Correlates of lower respiratory tract infections and nutritional state in children with severe generalized cerebral palsy and intellectual disability

Children with severe generalized cerebral palsy and intellectual disability represent a small part of the general Dutch population. Their share in healthcare, however, is disproportionally large. Due to their disabilities they are particularly susceptible to various medical problems, which cause much distress, and may even shorten their life expectancy. Many children do not reach adulthood, the main cause of death in this population being lower respiratory tract infections. The present study was initiated in 2001 in reaction to the need to gain insight into causes of pulmonary infections in these children, as expressed by paediatricians and intellectual disability physicians in the Netherlands. Although children were treated with antibiotics (as a prophylaxis and/or as treatment in case of acute pulmonary infection), recurrent lower respiratory tract infections continued to cause much morbidity and mortality. Preventive measures were needed. This study was set up to evaluate the incidence and correlates of pulmonary infections in this population, and should be considered as a first step that may lead towards the development of a guideline for the prevention of lower respiratory tract infections. The present dissertation is the second of two, resulting from this study. The first dissertation was written by Rebekka Veugelers, and dealt primarily with feasibility of diagnostic methods in this population.