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1
Laugharne, Jonathan. "Poverty and mental health in Aboriginal Australia." Psychiatric Bulletin 23, no. 6 (June 1999): 364–66. http://dx.doi.org/10.1192/pb.23.6.364.
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When the Australian Governor General, Sir William Deane, referred in a speech in 1996 to the “appalling problems relating to Aboriginal health” he was not exaggerating. The Australia Bureau of Statistics report on The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (McLennan & Madden, 1997) outlines the following statistics. The life expectancy for Aboriginal Australians is 15 to 20 years lower than for non-Aboriginal Australians, and is lower than for most countries of the world with the exception of central Africa and India. Aboriginal babies are two to three times more likely to be of lower birth weight and two to four times more likely to die at birth than non-Aboriginal babies. Hospitalisation rates are two to three times higher for Aboriginal than non-Aboriginal Australians. Death rates from infectious diseases are 15 times higher among Aboriginal Australians than non-Aboriginal Australians. Rates for heart disease, diabetes, injury and respiratory diseases are also all higher among Aboriginals – and so the list goes on. It is fair to say that Aboriginal people have higher rates for almost every type of illness for which statistics are currently recorded.
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Cheluvappa, Rajkumar, and Selwyn Selvendran. "Strengths-Based Nursing to Combat Common Infectious Diseases in Indigenous Australians." Nursing Reports 12, no. 1 (January 18, 2022): 22–28. http://dx.doi.org/10.3390/nursrep12010003.
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(1) Problem: The increasing incidence and prevalence of infectious diseases in Indigenous Australians (Aboriginal groups and Torres Strait Islanders) are concerning. Indigenous Australians experience the burden of infectious diseases disproportionately when compared to non-Indigenous Australians. (2) Aim: Our report aims to describe how to apply Strengths-Based Nursing (SBN) to ameliorate the impact of the most common infectious diseases in Indigenous Australians. Specifically, we aim to describe how nurses can use SBN to partner with Indigenous Australian communities to remediate, control, and mollify the impact of the most common infectious diseases encountered by them using their limited resources. (3) Methods: Meticulous PubMed, Google Scholar, and web searches were conducted pertaining to Strengths-Based Nursing and common infectious diseases in Indigenous Australians. (4) Findings: The two groups of infectious diseases considered are sexually transmitted infections (STIs) and infectious skin diseases (including parasitic infestations). The prevalence of these infectious diseases in Indigenous Australians is deliberated on, with data when possible, or known trends and impacts. Finally, existing, evidence-based, prudent, and possible SBN approaches are discussed towards tackling these infectious diseases judiciously with available local resources, in conjunction with the support of impacted people, their families, and their communities. (5) Discussion and Conclusion: The SBN approach is a relatively new perspective/approach to clinical and nursing care. In contradistinction to the commonly utilised medical model, SBN pits strengths against deficits, available resources against professional judgment, solutions against unavailable items, and collaborations against hierarchy. In light of the current situation/data, several SBN approaches to combat STIs and skin infections in Indigenous Australians were identified and discussed for the first time in the “Results” section of this paper.
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Graham, Simon, Catherine C. O'Connor, Stephen Morgan, Catherine Chamberlain, and Jane Hocking. "Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis." Sexual Health 14, no. 3 (2017): 201. http://dx.doi.org/10.1071/sh16013.
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Background Aboriginal and Torres Strait Islanders (Aboriginal) are Australia’s first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. Methods: In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I2 test) and within study bias (selection, measurement and sample size) was also conducted. Results: Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I2 = 38.3%, P = 0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. Conclusions: The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.
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Smith, K., L. Flicker, D. Atkinson, A. Dwyer, N. T. Lautenschlager, J. Thomas, O. P. Almeida, and D. LoGiudice. "The KICA Carer: informant information to enhance the Kimberley Indigenous Cognitive Assessment." International Psychogeriatrics 28, no. 1 (August 14, 2015): 101–7. http://dx.doi.org/10.1017/s1041610215001283.
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ABSTRACTBackground:A quality dementia-screening tool is required for older remote Aboriginal Australians who have high rates of dementia and limited access to appropriate medical equipment and clinicians. The Kimberley Indigenous Cognitive Assessment (KICA Cog) is a valid cognitive test for dementia in Aboriginal and Torres Strait Islander peoples. The KICA cognitive informant questionnaire (KICA Carer) had yet to be analyzed to determine validity alone or in combination with the KICA Cog.Methods:The KICA Carer was completed by nominated informants of 349 remote-living Aboriginal Australians in the Kimberley region, Western Australia. Validity was assessed by comparing KICA Carer with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) consensus diagnoses based on a blinded specialist review. KICA Carer and KICA Cog were then compared to determine joint validity.Results:A KICA Carer score of ≥3/16 gave optimum sensitivity (76.2%) and specificity (81.4%), area under curve (AUC) 0.89 (95% CI = 0.85, 0.94) with positive predictive value (PPV) of 35.8%, and negative predictive value (NPV) of 96.2%. A KICA Cog score of ≤33/39 gave a sensitivity of 92.9% and specificity of 89.9%, AUC 0.96 (95% CI = 0.94, 0.98), with PPV of 55.6% and NPV of 98.9%. Cut-off scores of KICA Cog ≤ 33/39 and KICA Carer ≥ 2/16 in series indicate possible dementia, with sensitivity of 90.5% and specificity of 93.5%. In this setting, PPV was 66.5% and NPV was 98.6%.Conclusions:The KICA Carer is an important tool to accurately screen dementia in remote Aboriginal Australians when the KICA Cog is unable to be used for a patient. It is readily accepted by caregivers.Key points:•For the best practice in the cognitive assessment of an Aboriginal Australian aged over 45 years, KICA Cog should be utilized.•In cases where Aboriginal patients are not assessed directly, KICA Carer should be conducted with an informant. A cut-off score of ≥3/16 should be used (these tools can be downloaded fromwww.wacha.org.au/kica.html).
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Bourke, Christopher J., Andrew McAuliffe, and Lisa M. Jamieson. "Addressing the oral health workforce needs of Aboriginal and Torres Strait Islander Australians." Australian Health Review 45, no. 4 (2021): 407. http://dx.doi.org/10.1071/ah20295.
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Tooth decay and gum disease, the main dental diseases affecting Australians, can cause pain and deformity as well as affecting eating and speech. Dental practitioners are efficient and effective in relieving dental pain, and they can effectively restore oral function. There is good evidence that better health care outcomes for Aboriginal and Torres Strait Islander patients are associated with care from Aboriginal and Torres Strait Islander health professionals. Unfortunately, the representation of Aboriginal and Torres Strait Islander people within the dental practitioner workforce is very low. We argue that a strategic approach, along with additional investment, is needed to increase the number of Aboriginal and Torres Strait Islander people qualified as dental practitioners.
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Bryant, Joanne, James Ward, Heather Worth, Peter Hull, Sarina Solar, and Sandra Bailey. "Safer sex and condom use: a convenience sample of Aboriginal young people in New South Wales." Sexual Health 8, no. 3 (2011): 378. http://dx.doi.org/10.1071/sh10138.
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Background This paper examines condom use in a sample of Aboriginal young people in New South Wales (NSW) aged 16–30 years. Methods: Cross-sectional data were collected using hand-held computer devices from 293 Aboriginal people attending two Aboriginal events in NSW. Results: Almost two-thirds of respondents reported having had a casual sex partner in the previous 6 months. Of these, 39.2% reported always using a condom with casual partners. Having always used a condom with casual partners varied among respondents, and was more likely among younger respondents (adjusted odds ratio (AOR): 2.7, 95% confidence interval (CI): 1.2–6.1) and less likely among those who used illicit drugs (AOR: 0.2, 95% CI: 0.1–0.7). Conclusions: In comparison to published studies of other Australians, casual sex appears to be more common among this sample of Aboriginal young people; however, the proportion who report having always used condoms with casual partners is very similar. This suggests that although casual sex is more common, Aboriginal young people do not engage in risky behaviour any more often than other young Australians. Further work should be conducted with those who do not always use condoms, such as those who are older and who use illicit drugs, particularly with regards to how abstinence from drug use supports protective behaviours such as condom use among this population of Aboriginal young people.
