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Carter E, Lane K, Ryan E, Jayaratnam S. Incidence of iron deficiency Anaemia during pregnancy in Far North Queensland. Aust J Rural Health 2023; 31:124-131. [PMID: 36321846 DOI: 10.1111/ajr.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 09/11/2022] [Accepted: 09/18/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The WHO estimates the incidence of iron deficiency anaemia in Australia is 25%. However there is considerable variation during pregnancy and in regional areas. OBJECTIVE The aim of this investigation is to quantify the incidence of iron deficiency anaemia during pregnancy within Far North Queensland. DESIGN This is a single-centre retrospective cohort study. Cairns Hospital is the main referral centre for complex maternity care in Far North Queensland with an estimated population of 280-000, which includes many people from rural and remote communities and a high proportion who identify as Aboriginal or Torres Strait Islander. This study included all births at the Cairns Hospital in 2018, a total of 2190 deliveries. FINDINGS The study randomly sampled 551 mothers from the cohort, and the incidence of iron deficiency anaemia was 34.9%. 48.7% of women who identified as Aboriginal or Torres Strait Islander within the region were anaemic. This was significantly higher than an incidence of 28.9% for the rest of the population. Other risk factors include booking appointment after 28-weeks, Asian ethnicity and age less than 25-years. A BMI greater than 35 was protective DISCUSSION: This study will inform antenatal care providers within the region and improve obstetric outcomes by increasing awareness. Identifying risk factors will also facilitate prompt treatment and improve maternity care for vulnerable patient groups. On a broader level, the study provides new data to inform population health estimates both nationally and internationally. CONCLUSION The incidence of iron deficiency anaemia during pregnancy in Far North Queensland is significantly higher than previous estimates.
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Affiliation(s)
- Edward Carter
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Katie Lane
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Elizabeth Ryan
- QFAB Biostatistics Clinic, Brisbane, Queensland, Australia
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2
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Australia's notifiable disease status, 2016: Annual report of the National Notifiable Diseases Surveillance System. ACTA ACUST UNITED AC 2021; 45. [PMID: 34074234 DOI: 10.33321/cdi.2021.45.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract In 2016, a total of 67 diseases and conditions were nationally notifiable in Australia. The states and territories reported 330,387 notifications of communicable diseases to the National Notifiable Diseases Surveillance System. Notifications have remained stable between 2015 and 2016. In 2016, the most frequently notified diseases were vaccine preventable diseases (139,687 notifications, 42% of total notifications); sexually transmissible infections (112,714 notifications, 34% of total notifications); and gastrointestinal diseases (49,885 notifications, 15% of total notifications). Additionally, there were 18,595 notifications of bloodborne diseases; 6,760 notifications of vectorborne diseases; 2,020 notifications of other bacterial infections; 725 notifications of zoonoses and one notification of a quarantinable disease.
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Affiliation(s)
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- Australian Government Department of Health
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Aboriginal and Torres Strait Islander COVID-19 Epidemiology Report 1: 28 February 2021. ACTA ACUST UNITED AC 2021; 45. [PMID: 34074232 DOI: 10.33321/cdi.2021.45.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose: This report presents information on specific Aboriginal and Torres Strait Islander surveillance indicators in the Australian National Disease Surveillance Plan for COVID-19, as well as additional aspects of the coronavirus disease 2019 (COVID-19) response which have specific relevance for Aboriginal and Torres Strait Islander peoples.
Reporting period: This report compiles data for the duration of the COVID-19 pandemic, reported according to the following time periods: cumulative: 25 January 2020 to 28 February 2021; this reporting period: 1 February to 28 February 2021. Where reporting periods differ, this is indicated in the text.
