Bronchiectasis among Indigenous adults in the Top End of the Northern Territory, 2011–2020: a retrospective cohort study

Abstract

ObjectivesTo assess the prevalence of bronchiectasis among Aboriginal and Torres Strait Islander (Indigenous) adults in the Top End of the Northern Territory, and mortality among Indigenous adults with bronchiectasis.Study designRetrospective cohort study.Setting, participantsAboriginal and Torres Strait Islander adults (18 years or older) living in the Top End Health Service region of the NT in whom bronchiectasis was confirmed by chest computed tomography (CT) during 1 January 2011 – 31 December 2020.Main outcome measuresPrevalence of bronchiectasis, and all‐cause mortality among Indigenous adults with CT‐confirmed bronchiectasis — overall, by sex, and by health district — based on 2011 population numbers (census data).ResultsA total of 23 722 Indigenous adults lived in the Top End Health Service region in 2011; during 2011–2020, 459 people received chest CT‐confirmed diagnoses of bronchiectasis. Their median age was 47.5 years (interquartile range [IQR], 39.9–56.8 years), 254 were women (55.3%), and 425 lived in areas classified as remote (93.0%). The estimated prevalence of bronchiectasis was 19.4 per 1000 residents (20.6 per 1000 women; 18.0 per 1000 men). The age‐adjusted prevalence of bronchiectasis was 5.0 (95% CI, 1.4–8.5) cases per 1000 people in the Darwin Urban health area, and 18–36 cases per 1000 people in the three non‐urban health areas. By 30 April 2023, 195 people with bronchiectasis had died (42.5%), at a median age of 60.3 years (IQR, 50.3–68.9 years).ConclusionThe prevalence of bronchiectasis burden among Indigenous adults in the Top End of the NT is high, but differed by health district, as is all‐cause mortality among adults with bronchiectasis. The socio‐demographic and other factors that contribute to the high prevalence of bronchiectasis among Indigenous Australians should be investigated so that interventions for reducing its burden can be developed.

Factors influencing survival and mortality among adult Aboriginal Australians with bronchiectasis—A 10-year retrospective study

“…Baseline demographics, age, sex, including smoking status and BMI when available were recorded. Patients usual place of residence as per community/suburb/postcode were collected, with further categorisation into the four health districts of the Top End (Darwin Urban, Darwin Rural, East Arnhem and Katherine), and by community when communities had >10 bronchiectasis cases were present ( 27 ). Presence of respiratory conditions alongside bronchiectasis and other medical comorbidities, including inhaled pharmacotherapy use [short-acting/long-acting beta antagonist (SABA/LABA), short-acting/long-acting muscarinic agents (SAMA/LAMA), inhaled corticosteroids (ICS)] were recorded.…”

“…Mortality data was extracted through the hospital information system, death registry linkage was not utilised, and all-cause mortality was documented up until 31st December 2020. Further details on methods and study design are available form a recent report from our centre ( 27 ). The primary outcome in this study was all-cause mortality.…”

Hospital admission rates and related outcomes among adult Aboriginal australians with bronchiectasis – a ten-year retrospective cohort study

“…ICU visits and mechanical ventilation data were collected at the person level and not broken down per visit. Further details on methods and study design are available form a recent report from our centre [ 16 ].…”

“…In the First Nations Indigenous people's context, for the majority bronchiectasis is a lifelong disease, or at best an early adulthood to middle-age disease [10][11][12][13] (from here on "Indigenous" is used to refer to global First nations populations, while "Aboriginal Australian" is used to specifically refer to Australia's' First Nations people). In the paediatric Aboriginal Australian population, bronchiectasis incidence is one among the highest in the world [14,15], and the prevalence remains significantly higher among Aboriginal Australians compared to non-Aboriginal Australian adults [16], as well as among global Indigenous populations, as observed among the New Zealand's First Nations Indigenous Māori and Pacific Islander populations compared to New Zealand's non-Indigenous population [17,18].…”

Deciphering Idiopathic Bronchiectasis One Gene at a Time

“…It is often seen in common conditions such as chronic obstructive pulmonary disease ( 3 ). Bronchiectasis is disproportionately prevalent in areas that are resource restricted, where infections and healthcare disparity are often blamed for the development of bronchiectasis among endogenous populations around the world ( 4 , 5 ). Moreover, an increased burden of childhood respiratory illnesses and exposures to environmental pollutants may be a culprit in different regions ( 5 ).…”