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Lansbury N, Memmott PC, Wyber R, Burgen C, Barnes SK, Daw J, Cannon J, Bowen AC, Burgess R, Frank PN, Redmond AM. Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1262. [PMID: 39338145 PMCID: PMC11431237 DOI: 10.3390/ijerph21091262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 09/19/2024] [Accepted: 09/20/2024] [Indexed: 09/30/2024]
Abstract
Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.
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Affiliation(s)
- Nina Lansbury
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul C Memmott
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Rosemary Wyber
- Yardhura Walani, National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT 0200, Australia
- The Kids Research Institute, Perth, WA 6009, Australia
| | | | - Samuel K Barnes
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Jessica Daw
- The Kids Research Institute, Perth, WA 6009, Australia
| | | | - Asha C Bowen
- The Kids Research Institute, Perth, WA 6009, Australia
- Perth Children's Hospital, Perth, WA 6009, Australia
| | | | | | - Andrew M Redmond
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, QLD 4072, Australia
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Oguoma VM, Mathew S, Begum T, Dyson E, Ward J, Leach AJ, Barzi F. Trajectories of otitis media and association with health determinants among Indigenous children in Australia: the Longitudinal Study of Indigenous Children. Public Health 2023; 225:53-62. [PMID: 37922586 DOI: 10.1016/j.puhe.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES Indigenous children in Australia experience high burden of persistent otitis media (OM) from very early age. The aim was to identify distinct trajectories of OM in children up to age 10-12 years and examine the association with socio-economic determinants. STUDY DESIGN A multistage clustered national panel survey. METHODS The study analysed the birth cohort of the Longitudinal Study of Indigenous Children from 2008 to 2018, comprising 11 study waves. Group-based trajectory modelling was used to identify different trajectories of OM outcome. Multinomial logistic regression was applied to examine the relationship between trajectories and individual, household and community-level socio-economic determinants. RESULTS This analysis included 894 children with at least three responses on OM over the 11 waves, and the baseline mean age was 15.8 months. Three different trajectories of OM were identified: non-severe OM prone, early/persistent severe OM and late-onset severe OM. Overall, 11.4% of the children had early/persistent severe OM from birth to 7.5 to nine years, while late-onset severe OM consisted of 9.8% of the children who had first OM from age 3.5 to five years. Children in communities with middle and the highest socio-economic outcomes have lower relative risk of early/persistent severe OM (adjusted relative risk ratio = 0.39, 95% confidence interval = 0.22-0.70 and adjusted relative risk ratio = 0.22, 95% confidence interval = 0.09-0.52, respectively) compared to children in communities with lowest socio-economic outcomes. CONCLUSION Efforts to close the gap in the quality of life of Indigenous children must prioritise strategies that prevent severe ear disease (runny ears and perforation), including improved healthcare access, reduced household crowding, and better education, and more employment opportunities.
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Affiliation(s)
- V M Oguoma
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia; Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - S Mathew
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
| | - T Begum
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
| | - E Dyson
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
| | - J Ward
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
| | - A J Leach
- Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - F Barzi
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
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3
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Brinkworth JF, Shaw JG. On race, human variation, and who gets and dies of sepsis. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022. [PMCID: PMC9544695 DOI: 10.1002/ajpa.24527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica F. Brinkworth
- Department of Anthropology University of Illinois Urbana‐Champaign Urbana Illinois USA
- Carl R. Woese Institute for Genomic Biology University of Illinois at Urbana‐Champaign Urbana Illinois USA
- Department of Evolution, Ecology and Behavior University of Illinois Urbana‐Champaign Urbana Illinois USA
| | - J. Grace Shaw
- Department of Anthropology University of Illinois Urbana‐Champaign Urbana Illinois USA
- Carl R. Woese Institute for Genomic Biology University of Illinois at Urbana‐Champaign Urbana Illinois USA
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Anderst A, Hunter K, Andersen M, Walker N, Coombes J, Raman S, Moore M, Ryan L, Jersky M, Mackenzie A, Stephensen J, Williams C, Timbery L, Doyle K, Lingam R, Zwi K, Sheppard-Law S, Erskine C, Clapham K, Woolfenden S. Screening and social prescribing in healthcare and social services to address housing issues among children and families: a systematic review. BMJ Open 2022; 12:e054338. [PMID: 35487725 PMCID: PMC9058796 DOI: 10.1136/bmjopen-2021-054338] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Housing is a social determinant of health that impacts the health and well-being of children and families. Screening and referral to address social determinants of health in clinical and social service settings has been proposed to support families with housing problems. This study aims to identify housing screening questions asked of families in healthcare and social services, determine validated screening tools and extract information about recommendations for action after screening for housing issues. METHODS The electronic databases MEDLINE, PsycINFO, EMBASE, Ovid Emcare, Scopus and CINAHL were searched from 2009 to 2021. Inclusion criteria were peer-reviewed literature that included questions about housing being asked of children or young people aged 0-18 years and their families accessing any healthcare or social service. We extracted data on the housing questions asked, source of housing questions, validity and descriptions of actions to address housing issues. RESULTS Forty-nine peer-reviewed papers met the inclusion criteria. The housing questions in social screening tools vary widely. There are no standard housing-related questions that clinical and social service providers ask families. Fourteen screening tools were validated. An action was embedded as part of social screening activities in 27 of 42 studies. Actions for identified housing problems included provision of a community-based or clinic-based resource guide, and social prescribing included referral to a social worker, care coordinator or care navigation service, community health worker, social service agency, referral to a housing and child welfare demonstration project or provided intensive case management and wraparound services. CONCLUSION This review provides a catalogue of housing questions that can be asked of families in the clinical and/or social service setting, and potential subsequent actions.
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Affiliation(s)
- Ania Anderst
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kate Hunter
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Melanie Andersen
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Natasha Walker
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Julieann Coombes
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Shanti Raman
- Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Melinda Moore
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Lola Ryan
- Child, Youth and Family Services, Population and Community Health, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - Michelle Jersky
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Amy Mackenzie
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Jennifer Stephensen
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Carina Williams
- Youth Health Services, Community Health, NSW Health, Sydney, New South Wales, Australia
| | - Lee Timbery
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Kerrie Doyle
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Zwi
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Suzanne Sheppard-Law
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, Australia
| | | | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
- Community Paediatrics Research Group, Institute for Women, Children and Families, Sydney Local Health District, Sydney, New South Wales, Australia
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Camphor HS, Bareja C, Glynn-Robinson A, Polkinghorne BG, Durrheim DN. A novel semi-quantitative methodology for national poliovirus reintroduction and outbreak risk assessment. Travel Med Infect Dis 2021; 44:102181. [PMID: 34678503 DOI: 10.1016/j.tmaid.2021.102181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Under the International Health Regulations (2005), World Health Organization Member States need to verify certification of polio-free status annually. In 2018, Australia sought to reassess and comprehensively characterise the risk posed by wild-type and vaccine-derived poliovirus introductions to national health security. However formal guidelines for national polio risk assessment were not publicly available. METHODS Four risk elements were identified and weighted using an expert-informed modified Delphi method: reintroduction hazard; population susceptibility; detection capability; and response capability. Australian data and qualitative evidence were analysed, documented and scored against risk element indicators to characterise polio risk as a semi-quantitative estimate and qualitative risk category statement. RESULTS The semi-quantitative risk characterisation calculated likelihood and impact scores of 0.43 and 0.13, respectively (possible range: 0.02-4.5). The assessment concluded that the risk of poliovirus reintroduction, resultant outbreaks of poliovirus infection, and sustained transmission occurring in Australia is very low. CONCLUSIONS Until poliovirus is eradicated, it remains in countries' strategic health security interest to maintain optimal investment in polio prevention, preparedness, surveillance and response capability to manage their level of risk. We present a structured, transparent and reproducible methodology for national or sub-national polio risk characterisation that generates evidence for targeted investment to maintain polio-free status.
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Affiliation(s)
- Hendrik S Camphor
- Office of Health Protection, Australian Government Department of Health, Canberra, Australia; The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
| | - Christina Bareja
- Office of Health Protection, Australian Government Department of Health, Canberra, Australia.
| | - Anna Glynn-Robinson
- Office of Health Protection, Australian Government Department of Health, Canberra, Australia.
| | - Benjamin G Polkinghorne
- The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
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Kua KP, Lee DSWH. Home environmental interventions for prevention of respiratory tract infections: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:297-307. [PMID: 33544536 DOI: 10.1515/reveh-2020-0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Poor housing conditions have been associated with increased risks of respiratory infections. This review aims to determine whether modifying the physical environment of the home has benefits in reducing respiratory infections. CONTENT We performed a systematic review and meta-analysis of the effectiveness of home environmental interventions for preventing respiratory tract infections. Ten electronic databases were searched to identify randomized controlled trials published from inception to July 31, 2020. Random-effects meta-analyses were used to assess the study outcomes. Our search identified 14 eligible studies across 12 countries, which comprised 87,428 households in total. The type of interventions on home environment included kitchen appliance and design, water supply and sanitation, house insulation, and home heating. Meta-analysis indicated a potential benefit of home environmental interventions in preventing overall respiratory tract infections (Absolute RR=0.89, 95% CI=0.78-1.01, p=0.07; Pooled adjusted RR=0.72, 95% CI=0.63-0.84, p<0.0001). Subgroup analyses depicted that home environmental interventions had no significant impact on lower respiratory tract infections, pneumonia, and severe pneumonia. A protective effect against respiratory infections was observed in high income country setting (RR=0.82, 95% CI=0.78-0.87, p<0.00001). SUMMARY AND OUTLOOK Home environmental interventions have the potential to reduce morbidity of respiratory tract infections. The lack of significant impact from stand-alone housing interventions suggests that multicomponent interventions should be implemented in tandem with high-quality health systems.