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Debattista, Joseph, Susan Hutton, and Peter Timms. "Chlamydial infections and Indigenous health." Microbiology Australia 30, no. 5 (2009): 197. http://dx.doi.org/10.1071/ma09197.
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Chlamydia are obligate, intracellular, bacterial pathogens that cause three main diseases in humans worldwide: sexually transmitted disease (infertility and pelvic inflammatory disease), trachoma and respiratory infections. Rates of sexually transmitted infections (STIs) due to C. trachomatis are increasing (a 61% increase in notifications in Australia between 2003 and 2007) and the levels in Indigenous Australians continue to be unacceptably high: nearly five times higher than in non-Indigenous people. C. trachomatis also causes the ocular disease trachoma and, unfortunately, this condition continues to be common in Indigenous Australians, a situation that is unacceptable in a developed country. The other chlamydial species that infects humans is C. pneumoniae. While clinically less severe, the Australian Aboriginal population in the Top End have high rates of serologically diagnosed C. pneumoniae infection, which may contribute to the higher rates of respiratory disease observed in this group.
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Ames, David. "Australia (Melbourne)." Psychiatric Bulletin 16, no. 9 (September 1992): 552–54. http://dx.doi.org/10.1192/pb.16.9.552.
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Australia is a unique, geologically ancient island continent. Its flora and fauna are unlike those found anywhere else and the same may be said of its people, politics and health services. The population of 17.3 millions represents a multicultural mix, with an anglo-celtic core conflated by sustained post-war immigration from southern Europe, Turkey, southeast Asia and south America. One in five current Australians was born elsewhere, one in ten comes from a non-English speaking background, and a quarter of those born here have a parent who was born overseas. Aboriginals and Torres Strait Islanders form 1.4% of the total population. They have third world mortality figures but die of first world diseases, their life expectancy being 20 years less than that of other Australians. Two hundred and four years after what they see as the British invasion, their standard of living lags far behind all other socio-cultural groups in the country. Most members of the Aboriginal community do not live long enough to develop Alzheimer's disease, but it and other age-related diseases are emerging as the major determinants of health costs as Australia moves towards the 21st century.
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Gatwiri, Kathomi, Darlene Rotumah, and Elizabeth Rix. "BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia." International Journal of Environmental Research and Public Health 18, no. 9 (April 21, 2021): 4399. http://dx.doi.org/10.3390/ijerph18094399.
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Despite decades of evidence showing that institutional and interpersonal racism serve as significant barriers to accessible healthcare for Aboriginal and Torres Strait Islander Peoples, attempts to address this systemic problem still fall short. The social determinants of health are particularly poignant given the socio-political-economic history of invasion, colonisation, and subsequent entrenchment of racialised practices in the Australian healthcare landscape. Embedded within Euro-centric, bio-medical discourses, Western dominated healthcare processes can erase significant cultural and historical contexts and unwittingly reproduce unsafe practices. Put simply, if Black lives matter in healthcare, why do Aboriginal and Torres Strait Islander Peoples die younger and experience ‘epidemic’ levels of chronic diseases as compared to white Australians? To answer this, we utilise critical race perspectives to theorise this gap and to de-center whiteness as the normalised position of ‘doing’ healthcare. We draw on our diverse knowledges through a decolonised approach to promote a theoretical discussion that we contend can inform alternative ways of knowing, being, and doing in healthcare practice in Australia.
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Yeshi, Karma, Gerry Turpin, Tenzin Jamtsho, and Phurpa Wangchuk. "Indigenous Uses, Phytochemical Analysis, and Anti-Inflammatory Properties of Australian Tropical Medicinal Plants." Molecules 27, no. 12 (June 15, 2022): 3849. http://dx.doi.org/10.3390/molecules27123849.
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Australian tropical plants have been a rich source of food (bush food) and medicine to the first Australians (Aboriginal people), who are believed to have lived for more than 50,000 years. Plants such as spreading sneezeweed (Centipeda minima), goat’s foot (Ipomoea pes-caprae), and hop bush (Dodonaea viscosa and D. polyandra) are a few popular Aboriginal medicinal plants. Thus far, more than 900 medicinal plants have been recorded in the tropical region alone, and many of them are associated with diverse ethnomedicinal uses that belong to the traditional owners of Aboriginal people. In our effort to find anti-inflammatory lead compounds in collaboration with Aboriginal communities from their medicinal plants, we reviewed 78 medicinal plants used against various inflammation and inflammatory-related conditions by Aboriginal people. Out of those 78 species, we have included only 45 species whose crude extracts or isolated pure compounds showed anti-inflammatory properties. Upon investigating compounds isolated from 40 species (for five species, only crude extracts were studied), 83 compounds were associated with various anti-inflammatory properties. Alphitolic acid, Betulinic acid, Malabaric acid, and Hispidulin reduced proinflammatory cytokines and cyclooxygenase enzymes (COX-1 and 2) with IC50 values ranging from 11.5 to 46.9 uM. Other promising anti-inflammatory compounds are Brevilin A (from Centipeda minima), Eupalestin, and 5′-methoxy nobiletin (from Ageratum conyzoides), Calophyllolide (from Calophyllum inophyllum), and Brusatol (from Brucea javanica). D. polyandra is one example of an Aboriginal medicinal plant from which a novel anti-inflammatory benzoyl ester clerodane diterpenoid compound was obtained (compound name not disclosed), and it is in the development of topical medicines for inflammatory skin diseases. Medicinal plants in the tropics and those associated with indigenous knowledge of Aboriginal people could be a potential alternative source of novel anti-inflammatory therapeutics.
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VALERY, P. C., M. WENITONG, V. CLEMENTS, M. SHEEL, D. McMILLAN, J. STIRLING, K. S. SRIPRAKASH, M. BATZLOFF, R. VOHRA, and J. S. McCARTHY. "Skin infections among Indigenous Australians in an urban setting in Far North Queensland." Epidemiology and Infection 136, no. 8 (October 24, 2007): 1103–8. http://dx.doi.org/10.1017/s0950268807009740.
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SUMMARYSkin infections are highly prevalent in many Australian Aboriginal communities. This study aimed to determine the prevalence of group A streptococcus (GAS) andStaphylococcus aureusin skin sores of Indigenous people living in an urban setting. We undertook a cross-sectional study of 173 children and youths attending the Wuchopperen Clinic (Cairns) for treatment of skin infections. Participants were interviewed using a structured questionnaire, and a skin lesion swab obtained. The median age was 5·3 years, with 42% identifying themselves as Torres Strait Islanders and 34% as Aboriginal. Impetigo (65%) was the most frequent diagnosis reported followed by scabies (19%); 79% of the lesions had erythema and 70% had exudate. Of 118 lesions, 114 were positive for pathogenic bacteria, with GAS isolated in 84 cases andS. aureusin 92; both these species were recovered from 63 lesions. Significant diversity ofemm-types of GAS was associated with skin lesions in Indigenous patients (22emm-types identified). Fifteen of the 92S. aureusisolates were suggestive of being community-acquired on the basis of antimicrobial susceptibility profile and nine of these strains were co-cultured from nine lesions. These results have implications for future changes of antibiotic policies for the treatment of skin infections in this population.
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Graham, Simon, Lucy Watchirs Smith, Christopher K. Fairley, and Jane Hocking. "Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis." Sexual Health 13, no. 2 (2016): 99. http://dx.doi.org/10.1071/sh15171.
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Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12–29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4–13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5–14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0–22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5–26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I2 <97.5%, P < 0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.
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Blyton, Greg. "Smoking Kills." International Journal of Critical Indigenous Studies 3, no. 2 (June 1, 2010): 2–10. http://dx.doi.org/10.5204/ijcis.v3i2.48.
