non-Aboriginal Children (non-aboriginal + child)

Distribution by Scientific Domains

Selected Abstracts

Management of children with otitis media: A survey of Australian Aboriginal Medical Service practitioners

Hasantha Gunasekera
Aim: To determine whether Australian Aboriginal Medical Service (AMS) practitioners treat otitis media (OM) more aggressively in Aboriginal than non-Aboriginal children and the factors influencing their management decisions. Methods: A case vignette questionnaire was sent to all AMS practitioners working in December 2006. We compared responses based on the child's Aboriginal status using ,2 analysis. Results: Questionnaires were returned from 63/87 (72%) of the AMSs by 131/238 (55%) eligible practitioners. Few practitioners (13%) reported using tympanometry or pneumatic otoscopy (9%) when examining children's ears. Practitioners were more likely to treat acute OM with antibiotics (92% vs. 49%, P < 0.01) and to treat with courses longer than 7 days (25% vs. 14%, P= 0.03) in Aboriginal than non-Aboriginal children. Most practitioners (60%) used oral antibiotics to treat chronic suppurative OM and OM with effusion in Aboriginal children (58%). Factors increasing the likelihood of antibiotic use included: the child being Aboriginal (67%), wet perforations (62%) and bulging eardrums (59%). No AMS or practitioner characteristics were significant predictors. Most practitioners (99%) were aware of Therapeutic Guidelines (Antibiotic). Only half (54%) were aware of the Australian Government guidelines for managing OM in Aboriginal and Torres Strait Islander populations and only 22% used them ,often' or ,always'. Conclusions: Australian AMS practitioners treat OM more aggressively in Aboriginal children, consistent with the Australian Government guidelines, despite half being unaware of them. Opportunities to improve management include increased use of pneumatic otoscopy and tympanometry, and decreased antibiotic usage for OM with effusion and chronic suppurative OM. [source]

Tobacco smoke exposure in hospitalised Aboriginal children in Central Australia

Lee Hudson
Aim: Child exposure to tobacco smoke is detrimental to health. Australian Aboriginal people have a higher rate of cigarette smoking compared with the national average. Thus, we aim to measure the proportion of children admitted to Alice Springs Hospital who are exposed to tobacco smoke at home, to correlate this with prevalence of regular cough and gauge smokers' interest in quitting. Method: A questionnaire was administered verbally to carers of children admitted to Alice Springs Hospital, November 2006 to January 2007. Main outcome measures were presence of a smoker at home and presence of a regular cough. We measured the interest of carers and speculated interest of other smokers in quitting. Eighty-two questionnaires were completed (60% of children admitted during the study period). Eighty-nine per cent of children were Aboriginal. Results: As so few non-Aboriginal children were included in the study, their results were not included in analysis. Sixty-four per cent of children lived with at least one smoker. Seventy per cent of children exposed to smoke at home lived with more than one smoker. Point prevalence of reported regular cough was 33%. Forty-three per cent of children who lived with at least one smoker had regular cough compared with 13% in those who did not (P= 0.035). The rate ratio for regular cough when living with a smoker versus when not living with a smoker was 2.77 (95% confidence interval: 1.06,7.23). Forty-two per cent of the smokers expressed interest in quitting. Conclusion: It is concerning that the majority of hospitalised children were exposed to tobacco smoke at home, while fewer than half of smokers were interested in quitting. [source]

Ascertainment of birth defects: The effect on completeness of adding a new source of data

C Bower
Background: The Western Australian (WA) Birth Defects Registry aims for complete ascertainment of birth defects in WA, but the proportions of birth defects in rural areas and in Aboriginal children are lower than in metropolitan and non-Aboriginal children. The effect on ascertainment of adding data from the Rural Paediatric Service (RPS) was investigated. Method: A file of all cases of birth defects for children born 1980,1997 and recorded on the RPS database was linked to the Registry. Results: The addition of this new data source had little effect on the overall prevalence of birth defects (an increase from 5.38 to 5.41%). There was a slightly greater effect on the prevalence of birth defects in rural residents (4.67%,4.76%) and Aboriginal children (4.55,4.78%), although the prevalence for each of these groups is still less than for metropolitan residents and non-Aboriginal infants, respectively. All major categories of birth defects were represented in the new cases and, in general, their addition made little difference to the prevalence of each category. The exception was fetal alcohol syndrome, which increased from 0.13 per 1000 to 0.18 per 1000 once the 21 new cases from the RPS were added. Conclusion: Complete ascertainment of birth defects is important in developing and evaluating preventive programs, and in investigating clusters of birth defects. [source]

The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerations

Deborah Lehmann
Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source]

Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, Canada

Herenia P. Lawrence
Abstract,,, Objectives:, To investigate (i) oral health inequalities between off-reserve Aboriginal and non-Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten-aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off-reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Methods:, Cross-sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3- to 5-year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District's Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16,20 First Nations communities. Results:, When compared with non-Aboriginal children aged 3,5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off-reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child's age and sex, school's risk level and clustered-correlated data. The mean dmft of on-reserve Aboriginal 4-year olds in 2005 was 11.2 and 5.9 for their off-reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old Aboriginal children in the SLZ were: 9.1 (8.3,9.9), 12.4 (11.8,13.1), 13.1 (12.1,14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2,7.1), 8.9 (8.2,9.6), 11.2 (10.5,11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Conclusions:, Significant disparities in caries experience exist between off-reserve Aboriginal and non-Aboriginal children living in the same locales and between Aboriginal children living on- and off-reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5-year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities. [source]

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Jye-Bin Lin
Abstract Taiwan was a hyperendemic area for hepatitis A and B viruses (HAV and HBV) infection before late 1980s. To study the seroprevalence of hepatitis A, B, C, and E viruses (HCV and HEV) infection among preschool children in Taiwan, a community-based survey was carried out in 54 kindergartens in 10 urban areas, 10 rural areas, and 2 aboriginal areas randomly selected through stratified sampling. Serum specimens of 2,538 preschool children were screened for the hepatitis A, C, and E antibodies by a commercially available enzyme immunoassay and for HBV markers by radioimmunoassay methods. The multivariate-adjusted odd ratios (OR) with their 95% confidence intervals (CI) were estimated through the multiple logistic regression analysis. Females had a statistically significantly higher HAV seroprevalence than males. The seroprevalence of HCV infection increased significantly with age. The larger the sibship size, the higher the seroprevalence of HBV infection. Aboriginal children had a significantly higher seroprevalence of HBV and HEV infection and lower seroprevalence of HCV infection than non-aboriginal children. A significantly higher seroprevalence of HBV infection was found in rural children than urban children. There was no significant association between serostatus of HAV and HEV infection and between serostatus of HBV and HCV infection among preschool children in Taiwan. The poor environmental and hygienic conditions in the aboriginal areas might play a role in infection with HBV and HEV. J. Med. Virol. 78:18,23, 2006. 2005 Wiley-Liss, inc. [source]