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Affiliation(s)
- Kok Pim Kua
- Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, Petaling, Malaysia
| | - Dr Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation, and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
- Gerontechnology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, 47500 Subang Jaya, Selangor, Malaysia
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AKCAN FA, BELADA A. Adenotonsiller Hipertrofili Hastalarda Efüzyonlu Otitis Media Gelişiminde Etkili Risk Faktörlerinin Araştırılması. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.804397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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8
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Foster T, Hall NL. Housing conditions and health in Indigenous Australian communities: current status and recent trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:325-343. [PMID: 33615929 DOI: 10.1080/09603123.2019.1657074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/14/2019] [Indexed: 06/12/2023]
Abstract
Ensuring sufficient and adequately maintained housing in Indigenous Australian communities remains an ongoing policy challenge for government, with major implications for the health of Indigenous Australians. This study sought to characterise the current status of housing conditions experienced by Indigenous Australians, with special reference to the Northern Territory. The assessment examined a range of indicators relating to crowding, dwelling condition, 'health hardware', and provision of maintenance and repairs. While acknowledging data deficiencies and inconsistencies, the analysis produced mixed results. There was evidence of a reduction in crowding but little observable improvement in the provision of maintenance and repairs. Some housing-related health outcomes have shown improvement, though these have tended to coincide with mass treatment campaigns. Achieving the goal of healthy homes - and ultimately closing the gap on Indigenous disadvantage - requires further investment in new houses that are appropriately designed and constructed, alongside an increased emphasis on cyclical maintenance.
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Affiliation(s)
- Tim Foster
- Institute for Sustainable Futures, University of Technology Sydney , Sydney, Australia
| | - Nina L Hall
- School of Public Health, The University of Queensland , Brisbane, Australia
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9
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Standen JC, Morgan GG, Sowerbutts T, Blazek K, Gugusheff J, Puntsag O, Wollan M, Torzillo P. Prioritising Housing Maintenance to Improve Health in Indigenous Communities in NSW over 20 years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5946. [PMID: 32824314 PMCID: PMC7460455 DOI: 10.3390/ijerph17165946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/26/2020] [Accepted: 08/08/2020] [Indexed: 11/17/2022]
Abstract
Many studies document the relationship between housing quality and health status. Poor housing in Aboriginal communities continues to be linked to the compromised health status of Aboriginal Australians. The New South Wales (NSW) Housing for Health (HfH) program has been assessing and repairing Aboriginal community housing across the state for 20 years using a standardised intervention methodology that aims to improve the health of Aboriginal people in NSW by improving their living environments. Items are tested and repairs are prioritised to maximise safety and health benefits and measured against 11 Critical Healthy Living Priorities (e.g., safety, facilities for washing people and clothes, removing waste and preparing food). Descriptive analysis of data collected pre- and post-intervention from 3670 houses was conducted to determine the effectiveness of the program. Analysis demonstrated statistically significant improvements in the ability of the houses to support safe and healthy living for all critical healthy living priorities post-interventions. Trend analysis demonstrated the magnitude of these improvements increased over 20 years. In 24 communities (n = 802 houses) where projects were repeated (5-17 years later), results indicate sustainability of improvements for 9 of 11 priorities. However, the overall condition of health-related hardware in Aboriginal community housing across NSW pre-intervention has not significantly changed during the program's 20 years. Results suggest a systematic lack of routine maintenance and quality control continues to be the overwhelming cause for this lack of improvement pre-intervention. Our evaluation of the HfH program demonstrated that fidelity to a standardised housing testing and repair methodology to improve residents' safety and health can have sustainable effects on housing infrastructure and associated health benefits, such as a 40% reduction in infectious disease hospital separations. Housing and health agencies should collaborate more closely on social housing programs and ensure programs are adequately resourced to address safety and health issues.
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Affiliation(s)
- Jeffrey C. Standen
- Health Protection NSW, St Leonards NSW 2065, Australia;
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown NSW 2006, Australia; (G.G.M.); (P.T.)
| | - Geoffrey G. Morgan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown NSW 2006, Australia; (G.G.M.); (P.T.)
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore NSW 2480, Australia
| | - Tim Sowerbutts
- Q Social Research Consultants Pty Ltd., Broadway NSW 2007, Australia;
| | - Katrina Blazek
- NSW Ministry of Health, St Leonards NSW 2065, Australia; (K.B.); (J.G.); (M.W.)
| | - Jessica Gugusheff
- NSW Ministry of Health, St Leonards NSW 2065, Australia; (K.B.); (J.G.); (M.W.)
| | - Otto Puntsag
- Health Protection NSW, St Leonards NSW 2065, Australia;
| | - Michael Wollan
- NSW Ministry of Health, St Leonards NSW 2065, Australia; (K.B.); (J.G.); (M.W.)
| | - Paul Torzillo
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown NSW 2006, Australia; (G.G.M.); (P.T.)
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Wozniak TM, Cuningham W, Buchanan S, Coulter S, Baird RW, Nimmo GR, Blyth CC, Tong SYC, Currie BJ, Ralph AP. Geospatial epidemiology of Staphylococcus aureus in a tropical setting: an enabling digital surveillance platform. Sci Rep 2020; 10:13169. [PMID: 32759953 PMCID: PMC7406509 DOI: 10.1038/s41598-020-69312-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/03/2020] [Indexed: 01/21/2023] Open
Abstract
Delivery of information to clinicians on evolving antimicrobial susceptibility needs to be accurate for the local needs, up-to-date and readily available at point of care. In northern Australia, bacterial infection rates are high but resistance to first- and second-line antibiotics is poorly described and currently-available datasets exclude primary healthcare data. We aimed to develop an online geospatial and interactive platform for aggregating, analysing and disseminating data on regional bacterial pathogen susceptibility. We report the epidemiology of Staphylococcus aureus as an example of the power of digital platforms to tackle the growing spread of antimicrobial resistance in a high-burden, geographically-sparse region and beyond. We developed an online geospatial platform called HOTspots that visualises antimicrobial susceptibility patterns and temporal trends. Data on clinically-important bacteria and their antibiotic susceptibility profiles were sought from retrospectively identified clinical specimens submitted to three participating pathology providers (96 unique tertiary and primary healthcare centres, n = 1,006,238 tests) between January 2008 and December 2017. Here we present data on S. aureus only. Data were available on specimen type, date and location of collection. Regions from the Australian Bureau of Statistics were used to provide spatial localisation. The online platform provides an engaging visual representation of spatial heterogeneity, demonstrating striking geographical variation in S. aureus susceptibility across northern Australia. Methicillin resistance rates vary from 46% in the west to 26% in the east. Plots generated by the platform show temporal trends in proportions of S. aureus resistant to methicillin and other antimicrobials across the three jurisdictions of northern Australia. A quarter of all, and up to 35% of methicillin-resistant S. aureus (MRSA) blood isolates in parts of the northern Australia were resistant to inducible-clindamycin. Clindamycin resistance rates in MRSA are worryingly high in regions of northern Australia and are a local impediment to empirical use of this agent for community MRSA. Visualising routinely collected laboratory data with digital platforms, allows clinicians, public health physicians and guideline developers to monitor and respond to antimicrobial resistance in a timely manner. Deployment of this platform into clinical practice supports national and global efforts to innovate traditional disease surveillance systems with the use of digital technology and to provide practical solutions to reducing the threat of antimicrobial resistance.
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Affiliation(s)
- T M Wozniak
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - W Cuningham
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - S Buchanan
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - S Coulter
- Queensland Health, Communicable Diseases Branch, Brisbane, Queensland, Australia
| | - R W Baird
- Territory Pathology, Northern Territory Government, Darwin, Northern Territory, Australia
| | - G R Nimmo
- Pathology Queensland Central Laboratory, Griffith University School of Medicine, Brisbane, Queensland, Australia
| | - C C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.,PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - S Y C Tong
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Victorian Infectious Disease Service, The Royal Melbourne Hospital and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - B J Currie
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - A P Ralph
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Petropoulos ZE, Levy JI, Scammell MK, Fabian MP. Characterizing community-wide housing attributes using georeferenced street-level photography. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:299-308. [PMID: 31548622 PMCID: PMC7044024 DOI: 10.1038/s41370-019-0167-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/18/2019] [Accepted: 06/30/2019] [Indexed: 06/10/2023]
Abstract
New methods are needed to efficiently characterize built environment attributes and residential behaviors to improve exposure assessment in epidemiologic research, given limitations of available databases and approaches. Window-opening and presence of air conditioning (AC) units predict indoor air quality and thermal comfort, but data are not widely available. In this study, we tested the utility of a GIS-based tool for rapidly assessing open windows and window/wall AC units in the city of Chelsea, Massachusetts using georeferenced street-level photographs and crowdsourced online surveys. We characterized open windows and window/wall AC units for 969 parcels in the winter and 1213 parcels in the summer, requiring ~40 person hours per season. In the winter, 21% of parcels surveyed had a window or wall AC unit and 19% had an open window. In the summer, 69% had a window or wall AC unit and 53% had an open window. We demonstrated an efficient method for rapidly characterizing open windows and window/wall AC units across an entire city. This tool can help to characterize exposures for epidemiological research, engage community members, and inform local land use planning and decision-making.
