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北领地顶端地区和偏远地区人群的慢性呼吸道疾病:专科呼吸外展服务的视角

Chronic respiratory disease in the regional and remote population of the Northern Territory Top End: A perspective from the specialist respiratory outreach service.

作者信息

Kruavit Anuk, Fox Melissa, Pearson Rebecca, Heraganahally Subash

机构信息

Royal Darwin Hospital, Darwin, Northern Territory, Australia.

出版信息

Aust J Rural Health. 2017 Oct;25(5):275-284. doi: 10.1111/ajr.12349. Epub 2017 Jun 15.

DOI:10.1111/ajr.12349
PMID:28618108
Abstract

OBJECTIVE

To study the demographic, rates and types of chronic respiratory conditions in Indigenous and non-Indigenous patients in regional and remote communities of Northern Territory Top End, who were referred to the specialist respiratory outreach service.

DESIGN

A retrospective, observational study over a 2 years period.

SETTING

Remote community health clinics within the Northern Territory Top End visited by the specialist respiratory outreach team.

PARTICIPANTS

Only patients referred to respiratory specialist outreach team were included. There were 444 participants, with 210 males and 234 females. In total, 79.3% were Indigenous.

MAIN OUTCOME MEASURES

The rates of chronic respiratory disease diagnoses and smoking status within the different communities and health district regions.

RESULTS

Chronic obstructive pulmonary disease (COPD) was the most common primary respiratory condition in our cohort of patients (50.5%) followed by sleep apnoea in (14.2%), bronchiectasis in (11.6%), asthma (11%), interstitial lung disease (2.5%), nodule/cancer (1.8%) sarcoidosis (0.2%) and others (9.2%). COPD, smoking status and bronchiectasis was more frequently noted among the Indigenous patients compared to non-Indigenous patients (56.3% versus 28.3%, P < 0.001), (52.6% versus 25.0%, P < 0.001), and (12.5% versus 3.3%, P = 0.01) respectively. Obstructive sleep apnoea was more commonly diagnosed in non-Indigenous patients.

CONCLUSION

Indigenous patients of the remote and rural communities of the Top End have significantly higher rates of smoking and COPD compared to non-Indigenous patients. Bronchiectasis is also more common among Indigenous patients. Further efforts are warranted to develop strategies to address the disparity and optimise the respiratory outreach service to this population.

摘要

目的

研究北领地顶端地区偏远社区中,被转诊至专科呼吸外展服务的原住民和非原住民患者的人口统计学特征、慢性呼吸道疾病的发病率及类型。

设计

一项为期2年的回顾性观察研究。

地点

北领地顶端地区的偏远社区健康诊所,由专科呼吸外展团队进行走访。

参与者

仅纳入被转诊至呼吸专科外展团队的患者。共有444名参与者,其中男性210名,女性234名。总计79.3%为原住民。

主要观察指标

不同社区和健康区区域内慢性呼吸道疾病的诊断率及吸烟状况。

结果

慢性阻塞性肺疾病(COPD)是我们患者队列中最常见的原发性呼吸道疾病(50.5%),其次是睡眠呼吸暂停(14.2%)、支气管扩张(11.6%)、哮喘(11%)、间质性肺疾病(2.5%)、结节/癌症(1.8%)、结节病(0.2%)以及其他(9.2%)。与非原住民患者相比,原住民患者中COPD、吸烟状况和支气管扩张更为常见(分别为56.3%对28.3%,P < 0.001),(52.6%对25.0%,P < 0.001),以及(12.5%对3.3%,P = 0.01)。阻塞性睡眠呼吸暂停在非原住民患者中更常被诊断出。

结论

与非原住民患者相比,北领地顶端地区偏远农村社区的原住民患者吸烟率和COPD发病率显著更高。支气管扩张在原住民患者中也更常见。有必要进一步努力制定策略,以解决这种差异,并优化针对该人群的呼吸外展服务。

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