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Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.

ABSTRACT: 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.

SUBMITTER: Howarth T

PROVIDER: S-EPMC7164616 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.

Howarth Timothy T Brunette Raelene R Davies Tanya T Andrews Ross M RM Patel Bhavini K BK Tong Steven S Barzi Federica F Kearns Therese M TM

PloS one 20200417 4

<h4>Objective</h4>To describe antibiotic prescription rates for Australian Aboriginal children aged <2 years living in three remote Northern Territory communities.<h4>Design</h4>A retrospective cohort study using electronic health records.<h4>Setting</h4>Three primary health care centres located in the Katherine East region.<h4>Participants</h4>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 ...[more]

PMID: 32302359

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Project description:BACKGROUND:Australian surveillance data document higher rates of sexually transmissible infections (STIs) among young Aboriginal people (15-29?years) in remote settings than non-Aboriginal young people. Epidemiological data indicate a substantial number of young Aboriginal people do not test for STIs. Rigorous qualitative research can enhance understanding of these findings. This paper documents socio-ecological factors influencing young Aboriginal people's engagement with clinic-based STI testing in two remote settings in the Northern Territory, Australia. METHODS:In-depth interviews with 35 young Aboriginal men and women aged 16-21?years; thematic analysis examining their perceptions and personal experiences of access to clinic-based STI testing. RESULTS:Findings reveal individual, social and health service level influences on willingness to undertake clinic-based STI testing. Individual level barriers included limited knowledge about asymptomatic STIs, attitudinal barriers against testing for symptomatic STIs, and lack of skills to communicate about STIs with health service staff. Social influences both promoted and inhibited STI testing. In setting 1, local social networks enabled intergenerational learning about sexual health and facilitated accompanied visits to health clinics for young women. In setting 2, however, social connectedness inhibited access to STI testing services. Being seen at clinics was perceived to lead to stigmatisation among peers and fear of reputational damage due to STI-related rumours. Modalities of health service provision both enhanced and inhibited STI testing. In setting 1, outreach strategies by male health workers provided young Aboriginal men with opportunities to learn about sexual health, initiate trusting relationships with clinic staff, and gain access to clinics. In setting 2, barriers were created by the location and visibility of the clinic, appointment procedures, waiting rooms and waiting times. Where inhibitive factors at the individual, social and health service levels exist, young Aboriginal people reported more limited access to STI testing. CONCLUSIONS:This is the first socio-ecological analysis of factors influencing young Aboriginal people's willingness to undertake testing for STIs within clinics in Australia. Strategies to improve uptake of STI testing must tackle the overlapping social and health service factors that discourage young people from seeking sexual health support. Much can be learned from young people's lived sexual health experiences and family- and community-based health promotion practices.

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Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.

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Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.

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