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Paediatric hospitalisations for lower respiratory tract infections in Mount Isa
Elisabeth K Janu1, Bhavana I Annabattula2, Saampavi Kumariah2
1School of Medicine, University of Western Sydney, Sydney, NSW, Australia. Elisabeth.Janu@health.nsw.gov.au.
Insights
Indigenous children in north-west Queensland experience significantly higher rates of acute lower respiratory tract infection (ALRI) and pneumonia compared to non-Indigenous children. These findings highlight persistent health disparities requiring targeted interventions.
Area of Science:
- Pediatric infectious diseases
- Public health
- Epidemiology
Background:
- Acute lower respiratory tract infection (ALRI) poses a significant health burden on children globally.
- Indigenous populations often face disproportionately higher rates of infectious diseases due to various socioeconomic and environmental factors.
- Understanding the specific epidemiology of ALRI in distinct regions is crucial for effective public health strategies.
Purpose of the Study:
- To compare the incidence of acute lower respiratory tract infection (ALRI) among children in north-west Queensland.
- To analyze ALRI rates based on age, sex, and Indigenous status.
- To identify specific types of ALRI, including pneumonia, bronchiolitis, and bronchiectasis, and their prevalence within different demographic groups.
Main Methods:
- A retrospective chart review was conducted at Mt Isa Base Hospital, Queensland.
- Data encompassed hospitalizations for children under 15 years of age from January 1, 2007, to December 31, 2011.
- Admission rates for specific ALRI conditions were calculated using Australian Bureau of Statistics population data.
Main Results:
- A total of 356 ALRI admissions involved 276 children, with significantly higher rates among Indigenous children (24.1 per 1000 population) compared to non-Indigenous children (4.5 per 1000 population).
- Pneumonia admissions were frequent, particularly among Indigenous children (13.7 per 1000 population), and bronchiectasis was exclusively observed in Indigenous children.
- Hospitalizations for bronchiolitis were also higher in Indigenous children (71.3% of cases), and a third of all ALRI cases presented with gastrointestinal symptoms.
Conclusions:
- ALRI rates in Mt Isa are comparable to the high rates reported in the Northern Territory, indicating a severe public health issue.
- The high frequency of multiple admissions suggests a substantial underlying burden of bronchiectasis, particularly among Indigenous children.
- Pneumonia may manifest with gastrointestinal symptoms, and invasive pneumococcal disease should be considered even in vaccinated children.
Objective:
To compare the rates of acute lower respiratory tract infection (ALRI) among children in north-west Queensland, according to age, sex and Indigenous status.
Design, Setting And Patients:
Retrospective chart review of hospitalisations at Mt Isa Base Hospital, Queensland, from 1 January 2007 to 31 December 2011 among children < 15 years of age.
Main Outcome Measures:
Rates of admission for bronchiolitis, pneumonia and bronchiectasis, calculated using population data from the Australian Bureau of Statistics.
Results:
There were 356 admissions for ALRI, involving 276 children. Of the 162 children aged < 12 months old, 125 (77.2%) were Indigenous. Hospitalisations increased over the study period, and rates were significantly higher among Indigenous children compared with non-indigenous children (24.1 v 4.5 per 1000 population per year). There were 195 admissions of 164 children with pneumonia, 126 (76.8%) of whom were Indigenous. Annual rates for Indigenous children were higher than for non-Indigenous children (13.7 v 2.3 per 1000 population). Multiple admissions were common. One-third presented with gastrointestinal symptoms and signs. Pneumococcal disease persisted despite vaccination. There were 160 hospitalisations for bronchiolitis; 114 occasions (71.3%) involved Indigenous children. Seven children had bronchiectasis; all were Indigenous.
Conclusion:
Rates of ALRI in Mt Isa are comparable to those in the Northern Territory, which is reported to have rates of pneumonia among the highest in the world for children < 12 months of age. Multiple admissions are common, suggesting an even higher rate of bronchiectasis. Pneumonia may present as gastrointestinal disease, and invasive pneumococcal infection must be suspected despite vaccination.