Preventing long-term lung problems in Aboriginal children
19 May 2003
Poor health associated with chronic (long-term) lung disease in Aboriginal children could be reduced with appropriate follow-up care after Aboriginal children are hospitalised for pneumonia, according to research published in the most recent edition of the Medical Journal of Australia.
The study looked at 109 Aboriginal children aged between 2 months and 13.5 years, who were admitted to Alice Springs Hospital between October 2000 and April 2001 with pneumonia.
Results of the study show that the children who had X-ray changes in the alveoli (the cells that are involved in oxygen exchange at the ends of the airways) when admitted to hospital were particularly susceptible to long-term respiratory illness.
The study recommends that these children should be followed up for early detection and management of diseases such as bronchiectasis (a persistent and progressive dilation of the small airways that can result from ongoing inflammation and/or infection of the airways).
Of the 109 children in the study, 78 received complete follow-up care, and a new, treatable chronic respiratory condition was diagnosed in over 25 per cent of these children.
The study found that all of the chronic respiratory disease identified in these children at the follow-up visit — 12 months after the hospital admission — had occurred in those children who showed no or only minimal resolution of alveolar changes on a pre-discharge chest X-ray.
‘It is common practice for children hospitalised in Australian paediatric centres to have an initial and follow-up chest X-ray,’ said one of the study authors Associate Professor Anne Chang, from the Royal Children’s Hospital in Brisbane.
However, Dr Chang added that: ‘For children in remote communities, a follow-up chest X-ray often involves a plane flight, overnight accommodation, major disruption to family life and high costs.
‘A pre-discharge X-ray could potentially reduce the economic and social costs of following up all children.
‘There are several reasons that may explain the high rates of disease found on follow-up, and one important reason is the children’s living environment. Thus, the increased risk of lower respiratory infection is associated with inadequate and poor quality housing, inadequate water supply and exposure to tobacco smoke.
‘A critical question for future research is whether treatment with antibiotics for 5 days is inadequate, resulting in persistent low-grade bacterial bronchitis. It is possible that incomplete eradication of bacteria in early bacterial pneumonia, as well as persistent airway inflammation, promotes the development of bronchiectasis,’ she said.
Last Reviewed: 16 May 2003
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