The respiratory health of urban indigenous children aged less than 5 years: Study protocol for a prospective cohort study

Background: Despite the burden of acute respiratory illnesses(ARI) among Aboriginal and Torres Strait Islander children being a substantialcause of childhood morbidity and associated costs to families, communities andthe health system, data on disease burden in urban children are lacking.Consequently evidence-based decision-making, data management guidelines, healthresourcing for primary health care services and prevention strategies arelacking. This study aims to comprehensively describe the epidemiology, impactand outcomes of ARI in urban Aboriginal and Torres Strait Islander children(hereafter referred to as Indigenous) in the greater Brisbane area.

Methods/Design: An ongoing prospective cohort study ofIndigenous children aged less than five years registered with a primary healthcare service in Northern Brisbane, Queensland, Australia. Children arerecruited at time of presentation to the service for any reason. Demographic,epidemiological, risk factor, microbiological, economic and clinical data arecollected at enrolment. Enrolled children are followed for 12 months duringwhich time ARI events, changes in child characteristics over time and monthlynasal swabs are collected. Children who develop an ARI with cough as a symptomduring the study period are more intensely followed-up for 28 (±3) daysincluding weekly nasal swabs and parent completed cough diary cards. Childrenwith persistent cough at day 28 post-ARI are reviewed by a paediatrician.

Discussion: Our study will be one of the first tocomprehensively evaluate the natural history, epidemiology, aetiology, economicimpact and outcomes of ARIs in this population. The results will inform studiesfor the development of evidence-based guidelines to improve the earlydetection, prevention and management of chronic cough and setting of prioritiesin children during and after ARI.