Risk factors for oral health in young, urban, Aboriginal and Torres Strait Islander children.
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ABSTRACT:
SUBMITTER: Butten K
PROVIDER: S-EPMC6392135 | biostudies-literature | 2019 Mar
REPOSITORIES: biostudies-literature
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Risk factors for oral health in young, urban, Aboriginal and Torres Strait Islander children.
Butten K K Johnson N W NW Hall K K KK Anderson J J Toombs M M King N N O'Grady K F KF
Australian dental journal 20181202 1
<h4>Background</h4>The caries process follows a strong social gradient which can commence in the first years of life. Yet data on young children remain limited. This study reports the potential risk factors and indicators in urban, Aboriginal and Torres Strait Islander children aged less than 5 and estimates the prevalence of caries.<h4>Methods</h4>Demographic and risk factor and risk indicator data were collected at baseline in a cohort study of children attending a health clinic in north Brisb ...[more]
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Project description:BackgroundUnderstanding normative retinal thickness characteristics is critical for diagnosis and monitoring of pathology, particularly in those predisposed to retinal disease. The macular retinal layer thickness of Australian Aboriginal and/or Torres Strait Islander children was examined using spectral-domain optical coherence tomography.MethodsHigh-resolution macular optical coherence tomography imaging was performed on 100 Aboriginal and/or Torres Strait Islander children and 150 non-Indigenous visually healthy children aged 4-18 years. The imaging protocol included a 6-line radial scan centred on the fovea. Images were segmented using semi-automated software to derive thickness of the total retina, inner and outer retina, and individual retinal layers across the macular region. Repeated measures ANOVAs examined variations in thickness associated with retinal region, age, gender and Indigenous status.ResultsRetinal thickness showed significant topographical variations (p < 0.01), being thinnest in the foveal zone, and thickest in the parafovea. The retina of Aboriginal and/or Torres Strait Islander children was significantly thinner than non-Indigenous children in the foveal (p < 0.001), parafoveal (p = 0.002), and perifoveal zones (p = 0.01), with the greatest difference in the foveal zone (mean difference: 14.2 μm). Inner retinal thickness was also thinner in Aboriginal and/or Torres Strait Islander children compared to non-Indigenous children in the parafoveal zone (p < 0.001), and outer retinal thickness was thinner in the foveal (p < 0.001) and perifoveal zone (p < 0.001). Retinal thickness was also significantly greater in males than females (p < 0.001) and showed a statistically significant positive association with age (p = 0.01).ConclusionThere are significant differences in macular retinal thickness between Aboriginal and/or Torres Strait Islander children and non-Indigenous children, which has implications for interpreting optical coherence tomography data and may relate to risk of macula disease in this population.
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Project description:Introduction: Acute respiratory infections with cough (ARIwC) contribute considerably to childhood morbidity, yet few studies have examined the cost of these illnesses among Australian children. Moreover, of the few studies that have, none are inclusive of Aboriginal and/or Torres Strait Islander children, despite this population experiencing a greater burden of respiratory illnesses. This study aimed to determine the costs of ARIwC among urban Aboriginal and/or Torres Strait Islander children from the perspective of caretakers, the public healthcare system, and employers. Methods: This cost of illness study used data collected from Aboriginal and/or Torres Strait Islander children aged <5 years enrolled in a 12 month prospective cohort study conducted through an urban primary healthcare clinic in Queensland, Australia. Illness-related resource use was collected for each episode of ARIwC reported, and costed at market rates. Linear regression was used to (a) examine cost per episode by season of illness onset and cough duration and (b) examine cost per month of observation by baseline child and family characteristics. Results: During the study period, a total of 264 episodes of ARIwC were reported among 138 children. The total mean cost was estimated to be $AU252 per non-hospitalized episode (95%CI 169-334). Caretakers, the public healthcare system and employers incurred 44, 39, and 17% of costs per episode, respectively. After accounting for months of completed follow-ups, the total mean cost per child per year was estimated to be $991 (95%CI 514-1468). Winter episodes and episodes resulting in chronic cough were associated with significantly higher costs per episode. A prior history of wheezing, connections to traditional lands and parent/guardian belief that antibiotics should be given until symptoms resolved were associated with significantly higher cost per child month of observation. Conclusion: The cost of ARIwC in this predominantly disadvantaged population is substantial, particularly for caretakers and this needs to be considered in both clinical management and public health initiatives. The importance of cultural factors on health and burden of illness should not be overlooked. Further research into the prevention of chronic cough may play an important role in reducing the economic burden of pediatric respiratory infections.
