Prevalence of chronic respiratory disease in Australian Aboriginal children

Abstract

<b>Introduction:</b> The burden of bronchiectasis is disproportionately high in Aboriginal adults, causing early mortality. Bronchiectasis precursors, i.e., protracted bacterial bronchitis (PBB) and chronic suppurative lung disease (CSLD) often commence in childhood. We previously reported 10% prevalence of PBB in Aboriginal children aged 0-7years. However, there are scant data on the prevalence of chronic lung disease in older children. Our study aimed to determine the prevalence of PBB, CSLD, bronchiectasis, asthma and chronic wet cough in Aboriginal children living in four communities. <b>Methods:</b> A whole-population cross-sectional community co-designed study of Aboriginal children aged &lt;18-years in four remote communities in Western Australia across two-time points, a month apart. Children were assessed by paediatric 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. <b>Results:</b> The median age of the 392 (91·6%) children recruited was 8·4 years (IQR 5·1-11·5). Seventy children (17·9%) had a chronic respiratory pathology or abnormal spirometry values. PBB was confirmed in 30 (7·7%), CSLD=13 (3·3%), bronchiectasis=5 (1·3%) and asthma=17 (4·3%). Prevalence of chronic wet cough (12.5% overall) significantly increased with age. <b>Conclusion:</b> The prevalence of PBB, CSLD and bronchiectasis is high in Aboriginal children. Chronic wet cough increases with age. The high disease burden in Aboriginal children highlights the urgent need for strategies to address these conditions.