Bronchiectasis among Australian Aboriginal and non-Aboriginal patients in the regional and remote population of the Northern Territory of Australia

Sumit  Mehra; Anne Chang; Chor  Lam; Stuart  Campbell; Joy  Mingi; Izaak Thomas; Suzanne Harwood; Graeme  Maguire; Subash Heraganahally

doi:10.22605/RRH6390

Rural and Remote Health (Apr 2021)

Bronchiectasis among Australian Aboriginal and non-Aboriginal patients in the regional and remote population of the Northern Territory of Australia

Sumit Mehra ,
Anne Chang,
Chor Lam ,
Stuart Campbell ,
Joy Mingi ,
Izaak Thomas,
Suzanne Harwood,
Graeme Maguire ,
Subash Heraganahally

Affiliations

Sumit Mehra: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; and Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia
Anne Chang: Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia; Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia; and Center of Children’s Health Research, Australian Centre For Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
Chor Lam: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
Stuart Campbell: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Department of General Medicine, Gold Coast University Hospital, Southport, Queensland, Australia; and School of Medicine, Griffith University, Southport, Queensland, Australia
Joy Mingi: Department of Public Health, Charles Darwin University, Darwin, Northern Territory, Australia; and Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia
Izaak Thomas: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Suzanne Harwood: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Graeme Maguire: Melbourne Medical School, The University of Melbourne, Victoria, Australia
Subash Heraganahally: Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; and Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia

DOI: https://doi.org/10.22605/RRH6390
Journal volume & issue: Vol. 21

Abstract

Read online

Introduction: Chronic respiratory disorders are highly prevalent among Australian Aboriginal people living in the Top End Health Service region in the Northern Territory, Australia. Bronchiectasis is a heterogenous disease that features among these chronic respiratory conditions in this population. However, there are sparse comparative data between Aboriginal and non-Aboriginal patients with bronchiectasis from this region. Methods: In this retrospective study, demographics, clinical characteristics and relevant laboratory parameters were compared among adult Aboriginal and non-Aboriginal patients diagnosed with bronchiectasis between 2012 and 2017. Results: A total of 388 adults had radiology-confirmed bronchiectasis and 258 (66%) were Aboriginal. Compared to non-Aboriginal patients, Aboriginal patients were significantly younger (mean age 54 v 67 years), the majority lived in rural and remote communities (80% v 9 %), had higher rates of self-reported smoking (52% v 19%), alcohol consumption (29% v 12%) and co-occurrence of chronic obstructive pulmonary disease (65% v 38%) and other chronic co-morbidities. Sputum microbiology was also different between the groups with Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis being more common in Aboriginal patients, while Pseudomonas aeruginosa, Aspergillus species and non-tuberculous mycobacteria were higher in non-Aboriginal patients. Further, Aboriginal patients had poorer lung function compared to non-Aboriginal patients (forced expiratory volume after 1 second predicted 33% v 53%, forced vital capacity predicted 49% v 60% respectively), higher exacerbation rates (29% v 18%) and poorer overall outcomes (age at death 60 v 76 years). Conclusion: Within a single health service, Aboriginal patients with bronchiectasis have significantly poorer outcomes with differing manifestations and higher comorbidities than non-Aboriginal patients. This warrants further studies to identify feasible interventions to reduce this inequity.

Published in Rural and Remote Health

ISSN: 1445-6354 (Online)
Publisher: James Cook University
Country of publisher: Australia
LCC subjects: Medicine: Internal medicine: Special situations and conditions; Medicine: Public aspects of medicine
Website: https://www.rrh.org.au/

About the journal

Abstract

Keywords