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Affiliation(s)
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- Australian Government Department of Health
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- Australian Government Department of Health
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Leonard D, Buettner P, McDermott R, Makrides M. The iron content of healthy diets for one day for breastfed babies and young children. Nutr Diet 2021; 78:415-423. [PMID: 33594814 DOI: 10.1111/1747-0080.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
AIMS Early childhood anaemia due to iron deficiency is widespread in remote communities across northern Australia. Current recommendations for healthy food to complement breastfeeding at age 6 to 23 months include iron-rich and iron-enriched foods. An electronic nutrient analysis was undertaken to assess the iron content of hypothetical healthy diets for breastfed babies and young children aged 6 to 23 months in Australia, in comparison with their estimated requirements. METHODS Hypothetical diets for 1 day were developed that were consistent with the Foundation Diets for breastfed infants 6 to 12 months and for toddlers 13 to 23 months. Nutrient content was derived using the Australian Food Composition database in FoodWorks 10. The iron content of these two diets were compared with Estimated Average Requirements (EARs) and Recommended Dietary Intakes (RDIs) for iron for infants aged 7 to 12 months and children aged 1 to 3 years. RESULTS The iron content of the hypothetical diet for breastfed infants aged 6 to 12 months (5.8 mg) was less than the EAR (7 mg, 83%) and the RDI (11 mg, 53%). For young breastfed children aged 13 to 23 months, the iron content of the hypothetical diet was 4.4 mg; above the EAR (4 mg, 110%) but less than RDI (9 mg, 49%). CONCLUSIONS Breastfeeding has health and neurodevelopmental benefits for infants and young children that are particularly important in remote Australia where food insecurity and poor nutrition compromise health and wellbeing. Adequate iron intake is also important for neurodevelopment in early life but healthy diets for breastfed babies and young children may have insufficient iron content to meet requirements. The upcoming revision of the Australian Dietary Guidelines provides an opportunity to consider this issue.
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Affiliation(s)
- Dympna Leonard
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Petra Buettner
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Robyn McDermott
- Public Health Medicine, University of South Australia, Adelaide, South Australia, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Phillips J, Brunette R, Hefler M, Brimblecombe J, Kearns T. How Barunga Aboriginal community implemented and sustained an anaemia program - A case study evaluation. Health Promot J Austr 2021; 32 Suppl 2:332-350. [PMID: 33455038 DOI: 10.1002/hpja.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/08/2022] Open
Abstract
ISSUE ADDRESSED Anaemia persists as a public health issue in many Aboriginal communities despite having standard practice guidelines. This case study reveals how Barunga Aboriginal Community in the Northern Territory (NT), Australia, implemented an Anaemia Program (1998-2016) which contributed to low anaemia prevalence in children aged under 5 years. METHODS This retrospective qualitative case study used purposive sampling to describe the Anaemia Program and factors influencing its implementation. Themes were developed from convergence of three data sources: interviews, program observation and document review. Data were inductively analysed by an Aboriginal and non-Aboriginal researcher and themes were validated by Barunga community health practitioners and compared to practice guidelines and implementation literature. RESULTS Health practitioners reported that the Anaemia Program contributed to a marked reduction in childhood anaemia prevalence over time. This was supported by available prevalence data. The locally adapted Anaemia Program was unique in the NT with a novel approach to community supplementation for anaemia prevention in addition to anaemia treatment. Supportive implementation influences included: Aboriginal leadership and the use of culturally supportive processes which reinforced the development of trust and strong relationships facilitating community acceptance of the Program. Routine, opportunistic and flexible health care practice, a holistic approach and a stable, skilled and experienced team sustained program implementation. CONCLUSIONS The holistic and successful Barunga Anaemia Program is supported by evidence and guidelines for treating and preventing childhood anaemia. The contextualisation of these guidelines aligned with the literature on effective Aboriginal primary health care implementation. SO WHAT?: This Anaemia Program provides a model for implementation of evidence-informed guidelines in an Aboriginal primary health care setting.