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Affiliation(s)
- Zoe E Petropoulos
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - M Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
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12
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Mealings K, Harkus S, Hwang J, Fragoso J, Chung K, Dillon H. Hearing loss and speech understanding in noise in Aboriginal and Torres Strait Islander children from locations varying in remoteness and socio-educational advantage. Int J Pediatr Otorhinolaryngol 2020; 129:109741. [PMID: 31677536 DOI: 10.1016/j.ijporl.2019.109741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage. METHOD 288 Aboriginal and Torres Strait Islander children aged 4-14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise - Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population. RESULTS The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote. CONCLUSIONS The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages.
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Affiliation(s)
| | | | | | | | - King Chung
- Northern Illinois University, United States
| | - Harvey Dillon
- National Acoustic Laboratories, Sydney, Australia; University of Manchester, Manchester, United Kingdom; Macquarie University, Sydney, Australia
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13
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Riva M, Fletcher C, Dufresne P, Perreault K, Muckle G, Potvin L, Bailie RS. Relocating to a new or pre-existing social housing unit: significant health improvements for Inuit adults in Nunavik and Nunavut. Canadian Journal of Public Health 2019; 111:21-30. [PMID: 31741307 DOI: 10.17269/s41997-019-00249-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 07/11/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES In 2014-2015, over 400 social housing units were constructed in selected communities in Nunavik and Nunavut, two Inuit regions in northern Canada where housing shortages and poor quality housing are endemic and undermine population health. This paper presents results from a before-and-after study examining the effects of rehousing, i.e., relocating to a newly constructed or pre-existing social housing unit, on psychosocial health and asthma-related symptoms for Inuit adults. METHODS Baseline data were collected 1-6 months before, and follow-up data 15-18 months after rehousing. Of the 289 participants at baseline, 186 were rehoused. Of the 169 participants eligible at follow-up, 102 completed the study. Self-reported health measures included psychological distress, perceived stress in daily life, perceived control over one's life, and asthma-related symptoms. Data are analyzed using multilevel models for longitudinal data. RESULTS After adjusting for age, sex, and region of residence, participants reported significantly lower levels of psychological distress and perceived stress in daily life, and improved sense of control over their lives 15 to 18 months after rehousing. Participants were also significantly less likely to report asthma-related symptoms at follow-up. CONCLUSION Significant positive health impacts are observed for adults who relocated to newly constructed or pre-existing social housing units. Increasing investments to redress the housing situation across Inuit Nunangat is required, not only to improve living conditions but also to improve the health and well-being of the population.
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Affiliation(s)
- Mylène Riva
- Canada Research Chair in Housing, Community, and Health; Assistant Professor, Institute for Health and Social Policy and Department of Geography, McGill University, Burnside Hall, 805 Sherbrooke Street West, Montreal, QC, H3A 0B9, Canada.
| | - Christopher Fletcher
- Université Laval; Centre de Recherche du CHU de Québec-Université Laval, Quebec, Canada
| | - Philippe Dufresne
- Canada Research Chair in Housing, Community, and Health; Assistant Professor, Institute for Health and Social Policy and Department of Geography, McGill University, Burnside Hall, 805 Sherbrooke Street West, Montreal, QC, H3A 0B9, Canada
| | - Karine Perreault
- Institut de recherche en santé publique, Université de Montréal, Montreal, Canada
| | - Gina Muckle
- Université Laval; Centre de Recherche du CHU de Québec-Université Laval, Quebec, Canada
| | - Louise Potvin
- Institut de recherche en santé publique, Université de Montréal, Montreal, Canada
| | - Ross S Bailie
- University of Sydney, University Centre for Rural Health, Lismore, Australia
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14
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Dossetor PJ, Thorburn K, Oscar J, Carter M, Fitzpatrick J, Bower C, Boulton J, Fitzpatrick E, Latimer J, Elliott EJ, Martiniuk AL. Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions. BMC Health Serv Res 2019; 19:758. [PMID: 31655576 PMCID: PMC6815358 DOI: 10.1186/s12913-019-4605-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. METHODS Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. RESULTS We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). CONCLUSIONS Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.
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Affiliation(s)
- Philippa J Dossetor
- Clinical Medical School, College of Medicine, Biology & Environment, Australian National University, ACT, Canberra, 2605, Australia.
| | - Kathryn Thorburn
- Nulungu Research Institute, University of Notre Dame, Broome, Australia
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Crossing, Fitzroy, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Crossing, Fitzroy, Australia
| | - James Fitzpatrick
- University of Sydney, Sydney Medical School, Sydney, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | | | - Emily Fitzpatrick
- University of Sydney, Sydney Medical School, Sydney, Australia.,The Sydney Children's Hospital Network (Westmead), Sydney, Australia
| | - Jane Latimer
- University of Sydney, Sydney Medical School, Sydney, Australia
| | - Elizabeth J Elliott
- University of Sydney, Sydney Medical School, Sydney, Australia.,The Sydney Children's Hospital Network (Westmead), Sydney, Australia
| | - Alexandra Lc Martiniuk
- University of Sydney, Sydney Medical School, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia.,The University of Toronto, Toronto, Canada
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Yoon J, Redmond M. Check the Ear. The Importance of Ear Examinations in Assessment of Intracranial Subdural Empyema. Trop Med Infect Dis 2019; 4:tropicalmed4030120. [PMID: 31540395 PMCID: PMC6789478 DOI: 10.3390/tropicalmed4030120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 11/24/2022] Open
Abstract
Intracranial subdural empyema (ISE) is an uncommon condition previously associated with almost 100% morbidity and mortality. Since the introduction of antibiotics and advancements in diagnosis the complication rates have significantly improved. We report an unusual case of a 32-year-old Aboriginal male diagnosed with ISE. On closer inspection the ISE was found to be a complication of otitis media with a cotton bud lodged in the external acoustic meatus. The report provides a literature review on the relationships of ISE, otitis media and foreign bodies. We conclude that although rare, all patients with suspected ISE should undergo an ear examination as it is at no cost to the patient or health service but may be the difference between life and death.
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Affiliation(s)
- Joseph Yoon
- Department of Neurosurgery, Royal Darwin Hospital, Darwin Northern Territory, Tiwi 0810, Australia.
| | - Michael Redmond
- Department of Neurosurgery, Royal Darwin Hospital, Darwin Northern Territory, Tiwi 0810, Australia.
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16
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The Relationship between Infectious Diseases and Housing Maintenance in Indigenous Australian Households. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122827. [PMID: 30545014 PMCID: PMC6313733 DOI: 10.3390/ijerph15122827] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/02/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
This research aimed to identify systemic housing-level contributions to infectious disease transmission for Indigenous Australians, in response to the Government program to ‘close the gap’ of health and other inequalities. A narrative literature review was performed in accordance to PRISMA guidelines. The findings revealed a lack of housing maintenance was associated with gastrointestinal infections, and skin-related diseases were associated with crowding. Diarrhoea was associated with the state of food preparation and storage areas, and viral conditions such as influenza were associated with crowding. Gastrointestinal, skin, ear, eye, and respiratory illnesses are related in various ways to health hardware functionality, removal and treatment of sewage, crowding, presence of pests and vermin, and the growth of mould and mildew. The research concluded that infectious disease transmission can be reduced by improving housing conditions, including adequate and timely housing repair and maintenance, and the enabling environment to perform healthy behaviours.
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Andersen MJ, Skinner A, Williamson AB, Fernando P, Wright D. Housing conditions associated with recurrent gastrointestinal infection in urban Aboriginal children in NSW, Australia: findings from SEARCH. Aust N Z J Public Health 2018; 42:247-253. [PMID: 29644760 DOI: 10.1111/1753-6405.12786] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 10/01/2017] [Accepted: 02/01/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the associations between housing and gastrointestinal infection in Aboriginal children in urban New South Wales. METHODS A total of 1,398 Aboriginal children were recruited through four Aboriginal Community Controlled Health Services. Multilevel regression modelling of survey data estimated associations between housing conditions and recurrent gastrointestinal infection, adjusting for sociodemographic and health factors. RESULTS Of the sample, 157 children (11%) had recurrent gastrointestinal infection ever and 37 (2.7%) required treatment for recurrent gastrointestinal infection in the past month. Children in homes with 3+ housing problems were 2.51 (95% CrI 1.10, 2.49) times as likely to have recurrent gastrointestinal infection ever and 6.79 (95% CrI 2.11, 30.17) times as likely to have received recent treatment for it (versus 0-2 problems). For every additional housing problem, the prevalence of recurrent gastrointestinal infection ever increased by a factor of 1.28 (95% CrI 1.14, 1.47) and the prevalence of receiving treatment for gastrointestinal infection in the past month increased by a factor of 1.64 (95% CrI 1.20, 2.48). CONCLUSIONS Housing problems were independently associated with recurrent gastrointestinal infection in a dose-dependent manner. Implications for public health: The role of housing as a potential determinant of health in urban Aboriginal children merits further attention in research and policy settings.
