Browsing by Author "Tong S."
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Item Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.(2020-05-02) Howarth T.; Brunette R.; Davies T.; Andrews R.M.; Patel B.K.; Tong S.; Barzi F.; Kearns T.M.Objective To describe antibiotic prescription rates for Australian Aboriginal children aged <2 years living in three remote Northern Territory communities. Design A retrospective cohort study using electronic health records. Setting Three primary health care centres located in the Katherine East region. Participants Consent was obtained from 149 mothers to extract data from 196 child records. There were 124 children born between January 2010 and July 2014 who resided in one of the three chosen communities and had electronic health records for their first two years of life. Main outcome measures Antibiotic prescription rates, factors associated with antibiotic prescription and factors associated with appropriate antibiotic prescription. Results There were 5,675 Primary Health Care (PHC) encounters for 124 children (median 41, IQR 25.5, 64). Of the 5,675 PHC encounters, 1,542 (27%) recorded at least one infection (total 1,777) and 1,330 (23%) had at least one antibiotic prescription recorded (total 1,468). Children had a median five (IQR 2, 9) prescriptions in both their first and second year of life, with a prescription rate of 5.99/person year (95% CI 5.35, 6.63). Acute otitis media was the most common infection (683 records, 38%) and Amoxycillin was the most commonly prescribed antibiotic (797 prescriptions, 54%). Of the 1,468 recorded prescriptions, 398 (27%) had no infection recorded and 116 (8%) with an infection recorded were not aligned with local treatment guidelines. Conclusion Prescription rates for Australian Aboriginal children in these communities are significantly higher than that reported nationally for non-Aboriginal Australians. Prescriptions predominantly aligned with treatment guidelines in this setting where there is a high burden of infectious disease.Copyright © 2020 Howarth et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Item Scabies and risk of skin sores in remote Australian Aboriginal communities: a self-controlled case series study.(2018-08-20) Aung P.T.Z.; Cuningham W.; Hwang K.; Andrews R.M.; Carapetis J.; Kearns T.; Clucas D.; McVernon J.; Simpson J.A.; Tong S.; Campbell P.T.Background: Skin sores caused by Group A streptococcus (GAS) infection are a major public health problem in remote Aboriginal communities. Skin sores are often associated with scabies, which is evident in scabies intervention programs where a significant reduction of skin sores is seen after focusing solely on scabies control. Our study quantifies the strength of association between skin sores and scabies among Aboriginal children from the East Arnhem region in the Northern Territory. Methods and Results: Pre-existing datasets from three published studies, which were conducted as part of the East Arnhem Healthy Skin Project (EAHSP), were analysed. Aboriginal children were followed from birth up to 4.5 years of age. Self-controlled case series design was used to determine the risks, within individuals, of developing skin sores when infected with scabies versus when there was no scabies infection. Participants were 11.9 times more likely to develop skin sores when infected with scabies compared with times when no scabies infection was evident (Incidence Rate Ratio (IRR) 11.9; 95% CI 10.3-13.7; p<0.001), and this was similar across the five Aboriginal communities. Children had lower risk of developing skin sores at age <=1 year compared to at age >1 year (IRR 0.8; 95% CI 0.7-0.9). Conclusion(s): The association between scabies and skin sores is highly significant and indicates a causal relationship. The public health importance of scabies in northern Australia is underappreciated and a concerted approach is required to recognise and eliminate scabies as an important precursor of skin sores.Copyright © 2018 Aung et al. http://creativecommons.org/licenses/by/4.0/.