Search

Background: Globally, adult Indigenous people, including Aboriginal Australians, have a high burden of chronic respiratory disorders, and bronchiectasis is no exception. However, literature detailing bronchiectasis disease characteristics among adult Indigenous people is sparse. This study assessed the clinical profile of bronchiectasis among adult Aboriginal Australians and compared against previously published international bronchiectasis registry reports., Methods: Aboriginal Australians aged >18 years with chest CT confirmed bronchiectasis between 2011 and 2020 in the Top End Northern Territory of Australia were included. Demographics, chest CT findings, pulmonary function results, sputum microbiology, coexistent medical comorbidities, and pharmacotherapy use were assessed and compared against five published international bronchiectasis registry reports (Australian (ABR), European (European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC)-Europe), Indian (EMBARC-India), Korean (KMBARC) and the USA (USBRR))., Results: A total of 459 patients were assessed. In comparison with international and non-Aboriginal Australian national cohorts, Aboriginal Australians were younger (median 56 years (IQR (48, 65)); however, sex distribution (55% female) and body mass index (23 kg/m 2 (IQR 19.4-27)) were comparable . Smoking rates were higher at 85% compared with other registry cohorts (22-46%) as was the prevalence of comorbidities (97%): cardiovascular diseases (73%), diabetes mellitus (50%) and chronic obstructive pulmonary disease (83%) compared with other registry cohorts (4-32%; 6-14%; and 14-37%, respectively). Spirometry demonstrated forced expiratory volume in 1 s of 38% predicted in comparison with 61-77% in other cohorts. Sputum microbiology showed Haemophilus influenzae (57%) isolated at 3.4 to 6 times the rate of other registry cohorts and Pseudomonas aeruginosa in 31%. Chest CT demonstrated multilobar and lower lobes involvement in 73% and inhaled pharmacotherapy use was recorded in up to 62% and long-term antibiotics in 5%., Conclusion: The overall bronchiectasis disease burden is higher in Aboriginal Australian adults in comparison with global ethnically diverse non-Indigenous populations. Further efforts are required to address this disparity secondary to bronchiectasis among Indigenous people., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: The prevalence of bronchiectasis among adult Aboriginal Australians is higher than that of non-Aboriginal Australians. However, despite evidence to suggest higher prevalence of bronchiectasis among Aboriginal people in Australia, there is sparce evidence in the literature assessing clinical parameters that may predict survival or mortality in this population., Methods: Aboriginal Australians residing in the Top End Health Service region of the Northern Territory of Australia aged >18 years with chest computed tomography (CT) confirmed bronchiectasis between 2011 and 2020 were included. Demographics, body mass index (BMI), medical co-morbidities, lung function data, sputum microbiology, chest CT scan results, hospital admissions restricted to respiratory conditions and all-cause mortality were assessed., Results: A total of 459 patients were included, of whom 146 were recorded deceased (median age at death 59 years). Among the deceased cohort, patients were older (median age 52 vs. 45 years, p = 0.023), had a higher prevalence of chronic obstructive pulmonary disease (91 vs. 79%, p = 0.126), lower lung function parameters (median percentage predicted forced expiratory volume in 1 s 29 vs. 40%, p = 0.149), a significantly greater proportion cultured non- Aspergillus fungi (65 vs. 46%, p = 0.007) and pseudomonas (46 vs. 28%, p = 0.007) on sputum microbiology and demonstrated bilateral involvement on radiology. In multivariate models advancing age, prior pseudomonas culture and Intensive care unit (ICU) visits were associated with increased odds of mortality. Higher BMI, better lung function on spirometry, prior positive sputum microbiology for Haemophilus and use of inhaled long-acting beta antagonist/muscarinic agents may have a favourable effect., Conclusion: The results of this study may be of use to stratify high risk adult Aboriginal patients with bronchiectasis and to develop strategies to prevent future mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Heraganahally, Gibbs, Ravichandran, Erdenebayar, Abeyaratne and Howarth.)