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Affiliation(s)
- Melanie J Andersen
- School of Public Health and Community Medicine, The University of New South Wales.,The Sax Institute, New South Wales
| | - Adam Skinner
- School of Public Health and Community Medicine, The University of New South Wales
| | - Anna B Williamson
- The Sax Institute, New South Wales.,The University of Sydney, New South Wales
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18
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Edmond KM, McAuley K, McAullay D, Matthews V, Strobel N, Marriott R, Bailie R. Quality of social and emotional wellbeing services for families of young Indigenous children attending primary care centers; a cross sectional analysis. BMC Health Serv Res 2018; 18:100. [PMID: 29426308 PMCID: PMC5807859 DOI: 10.1186/s12913-018-2883-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 01/23/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The quality of social and emotional wellbeing services for Indigenous families of young children is not known, in many settings especially services provided by primary care centers. METHODS Our primary objective was to assess delivery of social and emotional wellbeing services to the families of young (3-11 months) and older (12-59 months) Indigenous children attending primary care centers. Our secondary objective was to assess if delivery differed by geographic location. Two thousand four hundred sixty-six client files from 109 primary care centers across Australia from 2012 to 2014 were analysed using logistic regression and generalised estimating equations. RESULTS The proportion of families receiving social and emotional wellbeing services ranged from 10.6% (102) (food security) to 74.7% (1216) (assessment of parent child interaction). Seventy one percent (71%, 126) of families received follow up care. Families of children aged 3-11 months (39.5%, 225) were more likely to receive social and emotional wellbeing services (advice about domestic environment, social support, housing condition, child stimulation) than families of children aged 12-59 months (30.0%, 487) (adjusted odds ratio [aOR] 1.68 95% CI 1.33 to 2.13). Remote area families (32.6%, 622) received similar services to rural (29.4%, 68) and urban families (44.0%, 22) (aOR 0.64 95% CI 0.29, 1.44). CONCLUSIONS The families of young Indigenous children appear to receive priority for social and emotional wellbeing care in Australian primary care centers, however many Indigenous families are not receiving services. Improvement in resourcing and support of social and emotional wellbeing services in primary care centers is needed.
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Affiliation(s)
- Karen M Edmond
- School of Medicine, Division Paediatrics, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.
| | - Kimberley McAuley
- School of Medicine, Division Paediatrics, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Daniel McAullay
- School of Medicine, Division Paediatrics, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,Edith Cowen University, Perth, Western Australia, Australia
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - Natalie Strobel
- School of Medicine, Division Paediatrics, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Rhonda Marriott
- School of Psychology and Exercise Science, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia
| | - Ross Bailie
- University Centre for Rural Health, University of Sydney, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
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Differences in the occurrence and epidemiology of cryptosporidiosis in Aboriginal and non-Aboriginal people in Western Australia (2002 − 2012). INFECTION GENETICS AND EVOLUTION 2017; 53:100-106. [DOI: 10.1016/j.meegid.2017.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/16/2017] [Accepted: 05/20/2017] [Indexed: 01/08/2023]
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Andersen MJ, Williamson AB, Fernando P, Wright D, Redman S. Housing conditions of urban households with Aboriginal children in NSW Australia: tenure type matters. BMC Public Health 2017; 18:70. [PMID: 28764762 PMCID: PMC5540447 DOI: 10.1186/s12889-017-4607-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/18/2017] [Indexed: 11/29/2022] Open
Abstract
Background Housing is a key determinant of the poor health of Aboriginal Australians. Most Aboriginal people live in cities and large towns, yet research into housing conditions has largely focused on those living in remote areas. This paper measures the prevalence of housing problems amongst participants in a study of urban Aboriginal families in New South Wales, Australia, and examines the relationship between tenure type and exposure to housing problems. Methods Cross-sectional survey data was provided by 600 caregivers of 1406 Aboriginal children aged 0–17 years participating in Phase One of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Regression modelling of the associations between tenure type (own/mortgage, private rental or social housing) and housing problems was conducted, adjusting for sociodemographic factors. Results The majority (60%) of SEARCH households lived in social housing, 21% rented privately and 19% either owned their home outright or were paying a mortgage (“owned”). Housing problems were common, particularly structural problems, damp and mildew, vermin, crowding and unaffordability. Physical dwelling problems were most prevalent for those living in social housing, who were more likely to report three or more physical dwelling problems than those in owned (PR 3.19, 95%CI 1.97, 5.73) or privately rented homes (PR 1.49, 1.11, 2.08). However, those in social housing were the least likely to report affordability problems. Those in private rental moved home most frequently; children in private rental were more than three times as likely to have lived in four or more homes since birth than those in owned homes (PR 3.19, 95%CI 1.97, 5.73). Those in social housing were almost half as likely as those in private rental to have lived in four or more homes since birth (PR 0.56, 95%CI 0.14, 0.77). Crowding did not vary significantly by tenure type. Conclusions The high prevalence of housing problems amongst study participants suggests that urban Aboriginal housing requires further attention as part of efforts to reduce the social and health disadvantage experienced by Aboriginal Australians. Particular attention should be directed to the needs of those renting in the private and social housing sectors, who are experiencing the poorest dwelling conditions. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4607-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melanie J Andersen
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, 2052, Australia. .,The Sax Institute, 235 Jones St, Haymarket, Sydney, 2007, Australia.
| | - Anna B Williamson
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, 2052, Australia.,The Sax Institute, 235 Jones St, Haymarket, Sydney, 2007, Australia
| | - Peter Fernando
- The Sax Institute, 235 Jones St, Haymarket, Sydney, 2007, Australia
| | - Darryl Wright
- Tharawal Aboriginal Corporation, 187 Riverside Dr, Airds, 2560, Australia
| | - Sally Redman
- The Sax Institute, 235 Jones St, Haymarket, Sydney, 2007, Australia
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21
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Romani L, Whitfeld MJ, Koroivueta J, Kama M, Wand H, Tikoduadua L, Tuicakau M, Koroi A, Ritova R, Andrews R, Kaldor JM, Steer AC. The Epidemiology of Scabies and Impetigo in Relation to Demographic and Residential Characteristics: Baseline Findings from the Skin Health Intervention Fiji Trial. Am J Trop Med Hyg 2017; 97:845-850. [PMID: 28722612 DOI: 10.4269/ajtmh.16-0753] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Scabies and associated impetigo are under-recognized causes of morbidity in many developing countries. To strengthen the evidence base for scabies control we undertook a trial of mass treatment for scabies. We report on the occurrence and predictors of scabies and impetigo in participants at baseline. Participants were recruited in six island communities and were examined for the presence of scabies and impetigo. In addition to descriptive analyses, logistic regression models were fit to assess the association between demographic variables and outcome of interest. The study enrolled 2051 participants. Scabies prevalence was 36.4% (95% confidence interval [CI] 34.3-38.5), highest in children 5-9 years (55.7%). Impetigo prevalence was 23.4% (95% CI 21.5-25.2) highest in children aged 10-14 (39.0%). People with scabies were 2.8× more likely to have impetigo. The population attributable risk of scabies as a cause of impetigo was 36.3% and 71.0% in children aged less than five years. Households with four or more people sharing the same room were more likely to have scabies and impetigo (odds ratios [OR] 1.6, 95% CI 1.2-2.2 and OR 2.3, 95% CI 1.6-3.2 respectively) compared to households with rooms occupied by a single individual. This study confirms the high burden of scabies and impetigo in Fiji and the association between these two conditions, particularly in young children. Overcrowding, young age, and clinical distribution of lesion are important risk factors for scabies and impetigo. Further studies are needed to investigate whether the decline of endemic scabies would translate into a definite reduction of the burden of associated complications.
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Affiliation(s)
- Lucia Romani
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Margot J Whitfeld
- Department of Dermatology, St. Vincent's Hospital, Sydney, Australia
| | | | | | - Handan Wand
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | | | | | | | - Ross Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - John M Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Andrew C Steer
- Murdoch Children's Research Institute, Melbourne, Australia.,Centre for International Child Health, University of Melbourne, Australia
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Falster K, Banks E, Lujic S, Falster M, Lynch J, Zwi K, Eades S, Leyland AH, Jorm L. Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study. BMC Pediatr 2016; 16:169. [PMID: 27769208 PMCID: PMC5073450 DOI: 10.1186/s12887-016-0706-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 10/04/2016] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. METHODS This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage. RESULTS There were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9-91.4) in Aboriginal children and 44.9/1000 person-years (44.8-45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7-1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged <2 years to 5/1000 person-years and 1.8, respectively, for ages 12- < 14 years. Findings were similar for the subset of ambulatory care sensitive hospitalizations, but in contrast, non-avoidable hospitalization rates were almost identical in Aboriginal (10.1/1000 person-years, (9.6-10.5)) and non-Aboriginal children (9.6/1000 person-years (9.6-9.7)). CONCLUSIONS We observed substantial inequalities in avoidable hospitalizations between Aboriginal and non-Aboriginal children regardless of where they lived, particularly among young children. Policy measures that reduce inequities in the circumstances in which children grow and develop, and improved access to early intervention in primary care, have potential to narrow this gap.
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Affiliation(s)
- Kathleen Falster
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
| | - Sanja Lujic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Michael Falster
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - John Lynch
- School of Public Health, University of Adelaide, Adelaide, Australia
| | - Karen Zwi
- Sydney Children’s Hospitals Network, Sydney, Australia
- School of Women and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Sandra Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
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23
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Melody SM, Bennett E, Clifford HD, Johnston FH, Shepherd CCJ, Alach Z, Lester M, Wood LJ, Franklin P, Zosky GR. A cross-sectional survey of environmental health in remote Aboriginal communities in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2016; 26:525-535. [PMID: 27267619 DOI: 10.1080/09603123.2016.1194384] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/14/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The Australian Aboriginal population experiences significantly poorer health than the non-Aboriginal population. The contribution of environmental risk factors in remote communities to this health disparity is poorly understood. OBJECTIVE To describe and quantify major environmental risk factors and associated health outcomes in remote Aboriginal communities in Western Australia. METHODS The association between environmental health indicators, community infrastructure and reported health outcomes was analysed using linear and logistic regression of survey data. RESULTS Housing/overcrowding was significantly associated with increased reports of hearing/eyesight (OR 3.01 95 % CI 1.58-5.73), skin (OR 2.71 95 % CI 1.31-5.60), gastrointestinal (OR 3.51 95 % CI 1.49-8.26) and flu/colds (OR 2.47 95 % CI 1.27-4.78) as health concerns. Dust was significantly associated with hearing/eyesight (OR 3.16 95 % CI 1.82-5.48), asthma/respiratory (OR 2.48 95 % CI 1.43-4.29) and flu/colds (OR 3.31 95 % CI 1.88-5.86) as health concerns. CONCLUSION Poor environmental health is prevalent in remote Aboriginal communities and requires further delineation to inform environmental health policy.
