Title:Bronchiectasis Among Adult First Nations Indigenous People - A Scoping
Review
Volume: 19
Issue: 1
Author(s): Timothy Howarth, Sanjana S. Heraganahally and Subash S. Heraganahally*
Affiliation:
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
Keywords:
Aboriginal, chronic obstructive pulmonary disease, bronchiectasis disease, pathogenesis, mucous production, HRCT, LRTI’s.
Abstract:
Background: Among First Nations adults living in OECD nations bronchiectasis appears
at a particularly heightened rate, due to high childhood incidence, and high prevalence of associated
risk factors. To date, however, the extent of the bronchiectasis disease burden among adult First Nations
people has not been formally assessed.
Methods: Two databases (Pubmed and Scopus) were reviewed for English literature published from
January 2000 to March 2022 pertaining to bronchiectasis among adult First Nations indigenous
people residing in OECD nations. All studies that reported on prevalence, incidence, or outcomes
(i.e., hospitalisations, mortality) directly associated with bronchiectasis were included. Studies that
did not provide indigenous specific, bronchiectasis specific data, or were paediatric studies were excluded.
Participant numbers and demographics, bronchiectasis prevalence or incidence, respiratory
comorbidities and outcomes including mortality, hospitalisations or univariate or multivariate modelling
to describe the risk of bronchiectasis and outcomes were tabulated.
Results: Twenty-five studies were included, drawn from Australia (n=16), New Zealand (n=7) and
North America (n=1), with most studies (n=21) reporting on referred populations. A median number
of participants was 241 (range 31 to 1765) (excluding nationwide hospitalisation datasets (n=3))
with a mean age of 48.4 years, and 55% females. The hospital admission rate for bronchiectasis was
3.5x to 5x higher among Māori compared to non-Māori New Zealanders, and 5x higher in indigenous
compared to non-indigenous Australians. Mortality ranged from 10 to 56% on follow-up.
Conclusion: Bronchiectasis disease burden is higher among adult First Nations indigenous populations,
presenting earlier with high mortality and hospitalisation rate. Further studies are required to
address this inequality.
