Wanganui asthma rate alarms

By Lydia Anderson


Secondhand smoke, poor housing and a high proportion of Maori are contributing to Wanganui's high hospital admission rate for asthma sufferers, a paediatrician warns.

Whanganui District Health Board had the second-highest asthma admission rate of the country's 20 DHBs, according to 2011 Otago University figures, with 153 asthma patient hospital admissions.

Wanganui asthma patients are also using more medications each year, with prescription numbers rising from 27,005 to 29,993 between 2008 and 2012.

Nationwide, more than 800,000 asthma medicine prescriptions were issued in 2012, costing the Government more than $65 million.

About 52 New Zealanders die from asthma every year, a figure labelled "unacceptably high".

According to the Asthma Foundation, 70 per cent of local asthma hospital admissions for children aged 0-4 in 2011 were Maori.

Whanganui DHB clinical director of paediatrics Dr David Montgomery said around half of all infants born in the region were identified as being of Maori ethnicity.

"Maori children have higher rates of asthma compared with European and Asian children, and this could account for the high representation of Maori children in the hospital admissions with asthma."

He said Wanganui's high rate of asthma admissions compared to other DHBs was due to various likely factors, including a high percentage of Maori children, high rates of tobacco exposure (both ante-natal and post-natal), low-income families with young children, older housing stock with poor insulation, heating and ventilation, low rates of breastfeeding, and historically low rates of immunisation.

To address the high asthma admission rates, Whanganui DHB had partnered up with the Regional Health Network to target smoking, housing, immunisation, and good access to primary care, he said.

It was more useful to examine regional trends over a few years than capturing a snapshot in one time period, Dr Montgomery said.

The death of Hawke's Bay Year 12 student Wiremu Rawiri from an asthma attack last month highlighted the need for Kiwis to keep an eye on the respiratory condition.

The Te Aute College student had a severe attack at his school hostel, and died despite paramedics' efforts to save him.

Asthma Foundation medical adviser Dr Tristram Ingham said more asthma support was needed in schools.

"Sick asthmatic children just go quiet, staff fail to recognise the symptoms."

He knew of cases in the Hutt Valley where children had been disciplined for coughing in the classroom, while some had soiled themselves because they were coughing heavily.

Some schools made students hand over their inhalers to the school office for safe keeping, he said.

New Zealand has the world's second-highest asthma rates after the United Kingdom, according to 2012 statistics.

Possible reasons included high rates of house dust-mite allergens, cold, damp housing, lower breast feeding rates, higher fast-food intake/obesity, lower rates of childhood immunisation and paracetamol use in childhood, said Dr Ingham.

Overall children were more commonly affected by asthma, with Maori and Pacific children displaying higher, more severe rates of symptoms and being twice as likely to require hospitalisation.

Many deaths from asthma occurred among the over-50 age group, with higher rates for females than males.

Dr Ingham said most New Zealand asthmatics were under-treated.

"People just put up with chronic symptoms."

- Wanganui Chronicle

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