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Affiliation(s)
- S M Melody
- a Menzies Institute for Medical Research , University of Tasmania , Hobart , Australia
| | - E Bennett
- b Faculty of Health, School of Medicine , University of Tasmania , Hobart , Australia
| | - H D Clifford
- c Telethon Kids Institute , University of Western Australia , Perth , Australia
| | - F H Johnston
- a Menzies Institute for Medical Research , University of Tasmania , Hobart , Australia
| | - C C J Shepherd
- c Telethon Kids Institute , University of Western Australia , Perth , Australia
| | - Z Alach
- d Environmental Health Directorate, Western Australian Department of Health , Perth , Australia
| | - M Lester
- d Environmental Health Directorate, Western Australian Department of Health , Perth , Australia
| | - L J Wood
- e School of Population Health , University of Western Australia , Perth , Australia
| | - P Franklin
- d Environmental Health Directorate, Western Australian Department of Health , Perth , Australia
| | - G R Zosky
- b Faculty of Health, School of Medicine , University of Tasmania , Hobart , Australia
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Habib RR, Mikati D, Hojeij S, El Asmar K, Chaaya M, Zurayk R. Associations between poor living conditions and multi-morbidity among Syrian migrant agricultural workers in Lebanon. Eur J Public Health 2016; 26:1039-1044. [PMID: 27402635 PMCID: PMC5172490 DOI: 10.1093/eurpub/ckw096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Syrian migrant farmworkers are among the most marginalized populations in Lebanon, living in poverty, lacking basic legal protections and frequent targets of discrimination. These realities produce living conditions that undermine their basic health and wellbeing. This study explores associations between household living conditions and acute and chronic health problems among Syrian migrant agricultural workers in the Bekaa region of Lebanon. Methods: A survey was carried out in summer of 2011 with a sample of 290 migrant agriculture workers and members of their household living in a migrant farmworker camp. The survey assessed participants living conditions, assets and health conditions. Regression analyses were carried out to examine associations between multi-morbidity and quality of household and neighborhood living conditions. Results: The mean age for the population was 20 years. Forty-seven percent of participants reported health problems. Almost 20% reported either one acute or chronic illness, 15% reported two health problems and 13% reported three or more. The analysis showed a significant positive association between multi-morbidity and poor housing and infrastructure conditions among study participants. Conclusion: The situation for migrant communities in Lebanon has likely further deteriorated since the study was conducted, as hundreds of thousands of new migrants have entered Lebanon since the outbreak of the Syrian armed conflict in 2011. These findings should inspire multi-faceted community development initiatives that provide basic minimums of neighborhood infrastructure and housing quality for Syrian migrant informal settlements across Lebanon, safeguarding the health and wellbeing of community residents.
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Affiliation(s)
- Rima R Habib
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Diana Mikati
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Safa Hojeij
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil El Asmar
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Monique Chaaya
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rami Zurayk
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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Fang TY, Rafai E, Wang PC, Bai CH, Jiang PL, Huang SN, Chen YJ, Chao YT, Wang CH, Chang CH. Pediatric otitis media in Fiji: Survey findings 2015. Int J Pediatr Otorhinolaryngol 2016; 85:50-5. [PMID: 27240496 DOI: 10.1016/j.ijporl.2016.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/22/2016] [Accepted: 04/01/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Otitis media (OM), as a common infectious disease, is a major cause of hearing impairment among the general population. OM remains a major public health threat in the Pacific islands, but the risks of OM have not been thoroughly explored in this region. The objective of this study is to investigate the prevalence, clinical features, and quality-of-life impacts of OM in Fiji. METHODS In the medical service trip entitled "Healing and Hope - Taiwan Cathay Heart and Hearing Medical Mission to Fiji" (TCHHMMF), we conducted a cross-sectional OM survey study in Suva and Sigatoka areas (Korolevu, Cuvu, and Lomawai) in the summer of 2015. The otitis media - 6 (OM-6) was used to survey the OM-related quality of life. RESULTS In the 467 pediatric patients (aged 0-18 years old) screened, 13 (2.78%) have acute otitis media (AOM), 37 (7.92%) have otitis media with effusion (OME), and 19 (4.1%) have chronic otitis media (COM). Age (OR 0.53, 95% CI: 0.36-0.77) is a significant predictor of AOM, whereas male gender (OR 2.46, 95% CI: 1.13-5.37), smoke exposure (OR 2.81, 95% CI: 1.01-7.82), and concomitant chronic sinusitis (OR 6.05, 95% CI: 2.31-15.88) are significant predictors of OME. The mean OM-6 item scores are highest in caregiver concerns (3.8), physical suffering (3.7), and hearing loss (3.4) domains. CONCLUSION OM is an important primary care disease in Fiji that remains under-served. It is critical to educate professionals, parents, and patients to detect and to improve care for OM.
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Affiliation(s)
- Te-Yung Fang
- Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan; Fu Jen Catholic University School of Medicine, New Taipei City, Taiwan
| | - Eric Rafai
- Ministry of Health and Medical Services, Suva, Fiji
| | - Pa-Chun Wang
- Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan; Fu Jen Catholic University School of Medicine, New Taipei City, Taiwan.
| | - Chiy-Huey Bai
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Peng-Long Jiang
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan
| | - Shu-Nuan Huang
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan
| | - You-Ju Chen
- Department of Pharmacy, Cathay General Hospital, Taipei, Taiwan
| | - Yi-Ting Chao
- International Medical Affairs, Cathay General Hospital, Taipei, Taiwan
| | - Chen-Hsu Wang
- Medical Intensive Care Unit, Cathay General Hospital, Taipei, Taiwan
| | - Chia-Hsiu Chang
- Department of Cardiology, Cathay General Hospital, Taipei, Taiwan
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Andersen MJ, Williamson AB, Fernando P, Redman S, Vincent F. "There's a housing crisis going on in Sydney for Aboriginal people": focus group accounts of housing and perceived associations with health. BMC Public Health 2016; 16:429. [PMID: 27220748 PMCID: PMC4877811 DOI: 10.1186/s12889-016-3049-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 04/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. METHODS Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. RESULTS Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. CONCLUSIONS Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.
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Affiliation(s)
- Melanie J Andersen
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia. .,The Sax Institute, 235 Jones St, Haymarket, 2007, Australia.
| | - Anna B Williamson
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia.,The Sax Institute, 235 Jones St, Haymarket, 2007, Australia
| | - Peter Fernando
- The Sax Institute, 235 Jones St, Haymarket, 2007, Australia
| | - Sally Redman
- The Sax Institute, 235 Jones St, Haymarket, 2007, Australia
| | - Frank Vincent
- The Aboriginal Medical Service Western Sydney, 2 Palmerston Rd, Mt Druitt Village, 2770, Australia
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Pinzón-Rondón ÁM, Aguilera-Otalvaro P, Zárate-Ardila C, Hoyos-Martínez A. Acute respiratory infection in children from developing nations: a multi-level study. Paediatr Int Child Health 2016; 36:84-90. [PMID: 25936959 DOI: 10.1179/2046905515y.0000000021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Worldwide, acute respiratory infections (ARI) are the leading cause of death of children under 5 years of age. AIM To assess the accomplishment of the Millennium Development Goal on under-5 mortality particularly related to ARI in developing countries, and to explore the associations between country characteristics and ARI in children under 5 taking into account child, mother and household attributes. METHODS The study included a representative sample of 354,633 children under 5 years from 40 developing nations. A multilevel analysis of data from the Demographic and Health Surveys and the World Bank was conducted. RESULTS The prevalence of ARI was 13%. Country inequalities were associated with the disease - GINI index (95% CI 1.01-1.04). The country's per capita gross domestic product (GDP) (95% CI 1.00-1.01) and health expenditure (95% CI 1.01-1.01) affected the relationship between immunization and ARI, while inequalities influenced the relationship between household wealth (95% CI 0.99-0.99) and the disease. Other factors positively associated with ARI were male gender, low birthweight, working mothers and a high-risk indoor environment. Factors associated with ARI reduction were older children, immunization, breastfeeding for more than 6 months, older maternal age, maternal education and planned pregnancy. CONCLUSIONS In developing countries, public health campaigns to target ARI should consider the country's macro characteristics. At country level, inequalities but not health expenditure or GDP were associated with the disease and were independent of child, family and household characteristics. The effect of immunization on reducing ARI is greater in countries with a higher GDP and health expenditure. The effect of household wealth on ARI is less in countries with fewer inequalities. Reduction of inequalities is an important measure to decrease ARI in developing countries.
