Māori and rural kids face higher risk of severe appendicitis, study finds

Children are more likely to have severe appendicitis if they come from a rural site or if they are Māori.

• A study found Māori and rural children face a higher risk of severe paediatric appendicitis.
• Dr Ian Bissett and Dr Brodie Elliot highlight poorer health literacy and access as contributing factors.
• Rural children have severe appendicitis at four times the rate of urban children; Māori children, twice.

A holistic clinical study has revealed Māori and rural people face a significantly greater risk of developing more severe paediatric appendicitis, which can be life-threatening. That’s according to recent research published in the Royal Australasian College of Surgeons’ ANZ Journal of Surgery.

Dr Ian Bissett, a general surgeon at Auckland Hospital and fellow of the Royal Australasian College of Surgeons, says the research has found children are more likely to have severe appendicitis if they come from a rural site or if they are Māori.

Appendicitis is the inflammation of the appendix – a small pouch attached to the large intestine, often caused by a blockage or infection. This can result in severe lower abdominal pain and, if untreated, may lead to a burst appendix.

“Poorer health literacy was associated with longer delays to getting to the hospital, and longer delays in getting to the hospital were associated with worse appendicitis,” Bissett says.

Research lead Dr Brodie Elliot says, “We need to target issues where they arise and support our families. We chose appendicitis as it’s an easy, common thing – one in 10 children get this – but, if you work in the Healthline system, you know this is just the tip of the iceberg”.

The latest research reveals rural children suffer severe appendicitis at four times the rate of their urban counterparts. In contrast, Māori children face severe appendicitis at twice the rate of non-Māori children.

“Even the really rural people in the middle of nowhere, at least two hours away. The ones that came early either had access, there was a nurse in the whānau, there was a community member, or there was someone with health knowledge who would have stayed. ‘If it wasn’t for x, y, z, I would’ve stayed another night or two’,” Elliot says.

The most common symptoms of appendicitis are abdominal pain, nausea, and loss of appetite.

“We all know that this is a problem certainly in the medical profession. We all know that Māori and Pacific do worse if they have cancer, they do worse if they have hypertension, diabetes etcetera," Bissett says.

“In some senses we’ve done enough, saying there’s a difference. What we now have to do is work together to make a change to that so that equity is a reality, not just a dream.”