4.5; 6.9] | n = 73 2.2% [1.7; 2.7] | n = 39 7% [5.1; 9.5] | n.r. | n.r. |
Influenza | n.r. | n = 43 1.3% [0.9; 1.7] | n.r. | n.r. | n.r. |
Otitis | n.r. | n = 42 1.2% [0.9; 1.7] | n = 28 5% [3.4; 7.2] | n.r. | n.r. |
Other allergic diseases | n = 52 3.7% [2.8; 4.9] | n.r. | n.r. | n.r. | n.r. |
Tonsillitis | n.r. | n = 54 1.6% [1.2; 2.1] | n.r. | n.r. | n.r. |
Hypertrophy tonsils / adenoids | n.r. | n = 44 1.3% [1.0; 1.8] | n.r. | n.r. | n.r. |
Tuberculosis | n.r. | n.r. | n.r. | n.r. | n = 1 0.4% [0; 2.5] |
Bronchiectasis following pertussis | n.r. | n.r. | n.r. | n.r. | n = 1 0.4% [0; 2.5] |
Persistently atelectatic right middle lobe | n.r. | n.r. | n.r. | n.r. | n = 1 0.4% [0; 2.5] |
COPD | n.r. | n = 8 0.2% [0.1; 0.5] | n.r. | n.r. | n.r. |
Heart failure | n.r. | n = 0 0% [0; 0.1%] | n.r. | n.r. | n.r. |
Psychogenic cough | n.r. | n.r. | n.r. | n.r. | n = 0 0% [0; 1.8%] |
Cystic fibrosis | n.r. | n.r. | n.r. | n.r. | n = 0 0% [0; 1.8%] |
Foreign body nose / larynx / bronchus | n.r. | n.r. | n.r. | n.r. | n = 0 0% [0; 1.8%] |