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This paper brings to the reader‟s attention a history of tobacco smoking that arguably had a negative effect on the health of Aboriginal communities in the Hunter region of central eastern New South Wales during the early colonial contact period from 1800 to 1850. Furthermore, it will also be shown that tobacco was used by colonists to engage the services of Aboriginal people, not only in Aboriginal communities in the Hunter region, but further afield across many other frontiers of colonial expansion in Australia in the 19th century. It will be demonstrated through primary archival and secondary sources that colonists utilised tobacco as a coercive agent to appease, befriend, pacify, coerce and remunerate Aboriginal People, resulting in widespread addiction. It is argued that tobacco smoking not only undermined the health of traditional communities, but also this unhealthy habit has been largely overlooked in measurements of the impact of colonization on the health of Indigenous people. While historians widely acknowledge that exotic diseases such as smallpox had a negative effect on the health of Aboriginal People, it is rarely considered in contemporary historical accounts that tobacco had an even more insidious effect on the well being of Aboriginal societies during the early colonial contact period. Furthermore, while diseases such as smallpox have hopefully disappeared forever, health destroyers like tobacco have endured and continue to impact on Aboriginal health. Finally, this paper recognises the enormity of challenges faced by health authorities, and indeed Indigenous Australians, in contemporary society in combating a chronic problem that has been embedded in Aboriginal post-colonial culture during the long course of European occupation.
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PHUNG, D. T., and Z. WANG. "Risk of pneumonia in relation to body mass index in Australian Aboriginal people." Epidemiology and Infection 141, no. 12 (March 18, 2013): 2497–502. http://dx.doi.org/10.1017/s0950268813000605.
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SUMMARYThis study examined the relationship between body mass index (BMI) and the risk of pneumonia in Aboriginal Australians. A total of 677 adults aged 20–60 years were followed up from the baseline examination during 1992–1995 to June 2012. The pneumonia events were identified through hospital records. Pneumonia incident rates were calculated according to BMI groups. Hazard ratios were computed using Cox regression adjusting for age, smoking and alcohol consumption status. The incident rate of pneumonia was 13·3/1000 person-years, and this rate was significantly higher in females than males (hazard ratio = 1·5). Compared to males with normal BMI (18·5–24·9 kg/m2), the adjusted hazard ratio was 3·5 for males with lowest BMI (P < 0·01). Low BMI was significantly associated with a higher risk of hospitalized pneumonia for Aboriginal males. However, the U-shaped trend of this association indicates that the risk of pneumonia is likely to be associated with both low and high BMI.
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Graham, S. "P1-S2.68 Targeted interventions for remote Australians; trends in chlamydia and gonorrhoea notifications in aboriginal and non-indigenous Australians 2005-2009." Sexually Transmitted Infections 87, Suppl 1 (July 1, 2011): A152. http://dx.doi.org/10.1136/sextrans-2011-050108.125.
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Jamieson, Lisa M., Joanne Hedges, X. Ju, Kostas Kapellas, Cathy Leane, Dandara G. Haag, Pedro Ribeiro Santiago, Davi Manzini Macedo, Rachel M. Roberts, and Lisa G. Smithers. "Cohort profile: South Australian Aboriginal Birth Cohort (SAABC)—a prospective longitudinal birth cohort." BMJ Open 11, no. 2 (February 2021): e043559. http://dx.doi.org/10.1136/bmjopen-2020-043559.
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PurposeThe South Australian Aboriginal Birth Cohort (SAABC) is a prospective, longitudinal birth cohort established to: (1) estimate Aboriginal child dental disease compared with population estimates; (2) determine the efficacy of an early childhood caries intervention in early versus late infancy; (3) examine if efficacy was sustained over time and; (4) document factors influencing social, behavioural, cognitive, anthropometric, dietary and educational attainment over time.ParticipantsThe original SAABC comprised 449 women pregnant with an Aboriginal child recruited February 2011 to May 2012. At child age 2 years, 324 (74%) participants were retained, at age 3 years, 324 (74%) participants were retained and at age 5 years, 299 (69%) participants were retained. Fieldwork for follow-up at age 7 years is underway, with funding available for follow-up at age 9 years.Findings to dateAt baseline, 53% of mothers were aged 14–24 years and 72% had high school or less educational attainment. At age 3 years, dental disease experience was higher among children exposed to the intervention later rather than earlier in infancy. The effect was sustained at age 5 years, but rates were still higher than general child population estimates. Experiences of racism were high among mothers, with impacts on both tooth brushing and toothache. Compared with population estimates, levels of self-efficacy and self-rated oral health of mothers at baseline were low.Future plansOur data have contributed to a better understanding of the environmental, behavioural, dietary, biological and psychosocial factors contributing to Aboriginal child oral and general health, and social and emotional well-being. This is beneficial in charting the trajectory of cohort participants’ health and well-being overtime, particularly in identifying antecedents of chronic diseases which are highly prevalent among Aboriginal Australians. Funding for continued follow-up of the cohort will be sought.Trial registration numberACTRN12611000111976; Post-results.
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Lehmann, Deborah, Judith Willis, Hannah C. Moore, Carolien Giele, Denise Murphy, Anthony D. Keil, Catherine Harrison, Kathy Bayley, Michael Watson, and Peter Richmond. "The Changing Epidemiology of Invasive Pneumococcal Disease in Aboriginal and Non‐Aboriginal Western Australians from 1997 through 2007 and Emergence of Nonvaccine Serotypes." Clinical Infectious Diseases 50, no. 11 (June 2010): 1477–86. http://dx.doi.org/10.1086/652440.
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Worrall-Carter, Linda, Karen Daws, Muhammad Aziz Rahman, Sarah MacLean, Kevin Rowley, Shawana Andrews, Andrew MacIsaac, et al. "Exploring Aboriginal patients’ experiences of cardiac care at a major metropolitan hospital in Melbourne." Australian Health Review 40, no. 6 (2016): 696. http://dx.doi.org/10.1071/ah15175.
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Objectives The aim of the present study was to explore Aboriginal patients’ lived experiences of cardiac care at a major metropolitan hospital in Melbourne. Methods The study was a qualitative study involving in-depth interviews with a purposive sample of 10 Aboriginal patients who had been treated in the cardiology unit at the study hospital during 2012–13. A phenomenological approach was used to analyse the data. Results Eight themes emerged from the data, each concerning various aspects of participants’ experiences: ‘dislike of hospitals’, ‘system failures’, ‘engagement with hospital staff’, ‘experiences of racism’, ‘health literacy and information needs’, ‘self-identifying as Aboriginal’, ‘family involvement in care’ and ‘going home and difficulties adapting’. Most participants had positive experiences of the cardiac care, but hospitalisation was often challenging because of a sense of dislocation and disorientation. The stress of hospitalisation was greatly mediated by positive engagements with staff, but at times exacerbated by system failures or negative experiences. Conclusion Cardiac crises are stressful and hospital stays were particularly disorienting for Aboriginal people dislocated from their home land and community. What is known about the topic? Aboriginal people have higher mortality rates due to cardiovascular diseases compared with other Australians. Along with different factors contributing to the life expectancy gap, Aboriginal people also face significant barriers in the use of the healthcare system. What does this paper add? Aboriginal patients’ lived experience of cardiac care at a major metropolitan hospital in Melbourne is explored in this paper. Different issues were revealed during their interaction with the hospital staff and the hospital system in conjunction with their cultural aspect of patient care. What are the implications for practitioners? Positive interactions with staff, ongoing support from family and community, culturally appropriate cardiac rehabilitation programs can improve the cardiac care experiences of Aboriginal patients.
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Heath, Deanne L., Kathryn Panaretto, Vivienne Manessis, Sarah Larkins, Peter Malouf, Erin Reilly, and Jacinta Elston. "Factors to Consider in Smoking Interventions for Indigenous Women." Australian Journal of Primary Health 12, no. 2 (2006): 131. http://dx.doi.org/10.1071/py06032.