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Project description:BackgroundIn the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children.ObjectiveTo quantify differences between three algorithms in ascertaining Aboriginal and Torres Strait Islander children in linked administrative data.MethodsLinked administrative health data for children born in Western Australia (WA) from 2000-2013, were used to examine the cohorts identified by three methods: A) the Indigenous Status Flag (ISF, derived by the WA Data Linkage Branch using a multistage-median approach) for the children alone; B) the ISF of the children, their parents and grandparents; and C) Indigenous status of the child, mother or father on either of the child's perinatal records (Midwives or birth registration), to determine differing characteristics of each cohort.ResultsMethod B established a larger cohort (33,489) than Method C (33,306) and Method A (27,279), with all methods identifying a core group of 26,790 children (80-98%). Compared with children identified by Method A, additional children identified by Methods B or C, were from less-disadvantaged and more urban areas, and had better perinatal outcomes (e.g. lower proportions of small-for-gestational age, 10% vs 16%). Differences in demographics and health outcomes between Methods C and B were minimal.ConclusionsDemographic and perinatal health characteristics differ by Aboriginal identification method. Using perinatal records or the ISF of parents and grandparents (in addition to the ISF of the child) appear to be more inclusive methods for identifying young Indigenous children in administrative datasets.KeywordsAboriginal health, identification, data linkage, Indigenous, child, methodology.
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Project description:BACKGROUND:Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception. METHODS:The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities' Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed. RESULTS:Twenty-seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities. CONCLUSION:This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.
| S-EPMC7164228 | biostudies-literature
Project description:Background For Aboriginal and Torres Strait Islander peoples, culture is foundational to health and wellbeing. However, its inherent conceptual complexity and diversity across and within different Aboriginal and Torres Strait Islander cultural groups means that it has rarely been explored in depth by epidemiological research. As a result, there are very few measures which adequately represent the heterogeneity and importance of Aboriginal and Torres Strait Islander cultures for health and wellbeing. Tools grounded in the social determinants of health are mostly based on European academic opinion about what constitutes culture and wellbeing, and the views of Indigenous peoples are rarely included. Mayi Kuwayu, the National Study of Aboriginal and Torres Strait Islander Wellbeing, developed a new survey tool based on health and wellbeing as perceived by Aboriginal and Torres Strait Islander people. This paper describes several of the key processes used to identify cultural domains and develop questionnaire items for the survey tool, reflecting the importance of culture to Aboriginal and Torres Strait Islander peoples. Methods Focus groups were conducted at community organisations and conferences with Aboriginal and Torres Strait Islander people. These sessions were aimed at identifying key cultural domains to be addressed by the Mayi Kuwayu questionnaire and to field test drafts of the questionnaire, which were then modified according to focus group feedback and expert input. Results Extensive community consultations allowed us to identify key cultural domains, generate questionnaire items, and test initial content validity. The six overarching cultural domains identified during the development of the Mayi Kuwayu questionnaire were: Connection to Country; Beliefs and knowledge; Language; Family, kinship, and community; Cultural expression and continuity; and Self-determination and leadership. Conclusions The processes used by Mayi Kuwayu have generated meaningful cultural items for use in Aboriginal and Torres Strait Islander health and wellbeing research. Further assessment of these processes, including a comparison with best practice guidelines and psychometric testing of the items and scales developed, will be conducted in a future program of work. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01710-8.
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Project description:Australian Aboriginal and Torres Strait Islander children experience unacceptably high rates of dental caries compared to their non-Indigenous Australian counterparts. Dental caries significantly impacts the quality of life of children and their families, particularly in remote communities. While many socioeconomic and lifestyle factors impact caries risk, the central role of the oral microbiota in mediating dental caries has not been extensively investigated in these communities. Here, we examine factors that shape diversity and composition of the salivary microbiota in Aboriginal and Torres Strait Islander children and adolescents living in the remote Northern Peninsula Area (NPA) of Far North Queensland. We employed 16S ribosomal RNA amplicon sequencing to profile bacteria present in saliva collected from 205 individuals aged 4-17 years from the NPA. Higher average microbial diversity was generally linked to increased age and salivary pH, less frequent toothbrushing, and proxies for lower socioeconomic status (SES). Differences in microbial composition were significantly related to age, salivary pH, SES proxies, and active dental caries. Notably, a feature classified as Streptococcus sobrinus increased in abundance in children who reported less frequent tooth brushing. A specific Veillonella feature was associated with caries presence, while features classified as Actinobacillus/Haemophilus and Leptotrichia were associated with absence of caries; a Lactobacillus gasseri feature increased in abundance in severe caries. Finally, we statistically assessed the interplay between dental caries and caries risk factors in shaping the oral microbiota. These data provide a detailed understanding of biological, behavioral, and socioeconomic factors that shape the oral microbiota and may underpin caries development in this group. This information can be used in the future to improve tailored caries prevention and management options for Australian Aboriginal and Torres Strait Islander children and communities.
