Heraganahally Subash, Gibbs Claire, J Ravichandran Shiidheshwar, Erdenebayar Davaadorj, Chen Winnie, Abeyaratne Asanga, Jersmann Hubertus, Jayaram Lata, Howarth Timothy
Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Northern Territory Medical Program, Flinders University College of Medicine and Public Health, Darwin, Northern Territory, Australia.
BMJ Open Respir Res. 2025 Jan 21;12(1):e002139. doi: 10.1136/bmjresp-2023-002139.
Globally, adult Indigenous people, including Aboriginal Australians, have a high burden of chronic respiratory disorders, and bronchiectasis is no exception. However, literature detailing bronchiectasis disease characteristics among adult Indigenous people is sparse. This study assessed the clinical profile of bronchiectasis among adult Aboriginal Australians and compared against previously published international bronchiectasis registry reports.
Aboriginal Australians aged >18 years with chest CT confirmed bronchiectasis between 2011 and 2020 in the Top End Northern Territory of Australia were included. Demographics, chest CT findings, pulmonary function results, sputum microbiology, coexistent medical comorbidities, and pharmacotherapy use were assessed and compared against five published international bronchiectasis registry reports (Australian (ABR), European (European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC)-Europe), Indian (EMBARC-India), Korean (KMBARC) and the USA (USBRR)).
A total of 459 patients were assessed. In comparison with international and non-Aboriginal Australian national cohorts, Aboriginal Australians were younger (median 56 years (IQR (48, 65)); however, sex distribution (55% female) and body mass index (23 kg/m (IQR 19.4-27)) were comparable . Smoking rates were higher at 85% compared with other registry cohorts (22-46%) as was the prevalence of comorbidities (97%): cardiovascular diseases (73%), diabetes mellitus (50%) and chronic obstructive pulmonary disease (83%) compared with other registry cohorts (4-32%; 6-14%; and 14-37%, respectively). Spirometry demonstrated forced expiratory volume in 1 s of 38% predicted in comparison with 61-77% in other cohorts. Sputum microbiology showed (57%) isolated at 3.4 to 6 times the rate of other registry cohorts and in 31%. Chest CT demonstrated multilobar and lower lobes involvement in 73% and inhaled pharmacotherapy use was recorded in up to 62% and long-term antibiotics in 5%.
The overall bronchiectasis disease burden is higher in Aboriginal Australian adults in comparison with global ethnically diverse non-Indigenous populations. Further efforts are required to address this disparity secondary to bronchiectasis among Indigenous people.
在全球范围内，包括澳大利亚原住民在内的成年原住民慢性呼吸道疾病负担较重，支气管扩张也不例外。然而，详细描述成年原住民支气管扩张疾病特征的文献很少。本研究评估了成年澳大利亚原住民支气管扩张的临床特征，并与之前发表的国际支气管扩张登记报告进行了比较。
纳入2011年至2020年期间在澳大利亚北领地顶端地区年龄大于18岁且胸部CT确诊为支气管扩张的澳大利亚原住民。评估人口统计学、胸部CT检查结果、肺功能结果、痰液微生物学、并存的内科合并症以及药物治疗使用情况，并与五份已发表的国际支气管扩张登记报告（澳大利亚（ABR）、欧洲（欧洲多中心支气管扩张审计与研究协作组（EMBARC）-欧洲）、印度（EMBARC-印度）、韩国（KMBARC）和美国（USBRR））进行比较。
共评估了459例患者。与国际和非澳大利亚原住民全国队列相比，澳大利亚原住民年龄更小（中位年龄56岁（四分位间距（48, 65）））；然而，性别分布（55%为女性）和体重指数（23kg/m²（四分位间距19.4 - 27））相当。吸烟率为85%，高于其他登记队列（22 - 46%），合并症患病率也更高（97%）：心血管疾病（73%）、糖尿病（50%）和慢性阻塞性肺疾病（83%），而其他登记队列分别为（4 - 32%；6 - 14%；和14 - 37%）。肺量计显示第1秒用力呼气量预计值为38%，而其他队列则为61 - 77%。痰液微生物学显示，[具体微生物名称未给出]（57%）分离率是其他登记队列的3.4至6倍，[另一种具体微生物名称未给出]为31%。胸部CT显示73%的患者有多叶和下叶受累，高达62%的患者使用吸入药物治疗，5%的患者使用长期抗生素。
与全球不同种族的非原住民人群相比，成年澳大利亚原住民支气管扩张的总体疾病负担更高。需要进一步努力解决原住民中因支气管扩张导致的这种差异。
