Cough, step and jump: a profile of Professor Anne Chang

One doctor’s mission to beat childhood lung disease.

Look up the word ‘prolific’ in the dictionary and there she is. Sweet-looking, unassuming Anne Chang is small in stature, but a giant in the world of respiratory medicine.

She’s among Menzies’ most-published authors, with a current tally of around 240 peer-reviewed papers – her motto, “always do your best; do as much as you can,” may have something to do with that.

She’s also a leading light in the organisation’s push for research that triggers real change. Professor Chang, head of Menzies’ Child Health Division, diagnostically categorised a new condition, protracted bacterial bronchitis (PBB) in 2006.

At the time, around 40 per cent of her child patients were presenting with a chronic cough that lasted more than four weeks. PBB was the culprit.

 Though painless, the persistent cough was impacting kids’ sleep and wellbeing. “We thought that it could probably be treated with an antibiotic, but no one had looked at it scientifically,” she said.

Chang, who spends 70 per cent of her time in clinical practice, worked with PhD candidate Dr Julie Marchant to probe the cough further. Together they discovered the condition indeed responded, and was cured, by a two-week course of antibiotics, amoxil-clavulanate.

“This was the most important contribution I’ve made so far, because it changed the management of cough around the world: it made it into the cough guidelines in the UK and the USA,” she says.

“If you get to it early, treating the condition decreases the burden to the parent, and to the child. It prevents long-term lung damage.”

Damage-inducing cough is of particular concern among Australia’s Aboriginal and Torres Strait Islander communities as Chang says the symptom’s been ‘normalised’. Many sufferers don’t report it to medical staff. Alarmingly, however, cough is the most common sign of lung disease.

With this project now behind her, she’s excited for what’s next. “So many projects on the horizon!” she laughs, admitting she’s most looking forward to her probe into bronchiectasis in children.

“We ran a study where we looked at kids presenting to respiratory specialists around Australia,” she says. From their sample, 10 per cent of patients had bronchiectasis.

“If it’s picked up early, it’s treatable. If not, the condition develops into severe lung disease and Aboriginal people can die from it in their 30s and 40s,” she says. Chang’s project will involve an international randomised control trial of the antibiotics azithromycin and amoxil-clavulanate.

When collecting data, her Asian heritage uncomplicates things patients and community members find it easy to talk with her, she says, adding: “Working in this area is exciting, because there’s the biggest potential to make a difference here.”

This motivation, to make the biggest difference possible, was what first implored Chang to combine clinical work with research. Born in Malaysia, Chang traveled to Victoria to study medicine at the University of Melbourne.

After completing her training in general paediatrics, she embarked on a PhD, and later studied public health and tropical medicine.

She’s now engaged at the Royal Children’s Hospital in Brisbane, though regularly travels for work – at the time of writing, Chang was busily packing her bags in order to deliver four lectures to the Malaysian Thoracic Society.

Treating people may be her first love. But Chang says research lets her expand the impact of her medical skills.

“It’s always been my interest to use medicine to improve the lives and health of disadvantaged groups. Research lends you the freedom to think outside the box, look at different treatment options, and change the way things are done.”

As she says: “If you don’t publish, you don’t change things. That’s how ideas are acknowledged.”