The lung condition bronchiectasis remains under-recognised and undertreated in Australia, despite being the third most common chronic respiratory disorder, according to a perspective published in the Medical Journal of Australia.
An updated position statement on chronic suppurative lung disease and bronchiectasis in children, adolescents and adults has been published to help medical professionals in diagnosing and treating bronchiectasis.
Bronchiectasis is an obstructive lung disease featuring abnormal dilatation of the bronchi and is characterised by chronic cough, sputum production and recurrent respiratory infections that can have significant impact on quality of life.
In Australia, it is most commonly found in Indigenous populations in remote northern communities, with 1470 per 100 000 children aged less than 14 years and 23% of Indigenous adults undergoing computed tomography scans having evidence of bronchiectasis.
The condition has a devastating impact on life expectancy, with Indigenous Australians with bronchiectasis dying 20 years earlier than non-Indigenous adults with bronchiectasis.
In an Australian cohort study, 60% of adults referred for bronchiectasis had symptoms dating back to childhood.
Since bronchiectasis is potentially reversible if diagnosed and treated early in children, the authors hope to raise awareness of the disease with the updated statement.
The updated position statement expands on the 2015 guidelines, with modifications to 28 of the existing statements offering greater detail and explanatory comments.
The statements provide guidance for health practitioners for when to refer children to paediatric respiratory specialist services, suggested investigations for determining underlying aetiology, suggestions for antibiotic selection, and recommendations for optimising management of patients.
The update highlights the need to investigate underlying causes and comorbid conditions of bronchiectasis and emphasises the importance of providing patients with continuity of care when transitioning from paediatric to adult services.
The 2023 publication also covers emerging issues such as advising against the use of electronic cigarettes, and the potential of telehealth in maintaining equitable access to specialist services in remote areas.
Further updates in the future are expected as understanding of the disease evolves.
Read the perspective in the Medical Journal of Australia
- Annika Howells