Clucas Danielle B, Carville Kylie S, Connors Christine, Currie Bart J, Carapetis Jonathan R, Andrews Ross M
Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Bull World Health Organ. 2008 Apr;86(4):275-81. doi: 10.2471/blt.07.043034.
To determine the frequency of presentations and infectious-disease burden at primary health care (PHC) services in young children in two remote Aboriginal communities in tropical northern Australia.
Children born after 1 January 2001, who were resident at 30 September 2005 and for whom consent was obtained, were studied. Clinic records were reviewed for all presentations between 1 January 2002 and 30 September 2005. Data collected included reason for presentation (if infectious), antibiotic prescription and referral to hospital.
There were 7273 clinic presentations for 174 children aged 0-4.75 years, 55% of whom were male. The median presentation rate per child per year was 16 (23 in the first year of life). Upper-respiratory-tract infections (32%) and skin infections (18%) were the most common infectious reasons for presentation. First presentations for scabies and skin sores peaked at the age of 2 months. By 1 year of age, 63% and 69% of children had presented with scabies and skin sores, respectively.
These Aboriginal children average about two visits per month to PHC centres during their first year of life. This high rate is testament to the disease burden, the willingness of Aboriginal people to use health services and the high workload experienced by these health services. Scabies and skin sores remain significant health problems, with this study describing a previously undocumented burden of these conditions commencing within the first few months of life. Appropriate prevention and treatment strategies should encompass early infancy to reduce the high burden of infectious diseases in this population.
确定澳大利亚北部热带地区两个偏远原住民社区幼儿在初级卫生保健(PHC)服务机构的就诊频率和传染病负担。
对2001年1月1日以后出生、2005年9月30日时居住在此且已获得同意的儿童进行研究。回顾了2002年1月1日至2005年9月30日期间所有就诊记录。收集的数据包括就诊原因(若为感染性原因)、抗生素处方及转诊至医院的情况。
0至4.75岁的174名儿童共有7273次门诊就诊,其中55%为男性。每名儿童每年的就诊率中位数为16次(出生后第一年为23次)。上呼吸道感染(32%)和皮肤感染(18%)是最常见的感染性就诊原因。疥疮和皮肤溃疡首次就诊高峰出现在2个月龄。到1岁时,分别有63%和69%的儿童出现过疥疮和皮肤溃疡。
这些原住民儿童在出生后第一年平均每月到初级卫生保健中心就诊约两次。如此高的就诊率证明了疾病负担、原住民使用卫生服务的意愿以及这些卫生服务机构所承受的高工作量。疥疮和皮肤溃疡仍然是严重的健康问题,本研究描述了这些疾病在生命最初几个月内存在此前未记录的负担。适当的预防和治疗策略应涵盖婴儿早期,以减轻该人群的高传染病负担。