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Affiliation(s)
- Jodi Phillips
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.,School of Medicine, Faculty of Health Deakin University Waurn Ponds, Geelong, VIC, Australia
| | - Raelene Brunette
- Sunrise Health Service Aboriginal Corporation, Katherine, NT, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Julie Brimblecombe
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.,Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
| | - Therese Kearns
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
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Hansen M, Singh G, Barzi F, Brunette R, Howarth T, Morris P, Andrews R, Kearns T. Maternal Anaemia in Pregnancy: A Significantly Greater Risk Factor for Anaemia in Australian Aboriginal Children than Low Birth Weight or Prematurity. Matern Child Health J 2020; 24:979-985. [PMID: 32495246 DOI: 10.1007/s10995-020-02913-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To identify maternal and perinatal risk factors associated with childhood anaemia. METHODS A retrospective cohort study was conducted in three remote Katherine East Aboriginal communities in Northern Territory, Australia. Children born 2004-2014 in Community A and 2010-2014 in Community B and C, and their respective mothers were recruited into the study. Maternal and child data were linked to provide a longitudinal view of each child for the first 1000 days from conception to 2-years of age. Descriptive analyses were used to calculate mean maternal age, and proportions were used to describe other antenatal and perinatal characteristics of the mother/child dyads. The main outcome was the prevalence of maternal anaemia in pregnancy and risk factors associated with childhood anaemia at age 6 months. RESULTS Prevalence of maternal anaemia in pregnancy was higher in the third trimester (62%) compared to the first (46%) and second trimesters (48%). There was a strong positive linear association (R2 = 0.46, p < 0.001) between maternal haemoglobin (Hb) in third trimester pregnancy and child Hb at age 6 months. Maternal anaemia in pregnancy (OR 4.42 95% CI 2.08-9.36) and low birth weight (LBW, OR 2.62, 95% CI 1.21-5.70) were associated with an increased risk of childhood anaemia at 6 months of age. CONCLUSIONS FOR PRACTICE This is the first study to identify the association of maternal anaemia with childhood anaemia in the Australian Aboriginal population. A review of current policies and practices for anaemia screening, prevention and treatment during pregnancy and early childhood would be beneficial to both mother and child. Our findings indicate that administering prophylactic iron supplementation only to children who are born LBW or premature would be of greater benefit if expanded to include children born to anaemic mothers.
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Affiliation(s)
| | - Gurmeet Singh
- Royal Darwin Hospital, Darwin, NT, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Federica Barzi
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Raelene Brunette
- Sunrise Health Service Aboriginal Corporation, Katherine, NT, Australia
| | - Timothy Howarth
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Peter Morris
- Royal Darwin Hospital, Darwin, NT, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Ross Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Therese Kearns
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
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Leonard D, Buettner P, Thompson F, Makrides M, McDermott R. Early childhood anaemia more than doubles the risk of developmental vulnerability at school-age among Aboriginal and Torres Strait Islander children of remote Far North Queensland: Findings of a retrospective cohort study. Nutr Diet 2020; 77:298-309. [PMID: 31914484 PMCID: PMC7317940 DOI: 10.1111/1747-0080.12602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/15/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022]
Abstract
Aims Early childhood anaemia, usually attributed to iron deficiency, is associated with persistent detrimental effects on child development. This study investigates the association of anaemia between age six and 23 months with indicators of childhood development at school‐age among children of remote Aboriginal and Torres Strait Islander communities of Far North Queensland. Methods The triennial Australian Early Development Census (AEDC) encompasses five domains of early childhood development—physical health and wellbeing, social competence, emotional maturity, language and cognitive skills (school‐based), communication skills and general knowledge. AEDC 2012 and 2015 assessments were linked with health information for children and their mothers from remote Aboriginal and Torres Strait Islander communities of Far North Queensland. Results AEDC assessments were available for 250 children who had measurements of haemoglobin recorded at age 6 to 23 months. More children who had had early childhood anaemia (n = 66/143, 46.2%, [37.9%, 54.4%]) were developmentally vulnerable on two or more domains compared to those who had not been anaemic (n = 25/107, 23.4% [15.2%, 31.5%], P < .001). Multivariable analysis confirmed that early childhood anaemia more than doubled the risk of developmental vulnerability (OR 2.2 [1.1, 4.3] P = .020) at school age. Conclusions Early childhood anaemia is a risk factor for developmental vulnerability at school‐age in this setting. Interventions combining nutrition promotion and multi‐micronutrient food fortification, are effective in prevention of early childhood anaemia. Such interventions could also improve early childhood development and subsequent educational achievement.
