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New Zealand national incidence of bronchiectasis “too high” for a developed country

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Authors:
Summary:

This paper sought to examine the incidence, aetiology and severity of bronchiectasis amongst New Zealand children. New cases of bronchiectasis were collected via monthly survey of paediatricians, and confirmed cases were followed up by questionnaire after 12 months. Over 94% of paediatricians provided data, and of 99 notifications received, 65 cases were confirmed. Median age at diagnosis was 5.2 years. Bilateral disease was present in 83% of cases. Mean FEV1 was 77% of predicted, and the modified Bhalla HRCT score was 18. The overall incidence of bronchiectasis in children < 15 years was estimated at 3.7 per 100,000, but varied by ethnicity and region. Rates per 100,000 by ethnicity were 17.8 for Pacific children, 4.8 for Mäori and 1.5 for New Zealand Europeans. The authors find that the incidence of bronchiectasis is high in NZ children. It is 7x the rate in Finland, the only other country which has reported a childhood national rate.

Comment:
An alarming paper from Dr Byrnes (Raukawa) and others alerting us to the fact that bronchiectasis is a significant health issue for tamariki and whanau. The most common and important cause of bronchiectasis is repeated severe infection of the lungs due to pneumonia, TB or whooping cough. Prevention therefore includes appropriate immunisation and prompt diagnosis and antibiotic treatment of chest infections, particularly in infancy and early childhood. These steps in the care pathway may be important factors contributing to ethnic differences in rates on bronchiectasis.
Reference: Reference: Arc Dis Child 2005; 90:737-740
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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