New Zealand national incidence of bronchiectasis: "too high" in a developed country

Jacob Twiss ^1*, Russell Metcalfe ¹, Elizabeth A Edwards ² and Catherine A Byrnes ³

¹ Starship Children's Hospital, Auckland, New Zealand
² Starship Children's hospital, New Zealand
³ University of Auckland, New Zealand

^* To whom correspondence should be addressed. E-mail: jtwiss{at}ihug.co.nz.

Accepted 14 March 2005

Abstract

Aims:To prospectively estimate the incidence of bronchiectasis amongst New Zealand (NZ) children, to consider aetiology and severity, and to evaluate regional and ethnic variation.

Methodology:NZ paediatricians were surveyed monthly for new cases of bronchiectasis during 2001 and 2002 via the NZ paediatric surveillance unit (with coverage of > 94% of NZ paediatricians). Notified cases had their computer tomography scans reviewed and scored for severity. Confirmed cases were followed up by postal questionnaire one year after diagnosis. Demographic, aetiological and severity data was collected.

Results:Ninety nine notifications were received. Sixty five cases were confirmed. An overall incidence of 3.7 per 100,000 under 15 year old children per year was estimated. Incidence was highest in Pacific children, 17.8 compared with 4.8 in Maori, 1.5 in NZ European and 2.4 other per 100,000 per year. Incidence varied significantly by region. The median age at diagnosis was 5.2 years, the majority had symptoms for more than 2 years. Eighty three percent had bilateral disease, with a median of 3 lobes affected, mean FEV1 of 77% predicted and modified Bhalla HRCT score of 18.

Conclusions:The incidence of bronchiectasis is high in NZ children, nearly twice the rate for cystic fibrosis and 7 times the only other country reporting a childhood national rate, Finland. Incidence varied substantially between ethnicities. Most cases developed disease in early childhood and had delayed diagnosis.

Keywords: Bronchiectasis, Incidence, Indigenous, New Zealand, Paediatric

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