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Affiliation(s)
- Dympna Leonard
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Petra Buettner
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia.,Tropical Health Solutions Pty Ltd, Townsville, Queensland, Australia
| | - Fintan Thompson
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Maria Makrides
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robyn McDermott
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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McHugh L, Binks MJ, Gao Y, Andrews RM, Ware RS, Snelling T, Kildea S. Influenza vaccination in pregnancy among a group of remote dwelling Aboriginal and Torres Strait Islander mothers in the Northern Territory: The 1+1 Healthy Start to Life study. ACTA ACUST UNITED AC 2019; 43. [PMID: 31426733 DOI: 10.33321/cdi.2019.43.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Remote-living Aboriginal and Torres Strait Islander women experience a higher burden of influenza infection during pregnancy than any other Australian women. Despite recommendations of inactivated influenza vaccination (IIV) in pregnancy, uptake and safety data are scarce for this population. We examined uptake of IIV in pregnancy and report adverse birth outcomes amongst a predominantly unvaccinated group of remote-living Aboriginal and Torres Strait Islander women from the Northern Territory (NT), using data from the 1+1 Healthy Start to Life study. Data were deterministically linked with the NT Immunisation Register to ascertain IIV exposure in pregnant women during 2003-2006 and 2009-2011 inclusive. Overall, IIV uptake in pregnancy was 3% (n=20/697 pregnancies); 0% (0/414) pre-influenza A(H1N1)pdm09 and 7% (20/293) post-influenza A(H1N1)pdm09 (2009-2011). Vaccine uptake was poor in this cohort and it is unclear at what stage this policy failure occurred. Women with known comorbidities and/or high risk factors were not targeted for vaccination. Much larger study participant numbers are required to validate between group comparisons but there was no clinically nor statistically significant difference in median gestational ages (38 weeks for both groups), mean infant birthweights (3,001 g unvaccinated vs 3,175 g IIV vaccinated), nor birth outcomes between the few women who received IIV in pregnancy and those who did not. There were no stillbirths in women who received an IIV in pregnancy.
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Affiliation(s)
- Lisa McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Michael J Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Yu Gao
- Mater Midwifery Research Unit - University of Queensland, Women's Health and Newborn Services (Maternity) Mater Health Service; School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia; Applied Epidemiology Program, National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tom Snelling
- Infectious Disease Implementation Research, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia; Curtin University, School of Public Health, Perth, Western Australia, Australia
| | - Sue Kildea
- Mater Research Institute - University of Queensland, Women's Health and Newborn Services (Maternity) Mater Health Service; School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
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Leonard D, Buttner P, Thompson F, Makrides M, McDermott R. Anaemia in early childhood among Aboriginal and Torres Strait Islander children of Far North Queensland: a retrospective cohort study. Aust N Z J Public Health 2019; 43:319-327. [PMID: 31180619 DOI: 10.1111/1753-6405.12911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/01/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Early childhood anaemia affects health and neurodevelopment. This study describes anaemia among Aboriginal and Torres Strait Islander children of Far North Queensland. METHODS This retrospective cohort study used health information for children born between 2006 and 2010 and their mothers. We describe the incidence of early childhood anaemia and compare characteristics of children and mothers where the child had anaemia with characteristics of children and mothers where the child did not have anaemia using bivariate and multivariable analysis, by complete case (CC) and with multiple imputed (MI) data. RESULTS Among these (n=708) Aboriginal and Torres Strait Islander children of Far North Queensland, 61.3% (95%CI 57.7%, 64.9%) became anaemic between the ages of six and 23 months. Multivariable analysis showed a lower incidence of anaemia among girls (CC/MI p<0.001) and among children of Torres Strait Islander mothers or both Aboriginal and Torres Strait Islander mothers (CC/MI p<0.001) compared to children of Aboriginal mothers. A higher incidence of anaemia was seen among children of mothers with parity three or more (CC/MI p<0.001); children born by caesarean section (CC/MI p<0.001); and children with rapid early growth (CC/MI p<0.001). CONCLUSION Early childhood anaemia is common among Aboriginal and Torres Strait Islander children of Far North Queensland. Poor nutrition, particularly iron deficiency, and frequent infections are likely causes. Implications for public health: Prevention of early childhood anaemia in 'Close the Gap' initiatives would benefit the Aboriginal and Torres Strait Islander children of Far North Queensland - and elsewhere in northern Australia.
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Affiliation(s)
- Dympna Leonard
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Petra Buttner
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Maria Makrides
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute.,Discipline of Paediatrics, School of Medicine, The University of Adelaide, South Australia
| | - Robyn McDermott
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
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Leonard D, Buttner P, Thompson F, Makrides M, McDermott R. Anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland: A retrospective cohort study. Nutr Diet 2018; 75:457-467. [DOI: 10.1111/1747-0080.12481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/23/2018] [Accepted: 09/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Dympna Leonard
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences; James Cook University; Cairns Queensland Australia
| | - Petra Buttner
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences; James Cook University; Cairns Queensland Australia
| | - Fintan Thompson
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences; James Cook University; Cairns Queensland Australia
| | - Maria Makrides
- Healthy Mothers, Babies and Children; South Australian Health and Medical Research Institute; Adelaide South Australia Australia
| | - Robyn McDermott
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences; James Cook University; Cairns Queensland Australia
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