Risk factors of bronchiectasis

Su Siew Choo
Pantai Hospital, Kuala Lumpur, Malaysia

Bronchiectasis in children is a chronic, progressive condition characterised by dilatation of the bronchi, leading to persistent respiratory symptoms and recurrent infections. Paediatric bronchiectasis is often secondary to identifiable and potentially treatable underlying conditions. Early recognition of risk factors is crucial for timely diagnosis and intervention, which can significantly improve long-term outcomes and quality of life.

The key risk factors associated with bronchiectasis in children include severe or recurrent lower respiratory tract infections, genetic disorders such as cystic fibrosis and primary ciliary dyskinesia, primary and secondary immunodeficiencies, and structural airway abnormalities. Environmental and socioeconomic determinants—such as exposure to tobacco smoke, indoor air pollution, overcrowding, and poor access to healthcare—also play a significant role in disease development and progression.

Clinical clues that suggest an increased risk of bronchiectasis, the role of diagnostic tools such as high-resolution CT scans, and the importance of early and targeted investigations are important for early diagnosis and management. Strategies for prevention of bronchiectasis, including vaccination, nutritional support, and management of chronic respiratory symptoms are highlighted in at-risk populations.

By improving awareness and understanding of these risk factors, paediatricians can play a pivotal role in preventing disease progression and minimising long-term pulmonary damage in affected children.