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Affiliation(s)
| | | | - Carol Zárate-Ardila
- a Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá , Colombia
| | - Alfonso Hoyos-Martínez
- a Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá , Colombia
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Lal A, Cornish LM, Fearnley E, Glass K, Kirk M. Cryptosporidiosis: A Disease of Tropical and Remote Areas in Australia. PLoS Negl Trop Dis 2015; 9:e0004078. [PMID: 26393508 PMCID: PMC4579119 DOI: 10.1371/journal.pntd.0004078] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/20/2015] [Indexed: 11/20/2022] Open
Abstract
Cryptosporidiosis causes gastroenteritis and is transmitted to humans via contaminated water and food, and contact with infected animals and people. We analyse long-term cryptosporidiosis patterns across Australia (2001–2012) and review published Australian studies and jurisdictional health bulletins to identify high risk populations and potential risk factors for disease. Using national data on reported cryptosporidiosis, the average annual rate of reported illness was 12.8 cases per 100 000 population, with cycles of high and low reporting years. Reports of illness peak in summer, similar to other infectious gastrointestinal diseases. States with high livestock densities like New South Wales and Queensland also record a spring peak in illnesses. Children aged less than four years have the highest rates of disease, along with adult females. Rates of reported cryptosporidiosis are highest in the warmer, remote regions and in Aboriginal and Torres Strait Islander populations. Our review of 34 published studies and seven health department reports on cryptosporidiosis in Australia highlights a lack of long term, non-outbreak studies in these regions and populations, with an emphasis on outbreaks and risk factors in urban areas. The high disease rates in remote, tropical and subtropical areas and in Aboriginal and Torres Strait Islander populations underscore the need to develop interventions that target the sources of infection, seasonal exposures and risk factors for cryptosporidiosis in these settings. Spatial epidemiology can provide an evidence base to identify priorities for intervention to prevent and control cryptosporidiosis in high risk populations. The parasite Cryptosporidium is a common cause of gastroenteritis worldwide. Ineffectively focused interventions are partly why the disease remains a challenge to control. In this study, we describe the geographical, seasonal and demographic characteristics of reported cryptosporidiosis in Australia from 2001–2012. We combine this analysis of illnesses with evidence published in peer review articles and state health bulletins to identify high disease risk areas and populations. We find that rates of reported cryptosporidiosis are highest in warm, remote areas and in Aboriginal and Torres Strait Islander populations’ dominated regions. Our review of the published literature and health reports highlights a focus on short term outbreaks in metropolitan areas. This negligible overlap between areas with high disease rates and areas of public health focus is of concern. Public health interventions and promotion programs to prevent and control diarrhoea need to focus on remote and Indigenous dominated Australia to reduce the currently high rates in these regions and populations.
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Affiliation(s)
- Aparna Lal
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- * E-mail:
| | - Lisa Michelle Cornish
- National Centre for Geographic & Resource Analysis in Primary Health Care (GRAPHC), Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Emily Fearnley
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Martyn Kirk
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Kosai H, Tamaki R, Saito M, Tohma K, Alday PP, Tan AG, Inobaya MT, Suzuki A, Kamigaki T, Lupisan S, Tallo V, Oshitani H. Incidence and Risk Factors of Childhood Pneumonia-Like Episodes in Biliran Island, Philippines--A Community-Based Study. PLoS One 2015; 10:e0125009. [PMID: 25938584 PMCID: PMC4418693 DOI: 10.1371/journal.pone.0125009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/19/2015] [Indexed: 11/21/2022] Open
Abstract
Pneumonia is a leading cause of deaths in infants and young children in developing countries, including the Philippines. However, data at the community level remains limited. Our study aimed to estimate incidence and mortality rates and to evaluate risk factors and health-seeking behavior for childhood pneumonia. A household level interview survey was conducted in Biliran Island, the Philippines. Caregivers were interviewed using a semi-structured questionnaire to check if children had symptoms suggesting pneumonia-like episodes from June 2011 to May 2012. Of 3,327 households visited in total, 3,302 (99.2%) agreed to participate, and 5,249 children less than 5 years of age were included in the study. Incidence rates of pneumonia-like episodes, severe pneumonia-like episodes, and pneumonia-associated mortality were 105, 61, and 0.9 per 1,000 person-years, respectively. History of asthma [hazard ratio (HR): 5.85, 95% confidence interval (CI): 4.83–7.08], low socioeconomic status (SES) (HR: 1.11, 95% CI: 1.02–1.20), and long travel time to the healthcare facility estimated by cost distance analysis (HR: 1.32, 95% CI: 1.09–1.61) were significantly associated with the occurrence of pneumonia-like episodes by the Cox proportional hazards model. For severe pneumonia-like episodes, a history of asthma (HR: 8.39, 95% CI: 6.54–10.77) and low SES (HR: 1.30, 95% CI: 1.17–1.45) were significant risk factors. Children who had a long travel time to the hospital were less likely to seek hospital care (Odds ratio: 0.32, 95% CI: 0.19–0.54) when they experienced severe pneumonia-like episodes. Incidence of pediatric pneumonia-like episodes was associated with a history of asthma, SES, and the travel time to healthcare facilities. Travel time was also identified as a strong indicator for health-seeking behavior. Improved access to healthcare facilities is important for early and effective management. Further studies are warranted to understand the causal relationship between asthma and pneumonia.
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Affiliation(s)
- Hisato Kosai
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Raita Tamaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mayuko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Tohma
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Alvin Gue Tan
- Research Institute for Tropical Medicine, Metro Manila,The Philippines
| | | | - Akira Suzuki
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taro Kamigaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Soccoro Lupisan
- Research Institute for Tropical Medicine, Metro Manila,The Philippines
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Metro Manila,The Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
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Gisselsson-Solen M. Acute otitis media in children-current treatment and prevention. Curr Infect Dis Rep 2015; 17:476. [PMID: 25896748 DOI: 10.1007/s11908-015-0476-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acute otitis media (AOM) is the most common bacterial infection in children and has a very varied clinical spectrum, ranging from spontaneous resolutions to serious complications. The effect of antibiotics in AOM depends on the chosen outcome, but has been shown to reduce pain somewhat, and have a greater beneficial effect in severe cases of AOM. Today, not all episodes of AOM are treated with antibiotics, but most countries have issued guidelines that include an option of watchful waiting in many cases. Prevention of AOM reaches from modification of environmental risk factors to vaccinations and surgery. Conjugate pneumococcal vaccines and influenza vaccines have been shown to somewhat reduce the number of AOM episodes in different groups of children. Grommets, with or without adenoidectomy, are effective at least during the first 6 months after surgery.
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Affiliation(s)
- Marie Gisselsson-Solen
- Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, 22185, Lund, Sweden,
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Eliçora SŞ, Öztürk M, Sevinç R, Derin S, Dinç AE, Erdem D. Risk factors for otitis media effusion in children who have adenoid hypertrophia. Int J Pediatr Otorhinolaryngol 2015; 79:374-7. [PMID: 25596647 DOI: 10.1016/j.ijporl.2014.12.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/16/2014] [Accepted: 12/22/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Many studies have shown that children with adenoid hypertrophy (AH) are more likely to have chronic otitis media with effusion (COME). However, not every child with AH has COME. In this study, we investigated the socio-demographic risk factors of children who underwent surgery for AH, including a subgroup with COME. Our aim was to identify the factors involved in the development of COME. METHODS The study population consisted of 170 pediatric patients (118 males, 52 females) who underwent adenoidectomy between 2005 and 2008. The patients were divided into two groups, those with AH alone and those with AH and COME (AH+COME). Major factors such as age, gender, breast-milk feeding, bottle-feeding, tobacco smoke exposure, familial predisposition, allergies, congenital diseases, and school attendance were compared between the two groups. RESULTS AH alone was detected in 102 of the patients, 68% of whom were male, and AH+COME in the remaining 68, of whom 72% were male. The mean age was 6.5 years in the AH group and 5.3 years in the AH+COME group. There were no significant differences between the two groups with respect to breast-feeding, bottle-feeding, familial predisposition, tobacco exposure, and allergies. However, the relationships between COME and male sex, congenital diseases, and school attendance were significant. CONCLUSIONS COME is seen in young children with AH. Among the socio-demographic features examined in this study, only male sex, congenital diseases, and school attendance were statistically significant risk factors for COME development.
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Affiliation(s)
- Sultan Şevik Eliçora
- Otorhinolaryngology Department, Zonguldak Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey.