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More than 18,000 Australians die annually from diseases caused by tobacco. Indigenous Australians suffer a greater smoking-related disease burden than the remainder of the general public and have a higher prevalence of tobacco use than other Australians. The overall decline in smoking rates is slowest in women of low educational status between the ages of 25-44. This is of particular concern as these young women may be pregnant or raising young children. During pregnancy, the effects on the foetus from cigarette smoke include respiratory illness, low birthweight and Sudden Infant Death Syndrome. However, if the mother is able to give up smoking by her fourth month of pregnancy, her risk of delivering a low birthweight baby decreases to nearly that of a non-smoker. As part of the planning to develop an effective smoking cessation program for young Indigenous pregnant women, the Townsville Aboriginal and Islanders Health Services (TAIHS) surveyed a group of women to assess smoking habits, attitudes to smoking, nicotine dependence and readiness for change. This paper reports on this survey and the results found can be used to develop a tailored, smoking cessation program for Indigenous women.
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Ali, H., CC O’Connor, D. Callander, D. Saulo, S. Graham, M. Kong, DJ Regan, et al. "LB1.3 The impact of hpv vaccination on genital warts in aboriginal australians: analysis of national data." Sexually Transmitted Infections 91, Suppl 2 (September 2015): A78.1—A78. http://dx.doi.org/10.1136/sextrans-2015-052270.208.
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MacPhail, Catherine, and Kathy McKay. "P01.08 Structural and contextual factors in the sexual health of adolescent aboriginal australians: a systematic review." Sexually Transmitted Infections 91, Suppl 2 (September 2015): A82.1—A82. http://dx.doi.org/10.1136/sextrans-2015-052270.218.
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O'Grady, Kerry-Ann F., Amber Revell, Graeme P. Maguire, Renate Millonig, Michael A. Newman, David W. Reid, Deborah C. Hill, and Anne B. Chang. "Lung health care for Aboriginal and Torres Strait Islander Queenslanders: breathing easy is not so easy." Australian Health Review 35, no. 4 (2011): 512. http://dx.doi.org/10.1071/ah10973.
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Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial. What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis). What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery. What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.
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Thompson, Kelly J., Simon R. Finfer, Julieann Coombes, Sandra Eades, Kate Hunter, Robert Neil F. Leong, Ebony Lewis, and Bette Liu. "Incidence and outcomes of sepsis in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales: population-based cohort study." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 337–45. http://dx.doi.org/10.51893/2021.3.oa11.
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OBJECTIVE: To estimate the incidence and outcomes of sepsis hospitalisations in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales. DESIGN AND PARTICIPANTS: Prospective cohort study of residents aged 45 years and older, recruited between 2006 and 2009, and followed for hospitalisation for sepsis. MAIN OUTCOME MEASURES: Incidence and hazard ratio (HR) of sepsis hospitalisation and intensive care unit (ICU) admission identified using International Classification of Diseases (10th revision) coding on discharge data. Length of stay, readmission and mortality in those admitted for sepsis. RESULTS: Of 264 678 participants, 1928 (0.7%) identified as Aboriginal and/or Torres Strait Islander. Sepsis hospitalisation was higher in Aboriginal and Torres Strait Islander participants (8.67 v 6.12 per 1000 person-years; age- and sex-adjusted HR, 2.35; 95% CI, 1.98–2.80) but was attenuated after adjusting for sociodemographic factors, health behaviour and comorbidities (adjusted HR, 1.56; 95% CI, 1.31–1.86). Among those hospitalised for sepsis, after adjusting for age and sex, there were no differences between the proportions of Aboriginal and Torres Strait Islander and non-Indigenous participants admitted to an ICU (18.0% v 16.1%; P = 0.42) or deceased at 1 year (36.1% v 36.8%; P = 0.92). Aboriginal and Torres Strait Islander participants had shorter lengths of hospital stay (9.98 v 11.72 days; P < 0.001) and ICU stay (4.38 v 6.35 days; P < 0.001) than non-Indigenous participants. Overall, more than 70% of participants were readmitted to hospital within 1 year. CONCLUSION: We found that the rate of sepsis hospitalisation in NSW was higher for Aboriginal and Torres Strait Islander adults. Culturally appropriate, community-led strategies targeting chronic disease prevention and the social determinants of health may reduce this gap. Preventing readmission following sepsis is a priority for all Australians.
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Lea, Toby, Michael Costello, Limin Mao, Garrett Prestage, Iryna Zablotska, James Ward, John Kaldor, John de Wit, and Martin Holt. "Elevated reporting of unprotected anal intercourse and injecting drug use but no difference in HIV prevalence among Indigenous Australian men who have sex with men compared with their Anglo-Australian peers." Sexual Health 10, no. 2 (2013): 146. http://dx.doi.org/10.1071/sh12097.
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Background Although half of the HIV notifications among Aboriginal and Torres Strait Islander people (‘Indigenous Australians’) are attributed to homosexual transmission, there has been little research examining sexual and drug use risk practices among Indigenous Australian men who have sex with men (MSM). Methods: Respondents were Indigenous Australian (n = 1278) and Anglo-Australian men (n = 24 002) participating in the routine cross-sectional Gay Community Periodic Surveys conducted in Australia from 2007 to 2011. Sociodemographic characteristics, sexual risk practices, drug use, HIV testing and HIV status of Indigenous and Anglo-Australian men were compared and evaluated to discover whether Indigenous status was independently associated with HIV risk practices. Results: Although an equivalent proportion of Indigenous and Anglo-Australian men reported being HIV-positive (9.6%), Indigenous MSM were more likely to report unprotected anal intercourse with casual partners in the previous 6 months (27.9% v. 21.5%; Adjusted odds ratio (AOR) = 1.29, 95% confidence interval (CI): 1.11–1.49). Indigenous men were more likely than Anglo-Australian men to report use of several specific drugs and twice as likely to report injecting drug use in the previous 6 months (8.8% v. 4.5%; AOR = 1.43, 95% CI: 1.11–1.86). Conclusions: Despite a higher proportion of Indigenous men reporting sexual and drug use practices that increase the risk of HIV transmission, there were no differences in the HIV status of Indigenous and Anglo-Australian men. However, the elevated rates of risk practices suggest that Indigenous MSM should remain a focus for HIV prevention, care and support.
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ROWLEY, Kevin, Kerin O'DEA, Qing SU, Alicia J. JENKINS, and James D. BEST. "Low plasma concentrations of diet-derived antioxidants in association with microalbuminuria in Indigenous Australian populations." Clinical Science 105, no. 5 (November 1, 2003): 569–75. http://dx.doi.org/10.1042/cs20030162.
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Microalbuminuria is a risk factor for renal and cardiovascular diseases. Oxidant stress may contribute to vascular disease risk by promoting damage to renal and vascular tissues. This study examined the associations of plasma levels of diet-derived antioxidants with albuminuria in Australian population groups at high risk of renal and cardiovascular disease. Data on microalbuminuria and diet-derived plasma antioxidants were drawn from results of cross-sectional community-based risk factor surveys of Aboriginal and Torres Strait Islander peoples (n=698, 15 years and older). Prevalence of microalbuminuria ranged from 17–21%. After adjustment for age, gender, body mass index, diabetes, smoking status, plasma lipids and blood pressure, microalbuminuria was associated with significantly lower plasma concentrations of lycopene (-29%; P<0.001), β-carotene (-22%; P<0.001), α-carotene (-22%; P<0.001) and cryptoxanthin (-17%; P<0.001) compared with normalbuminuric persons. Significant associations of microalbuminuria with plasma concentrations of α-tocopherol, retinol, lutein plus zeaxanthin and homocysteine were absent. The data are consistent with a protective effect of diets rich in carotenoids on vascular endothelium and/or renal tissues, and support the need for interventions to address affordable food supplies and dietary quality among Indigenous Australians.
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McDONALD, M. I., R. J. TOWERS, P. FAGAN, J. R. CARAPETIS, and B. J. CURRIE. "Molecular typing ofStreptococcus pyogenesfrom remote Aboriginal communities where rheumatic fever is common and pyoderma is the predominant streptococcal infection." Epidemiology and Infection 135, no. 8 (February 19, 2007): 1398–405. http://dx.doi.org/10.1017/s0950268807008023.
