Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
Arch Bronconeumol. 2024 Jun;60(6):364-373. doi: 10.1016/j.arbres.2024.03.003. Epub 2024 Mar 10.
Bronchiectasis, particularly in children, is an increasingly recognised yet neglected chronic lung disorder affecting individuals in both low-to-middle and high-income countries. It has a high disease burden and there is substantial inequity within and between settings. Furthermore, compared with other chronic lung diseases, considerably fewer resources are available for children with bronchiectasis. The need to prevent bronchiectasis and to reduce its burden also synchronously aligns with its high prevalence and economic costs to health services and society. Like many chronic lung diseases, bronchiectasis often originates early in childhood, highlighting the importance of reducing the disease burden in children. Concerted efforts are therefore needed to improve disease detection, clinical management and equity of care. Modifiable factors in the causal pathways of bronchiectasis, such as preventing severe and recurrent lower respiratory infections should be addressed, whilst also acknowledging the role played by social determinants of health. Here, we highlight the importance of early recognition/detection and optimal management of bronchiectasis in children, and outline our research, which is attempting to address important clinical knowledge gaps discussed in a recent workshop. The research is grouped under three themes focussing upon primary prevention, improving diagnosis and disease characterisation, and providing better management. Our hope is that others in multiple settings will undertake additional studies in this neglected field to further improve the lives of people with bronchiectasis. We also provide a resource list with links to help inform consumers and healthcare professionals about bronchiectasis and its recognition and management.
支气管扩张症，特别是在儿童中，是一种日益被认识但被忽视的慢性肺部疾病，影响着中低收入和高收入国家的个体。它具有很高的疾病负担，在不同环境中存在着很大的不平等。此外，与其他慢性肺部疾病相比，患有支气管扩张症的儿童可获得的资源要少得多。预防支气管扩张症和减轻其负担的需求也与它在卫生服务和社会中的高患病率和经济成本同步。与许多慢性肺部疾病一样，支气管扩张症通常在儿童早期就已出现，这突显了减少儿童疾病负担的重要性。因此，需要共同努力来改善疾病的检测、临床管理和护理的公平性。应该解决支气管扩张症病因途径中的可改变因素，如预防严重和反复的下呼吸道感染，同时也要认识到健康决定因素在其中的作用。在这里，我们强调了早期识别/检测和优化儿童支气管扩张症管理的重要性，并概述了我们的研究，这些研究正在尝试解决最近一次研讨会讨论的重要临床知识空白。该研究分为三个主题，重点关注初级预防、改善诊断和疾病特征以及提供更好的管理。我们希望在这个被忽视的领域，其他多个环境中的其他人也能进行更多的研究，以进一步改善支气管扩张症患者的生活。我们还提供了一个资源列表，链接到相关信息，以帮助告知消费者和医疗保健专业人员关于支气管扩张症及其识别和管理的信息。
