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Published on: August 7, 2017
Prevalence of chronic respiratory diseases in Aboriginal children: A whole population study
Pamela Laird1,2,3, Nicola Ball1,4, Shekira Brahim1
1Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.
Insights
Protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD), and bronchiectasis are common in Aboriginal children. Chronic wet cough prevalence increases with age, highlighting a significant disease burden requiring urgent intervention.
Area of Science:
- Pediatric Respiratory Medicine
- Indigenous Health
- Epidemiology
Background:
- Bronchiectasis and its precursors, protracted bacterial bronchitis (PBB) and chronic suppurative lung disease (CSLD), disproportionately affect Aboriginal adults, often originating in childhood.
- Previous research indicated a 10% PBB prevalence in Aboriginal children aged 0-7 years, but data on older children were lacking.
- Chronic lung diseases pose a significant health burden in Indigenous populations, necessitating further investigation into early-life prevalence.
Purpose of the Study:
- To determine the prevalence of PBB, CSLD, bronchiectasis, and asthma in Aboriginal children.
- To assess chronic respiratory conditions in Aboriginal children across four Western Australian communities.
- To understand the age-related prevalence of chronic respiratory diseases in this population.
Main Methods:
- A cross-sectional, community co-designed study involving Aboriginal children under 18 years in four remote Western Australian communities.
- Pediatric respiratory clinician assessments, including spirometry where feasible, conducted across two time points.
- Follow-up via medical record audit and specialist clinic review to establish final diagnoses for children with respiratory symptoms.
Main Results:
- A total of 392 Aboriginal children were recruited, with a median age of 8.4 years.
- Seventy children (17.9%) presented with chronic respiratory pathology or abnormal spirometry.
- Prevalence rates included: PBB (7.7%), CSLD (3.3%), bronchiectasis (1.3%), and asthma (4.3%).
Conclusions:
- Protracted bacterial bronchitis, chronic suppurative lung disease, and bronchiectasis are highly prevalent in Aboriginal children.
- The incidence of chronic wet cough significantly increases with age in this demographic.
- Urgent implementation of targeted strategies is required to mitigate the high burden of these respiratory conditions in Aboriginal children.
Background:
The burden of bronchiectasis is disproportionately high in Aboriginal adults, with early mortality. Bronchiectasis precursors, that is, protracted bacterial bronchitis (PBB) and chronic suppurative lung disease (CSLD), often commence in early childhood. We previously reported a 10% prevalence of PBB in Aboriginal children aged 0 to 7 years, however there are no data on prevalence of chronic lung diseases in older children. Our study aimed to determine the prevalence of PBB, CSLD, bronchiectasis, and asthma in Aboriginal children living in four communities.
Methods:
A whole-population cross-sectional community co-designed study of Aboriginal children aged <18-years in four remote communities in Western Australia across two-time points, a month apart. Children were assessed by pediatric respiratory clinicians with spirometry undertaken (when possible) between March-September 2021. Children with respiratory symptoms were followed up via medical record audit from either the local medical clinic or via a respiratory specialist clinic through to March 2022 to establish a final diagnosis.
Findings:
We recruited 392 (91.6%) of those in the selected communities; median age = 8.4 years (interquartile range [IQR] 5.1-11.5). Seventy children (17.9%) had a chronic respiratory pathology or abnormal spirometry results. PBB was confirmed in 30 (7.7%), CSLD = 13 (3.3%), bronchiectasis = 5 (1.3%) and asthma = 17 (4.3%). The prevalence of chronic wet cough significantly increased with increasing age.
Interpretation:
The prevalence of PBB, CSLD and bronchiectasis is high in Aboriginal children and chronic wet cough increases with age. This study highlights the high disease burden in Aboriginal children and the urgent need for strategies to address these conditions.
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