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SUMMARYAboriginal Australians in remote communities have high rates of rheumatic heart disease (RHD); yet pharyngitis is reportedly rare whilst pyoderma is common. Some strains of group A streptococci (GAS) have preference for the throat and others for the skin depending on M protein type. A study in three remote communities provided 350 GAS isolates foremmsequence typing, 244 were alsoemmpattern typed. There was 100% correlation betweenemmsequence and pattern type. Patterns D and E (non-throat tropic) made up 71% of throat and 87% of skin isolates although patterns A–C (throat tropic) were more common in the throat than the skin (RR 2·3, 95% CI 1·4–3·8) whilst the opposite was found for pattern D (RR 2·2, 95% CI 1·7–3·0). Pattern E favoured the throat (RR 1·4, 95% CI 1·1–1·8). Where environmental factors predispose to skin infection,emmpattern types D and E prevail, whatever the recovery site.
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BROOKE, C. J., T. V. RILEY, and D. J. HAMPSON. "Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations." Epidemiology and Infection 134, no. 3 (September 15, 2005): 627–34. http://dx.doi.org/10.1017/s0950268805005170.
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This study examined the prevalence of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in different Western Australian (WA) populations. Faecal samples included 287 from rural patients with gastrointestinal symptoms, comprising 142 from non-Aboriginal and 145 from Aboriginal people; 227 from recent healthy migrants to WA from developing countries; and 90 from healthy non-Aboriginal individuals living in Perth, WA. DNA was extracted from faeces, and subjected to PCR assays for both species. B. pilosicoli-positive individuals were confined to the rural Aboriginal (14·5%) and migrant (15·0%) groups. B. aalborgi was detected at a lower but similar prevalence in all four groups: rural non-Aboriginals, 5·6%; rural Aboriginals, 6·9%; migrants, 7·9%; controls, 5·6%. In migrants and Aborigines, the presence of B. pilosicoli and B. aalborgi was associated (P<0·001), suggesting that colonization by B. pilosicoli may be facilitated by colonization with B. aalborgi. Amongst the Aboriginal patients, logistic regression identified both spirochaete species as being associated with chronic diarrhoea, failure to thrive and being underweight. Both species may have pathogenic potential, but B. aalborgi appears more host-adapted than the opportunistic B. pilosicoli.
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Morgan, D. S., D. Fisher, A. Merianos, and B. J. Currie. "An 18 year clinical review of septic arthritis from tropical Australia." Epidemiology and Infection 117, no. 3 (December 1996): 423–28. http://dx.doi.org/10.1017/s0950268800059070.
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SummaryA retrospective study of 191 cases of septic arthritis was undertaken at Royal Darwin Hospital in the tropical north of Australia. Incidence was 9·2 per 100000 overall and 29·1 per 100000 in Aboriginal Australians (RR 6·6; 95% CI 5·0–8·9). Males were affected more than females (RR 1·6; 95% CI 1·2–2·1). There was no previous joint disease or medical illness in 54%. The commonest joints involved were the knee (54%) and hip (13%). Significant age associations were infected hips in those under 15 years and infected knees in those over 45 years. Seventy-two percent of infections were haematogenous. Causative organisms included Staphylococcus aureus (37%),Streptococcus pyogenes(16%) andNeisseria gonorrhoeae(12%). Unusual infections included three melioidosis cases. Polyarthritis occurred in 17%, withN. gonorrhoeae(11/23) more likely to present as polyarthritis than other organisms (22/168) (OR 6·0; 95% CI 2·1–16·7). Univariate and multivariate analysis showed the hip to be at greater risk forS. aureusthan other joints. Open arthrotomy was a more successful treatment procedure than arthroscopic washout or needle aspiration.
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Gray, Lesley-Ann, Heather A. D’Antoine, Steven Y. C. Tong, Melita McKinnon, Dawn Bessarab, Ngiare Brown, Bo Reményi, et al. "Genome-Wide Analysis of Genetic Risk Factors for Rheumatic Heart Disease in Aboriginal Australians Provides Support for Pathogenic Molecular Mimicry." Journal of Infectious Diseases 216, no. 11 (September 26, 2017): 1460–70. http://dx.doi.org/10.1093/infdis/jix497.
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Medlin, Linda G., Anne B. Chang, Kwun Fong, Rebecca Jackson, Penny Bishop, Annette Dent, Deb C. Hill, Stephen Vincent, and Kerry-Ann F. O'Grady. "Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia." Australian Health Review 38, no. 4 (2014): 447. http://dx.doi.org/10.1071/ah13136.
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Objective Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. Methods The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. Results IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43 000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. Conclusion IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia. What is known about this topic? The high rates of respiratory illnesses in Australian Indigenous children have been poorly explored. There is a dearth of research quantifying and qualifying risk from birth and throughout early childhood, and there are virtually no evidence-based evaluations of interventions to prevent and manage disease. Despite data suggesting an excess burden of disease, there has been little attention paid to respiratory health in this population. The limited research that has been done highlights that a ‘one size fits all’ model will not be effective in all communities, and that health service must meet the needs of communities, be culturally appropriate and be accessible to Aboriginal people for it to be effective and sustainable. The ‘common theme’ is that although health services are improving, service delivery needs to adapt to meet the needs of communities; this is not happening quickly enough for many Aboriginal people. What does this paper add? This paper highlights the importance of working with communities in the development and delivery of a culturally appropriate and accessible specialist respiratory service. In addition, this paper acknowledges the importance of recruiting Indigenous staff in the implementation, engagement and delivery of the project. What are the implications for clinicians? This paper provides an outline on how best to deliver a culturally appropriate respiratory outreach service and the role of clinicians, communities and Indigenous staff. This model supports the view that Aboriginal people must be a part of service delivery that is aligned to the ‘holistic concept of health’ for Aboriginal people, thus providing a culturally appropriate service that meets their needs and addresses the health continuum from within culture and community.
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Gunzburg, S., M. Gracey, V. Burke, and B. Chang. "Epidemiology and microbiology of diarrhoea in young Aboriginal children in the Kimberley region of Western Australia." Epidemiology and Infection 108, no. 1 (February 1992): 67–76. http://dx.doi.org/10.1017/s0950268800049517.
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Infectious diarrhoea is common in young Australian Aborigines [1–3] and is one of the main causes for their unsatisfactory health standards with consequent widespread failure to thrive and undernutrition [4–5]. Most published reports relate to patients in hospital or to hospital admission statistics and give little indication of the extent or severity of diarrhoeal disease in children in Aboriginal communities.The present investigation involved more than 100 Aboriginal children up to 5 years of age living in remote communities in the tropical north of Western Australia who were studied prospectively over a 12–month period.
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Hamada, Atsumi, Takashi Taguchi, Hideki Mori, Marjorie Thorpe, Yukio Yamori, and Mari Mori. "Possible Association of High Urinary Magnesium and Taurine to Creatinine Ratios with Metabolic Syndrome Risk Reduction in Australian Aboriginals." Cardiology Research and Practice 2011 (2011): 1–7. http://dx.doi.org/10.4061/2011/235653.
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Background. Because of the epidemic of metabolic syndrome (MS) in Australian Aboriginals known for their higher cardiovascular mortality and shorter life expectancy, we analyzed the possible relationship of their MS risks with the current dietary custom.Methods. The subjects were 84 people aged 16–79 years. The health examination was conducted according to the basic protocol of WHO-CARDIAC (Cardiovascular Diseases and Alimentary Comparison) Study.Results. The highest prevalence among MS risks was abdominal obesity (over 60%). After controlling for age and sex, the odds of obesity decreased significantly with high level of urinary magnesium/creatinine ratio (Mg/cre) (OR, 0.11; 95% CI, 0.02–0.57;P<.05). The significant inverse associations of fat intake with Mg/cre and of fast food intake with urinary taurine/creatinine ratio were revealed.Conclusions. The high prevalence of obesity in the Aboriginal people of this area may partly be due to the reduction of beneficial nutrients intake including Mg and taurine.
