24 Feb 2016

Who should take action on bronchiectasis?

10:52 pm on 24 February 2016

Medical specialists are calling on the Ministry of Health to introduce a campaign to raise awareness about bronchiectasis, in line with existing efforts around rheumatic fever.

An x-ray is used to assess whether bronchiectasis is present in the lungs.

An x-ray is used to assess whether bronchiectasis is present in the lungs. Photo: S & I / Sciences & Images / BSIP

Doctors and specialists have warned the lung disease, which can cause scarring in the lungs and in some cases death, is on the rise in children.

The number of people dying from it each year has doubled in the last decade to 84.

While doctors and their training bodies need to take responsibility for improvements in education, awareness, diagnosis and prevention, the ministry needs to provide more support, they say.

A diagram shows an airway with bronchiectasis.

Bronchiectasis, which can be fatal, causes scarring and thickening in the lungs. Photo: SUPPLIED

Starship Hospital paediatrician Innes Asher said the ministry must take a leadership role.

The increasing rates and severity of bronchiectasis were extremely alarming, and cold, damp and overcrowded housing were partly to blame, Dr Asher said.

"We would certainly like to see some more effective action, and of course this isn't just a Ministry of Health issue, it's an inter-sectorial issue involving the housing sector, the income sector and the education sector - but the ministry could, or should, take a lead because the outcomes are health issues.

"The government really needs to get in behind this because our children, really to be honest, we're maiming our children, and that's a terrible situation for New Zealand."

Steven Lucas, a visiting paediatrician and researcher from Uppsala University Children's Hospital in Sweden

Steven Lucas Photo: SUPPLIED

Steven Lucas, a visiting paediatrician and researcher from Uppsala University Children's Hospital in Sweden, agreed

Dr Lucas said he was surprised by New Zealand's high bronchiectasis rates, considering cases were very rare in Sweden.

It would be logical for the ministry to have a campaign to increase awareness, he said.

"If there are areas that can be identified, either where we can find these children earlier by due diligence within schools or healthcare, that's definitely information that has to be spread in order to catch the kids earlier."

Paediactrics Society president David Newman said it was getting to the point where bronchiectasis could not be ignored anymore.

While it was the responsibility of those who trained doctors to make them aware of the disease, he said, the government needed to create a national strategy that addressed the problem and contributing factors such as poor housing.

"The health professionals who have identified the problem need to work with their professional groups such as the respiratory physicians and paediatricians and work with the ministry to develop a strategy that will address these issues."

The Asthma and Respiratory Foundation also wants the government to do more to support the health sector in combating it and other respiratory diseases.

Its national research manager, Kathy Lys, said the Ministry of Health needed to provide the tools for training organisations and doctors to identify and diagnose bronchiectasis.

"We think that the government can take a lead role in acknowledging respiratory disease as a national health priority.

"Bronchiectasis is one of our chronic respiratory diseases, and altogether they make up a third of our deaths in New Zealand as a group, and yet respiratory disease is not in the top long-term conditions of focus at the Ministry of Health."

Ms Lys said the ministry should adopt its national respiratory strategy to bring down the rates.

Ministry of Health chief advisor for child and youth health, Dr Pat Tuohy, said the ministry was very aware of the seriousness of the condition.

Dr Tuohy said it had been working closely with the Asthma and Respiratory Foundation, and they were in the process of preparing a report to the minister about how it should respond to the issues that they raised.

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