Chronic cough is one of the most common reasons for presentation in primary care and, when persistent, can indicate serious underlying conditions such as asthma, protracted bacterial bronchitis, chronic obstructive pulmonary disease (COPD), or bronchiectasis. If left uninvestigated or untreated, chronic cough can lead to irreversible lung damage, reduced quality of life, and increased healthcare burden. Early diagnosis and evidence-based management are essential to prevent progression and improve outcomes.
The burden is particularly high among Aboriginal and Torres Strait Islander peoples, who are disproportionately affected by chronic respiratory conditions. Chronic wet cough is often under-recognised and sometimes incorrectly considered “normal” in children, with up to 24% of Aboriginal children under five experiencing chronic cough. This can delay treatment and contribute to long-term complications, contributing to a 22-year mortality gap compared to non-Indigenous Australians. Health professionals play a vital role in recognising chronic cough early, initiating appropriate care, and providing culturally safe support to reduce this inequity.
For health professionals, recognising the red flags, using age-specific diagnostic pathways, and considering culturally safe approaches to care are essential to ensuring early, effective treatment.
Key considerations
- Assessment of chronic cough should be undertaken differently for children and adults, requiring a focused history of the chronic cough to elicit any ‘red flag’ cough pointers which may indicate underlying disease.
- Reaching a definitive diagnosis may require continual reassessment of symptoms and response to treatment to guide further investigations or referrals if required.
- Communicate with patients about the diagnostic process, manage expectations and the importance of active participation in the investigation.
- Chronic wet cough is particularly prevalent in Aboriginal and Torres Strait Islander children but is often normalised by both families and health professionals. Providing culturally secure care is key to improving respiratory health outcomes of Aboriginal and Torres Strait Islander children.
Clinical tools and resources
Diagnosis and assessment of chronic cough in adults – clinical algorithm
This clinical guidance tool supports primary health care professionals in the assessment and management of chronic cough in adults. It includes definitions, common causes, risk factors, and prevention strategies, along with a clear, evidence-based diagnostic algorithm. Step-by-step recommendations are supplemented with key messages to guide effective clinical decision-making in primary care settings.
Read the clinical algorithm for adults
Diagnosis and assessment of chronic cough in children – clinical algorithm
This clinical guidance tool provides an overview of definitions, causes and risk factors and prevention of chronic cough in children. It provides clear step-by-step, evidence-based recommendations supplemented with key messages for primary health care professionals on how to assess and manage children presenting with chronic cough.
Read the clinical algorithm for children
Lung Health in First Nations Children eLearning modules
Gain essential knowledge and skills to improve respiratory care for First Nations children with Lung Health in First Nations Children—a free, accredited eLearning program for health professionals. These interactive modules focus on identifying and managing chronic wet cough, a common sign of serious lung disease, while supporting culturally secure care. Learn how to engage effectively with First Nations families and address the high burden of respiratory illness in children. The two modules take approximately one hour each and are designed to strengthen your clinical practice and cultural capability.
Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA) Australian Chronic Cough Position Statement Update
The position statement provides updated, evidence-based guidance on the clinical management of chronic cough in both children and adults. Developed by the CICADA Expert Committee between March 2021 and June 2022, this resource supports best practice in primary care. It includes prevalence, risk factors, and neurophysiology of chronic cough, with dedicated sections on Aboriginal and Torres Strait Islander populations. The statement also features practical assessment and management algorithms to support decision-making in clinical consultations.
Lung health in First Nations children: Early detection of chronic wet cough webinar
Early detection and management of wet cough is critical to preventing chronic lung disease in children. In this one-hour webinar, leading experts explore the latest evidence on chronic wet cough in Aboriginal and Torres Strait Islander children and share culturally safe strategies for care. Watch the recording to hear Dr Pamela Laird discuss best practice identification and management, and Prof Maree Toombs on the enablers and barriers to improving outcomes in respiratory care.
Watch now
Resources for your patients
Chronic cough in children fact sheet
This resource provides information about causes of chronic cough in children, diagnosis and questions to ask the GP.
Chronic wet cough in Aboriginal and Torres Strait Islander children fact sheet
This resource was designed with community and clinicians to help families to be able to identify their child’s cough and bring them to the clinic to get their lungs checked out.
The resource also focuses on ways to build strong lungs and keep little lungs healthy.
Chronic cough in adults fact sheet
This fact sheet helps patients understand chronic cough, when to seek medical advice, and how it may be diagnosed and managed. It’s a useful tool to support key messages during consultations.
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