Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.
Department of Physiotherapy, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Pediatr Pulmonol. 2022 Dec;57(12):3136-3144. doi: 10.1002/ppul.26148. Epub 2022 Sep 23.
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.
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.
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.
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.
支气管扩张症在原住民成年人中负担过重，死亡率较高。支气管扩张症的前体，即迁延性细菌性支气管炎（PBB）和慢性化脓性肺疾病（CSLD），通常在儿童早期开始。我们之前报告了 0 至 7 岁原住民儿童中 PBB 的患病率为 10%，但尚无关于年长儿童慢性肺部疾病患病率的数据。我们的研究旨在确定居住在四个社区的原住民儿童中 PBB、CSLD、支气管扩张症和哮喘的患病率。
这是一项在西澳大利亚州四个偏远社区进行的全人群、横断面、社区共同设计的研究，涉及两个时间点，间隔一个月。由儿科呼吸临床医生对儿童进行评估，并在 2021 年 3 月至 9 月期间尽可能进行肺功能检查。对有呼吸道症状的儿童进行随访，通过当地诊所的医疗记录审核或通过呼吸道专家诊所进行随访，一直随访到 2022 年 3 月，以确定最终诊断。
我们从选定的社区中招募了 392 名（91.6%）儿童；中位数年龄为 8.4 岁（四分位距 [IQR] 5.1-11.5）。70 名儿童（17.9%）有慢性呼吸道病理或异常肺功能检查结果。30 名（7.7%）儿童确诊为 PBB，13 名（3.3%）儿童确诊为 CSLD，5 名（1.3%）儿童确诊为支气管扩张症，17 名（4.3%）儿童确诊为哮喘。慢性湿咳的患病率随年龄增长而显著增加。
原住民儿童中 PBB、CSLD 和支气管扩张症的患病率较高，慢性湿咳随年龄增长而增加。这项研究强调了原住民儿童的高疾病负担，迫切需要制定策略来解决这些问题。
