Bronchiectasis in the Kimberley region of Western Australia

Barton, Justin; Scott, Lydia; Maguire, Graeme

doi:10.1111/ajr.12411

Cited by 11 publications

(19 citation statements)

References 11 publications

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“…The study was conducted between October 2017 and June 2018 in two primary healthcare AMS (town and remote community) and a regional hospital in the Kimberley, Western Australia, known to have a high incidence of respiratory morbidity . The Kimberley is a vast and remote region with a tropical, monsoonal climate.…”

Section: Methodsmentioning

confidence: 99%

“…6 Over time, PBB can lead to chronic suppurative lung disease (CSLD) and bronchiectasis, 2,7 which can occur in early childhood. 1 Bronchiectasis is prevalent in Aboriginal Australians and results in impaired general health, 8,9 reduced quality of life 10 and premature mortality, 11,12 contributing to the substantial gap in health outcomes and life expectancy between Aboriginal and non-Aboriginal people. 11,12 Children with PBB are typically preschool aged and apart from having a cough, appear well.…”

Section: Introductionmentioning

confidence: 99%

“…1 Bronchiectasis is prevalent in Aboriginal Australians and results in impaired general health, 8,9 reduced quality of life 10 and premature mortality, 11,12 contributing to the substantial gap in health outcomes and life expectancy between Aboriginal and non-Aboriginal people. 11,12 Children with PBB are typically preschool aged and apart from having a cough, appear well. 5 The cough typically worsens with inter-current viral illnesses but never completely resolves except with appropriate antibiotic therapy.…”

Section: Introductionmentioning

confidence: 99%

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We won't find what we don't look for: Identifying barriers and enablers of chronic wet cough in Aboriginal children

et al. 2019

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Background and objective Chronic lung disease is prevalent among Australian Aboriginal children. Chronic wet cough is an early marker of disease but often goes undetected. Currently, no studies have examined health practitioner knowledge of chronic wet cough. We set out to examine health practitioner knowledge of chronic wet cough and chronic lung disease in Aboriginal children and to identify barriers and enablers to effective management. Method A qualitative study, gathering data through individual semi‐structured, in‐depth interviews and focus groups to ascertain health practitioner knowledge about management of Aboriginal children with chronic wet cough in a regional Kimberley town and remote community. Results Thirty‐seven health practitioners participated. Key barriers identified were: (i) limited training in assessment and management of chronic wet cough; (ii) prioritization of acute presentations and competing complex chronic conditions; and (iii) normalization of cough in children by health practitioners. Key enablers were: (i) improving practitioners’ knowledge and expertise in managing chronic wet cough; and (ii) health system changes to facilitate longitudinal patient care, improved cultural competence, improved chronic disease management and post‐hospitalization follow‐up. Conclusion Key barriers to effective management of chronic wet cough are limited training in chronic wet cough management combined with competing complexities of both acute and chronic healthcare needs for Aboriginal families. Early detection and management of chronic wet cough in Aboriginal children can be facilitated through health practitioner training, access to standardized management guidelines and a service model that allows longitudinal patient follow‐up and resources to effectively prevent and manage chronic lung disease in children.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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We won't find what we don't look for: Identifying barriers and enablers of chronic wet cough in Aboriginal children

et al. 2019

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“…2 In the Kimberley region of Australia, the median age at death for Aboriginal adults hospitalised with bronchiectasis is 33 years. 3 Early recognition leading to the diagnosis and treatment of the precursors of bronchiectasis, that is, protracted bacterial bronchitis (PBB) and chronic suppurative lung disease, can potentially prevent progression to irreversible bronchiectasis. [4][5][6] As chronic wet/productive cough is the dominant symptom of PBB and bronchiectasis 7 in children, recognition of this symptom by parents and health practitioners is necessary for early detection.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…A recent study reported that the average age of death in patients with bronchiectasis was 22 years younger in Aboriginal patients than non‐Aboriginal patients . In the Kimberley region of Australia, the median age at death for Aboriginal adults hospitalised with bronchiectasis is 33 years …”

mentioning

confidence: 99%

Chronic wet cough in Aboriginal children: It's not just a cough

D'Sylva

Walker

Lane

et al. 2018

J Paediatrics Child Health

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Aim Chronic respiratory disease is common among Aboriginal Australians. Chronic wet cough is an early marker of chronic disease in children but often goes undetected due, in part, to delayed health seeking by families. Currently, no studies have examined the reasons for delayed health seeking for children's chronic cough. To identify the barriers to, and enablers for, seeking medical help for chronic wet cough in Aboriginal children. Methods This was a qualitative study, gathering data through individual semi‐structured, in‐depth interviews and focus groups to ascertain Aboriginal family knowledge, attitudes and beliefs about seeking health care for chronic wet cough in children in a regional Kimberley town, Western Australia between October 2017 and March 2018. Results Forty Aboriginal community members participated. The three key barriers identified were: ‘Cough normalisation’, that is, 70% of participants considered chronic cough normal (with 53% of participants' previous interactions with doctors informing their understanding of chronic cough); the lack of health literacy information; and a sense of disempowerment (belief that no medical action would be taken and inability to challenge doctors). The key expressed enablers were provision of health literacy information and health practitioner training to assess and treat chronic wet cough in children. All participants reported that they would seek help for chronic wet cough once they were informed that it could signify underlying disease. Conclusion Results highlight the need for a culturally appropriate information and education to inform Aboriginal families and their health practitioners of the importance of chronic wet cough in children.

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Improving care for people with bronchiectasis: opportunities and challenges highlighted from service evaluation

Rees

Liu

Pascoe

et al. 2022

Internal Medicine Journal

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Background Bronchiectasis is a serious, debilitating condition warranting specialist care. Aims To determine if care provided in a tertiary hospital general respiratory clinic was guideline concordant and to validate the Bronchiectasis Severity Index (BSI) in the Australian context. Methods A single‐centre ambispective study was conducted. The first stage involved a retrospective medical record audit between 1 January 2015 and 31 December 2016. All aspects of bronchiectasis management were reviewed. In the second prospective phase the cohort was followed for 4 years to determine survival and the validity of the BSI determined. Results A total of 145 patients was included, with mean age of 65 years (standard deviation = 16.6). The aetiology of bronchiectasis was explicitly documented for 58 (40%) patients, with potential causes identified in another 37 patients. Post‐infectious aetiologies were described in 62 (43%) patients. Most patients had lung function testing (n = 142; 97%) and sputum culture results (n = 120; 83%). Long‐term antibiotics were prescribed to 49 (34%) patients. Only patients culturing Pseudomonas spp. were prescribed inhaled antibiotics. Documentation regarding essential management recommendations was low, including airway clearance (46%), pneumococcal vaccination (27%) and written action plans (32%). Severe disease was common, with more than one‐third (34–48%) having BSI scores >9. One‐fifth (21%) of the cohort died during the 4‐year follow‐up period. The BSI was significantly associated with mortality risk (odds ratio 7.7; 95% confidence interval = 3.1–19.3; P < 0.001). Conclusion Our cohort had a high proportion of patients with severe disease and significant mortality; some, but not all, aspects of recommended care were delivered.

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Bronchiectasis in the Kimberley region of Western Australia

Cited by 11 publications

References 11 publications

We won't find what we don't look for: Identifying barriers and enablers of chronic wet cough in Aboriginal children

We won't find what we don't look for: Identifying barriers and enablers of chronic wet cough in Aboriginal children

Chronic wet cough in Aboriginal children: It's not just a cough

Improving care for people with bronchiectasis: opportunities and challenges highlighted from service evaluation

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