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Spokes, P., M. Bartlett, and K. Stewart. "19. INFECTIOUS SYPHILIS ELIMINATION FOR ABORIGINAL PEOPLE IN NSW: CHALLENGES AND OPPORTUNITIES." Sexual Health 4, no. 4 (2007): 292. http://dx.doi.org/10.1071/shv4n4ab19.
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Elimination of syphilis within Aboriginal communities is one of the stated goals of the NSW Sexually Transmissible Infections Strategy 2006-2009. In 2007, a project was undertaken to inform strategy development to achieve the goal of elimination of infectious syphilis in Aboriginal communities. Australian and international literature on elimination strategies for syphilis, STIs and other diseases was reviewed. Surveillance data were accessed through the National Notifiable Diseases Surveillance System and NSW Notifiable Disease Database and analysed to describe the current burden of disease. Key informants were consulted for advice on elimination strategies for infectious syphilis for Aboriginal people and possible barriers to the goal. Infectious syphilis notifications for Aboriginal people have decreased significantly from 64% of all infectious syphilis cases in 1995 to 3% in 2006. For the rest of the population notifications have increased. Changes in male to female ratios and an increase in metropolitan notifications have been noted in recent years. Improvements in recording of Aboriginality information for infectious syphilis in NSW have allowed greater confidence in interpreting these trends. The role of accurate and complete surveillance information will play an important role in planning and directing the implementation of interventions to achieve the goal of syphilis elimination for Aboriginal people in NSW. Challenges to the goal of elimination and the feasibility of a disease elimination strategy specific for Aboriginal people include issues of access to services for testing, diagnosis and treatment; cross-border mobility of Aboriginal people; prevalence of syphilis in the wider community; and continued access to accurate information. Lessons learned from international and Australian elimination strategies; burden of disease information; definition of elimination and target rates; challenges and strategies for achieving the goal of syphilis elimination and will be discussed.
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Reekie, Joanne, Basil Donovan, Rebecca Guy, Jane S. Hocking, John M. Kaldor, Donna B. Mak, Sallie Pearson, et al. "Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001–2013: a population-based cohort study." Sexual Health 14, no. 6 (2017): 574. http://dx.doi.org/10.1071/sh16207.
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Background: This study aimed to examine trends in chlamydia and gonorrhoea testing and positivity in Aboriginal and non-Aboriginal women of reproductive age. Methods: A cohort of 318002 women, born between 1974 and 1995, residing in Western Australia (WA) was determined from birth registrations and the 2014 electoral roll. This cohort was then probabilistically linked to all records of chlamydia and gonorrhoea nucleic acid amplification tests conducted by two large WA pathology laboratories between 1 January 2001 and 31 December 2013. Trends in chlamydia and gonorrhoea testing and positivity were investigated over time and stratified by Aboriginality and age group. Results: The proportion of women tested annually for chlamydia increased significantly between 2001 and 2013 from 24.5% to 36.6% in Aboriginal and 4.0% to 8.5% in non-Aboriginal women (both P-values <0.001). Concurrent testing was high (>80%) and so patterns of gonorrhoea testing were similar. Chlamydia and gonorrhoea positivity were substantially higher in Aboriginal compared with non-Aboriginal women; age-, region- and year-adjusted incidence rate ratios were 1.52 (95% confidence interval (CI) 1.50–1.69, P < 0.001) and 11.80 (95% CI 10.77–12.91, P < 0.001) respectively. Chlamydia positivity increased significantly in non-Aboriginal women aged 15–19 peaking in 2011 at 13.3% (95% CI 12.5–14.2%); trends were less consistent among 15–19-year-old Aboriginal women but positivity also peaked in 2011 at 18.5% (95% CI 16.9–20.2%). Gonorrhoea positivity was 9.7% (95% CI 9.3–10.1%), 6.7% (95% CI 6.4–7.0%), 4.7% (4.4–5.0%), and 3.1% (2.8–3.4%) among Aboriginal women aged respectively 15–19, 20–24, 25–29 and ≥30 years, compared with <1% in all age groups in non-Aboriginal women. Over time, gonorrhoea positivity declined in all age groups among Aboriginal and non-Aboriginal women. Conclusion: Between 2001 and 2013 in WA chlamydia and gonorrhoea positivity remained highest in young Aboriginal women despite chlamydia positivity increasing among young non-Aboriginal women. More effective prevention strategies, particularly for young Aboriginal women, are needed to address these disparities.
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Santiago, Pedro Henrique Ribeiro, Marko Milosevic, Xiangqun Ju, Wendy Cheung, Dandara Haag, and Lisa Jamieson. "A network psychometric validation of the Children Oral Health-Related Quality of Life (COHQoL) questionnaire among Aboriginal and/or Torres Strait Islander children." PLOS ONE 17, no. 8 (August 18, 2022): e0273373. http://dx.doi.org/10.1371/journal.pone.0273373.
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In Australia, research evidence has shown that Aboriginal and/or Torres Strait Islander children experience a higher burden of oral health diseases compared to other non-Indigenous children. The impact of oral health diseases on children’s functional and psychosocial outcomes led to the development of several instruments to evaluate child oral health-related quality of life (COHQoL), such as the Parental-Caregiver Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). However, the psychometric properties of these instruments have been evaluated only in Western cultures and have not been investigated for Aboriginal children in Australia. The current study aimed to examine the psychometric properties of the short-forms P-CPQ and FIS for Aboriginal and/or Torres Strait Islander children aged 2–3 years. Data were collected from the South Australian Aboriginal Birth Cohort (SAABC), including 270 Aboriginal children aged 2–3 years. Network psychometric models were used to investigate dimensionality, item redundancy, structural consistency and item stability, model fit, internal consistency reliability and criterion validity. We propose an instrument named Aboriginal Children’s Oral Health-Related Quality of Life Questionnaire (A-COHQoL). Our findings indicated that, after the exclusion of four problematic items, the A-COHQoL showed a three-dimensional structure (“Parent/Family Activities”, “COHQoL” and “Family Conflict”) with good model fit and reliability. The A-COHQoL is a psychometrically robust and sensitive instrument that is readily available for Aboriginal and/or Torres Strait Islander children aged 2–3 years in Australia and can be adapted in the future for Indigenous child groups in other countries.
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Campbell, Margaret, Naomi van der Linden, Karen Gardner, Helen Dickinson, Jason Agostino, Michelle Dowden, Irene O’Meara, et al. "Health care cost of crusted scabies in Aboriginal communities in the Northern Territory, Australia." PLOS Neglected Tropical Diseases 16, no. 3 (March 28, 2022): e0010288. http://dx.doi.org/10.1371/journal.pntd.0010288.
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Background Crusted scabies is a debilitating dermatological condition. Although still relatively rare in the urban areas of Australia, rates of crusted scabies in remote Aboriginal communities in the Northern Territory (NT) are reported to be among the highest in the world. Objective To estimate the health system costs associated with diagnosing, treating and managing crusted scabies. Methods A disease pathway model was developed to identify the major phases of managing crusted scabies. In recognition of the higher resource use required to treat more severe cases, the pathway differentiates between crusted scabies severity grades. The disease pathway model was populated with data from a clinical audit of 42 crusted scabies patients diagnosed in the Top-End of Australia’s Northern Territory between July 1, 2016 and May 1, 2018. These data were combined with standard Australian unit costs to calculate the expected costs per patient over a 12-month period, as well as the overall population cost for treating crusted scabies. Findings The expected health care cost per patient diagnosed with crusted scabies is $35,418 Australian dollars (AUD) (95% CI: $27,000 to $43,800), resulting in an overall cost of $1,558,392AUD (95% CI: $1,188,000 to $1,927,200) for managing all patients diagnosed in the Northern Territory in a given year (2018). By far, the biggest component of the health care costs falls on the hospital system. Discussion This is the first cost-of-illness analysis for treating crusted scabies. Such analysis will be of value to policy makers and researchers by informing future evaluations of crusted scabies prevention programs and resource allocation decisions. Further research is needed on the wider costs of crusted scabies including non-financial impacts such as the loss in quality of life as well as the burden of care and loss of well-being for patients, families and communities.