| | - Murat Öztürk
- Otorhinolaryngology Department, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Rukiye Sevinç
- Otorhinolaryngology Department, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Serhan Derin
- Otorhinolaryngology Department, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
| | - Aykut Erdem Dinç
- Otorhinolaryngology Department, Zonguldak Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
| | - Duygu Erdem
- Otorhinolaryngology Department, Zonguldak Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
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Xu Z, Liu Y, Ma Z, Li S, Hu W, Tong S. Impact of temperature on childhood pneumonia estimated from satellite remote sensing. ENVIRONMENTAL RESEARCH 2014; 132:334-41. [PMID: 24834830 DOI: 10.1016/j.envres.2014.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/07/2014] [Accepted: 04/10/2014] [Indexed: 05/20/2023]
Abstract
The effect of temperature on childhood pneumonia in subtropical regions is largely unknown so far. This study examined the impact of temperature on childhood pneumonia in Brisbane, Australia. A quasi-Poisson generalized linear model combined with a distributed lag non-linear model was used to quantify the main effect of temperature on emergency department visits (EDVs) for childhood pneumonia in Brisbane from 2001 to 2010. The model residuals were checked to identify added effects due to heat waves or cold spells. Both high and low temperatures were associated with an increase in EDVs for childhood pneumonia. Children aged 2-5 years, and female children were particularly vulnerable to the impacts of heat and cold, and Indigenous children were sensitive to heat. Heat waves and cold spells had significant added effects on childhood pneumonia, and the magnitude of these effects increased with intensity and duration. There were changes over time in both the main and added effects of temperature on childhood pneumonia. Children, especially those female and Indigenous, should be particularly protected from extreme temperatures. Future development of early warning systems should take the change over time in the impact of temperature on children's health into account.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Zongwei Ma
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Shenghui Li
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
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Xu Z, Liu Y, Ma Z, Sam Toloo G, Hu W, Tong S. Assessment of the temperature effect on childhood diarrhea using satellite imagery. Sci Rep 2014; 4:5389. [PMID: 24953087 PMCID: PMC4066260 DOI: 10.1038/srep05389] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/29/2014] [Indexed: 11/18/2022] Open
Abstract
A quasi-Poisson generalized linear model combined with a distributed lag non-linear model was used to quantify the main effect of temperature on emergency department visits (EDVs) for childhood diarrhea in Brisbane from 2001 to 2010. Residual of the model was checked to examine whether there was an added effect due to heat waves. The change over time in temperature-diarrhea relation was also assessed. Both low and high temperatures had significant impact on childhood diarrhea. Heat waves had an added effect on childhood diarrhea, and this effect increased with intensity and duration of heat waves. There was a decreasing trend in the main effect of heat on childhood diarrhea in Brisbane across the study period. Brisbane children appeared to have gradually adapted to mild heat, but they are still very sensitive to persistent extreme heat. Development of future heat alert systems should take the change in temperature-diarrhea relation over time into account.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Zongwei Ma
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Ghasem Sam Toloo
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Bailie RS, Stevens M, McDonald EL. Impact of housing improvement and the socio-physical environment on the mental health of children's carers: a cohort study in Australian Aboriginal communities. BMC Public Health 2014; 14:472. [PMID: 24885617 PMCID: PMC4060879 DOI: 10.1186/1471-2458-14-472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mental health of carers is an important proximate factor in the causal web linking housing conditions to child health, as well as being important in its own right. Improved understanding of the nature of the relationships between housing conditions, carer mental health and child health outcomes is therefore important for informing the development of housing programs. This paper examines the relationship between the mental health of the carers of young children, housing conditions, and other key factors in the socio-physical environment. METHODS This analysis is part of a broader prospective cohort study of children living in Aboriginal communities in the Northern Territory (NT) of Australia at the time of major new community housing programs. Carer's mental health was assessed using two validated scales: the Affect Balance scale and the Brief Screen for Depression. The quality of housing infrastructure was assessed through detailed surveys. Secondary explanatory variables included a range of socio-environmental factors, including validated measures of stressful life events. Hierarchical regression modelling was used to assess associations between outcome and explanatory variables at baseline, and associations between change in housing conditions and change in outcomes between baseline and follow-up. RESULTS There was no clear or consistent evidence of a causal relationship between the functional state of household infrastructure and the mental health of carers of young children. The strongest and most consistent associations with carer mental health were the measures of negative life events, with a dose-response relationship, and adjusted odds ratio of over 6 for carers in the highest stress exposure category at baseline, and consistent associations in the follow up analysis. CONCLUSIONS The findings highlight the need for housing programs to be supported by social, behavioral and community-wide environmental programs if potential health gains are to be more fully realized, and for rigorous evaluation of such programs for the purpose of informing future housing initiatives.
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Affiliation(s)
- Ross S Bailie
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
| | - Matthew Stevens
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
| | - Elizabeth L McDonald
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
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Spurling GKP, Askew DA, Schluter PJ, Simpson F, Hayman NE. Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study. Aust J Prim Health 2014; 20:285-90. [DOI: 10.1071/py13009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 05/07/2013] [Indexed: 12/26/2022]
Abstract
Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.
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Otitis media in Indigenous Australian children: review of epidemiology and risk factors. The Journal of Laryngology & Otology 2013; 128 Suppl 1:S16-27. [DOI: 10.1017/s0022215113003083] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractBackground:Otitis media represents a major health concern in Australian Indigenous children (‘Indigenous children’), which has persisted, despite public health measures, for over 30 years.Methods:Global searches were performed to retrieve peer-reviewed and ‘grey’ literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012.Results:In Indigenous children, the prevalence of otitis media subtypes is 7.1–12.8 per cent for acute otitis media, 10.5–30.3 per cent for active chronic otitis media and 31–50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media.Conclusion:Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.
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Falster K, Randall D, Banks E, Eades S, Gunasekera H, Reath J, Jorm L. Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study. BMJ Open 2013; 3:e003807. [PMID: 24285631 PMCID: PMC3845074 DOI: 10.1136/bmjopen-2013-003807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Australian Aboriginal children experience earlier, more frequent and more severe otitis media, particularly in remote communities, than non-Aboriginal children. Insertion of ventilation tubes is the main surgical procedure for otitis media. Our aim was to quantify inequalities in ventilation tube insertion (VTI) procedures between Australian Aboriginal and non-Aboriginal children, and to explore the influence of birth characteristics, socioeconomic background and geographical remoteness on this inequality. DESIGN Retrospective cohort study using linked hospital and mortality data from July 2000 to December 2008. SETTING AND PARTICIPANTS A whole-of-population cohort of 653 550 children (16 831 Aboriginal and 636 719 non-Aboriginal) born in a New South Wales hospital between 1 July 2000 and 31 December 2007 was included in the analysis. OUTCOME MEASURE First VTI procedure. RESULTS VTI rates were lower in Aboriginal compared with non-Aboriginal children (incidence rate (IR), 4.3/1000 person-years; 95% CI 3.8 to 4.8 vs IR 5.8/1000 person-years; 95% CI 5.7 to 5.8). Overall, Aboriginal children were 28% less likely than non-Aboriginal children to have ventilation tubes inserted (age-adjusted and sex-adjusted rate ratios (RRs) 0.72; 95% CI 0.64 to 0.80). After adjusting additionally for geographical remoteness, Aboriginal children were 19% less likely to have ventilation tubes inserted (age-adjusted and sex-adjusted RR 0.81; 95% CI 0.73 to 0.91). After adjusting separately for private patient/health insurance status and area socioeconomic status, there was no significant difference (age-adjusted and sex-adjusted RR 0.96; 95% CI 0.86 to 1.08 and RR 0.93; 95% CI 0.83 to 1.04, respectively). In the fully adjusted model, there were no significant differences in VTI rates between Aboriginal and non-Aboriginal children (RR 1.06; 95% CI 0.94 to 1.19). CONCLUSIONS Despite a much higher prevalence of otitis media, Aboriginal children were less likely to receive VTI procedures than their non-Aboriginal counterparts; this inequality was largely explained by differences in socioeconomic status and geographical remoteness.
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Affiliation(s)
- Kathleen Falster
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Deborah Randall
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
| | - Sandra Eades
- School of Public Health, University of Sydney, Sydney, Australia
| | - Hasantha Gunasekera
- Department of General Medicine, The Children's Hospital at Westmead, Westmead, Australia
| | - Jennifer Reath
- School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Louisa Jorm
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
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Chronic airways disease in First Nations, Inuit and Métis in Canada. Can Respir J 2013; 19:353-4. [PMID: 23248797 DOI: 10.1155/2012/590658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Hoffman HJ, Daly KA, Bainbridge KE, Casselbrant ML, Homøe P, Kvestad E, Kvaerner KJ, Vernacchio L. Panel 1: Epidemiology, natural history, and risk factors. Otolaryngol Head Neck Surg 2013; 148:E1-E25. [PMID: 23536527 DOI: 10.1177/0194599812460984] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The First International Symposium on Recent Advances in Otitis Media (OM) with Effusion was held in Columbus, Ohio, in 1975. The symposium has been organized in the United States every 4 years since, followed by a research conference to (a) assess major research accomplishments, (b) identify important research questions and opportunities, (c) develop consensus on definitions and terminology, and (d) establish priorities with short- and long-term research goals. One of the principal areas reviewed quadrennially is Epidemiology, Natural History, and Risk Factors. OBJECTIVE To provide a review of recent literature on the epidemiology, natural history, and risk factors for OM. DATA SOURCES AND REVIEW METHODS A search of OM articles in English published July 2007 to June 2011 was conducted using PubMed and related databases. Those with findings judged of importance for epidemiology, public health, and/or statistical methods were reviewed. RESULTS The literature has continued to expand, increasing understanding of the worldwide burden of OM in childhood, complications from treatment failures, and comorbidities. Novel risk factors, including genetic factors, have been examined for OM susceptibility. Population-based studies in Canada, the United States, and other countries confirmed reductions in OM prevalence. Although most studies concentrated on acute OM (AOM) or OM with effusion (OME), a few examined severe chronic suppurative OM (CSOM), a major public health problem in developing countries and for certain indigenous populations around the world. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Recent publications have reinforced earlier epidemiological findings, while extending our knowledge in human population groups with high burden of OM.
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Affiliation(s)
- Howard J Hoffman
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland 20892, USA.
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Shepherd CCJ, Li J, Mitrou F, Zubrick SR. Socioeconomic disparities in the mental health of Indigenous children in Western Australia. BMC Public Health 2012; 12:756. [PMID: 22958495 PMCID: PMC3508977 DOI: 10.1186/1471-2458-12-756] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 09/05/2012] [Indexed: 11/18/2022] Open
Abstract
Background The burden of mental health problems among Aboriginal and Torres Strait Islander children is a major public health problem in Australia. While socioeconomic factors are implicated as important determinants of mental health problems in mainstream populations, their bearing on the mental health of Indigenous Australians remains largely uncharted across all age groups. Methods We examined the relationship between the risk of clinically significant emotional or behavioural difficulties (CSEBD) and a range of socioeconomic measures for 3993 Indigenous children aged 4–17 years in Western Australia, using a representative survey conducted in 2000–02. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results Almost one quarter (24%) of Indigenous children were classified as being at high risk of CSEBD. Our findings generally indicate that higher socioeconomic status is associated with a reduced risk of mental health problems in Indigenous children. Housing quality and tenure and neighbourhood-level disadvantage all have a strong direct effect on child mental health. Further, the circumstances of families with Indigenous children (parenting quality, stress, family composition, overcrowding, household mobility, racism and family functioning) emerged as an important explanatory mechanism underpinning the relationship between child mental health and measures of material wellbeing such as carer employment status and family financial circumstances. Conclusions Our results provide incremental evidence of a social gradient in the mental health of Aboriginal and Torres Strait Islander children. Improving the social, economic and psychological conditions of families with Indigenous children has considerable potential to reduce the mental health inequalities within Indigenous populations and, in turn, to close the substantial racial gap in mental health. Interventions that target housing quality, home ownership and neighbourhood-level disadvantage are likely to be particularly beneficial.
