Acute respiratory infections in Australian Aboriginal children: current knowledge and future requirements.

Although inadequately documented, it is clear that acute respiratory infection (ARI) is a major cause of morbidity and hospitalization in Australian Aboriginal children. ARIs continue to cause substantial mortality in Aboriginal children, and they are likely to cause a variety of potentially serious sequelae. The literature emphasizes the importance of pneumonia as a cause of hospitalization of Aboriginal children. There is good evidence that Streptococcus pneumoniae and Haemophilus influenzae are predominant causes of severe pneumonia, but little is known about the importance of other respiratory pathogens, such as respiratory syncytial virus, as causes of ARI in Aboriginal children. Poor living conditions, low birthweight and malnutrition are likely to be important risk factors for ARI in some groups of Aboriginal children. Although broad-ranging economic and environmental changes will be required to bring about a sustained reduction in ARI in Aboriginal children, there should be an emphasis upon correct case management of ARI at the primary care level so as to reduce the need for hospitalization. Some research priorities are discussed.