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FAIRLEY, CHRISTOPHER K., SEPEHR N. TABRIZI, SUZANNE M. GARLAND, and FRANCIS J. BOWDEN. "Canadian and Australian Aborigines." Sexually Transmitted Diseases 25, no. 1 (January 1998): 55–56. http://dx.doi.org/10.1097/00007435-199801000-00012.
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Batzloff, Michael R., David McMillan, and Manisha Pandey. "Progress towards a vaccine for Streptococcus pyogenes." Microbiology Australia 30, no. 5 (2009): 187. http://dx.doi.org/10.1071/ma09187.
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Infection with Streptococcus pyogenes (group A streptococcus, GAS) can lead to rheumatic fever (RF) and rheumatic heart disease (RHD), which are significant health concerns in the Indigenous populations of developed countries, including Australian Aboriginal people. The global burden of GAS diseases had been recently reviewed 1 and multiple studies have demonstrated the high burden of these diseases in Australia. RF and RHD are autoimmune type diseases, in which T-cells and antibodies targeting the bacteria may also cross-react with human tissues, therefore rendering a whole cell vaccine impractical.
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Chisholm, Rebecca H., Bradley Crammond, Yue Wu, Asha C. Bowen, Patricia T. Campbell, Steven Y. C. Tong, Jodie McVernon, and Nicholas Geard. "A model of population dynamics with complex household structure and mobility: implications for transmission and control of communicable diseases." PeerJ 8 (November 3, 2020): e10203. http://dx.doi.org/10.7717/peerj.10203.
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Households are known to be high-risk locations for the transmission of communicable diseases. Numerous modelling studies have demonstrated the important role of households in sustaining both communicable diseases outbreaks and endemic transmission, and as the focus for control efforts. However, these studies typically assume that households are associated with a single dwelling and have static membership. This assumption does not appropriately reflect households in some populations, such as those in remote Australian Aboriginal and Torres Strait Islander communities, which can be distributed across more than one physical dwelling, leading to the occupancy of individual dwellings changing rapidly over time. In this study, we developed an individual-based model of an infectious disease outbreak in communities with demographic and household structure reflective of a remote Australian Aboriginal community. We used the model to compare the dynamics of unmitigated outbreaks, and outbreaks constrained by a household-focused prophylaxis intervention, in communities exhibiting fluid vs. stable dwelling occupancy. We found that fluid dwelling occupancy can lead to larger and faster outbreaks in modelled scenarios, and may interfere with the effectiveness of household-focused interventions. Our findings suggest that while short-term restrictions on movement between dwellings may be beneficial during outbreaks, in the longer-term, strategies focused on reducing household crowding may be a more effective way to reduce the risk of severe outbreaks occurring in populations with fluid dwelling occupancy.
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Lawrence, Chris G., Patrick Rawstorne, Peter Hull, Andrew E. Grulich, Scott Cameron, and Garrett P. Prestage. "Risk behaviour among Aboriginal and Torres Strait Islander gay men: comparisons with other gay men in Australia." Sexual Health 3, no. 3 (2006): 163. http://dx.doi.org/10.1071/sh05053.
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Objectives: To determine any differences in HIV-risk and drug-use behaviour among Aboriginal and Torres Strait Islander gay men and other gay men in Australia. Methods: The Gay Community Periodic Survey is a repeated cross-sectional prevalence study of the sexual and drug use behaviours of Australian gay men conducted since 1996. Responses from Aboriginal and Torres Strait Islander (ATSI) gay men were compared with those from non-ATSI gay men for the years 2000–2004. Results: Of 34 708 responses collected in major Australian cities over a 6-year period, 1208 identified as Aboriginal or Torres Strait Islander. There was little difference between ATSI and non-ATSI men in the reported prevalence of HIV, though ATSI gay men were more likely than non-ATSI gay men to engage in unprotected anal intercourse with casual partners and to inject illicit drugs but were more likely to have been recently tested for HIV. Conclusions: These ATSI gay men were at increased risk of HIV and other blood-borne viruses, though this may be due to differences in socio-economic status as much as cultural background. These findings indicate the continued need for targeted sexual and injecting-drug-use health interventions among this population.
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Roberts-Witteveen, April, Kate Pennington, Nasra Higgins, Carolyn Lang, Monica Lahra, Russell Waddell, and John Kaldor. "Epidemiology of gonorrhoea notifications in Australia, 2007–12." Sexual Health 11, no. 4 (2014): 324. http://dx.doi.org/10.1071/sh13205.
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Background An increase in the notification rate of gonorrhoea was observed in the national surveillance system. In Australia, gonorrhoea is relatively rare, apart from among some populations of Aboriginal people and men who have sex with men. Methods: Data about gonorrhoea cases reported between 2007 and 2012 from all Australian jurisdictions were extracted from the National Notifiable Diseases Surveillance System. Analyses were undertaken of the time trends in counts and rates, according to jurisdiction, gender, Aboriginal and Torres Strait Islander status, diagnosis method and sexual orientation. Results: The largest increase in notifications between 2007 and 2012 was observed in both men and women in New South Wales (2.9- and 3.7-fold greater in 2012 than 2007, respectively) and Victoria (2.4- and 2.7-fold greater in 2012 than 2007, respectively), men in the Australian Capital Territory and women in Queensland. The highest notification rates remained in Indigenous people in the Northern Territory and Western Australia, and particularly in women, although rates may have decreased over the study period. Changes in age and sex distribution, antimicrobial resistance and patterns of exposure and acquisition were negligible. Conclusions: There is an ongoing gonorrhoea epidemic affecting Aboriginal and Torres Strait Islander people in Australia, but the increases in notifications have occurred primarily in non-Aboriginal populations in the larger jurisdictions. Interpretation of these surveillance data, especially in relation to changes in population subgroups, would be enhanced by laboratory testing data. Further efforts are needed to decrease infection rates in populations at highest risk.
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Akhtar, Most A., Ritesh Raju, Karren D. Beattie, Frances Bodkin, and Gerald Münch. "Medicinal Plants of the Australian Aboriginal Dharawal People Exhibiting Anti-Inflammatory Activity." Evidence-Based Complementary and Alternative Medicine 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/2935403.
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Chronic inflammation contributes to multiple ageing-related musculoskeletal and neurodegenerative diseases, cardiovascular diseases, asthma, rheumatoid arthritis, and inflammatory bowel disease. More recently, chronic neuroinflammation has been attributed to Parkinson’s and Alzheimer’s disease and autism-spectrum and obsessive-compulsive disorders. To date, pharmacotherapy of inflammatory conditions is based mainly on nonsteroidal anti-inflammatory drugs which in contrast to cytokine-suppressive anti-inflammatory drugs do not influence the production of cytokines such as tumour necrosis factor-α or nitric oxide. However, their prolonged use can cause gastrointestinal toxicity and promote adverse events such as high blood pressure, congestive heart failure, and thrombosis. Hence, there is a critical need to develop novel and safer nonsteroidal anti-inflammatory drugs possessing alternate mechanism of action. In this study, plants used by the Dharawal Aboriginal people in Australia for the treatment of inflammatory conditions, for example, asthma, arthritis, rheumatism, fever, oedema, eye inflammation, and inflammation of bladder and related inflammatory diseases, were evaluated for their anti-inflammatory activity in vitro. Ethanolic extracts from 17 Eucalyptus spp. (Myrtaceae) were assessed for their capacity to inhibit nitric oxide and tumor necrosis factor-α production in RAW 264.7 macrophages. Eucalyptus benthamii showed the most potent nitric oxide inhibitory effect (IC50 5.57±1.4 µg/mL), whilst E. bosistoana, E. botryoides, E. saligna, E. smithii, E. umbra, and E. viminalis exhibited nitric oxide inhibition values between 7.58 and 19.77 µg/mL.
