Review of respiratory disease among Aboriginal and Torres Strait Islander children

The term respiratory disease refers to a number of conditions that affect the lungs or their components [1]; each of these conditions is characterised by some level of impairment of the lungs in performing the essential function of gas exchange [2]. Respiratory diseases, which can be caused by a variety of different factors and other medical problems (which may or may not start in the lungs), are generally divided into two basic categories: acute respiratory infections and chronic respiratory diseases [3]. While respiratory diseases are major causes of poor health across the lifespan and death in Aboriginal and Torres Strait Islander people [4], this review focuses on the respiratory health of Aboriginal and Torres Strait Islander children. In 2012–2013, one-fifth of Aboriginal and Torres Strait Islander children aged 0–14 years were reported to have had a long-term respiratory condition [5]. In 2014–15, they were up to two times more likely to be hospitalised for selected respiratory conditions (asthma, influenza and pneumonia, whooping cough and acute respiratory infections) compared with non-Indigenous children [6]. Selected respiratory diseases (asthma, upper and lower respiratory conditions) were in the top ten specific conditions responsible for the total burden of diseases among Aboriginal and Torres Strait Islander children in 2011 [3]. The high levels of respiratory disease among Aboriginal and Torres Strait Islander children reflect a broad range of contributing factors, which are discussed in this review. Throughout this review, it important for readers to take into account that Aboriginal and Torres Strait Islander groups vary with regard to geography, socioeconomic status and local customs, and ‘Indigenous’ as a descriptor belies the heterogeneity among cultures and belief systems that impacts on perceptions of disease and treatments. Further, as the review highlights, there is a paucity of high quality data and research that addresses respiratory diseases in children, with most limited to children in remote regions of Western Australia (WA), the Northern Territory (NT) and Queensland (Qld). Hence caution is required in generalising information from limited data to all Aboriginal and Torres Strait Islander children, particularly from data collected in remote communities and applying to urban communities and vice-versa.