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Hendrickx D, Amgarth-Duff I, C Bowen A, R Carapetis J, Chibawe R, Samson M, Walker R. Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E808. [PMID: 32012972 PMCID: PMC7037003 DOI: 10.3390/ijerph17030808] [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: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/16/2022]
Abstract
In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers (n = 16), healthcare practitioners (n = 15) and other community service providers (n = 25). We used Andersen's health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.
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Affiliation(s)
- David Hendrickx
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Ingrid Amgarth-Duff
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Asha C Bowen
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Jonathan R Carapetis
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Robby Chibawe
- Puntukurnu Aboriginal Medical Service Unit 5, 15, Iron Ore Parade, Newman, WA 6753, Australia
| | - Margaret Samson
- Jigalong Community Council, Pmb 8, Newman, WA 6753, Australia
| | - Roz Walker
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
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May PJ, Tong SYC, Steer AC, Currie BJ, Andrews RM, Carapetis JR, Bowen AC. Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health 2019; 24:280-293. [PMID: 30582783 PMCID: PMC6850630 DOI: 10.1111/tmi.13198] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We conducted a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource‐limited settings where skin infections are endemic. The aim is to inform strategies, guidelines and research to improve skin health in populations that are inequitably affected by infections of the skin and the downstream consequences of these. The systematic review is reported according to the PRISMA statement. From 1759 titles identified, 81 full text studies were reviewed and key findings outlined for impetigo, scabies, crusted scabies and tinea. Improvements in primary care and public health management of skin infections will have broad and lasting impacts on overall quality of life including reductions in morbidity and mortality from sepsis, skeletal infections, kidney and heart disease.
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Affiliation(s)
- Philippa J May
- Northern Territory Centre for Disease Control, Casuarina, Australia
| | - Steven Y C Tong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Parkville, Australia.,Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Andrew C Steer
- Royal Children's Hospital, Parkville, Australia.,Murdoch Children's Research Institute, University of Melbourne, Parkville, Australia
| | - Bart J Currie
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,Royal Darwin Hospital, Casuarina, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Jonathan R Carapetis
- Perth Children's Hospital, Nedlands, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, University of Western Australia, Nedlands, Australia.,School of Medicine, University of Western Australia, Nedlands, Australia
| | - Asha C Bowen
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,Perth Children's Hospital, Nedlands, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, University of Western Australia, Nedlands, Australia.,School of Medicine, University of Western Australia, Nedlands, Australia.,University of Notre Dame Australia, Fremantle, Australia
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3
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Hendrickx D, Bowen AC, Marsh JA, Carapetis JR, Walker R. Ascertaining infectious disease burden through primary care clinic attendance among young Aboriginal children living in four remote communities in Western Australia. PLoS One 2018; 13:e0203684. [PMID: 30222765 PMCID: PMC6141079 DOI: 10.1371/journal.pone.0203684] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 08/24/2018] [Indexed: 11/18/2022] Open
Abstract
Infectious diseases contribute a substantial burden of ill-health in Australia’s Aboriginal children. Skin infections have been shown to be common in remote Aboriginal communities, particularly in the Northern Territory, Australia. However, primary care data on skin and other infectious diseases among Aboriginal children living in remote areas of Western Australia are limited. We conducted a retrospective review of clinic presentations of all children aged 0 to 5 years presenting to four clinics located in the Western Desert region of Western Australia between 2007 and 2012 to determine this burden at a local level. Infectious diseases accounted for almost 50% of all clinic presentations. Skin infections (sores, scabies and fungal infections) were the largest proportion (16%), with ear infections (15%) and upper respiratory infections (13%) also high. Skin infections remained high in all age groups; 72% of children presented at least once with skin infections. Scabies accounted for only 2% of all presentations, although one-quarter of children presented during the study for management of scabies. Skin sores accounted for 75% of the overall burden of skin infections. Improved public health measures targeting bacterial skin infections are needed to reduce this high burden of skin infections in Western Australia.