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Watson, Colin, Kirsty Smith, Ahmed Latif, Wendy Armstrong, James Ward, Rebecca Guy, and Kate Senior. "Contextual and behavioural risk factors for sexually transmissible infections in young Aboriginal people in central Australia: a qualitative study." Sexual Health 17, no. 2 (2020): 198. http://dx.doi.org/10.1071/sh19181.
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Rates of sexually transmissible infections (STIs) in remote central Australian Aboriginal communities have been persistently high for over two decades, yet risk factors for STIs in these communities are not well understood. This qualitative study explored behavioural and contextual risk factors for STIs in young Aboriginal people in central Australia. The study identified that casual relationships between young people are common and that there is a strong association between travel, alcohol and casual sex, highlighting the ongoing need for comprehensive sexual health programs that are tailored to the specific social, cultural and interpersonal circumstances of young people in this setting.
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Lobo, Roanna, Belinda D'Costa, Linda Forbes, and James Ward. "Young Deadly Free: impact evaluation of a sexual health youth peer education program in remote Australian communities." Sexual Health 17, no. 5 (2020): 397. http://dx.doi.org/10.1071/sh20069.
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Background Aboriginal and Torres Strait Islander people in remote and very remote communities in Australia experience high rates of sexually transmissible infections (STIs), 4- to 29-fold the rates reported for non-Aboriginal people living in remote areas. Young people aged 16–29 years are particularly vulnerable to STIs. The Young Deadly Free (YDF) sexual health youth peer education program was implemented in 15 remote or very remote communities in four Australian jurisdictions in an effort to address endemic STI rates in these communities. The present study sought to evaluate the effect of YDF for Aboriginal young people. Methods: Young people (n = 128) participated in youth peer educator training to deliver peer education sessions on sexual health topics to other young people in their communities. Pre and post surveys were used to examine changes in STI knowledge, attitudes and behavioural intentions of the young people attending the peer education sessions. GHRANITE software extracted deidentified STI testing data for young people attending 13 community health services. Results: Young people (n = 426) attended peer education sessions delivered by trained youth peer educators. Pre and post surveys were completed by 174 and 172 young people respectively (median age 20 years). Gains were reported in STI knowledge, intentions to test (χ2 = 10.58, d.f. = 4, n = 142, P < 0.001) and number of STI tests (50.8% increase from baseline). Feelings of shame associated with STI testing remained high (39.5% post survey). Conclusions: Peer education can enhance the sexual health literacy of young Aboriginal people residing in remote communities. The extent to which knowledge gains result in behaviours that prevent STI transmission requires further evaluation. Normalising STI testing among Aboriginal young people would help reduce feelings of shame.
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Beh, Chau Chun, and Wen Hui Teoh. "Recent Advances in the Extraction of Pittosporum angustifolium Lodd. Used in Traditional Aboriginal Medicine: A Mini Review." Nutraceuticals 2, no. 2 (April 1, 2022): 49–59. http://dx.doi.org/10.3390/nutraceuticals2020004.
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Numerous native Australian plants are widely used as traditional medicines by the Australian Aboriginal and Torres Strait Islander peoples. Among the native plants, Pittosporum angustifolium Lodd. (Gumby Gumby) is claimed to be a promising medicinal plant in the treatment of a wide range of diseases that includes viral symptoms (colds and coughs), eczema, cancer, muscle aches, varicose veins, and many more. Various extraction techniques are used to extract the bioactive compounds of P. angustifolium, which are formulated into nutraceuticals. The present paper will provide an overview of the recent development in the extraction of bioactive ingredients from P. angustifolium, as well as the findings on the phytochemicals and antimicrobial activity of P. angustifolium extracts.
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Guy, Rebecca, James S. Ward, Kirsty S. Smith, Jiunn-Yih Su, Rae-Lin Huang, Annie Tangey, Steven Skov, et al. "The impact of sexually transmissible infection programs in remote Aboriginal communities in Australia: a systematic review." Sexual Health 9, no. 3 (2012): 205. http://dx.doi.org/10.1071/sh11074.
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Objective To systematically review evaluations of the impact of sexually transmissible infection (STI) programs delivered by primary health care services in remote Aboriginal communities. Methods: PubMed, Google Scholar, InfoNet, Cochrane Controlled Trials Register, Australian New Zealand Clinical Trial Registry, conference proceedings and bulletins were searched to April 2011 using variations of the terms ‘Aboriginal’, ‘programs’ and ‘STI’. The primary outcome of interest in the review was the change in bacterial STI infection prevalence in the target age group assessed through cross-sectional screening studies over a 5-year period or more. The characteristics of the primary health care service, STI programs and other clinical service outcomes were also described. Results: Twelve reports described four distinct STI programs in remote communities and their impact on STI prevalence. In the Anangu Pitjantjatjara Yankunytjatjara (APY) lands of northern South Australia, there was a reduction in the age-adjusted chlamydia and gonorrhoea prevalence by 58% and 67%, respectively (1996–2003). In the Tiwi Islands of Northern Territory (NT), chlamydia and gonorrhoea positivity decreased by 94% and 34%, respectively (2002–2005). In the Ngaanyatjarra Lands of Western Australia, crude chlamydia and gonorrhoea prevalence decreased by 36% and 48%, respectively (2001–2005), and in the central Australian region of NT, there was no sustained decline in crude prevalence (2001–2005). Conclusion: In three of the four programs, there was some evidence that clinical best practice and well coordinated sexual health programs can reduce STI prevalence in remote Aboriginal communities.
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Spurling, Geoffrey K., Chelsea J. Bond, Philip J. Schluter, Corey I. Kirk, and Deborah A. Askew. "'I'm not sure it paints an honest picture of where my health's at' – identifying community health and research priorities based on health assessments within an Aboriginal and Torres Strait Islander community: a qualitative study." Australian Journal of Primary Health 23, no. 6 (2017): 549. http://dx.doi.org/10.1071/py16131.
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Aboriginal and Torres Strait Islander health assessments are conducted annually in Australian primary care to detect risk factors, chronic diseases and implement preventive health measures. At the Inala Indigenous Health Service, health assessment data have also been used for research purposes. This research has been investigator-driven, which risks misinterpreting or ignoring community priorities compared with community-led research. The objective of this research was to learn about the Aboriginal and Torres Strait Islander community’s health priorities that could be translated into research themes, and investigate these using health assessment data. A thematic analysis of data was conducted from 21 semi-structured interviews with purposively selected key informants from an urban Aboriginal and Torres Strait Islander community. Key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural and environmental determinants operated in a ‘cycle’ to influence the community’s health. Key informant views supported the inclusion of these determinants in health assessments, reinforced the importance of comprehensive primary healthcare and strengthened referral pathways to community resources. Some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. This research also revealed limitations of health assessment-based research and the biomedical emphasis of the health system more broadly.
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Bell, Stephen, James Ward, Peter Aggleton, Walbira Murray, Bronwyn Silver, Andrew Lockyer, Tellisa Ferguson, et al. "Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia." Sexual Health 17, no. 4 (2020): 303. http://dx.doi.org/10.1071/sh19204.
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Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16–21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people’s sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people’s existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people’s sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as ‘youth health workers’.
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Moore, Hannah Catherine, Karthik Raj Manoharan, Faye Janice Lim, Geoffrey Shellam, and Deborah Lehmann. "Diverging Trends in Gastroenteritis Hospitalizations During 2 Decades in Western Australian Aboriginal and Non-Aboriginal Children." Pediatric Infectious Disease Journal 32, no. 11 (November 2013): 1169–74. http://dx.doi.org/10.1097/inf.0b013e31829dd34e.
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Carville, Kylie S., Deborah Lehmann, Gillian Hall, Hannah Moore, Peter Richmond, Nicholas de Klerk, and David Burgner. "Infection Is the Major Component of the Disease Burden in Aboriginal and Non-Aboriginal Australian Children." Pediatric Infectious Disease Journal 26, no. 3 (March 2007): 210–16. http://dx.doi.org/10.1097/01.inf.0000254148.09831.7f.
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