Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne, Victoria.
Menzies School of Health Research, Charles Darwin University, Northern Territory.
Aust N Z J Public Health. 2019 Apr;43(2):149-155. doi: 10.1111/1753-6405.12876. Epub 2019 Feb 6.
To quantify the childhood infectious disease burden and antibiotic use in the Northern Territory's East Arnhem region through synthesis and analysis of historical data resources.
We combined primary health clinic data originally reported in three separate publications stemming from the East Arnhem Healthy Skin Project (Jan-01 to Sep-07). Common statistical techniques were used to explore the prevalence of infectious conditions and the seasonality of infections, and to measure rates of antibiotic use.
There was a high monthly prevalence of respiratory (mean: 32% [95% confidence interval (CI): 20%, 34%]) and skin (mean: 20% [95%CI: 19%, 22%]) infectious syndromes, with upper respiratory tract infections (mean: 29% [95%CI: 27%, 31%]) and skin sores (mean: 15% [95%CI: 14%, 17%]) the most common conditions. Antibiotics were frequently prescribed with 95% (95%CI: 91%, 97%) of children having received at least one antibiotic prescription by their first birthday, and 47% having received six antibiotic prescriptions; skin sores being a key driver.
Early life infections drive high antibiotic prescribing rates in remote Aboriginal communities. Implications for public health: Eliminating skin disease could reduce antibiotic use by almost 20% in children under five years of age in this population.
通过综合和分析历史数据资源，量化北领地东阿纳姆地区儿童传染病负担和抗生素使用情况。
我们结合了源自东阿纳姆健康皮肤项目的三项独立出版物中最初报告的初级保健诊所数据（2001 年 1 月至 2007 年 9 月）。使用常见的统计技术来探讨传染病的流行率和感染的季节性，并衡量抗生素的使用率。
呼吸道（平均：32%[95%置信区间（CI）：20%，34%]）和皮肤（平均：20%[95%CI：19%，22%]）传染病综合征的每月患病率很高，上呼吸道感染（平均：29%[95%CI：27%，31%]）和皮肤溃疡（平均：15%[95%CI：14%，17%]）是最常见的病症。抗生素经常被开处方，95%（95%CI：91%，97%）的儿童在一岁生日前至少接受过一次抗生素处方，47%的儿童接受过六次抗生素处方；皮肤溃疡是一个关键驱动因素。
生命早期的感染导致偏远的土著社区抗生素使用率较高。对公共卫生的影响：在该人群中，消除皮肤疾病可使五岁以下儿童的抗生素使用量减少近 20%。