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Affiliation(s)
- David Hendrickx
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
- NHMRC Centre for Research Excellence in Aboriginal Health and Wellbeing, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Asha C. Bowen
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Julie A. Marsh
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan R. Carapetis
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Roz Walker
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
- NHMRC Centre for Research Excellence in Aboriginal Health and Wellbeing, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012. PLoS One 2017; 12:e0188803. [PMID: 29190667 PMCID: PMC5708667 DOI: 10.1371/journal.pone.0188803] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/13/2017] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA). We conducted a retrospective cohort study of all children born in WA between 1996 and 2012 (n = 469,589). Of these, 31,348 (6.7%) were Aboriginal and 240,237 (51.2%) were boys. We report the annual age-specific hospital admission rates by geographical location and diagnostic category. We applied log-linear regression modelling to analyse changes in temporal trends of hospitalizations. Hospitalization rates for skin infections in Aboriginal children (31.7/1000 child-years; 95% confidence interval [CI] 31.0–32.4) were 15.0 times higher (95% CI 14.5–15.5; P<0.001) than those of non-Aboriginal children (2.1/1000 child-years; 95% CI 2.0–2.1). Most admissions in Aboriginal children were due to abscess, cellulitis and scabies (84.3%), while impetigo and pyoderma were the predominant causes in non-Aboriginal children (97.7%). Admissions declined with age, with the highest rates for all skin infections observed in infants. Admissions increased with remoteness. Multiple admissions were more common in Aboriginal children. Excess admissions in Aboriginal children were observed during the wet season in the Kimberley and during summer in metropolitan areas. Our study findings show that skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, with Aboriginal children at a particularly high risk. Improved community-level prevention of skin infections and the provision of effective primary care are crucial in reducing the burden of skin infection associated hospitalizations. The contribution of sociodemographic and environmental risk factors warrant further investigation.
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Nepal S, Thomas SL, Franklin RC, Taylor KA, Massey PD. Systematic literature review to identify methods for treating and preventing bacterial skin infections in Indigenous children. Australas J Dermatol 2017; 59:194-200. [DOI: 10.1111/ajd.12680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 05/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Smriti Nepal
- Discipline of Public Health and Tropical Medicine; College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville Queensland Australia
| | - Susan L Thomas
- Hunter Medical Research Institute; University of Newcastle; Newcastle New South Wales Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine; College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville Queensland Australia
| | - Kylie A Taylor
- School of Health; University of New England; Armidale New South Wales Australia
| | - Peter D Massey
- Hunter New England Population Health; Tamworth New South Wales Australia
- College of Medicine and Dentistry; James Cook University; Townsville Queensland Australia
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Hendrickx D, Stephen A, Lehmann D, Silva D, Boelaert M, Carapetis J, Walker R. A systematic review of the evidence that swimming pools improve health and wellbeing in remote Aboriginal communities in Australia. Aust N Z J Public Health 2015; 40:30-6. [DOI: 10.1111/1753-6405.12433] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/01/2014] [Accepted: 04/01/2015] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Anna Stephen
- Child Health Division, Menzies School of Health Research; Royal Darwin Hospital; Northern Territory
| | | | - Desiree Silva
- Telethon Kids Institute; University of Western Australia
| | - Marleen Boelaert
- Department of Public Health; Institute of Tropical Medicine; Belgium
| | - Jonathan Carapetis
- Telethon Kids Institute; University of Western Australia
- Princess Margaret Hospital for Children; Western Australia
| | - Roz Walker
- Telethon Kids Institute; University of Western Australia
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Warren JM, Birrell AL. Trachoma in remote Indigenous Australia: a review and public health perspective. Aust N Z J Public Health 2015; 40 Suppl 1:S48-52. [PMID: 26123218 DOI: 10.1111/1753-6405.12396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/01/2015] [Accepted: 02/01/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Trachoma remains a major health concern in many remote Indigenous Australian communities, despite behaviour-modifying and biomedical strategies. This review aims to examine the social epidemiology of trachoma in remote Indigenous communities and identify practical, sustainable strategies to alter the social determinants of the disease. METHODS A systematic search and critical review explored the proximal, intermediate and distal determinants of trachoma. The impact of swimming pools in remote Indigenous communities on trachoma and other infectious diseases was further examined. RESULTS Having a clean face was found to be protective for trachoma, but face-washing education programs have produced no significant benefits. Sanitation infrastructure in a community was the key determinant of facial cleanliness. Installation of swimming pools in remote Indigenous communities has been demonstrated to reduce the prevalence of several common childhood infections. However, minimal research has explored the impact of pools on trachoma rates. CONCLUSIONS The locally supported construction of pools in remote Indigenous communities may contribute to a decline in trachoma. A prospective, controlled trial is needed to test this hypothesis in endemic communities. IMPLICATIONS If validated by a well-designed study, pool construction may provide a much sought-after practical government strategy to combat trachoma in remote Indigenous communities.