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Affiliation(s)
- Carrington C J Shepherd
- Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
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Findlay LC, Janz TA. The health of Inuit children under age 6 in Canada. Int J Circumpolar Health 2012; 71:IJCH-71-18580. [PMID: 22973565 PMCID: PMC3417691 DOI: 10.3402/ijch.v71i0.18580] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 03/01/2012] [Accepted: 03/29/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Previous research has suggested that Inuit children experience poor health as compared to their non-Aboriginal counterparts, although social determinants such as family and social conditions, lifestyle or behaviour, and cultural factors may be at play. The purpose of the current study was to examine the parent-reported health of Inuit children under 6 years of age living in Canada. STUDY DESIGN AND METHODS Data from the 2006 Aboriginal Children's Survey were used to examine measures of Inuit child health as rated by parents including child health, limitations to physical activity, chronic conditions, ear infections, and dental problems. Associations between social determinants of health and parent-rated Inuit child health were also explored. RESULTS Most Inuit children under age 6 were reported by their parents or guardians to be in excellent or very good health. The most common chronic conditions identified were asthma, speech and language difficulties, allergies, lactose intolerance, and hearing impairment. Several social determinants of health were associated with child health, including parental education, household income, breastfeeding, and perceived housing conditions. CONCLUSIONS The findings show that social determinants of health, including both socio-economic and household characteristics, are associated with Inuit child health.
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Stevens M, Bailie R. Gambling, housing conditions, community contexts and child health in remote indigenous communities in the Northern Territory, Australia. BMC Public Health 2012; 12:377. [PMID: 22632458 PMCID: PMC3676167 DOI: 10.1186/1471-2458-12-377] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 05/25/2012] [Indexed: 11/10/2022] Open
Abstract
Background Recent government reports have identified gambling, along with alcohol abuse,
drug abuse and pornography, as contributing to child neglect and abuse in
Indigenous communities in the Northern Territory (NT). These reports also
identify gaps in empirical evidence upon which to base sound policy. To
address this shortfall, data from ten remote Indigenous communities was
analysed to determine the relationship between gambling problems, housing
conditions, community contexts and child health in indigenous
communities. Methods Logistic regression was used to assess associations between gambling
problems, community contexts, housing conditions and child health. Separate
multivariable models were developed for carer reported gambling problems in
houses and six child health outcomes. Results Carer reported gambling problems in households across the ten communities
ranged from 10% to 74%. Inland tropical communities had the highest level of
reported gambling problems. Less access to a doctor in the community showed
evidence of a multivariable adjusted association with gambling problems in
houses. No housing variables showed evidence for a multivariable association
with reported gambling problems. There was evidence for gambling problems
having a multivariable adjusted association with carer report of scabies and
ear infection in children. Conclusions The analyses provide evidence that gambling is a significant problem in
Indigenous communities and that gambling problems in households is related
to poor child health outcomes. A comprehensive (prevention, treatment,
regulation and education) public health approach to harm minimisation
associated with gambling amongst the Indigenous population is required that
builds on current normative community regulation of gambling.
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Affiliation(s)
- Matthew Stevens
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
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Abstract
Human milk provides infants with antimicrobial, anti-inflammatory, and immunomodulatory agents that contribute to optimal immune system function. The act of breastfeeding allows important bacterial and hormonal interactions between the mother and baby and impacts the mouth, tongue, swallow, and eustachian tubes. Previous meta-analyses have shown that lack of breastfeeding and less intensive patterns of breastfeeding are associated with increased risk of acute otitis media, one of the most common infections of childhood. A review of epidemiologic studies indicates that the introduction of infant formula in the first 6 months of life is associated with increased incidence of acute otitis media in early-childhood. More recent research raises the issues of how long this increased risk persists, and whether lack of breastfeeding is associated with diagnosis of otitis media with effusion. However, many studies suffer from lack of study of younger populations and imprecise definitions of infant feeding patterns. These findings suggest that measures of the association between breastfeeding history and otitis media risk are sensitive to the definition of breastfeeding used; future research is needed with more precise and consistent definitions of feeding, with attention to distinctions between direct breastfeeding and human milk feeding by bottle.
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Bentley R, Baker E, Mason K, Subramanian SV, Kavanagh AM. Association between housing affordability and mental health: a longitudinal analysis of a nationally representative household survey in Australia. Am J Epidemiol 2011; 174:753-60. [PMID: 21821543 DOI: 10.1093/aje/kwr161] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Evidence about the mental health consequences of unaffordable housing is limited. The authors investigated whether people whose housing costs were more than 30% of their household income experienced a deterioration in their mental health (using the Short Form 36 Mental Component Summary), over and above other forms of financial stress. They hypothesized that associations would be limited to lower income households as high housing costs would reduce their capacity to purchase other essential nonhousing needs (e.g., food). Using fixed-effects longitudinal regression, the authors analyzed 38,610 responses of 10,047 individuals aged 25-64 years who participated in the Household, Income, and Labour Dynamics in Australia (HILDA) Survey (2001-2007). Respondents included those who remained in affordable housing over 2 consecutive waves (reference group) or had moved from affordable to unaffordable housing over 2 waves (comparison group). For individuals living in low-to-moderate income households, entering unaffordable housing was associated with a small decrease in their mental health score independent of changes in equivalized household income or having moved house (mean change = -1.19, 95% confidence interval: -1.97, -0.41). The authors did not find evidence to support an association for higher income households. They found that entering unaffordable housing is detrimental to the mental health of individuals residing in low-to-moderate income households.
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Affiliation(s)
- Rebecca Bentley
- Melbourne School of Population Health, University of Melbourne, Victoria, Australia.
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Bailie RS, Stevens M, McDonald EL. The impact of housing improvement and socio-environmental factors on common childhood illnesses: a cohort study in Indigenous Australian communities. J Epidemiol Community Health 2011; 66:821-31. [PMID: 21693472 PMCID: PMC3412050 DOI: 10.1136/jech.2011.134874] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Improvements in health are an important expected outcome of many housing infrastructure programs. The authors aimed to determine if improvement in the notoriously poor housing infrastructure in Australian Indigenous communities results in reduction in common childhood illness and to identify important mediating factors in this relationship. Methods The authors conducted a prospective cohort study of 418 children aged 7 years or younger in 10 Australian Indigenous communities, which benefited most substantially from government-funded housing programs over 2004–2005. Data on functional and hygienic state of houses, reports of common childhood illness and on socio-economic conditions were collected through inspection of household infrastructure and interviews with children's carers and householders. Results After adjustment for a range of potential confounding variables, the analysis showed no consistent reduction in carers' reporting of common childhood illnesses in association with improvements in household infrastructure, either for specific illnesses or for these illnesses in general. While there was strong association between improvement in household infrastructure and improvement of hygienic condition of the house, there were only marginal improvements in crowding. Conclusions High levels of household crowding and poor social, economic and environmental conditions in many Australian Indigenous communities appear to place major constraints on the potential for building programs to impact on the occurrence of common childhood illness. These findings reinforce the need for building programs to be supported by a range of social, behavioural and community-wide environmental interventions in order for the potential health gains of improved housing to be more fully realised.
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Affiliation(s)
- Ross S Bailie
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia.
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Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related bacteria in Australian Aboriginal and non-Aboriginal children. Pediatr Infect Dis J 2011; 30:480-5. [PMID: 21593705 DOI: 10.1097/inf.0b013e318217dc6e] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Streptococcus pneumoniae, Moraxella catarrhalis, and nontypeable Haemophilus influenzae is associated with otitis media (OM). Data are limited on risk factors for carriage of these pathogens, particularly for Indigenous populations. We investigated predictors of nasopharyngeal carriage in Australian Aboriginal and non-Aboriginal children. METHODS Nasopharyngeal aspirates were collected up to 7 times before age 2 years from 100 Aboriginal and 180 non-Aboriginal children. Longitudinal modeling estimated effects of environmental factors and concurrent carriage of other bacteria on the probability of bacterial carriage. We present a novel method combining the effects of number of household members and size of house into an overall crowding model. RESULTS Each additional household member increased the risk of carriage of S. pneumoniae (odds ratio [OR] = 1.45 per additional Aboriginal child in a 4-room house, 95% confidence interval [CI]: 1.15-1.84; OR = 2.34 per additional non-Aboriginal child, 95% CI: 1.76-3.10), with similar effect sizes for M. catarrhalis, and nontypeable Haemophilus influenzae. However, living in a larger house attenuated this effect among Aboriginal children. Daycare attendance predicted carriage of the 3 OM-associated bacteria among non-Aboriginal children. Exclusive breast-feeding at 6 to 8 weeks protected against Streptococcus aureus carriage (OR = 0.42, 95% CI: 0.19-0.90 in Aboriginal children and OR = 0.49, 95% CI: 0.25-0.96 in non-Aboriginal children). OM-associated bacteria were more likely to be present if there was concurrent carriage of the other OM-associated species. CONCLUSIONS This study highlights the importance of household transmission in carriage of OM bacteria, underscoring the need to reduce the crowding in Aboriginal households.
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