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In addition, both of these groups are disadvantaged with regard to disposable income,
adequate housing, educational opportunities, unemployment rates and access to healthcare
(Ministry of Health 2002; Statistics New Zealand2002; Asher 2006).
A review of the statistics for the different paediatric respiratory conditions follows. Nationally
the admission rate for children < one year of age for lower respiratory tract infection,
predominantly bronchiolitis and pneumonia, is L02.61t000 but up to 176.5/1000 in certain
regions (Graham, Irversha et al. 2001). The rates of admission for bronchiolitis for children <
one year of age have increased from 26.611000 children in 1988 to 58.U1000 in 1998, an
increase of ll87o (Vogel, knnon et al.2003). In addition, this increase in admission rates is
accompanied by more severe disease in those admitted in comparison to the previous decade
and in comparison to paediatric admissions of bronchiolitis in other developed countries. Of
the children admitted; 59Vo required oxygen, 2lVo required nasogastric fluids, 22Vo
intravenous fluids, 8Vo werc admitted with apnoea and 3.LVo reeuired ventilation (Vogel,
lrnnon et al. 2003). Pneumonia continues to be a worldwide problem with acute lower
respiratory tract infections being an important cause of mortality in children < five years of
age and remains one of the leading causes of disability-adjusted life years lost worldwide.
This largely reflects children in developing countries where it is estimated that 4.3 million
children aged < five years die annually from lower respiratory tract infections (Garenne,
Ronsmans et al. t992). The incidence tends to be higher in children < five years of age at 34-
40 cases per 1000 compared to any other age group except possibly for adults > 75 years
(Mclntosh 2002). A recent study conducted in New 7-ealand ascertained that the national
pneumonia admission rate for children 0-14 years of age was 4.0/1000 based on the discharge
diagnoses for pneumonia in 1998 to 1999 (Milne,Irnnon et al. 2003). These admissions were
skewed toward the younger age group. This equated to t,534 admissions per 100,000 for
children aged < two years, 562 admissions per 100,000 for children aged 2-4 yeus and 170
admissions for children aged 5-9 years. Extrapolation of this data amounts to approximately
3000 paediatric hospital admissions for pneumonia in New Tx,aland per year. Furthermore,
from 1988 to 1995 there was an annual increase of SVo in the hospital admission rate. This
increase was not due to admitting children with less severe disease; indeed the disease
severity also seemed to be on the rise (Ministry of Health 1998; Grant 2006). Even pertussis,
which is largely preventable by immunisation, continues to be a significant problem. Reported
coverage of pertussis immunisation shows that only 60Vo of children are fully immunised,
with only 42Vo of Maori and 45Vo of Pacific children completing the recommended