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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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Johnston L, Doyle J, Morgan B, Atkinson-Briggs S, Firebrace B, Marika M, Reilly R, Cargo M, Riley T, Rowley K. A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3518-42. [PMID: 23939388 PMCID: PMC3774452 DOI: 10.3390/ijerph10083518] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
Abstract
Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge.
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Affiliation(s)
- Leah Johnston
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Joyce Doyle
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Bec Morgan
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
| | | | - Bradley Firebrace
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Mayatili Marika
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Rachel Reilly
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Population Health, University of South Australia, Adelaide, SA 5000, Australia; E-Mail:
| | - Therese Riley
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +61-03-8344-0814
| | - Kevin Rowley
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
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Taylor HR, Anjou MD. Trachoma in Australia: an update. Clin Exp Ophthalmol 2012; 41:508-12. [DOI: 10.1111/ceo.12023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 10/01/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Hugh R Taylor
- Indigenous Eye Health Unit; Melbourne School of Population Health; The University of Melbourne; Melbourne; Victoria; Australia
| | - Mitchell D Anjou
- Indigenous Eye Health Unit; Melbourne School of Population Health; The University of Melbourne; Melbourne; Victoria; Australia
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Wiertsema SP, Leach AJ. Theories of otitis media pathogenesis, with a focus on Indigenous children. Med J Aust 2010; 191:S50-4. [PMID: 19883357 DOI: 10.5694/j.1326-5377.2009.tb02927.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 09/01/2009] [Indexed: 11/17/2022]
Abstract
Otitis media is a common childhood illness associated with hearing loss, social disadvantage and medical costs. Prevalence and severity are high among Indigenous children. Respiratory bacterial and viral pathogens ascend the eustachian tube from the nasopharynx to the middle ear, causing inflammation, fluid accumulation, and bulging of the tympanic membrane, with or without pain. Among Australian Indigenous children, ear disease commences earlier in life, and involves multiple strains of bacterial pathogens at high density that persist longer. Persistent nasal discharge, overcrowded living conditions (particularly exposure to many children) and poor facilities for washing children perpetuate a vicious cycle of transmission and infection. Risk factors include environmental tobacco smoke, season, lack of breastfeeding, younger age and immature immune system, and possibly genetic factors. The innate immune system is a critical first response to infection, particularly as passive maternal antibodies decline and during the maturation of the infant adaptive immune response. The relative contributions of innate factors to protection from otitis media are currently not well understood. A diversity of antibodies that target strain-specific and conserved antigens are generated in response to natural exposure to otitis media pathogens (or to vaccines). Deficiencies in these antibodies may explain susceptibility to recurrent infections. Incremental contributions from all these elements are likely to be important in otitis media susceptibility versus protection. Effective medical and social strategies to prevent early age of onset are urgently needed.
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Affiliation(s)
- Selma P Wiertsema
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
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Mathew AA, McDonnell CJ, Benson J, Taylor HR. Effect of swimming pools on antibiotic use and clinic attendance for infections in two Aboriginal communities in Western Australia. Med J Aust 2009; 191:410-1. [DOI: 10.5694/j.1326-5377.2009.tb02857.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Accepted: 08/19/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Anu A Mathew
- Emergency Department, Royal Victorian Eye and Ear Hospital, Melbourne, VIC
| | - Collin J McDonnell
- Population Health Unit, Centre for Eye Research Australia, Melbourne, VIC
| | - Jill Benson
- Discipline of General Practice, University of Adelaide, Adelaide, SA
| | - Hugh R Taylor
- Melbourne School of Population Health, University of Melbourne, Melbourne, VIC
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Roe Y, McDermott RA. Effect of swimming pools on antibiotic use and clinic attendance for infections in two Aboriginal communities in Western Australia. Med J Aust 2009; 190:602. [DOI: 10.5694/j.1326-5377.2009.tb02579.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 04/08/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Yvette Roe
- Division of Health Sciences, University of South Australia, Adelaide, SA
| | - Robyn A McDermott
- Division of Health Sciences, University of South Australia, Adelaide, SA
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