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Project description: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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Project description:BackgroundAboriginal and Torres Strait Islander children have higher incidence, severity and hospital length of stay for their acute burn injuries than other Australian children. We examined factors contributing to longer length of stay for Aboriginal and Torres Strait Islander children with an acute burn injury.MethodsBurns Registry of Australia and New Zealand admissions of children < 16 years of age between October 2009 and July 2018 were analysed. Descriptive statistics explored patient and injury characteristics; Cox-regression models estimated characteristics associated with longer length of stay. Knowledge Interface methodology and Indigenous research methods were used throughout.ResultsA total of 723 children were identified as Aboriginal and Torres Strait Islander and 6257 as other Australian. The median hospital length of stay for Aboriginal and Torres Strait Islander children (5 days [CI 5-6]) was 4 days longer than other Australian children (1 day [CI 1-2]). Remoteness, flame burns, high percentage total body surface area (%TBSA) and full thickness burns were factors associated with longer length of stay for Aboriginal and Torres Strait Islander children. Similar prognostic factors were identified for other Australian children along with Streptococcus sp. and Staphylococcus sp. infection.ConclusionRemoteness, flame burns, %TBSA, and full thickness burns are prognostic factors contributing to extended hospital length of stay for all Australian children. These factors are more prevalent in Aboriginal and Torres Strait Islander children, impacting length of stay. Treatment programs, clinical guidelines, and burns policies should engage with the unique circumstances of Aboriginal and Torres Strait Islander children to mitigate inequities in health.
| S-EPMC7534159 | biostudies-literature
Project description:BACKGROUND:Respiratory morbidity in Australian Indigenous children is higher than their non-Indigenous counterparts, irrespective of urban or remote residence. There are limited studies addressing acute respiratory illness (ARI) in urban Indigenous children, particularly those that address the upper airway microbiome and its relationship to disease. We aimed to describe the prevalence of upper airway viruses and bacteria in symptomatic and asymptomatic urban-based Australian Indigenous children aged less than 5 years. METHODS:A cross-sectional analysis of data collected at baseline in an ongoing prospective cohort study of urban Aboriginal and Torres Strait Islander children registered with a primary health care service in the northern suburbs of Brisbane, Australia. Clinical, demographic and epidemiological data and bilateral anterior nasal swabs were collected on enrolment. Polymerase chain reaction was performed on nasal swabs to detect 17 respiratory viruses and 7 bacteria. The primary outcome was the prevalence of these microbes at enrolment. Logistic regression was performed to investigate differences in microbe prevalence between children with and without acute respiratory illness with cough as a symptom (ARIwC) at time of specimen collection. RESULTS:Between February 2013 and October 2015, 164 children were enrolled. The median age at enrolment was 18.0 months (IQR 7.2-34.3), 49.4% were boys and 56 children (34.2%) had ARIwC. Overall, 133/164 (81%) nasal swabs were positive for at least one organism; 131 (79.9%) for any bacteria, 59 (36.2%) for any virus and 57 (34.8%) for both viruses and bacteria. Co-detection of viruses and bacteria was more common in females than males (61.4% vs 38.6%, p = 0.044). No microbes, alone or in combination, were significantly associated with the presence of ARIwC. CONCLUSIONS:The prevalence of upper airways microbes in asymptomatic children is similar to non-Indigenous children with ARIwC from the same region. Determining the aetiology of ARIwC in this community is complicated by the high prevalence of multiple respiratory pathogens in the upper airways. STUDY REGISTRATION:Australia New Zealand Clinical Trial Registry Registration Number: 12,614,001,214,628. Retrospectively registered.
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Project description:BackgroundLiver disease and hepatocellular carcinoma (HCC) are important contributors to the mortality gap between Indigenous and non-Indigenous Australians. However, there is a lack of population based high quality data assessing the differences in HCC epidemiology and outcomes according to Indigenous status. The aim of this study was therefore to perform a large epidemiological study of HCC investigating differences between Indigenous and non-Indigenous Australians with HCC.MethodsStudy design was a retrospective cohort study. Data linkage methodology was used to link data from cancer registries with hospital separation summaries across three Australian jurisdictions during 2000-2017. Cumulative survival (Kaplan-Meier) and the differences in survival (Multivariable Cox-regression) by Indigenous status were assessed.FindingsA total of 229 Indigenous and 3587 non-Indigenous HCC cases were included in the analyses. Significant epidemiological differences identified for Indigenous HCC cases included younger age at onset, higher proportion of females, higher rurality, lower socioeconomic status, and higher comorbidity burden (all p < 0.001). The distribution of cofactors was also significantly different for Indigenous Australians including higher prevalence of alcohol misuse, hepatitis B, and diabetes and more frequent presence of multiple HCC cofactors (all p < 0.001). Indigenous Australians received curative HCC therapies less frequently (6.6% vs. 14.5%, p < 0.001) and had poorer 5-year survival (10.0% vs. 17.3%, p < 0.001; unadjusted hazard ratio (HR) =1.42 96%CI 1.21-1.65) compared to non-Indigenous Australians. The strength of the association between indigenous status and survival was weaker and statistically non-significant after adjusting for rurality, comorbidity burden and lack of curative therapy (adjusted-HR=1.20 95%CI 0.97-1.47).InterpretationSuch data provide a call to action to help design and implement health literacy, liver management and HCC surveillance programs for Indigenous people to help close the liver cancer mortality gap.
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