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Title: Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand
Contributor(s): Blackall, Sean R (author); Hong, Jae B (author); King, Paul (author); Wong, Conroy (author); Einsiedel, Lloyd (author); Rémond, Marc G W (author); Woods, Cindy  (author)orcid ; Maguire, Graeme P (author)
Publication Date: 2018
DOI: 10.1111/resp.13280
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Abstract: Background and objective: Bronchiectasis not associated with cystic fibrosis is an increasingly recognized chronic lung disease. In Oceania, indigenous populations experience a disproportionately high burden of disease. We aimed to describe the natural history of bronchiectasis and identify risk factors associated with premature mortality within a cohort of Aboriginal Australians, New Zealand Māori and Pacific Islanders, and non-indigenous Australians and New Zealanders. Methods: This was a retrospective cohort study of bronchiectasis patients aged >15 years at three hospitals: Alice Springs Hospital and Monash Medical Centre in Australia, and Middlemore Hospital in New Zealand. Data included demographics, ethnicity, sputum microbiology, radiology, spirometry, hospitalization and survival over 5 years of follow-up. Results: Aboriginal Australians were significantly younger and died at a significantly younger age than other groups. Age- and sex-adjusted all-cause mortality was higher for Aboriginal Australians (hazard ratio (HR): 3.9), and respiratory-related mortality was higher for both Aboriginal Australians (HR: 4.3) and Māori and Pacific Islander people (HR: 1.7). Hospitalization was common: Aboriginal Australians had 2.9 admissions/person-year and 16.9 days in hospital/person-year. Despite Aboriginal Australians having poorer prognosis, calculation of the FACED score suggested milder disease in this group. Sputum microbiology varied with Aspergillus fumigatus more often isolated from non-indigenous patients. Airflow obstruction was common (66.9%) but not invariable. Conclusions: Bronchiectasis is not one disease. It has a significant impact on healthcare utilization and survival. Differences between populations are likely to relate to differing aetiologies and understanding the drivers of bronchiectasis in disadvantaged populations will be key.
Publication Type: Journal Article
Source of Publication: Respirology, 23(8), p. 743-749
Publisher: Wiley-Blackwell Publishing Asia
Place of Publication: Australia
ISSN: 1440-1843
Fields of Research (FoR) 2008: 111099 Nursing not elsewhere classified
Fields of Research (FoR) 2020: 420202 Disease surveillance
450406 Aboriginal and Torres Strait Islander epidemiology
451005 Te mātai tahumaero o te Māori (Māori epidemiology)
Socio-Economic Objective (SEO) 2008: 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes
920305 Maori Health - Health Status and Outcomes
Socio-Economic Objective (SEO) 2020: 210302 Aboriginal and Torres Strait Islander health status and outcomes
210702 Te tūnga me ngā putanga hauora (Māori health status and outcomes)
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Health

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