Prevalence of chronic moist cough in Kimberley Aboriginal children

Respiratory illnesses account for 8% of the health-gap in mortality between Aboriginal and other Australians and most deaths occur before the age of 65. Respiratory illness is the most common reason for hospitalisation of Aboriginal children and the second most common cause of hospitalisation in Aboriginal adults. The burden of chronic lung disease in Aboriginal adults can be substantially reduced if early lung disease is managed effectively in children.

Chronic moist cough (CC) in children is the earliest sign of chronic lung disease –specifically chronic suppurative lung disease (CSLD) that leads to irreversible structural lung damage. Unfortunately CC is often normalised in Aboriginal children. Normalisation of symptoms prevents timely medical health seeking behaviour and appropriate treatment that could prevent long-term structural lung damage. Experience and evidence suggest that CC is highly prevalent amongst Aboriginal children in regional and remote Australia.

Determining the presence of moist cough in children requires expertise –particularly as children may not cough on demand and normalisation of symptoms prevents accurate history taking. Physiotherapists with training in paediatric respiratory medicine are perhaps the most skilled to elicit moist cough in children. We aim to determine the prevalence of CC in remote Aboriginal communities. We will do so by partnering with and up-skilling of regional physiotherapists, who regularly visit the communities, thereby allowing accurate longitudinal follow-up.

The study will occur in 4 Kimberley communities. The Kimberly has a high prevalence of CSLD in Aboriginal children and disproportionately high incidence of pneumonia in Aboriginal children (14.5 times the number of admissions than Non-Aboriginal children and almost double the number of admissions for Aboriginal children in Perth. Pneumonia carries a high risk for development of CSLD. In addition we currently conduct paediatric respiratory clinics in the Kimberley and we have strong support from local stakeholders, increasing the likelihood of impact.