Home visits by nurses cut lung infections

A study of indigenous children in three countries has found that sending nurses into family homes made more difference than medicines for children with severe lung problems.

Maori and Pacific children in New Zealand, Aboriginal children in Australia and Native American children in Alaska are all admitted to hospitals with "lung scarring", or bronchiectasis, at rates that are many times the average for developed countries.

New Zealand researchers have reduced the infection by 75 per cent in 42 families where nurses have visited their homes once a week for a year to make sure the children took their medicines.

But Auckland University paediatrician Dr Cass Byrnes, who led the New Zealand research team, said Australian researchers using the same medicines did not reduce infection because they did not directly observe children taking them.

Results from Alaska are not yet in.

One of the two nurses who visited the families, Charmaine Mobberley, said the home visits helped to fix other problems that led to the lung infections, such as cold and damp houses.

Dr Byrnes said: "We could have almost thrown away the medicine. If we had just done the weekly visits without the medicine, all the kids would have improved."

She told the Maori affairs select committee, which opened hearings on an inquiry into the determinants of Maori children's well-being yesterday at Hoani Waititi Marae, that relying on patients visiting hospitals or even doctors' clinics was not enough.

She said the health system put fewer resources into bronchiectasis and other conditions that affected mainly poor children than it did into other conditions that affected mainly better-off European families.

LUNG INFECTIONS

Hospitalisations for lower respiratory tract infections per 1000 infants under 2, South Auckland, 2002-06:

* Pasifika - 280
* Maori - 215
* Others - 43.