Lay summary
Acute respiratory infection requiring hospitalization in early childhood leads to ongoing reduced lung function and the development of later chronic lung disease. Tamariki Māori and Pasifika, and children in the poorest socioeconomic quintile are at highest risk; a population profile seen in South Auckland. An intervention programme (regular, formal follow-up) compared to usual parent-directed care instituted at time of hospital discharge revealed significant respiratory morbidity two years later but more were diagnosed with permanent lung scarring (bronchiectasis) in the closely followed intervention group. Assessing these children now in later childhood with more robust respiratory assessment (lung function, chest CT scan) will determine whether the intervention programme made an impact in the longer term and define further unrecognized disease especially in controls. The European-derived model of care used also needs challenging. Involving participating whānau, we will start to codesign a future health care model more suited to this community