Children In Remote Communities Research Articles

Molecular characterisation of pneumococcal serotype 16F: Established predominant carriage and otitis media serotype in the 7vPCV era

Young Australian Aboriginal children in remote communities experience very high rates of pneumococcal carriage and otitis media. Prior to introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV, Prevenar), serotype 16F was an important type found in nasal and ear discharge swabs. Since commencement of pneumococcal immunisation for Aboriginal infants in 2001, 16F has become the predominant established serotype in carriage and otitis media in young Aboriginal children. BOX typing and multi-locus sequence typing revealed a diverse population of serotype 16F strains, and evidence of potential capsule switching from a vaccine serotype 4 to a serotype 16F.

Dental self-care and dietary characteristics of remote-living Indigenous children

Indigenous children in remote communities carry a disproportionate amount of the dental disease burden among Australian 4-12 year-olds. However, there have been no reports of dental service use, dental self-care or dietary characteristics among remote-living Indigenous children. This information may provide insight into behaviours linked with the high levels of dental disease observed. The purpose of this study was to examine such behaviours among Indigenous children in three remote communities in the Top End of the Northern Territory of Australia. The study is part of a wider investigation involving the implementation and monitoring of water fluoridation plants in two of the communities, and the collection of clinical dental data from children in these three and other remote communities. In 2003, small-scale fluoridation plants were installed in two remote communities (Communities A and B) in the Top End of the Northern Territory with naturally low fluoride levels in the water and with a high prevalence of child dental disease. Another community (Community C) was selected as a comparison site (natural levels of water fluoride low). A convenience sample of carers of children from all communities completed a questionnaire that sought information on carer education and their children's age, sex, use of dental services, dental self-care behaviours, dietary characteristics, household water source and water consumption. The questionnaires were administered by a project worker and community residents once consent had been obtained. Data were analysed using SPSS version vers.13.0 (SPSS Inc; Chicago, IL, USA). Some 214 carers completed the questionnaire for 409 children aged 4-12 years; 131 (32.0%) from Community A, 158 (38.6%) from Community B and 120 (29.3%) from Community C. The response rates for the child survey based on Census data (generally regarded as an undercount) was 55% across the three communities. Approximately one-third of carers had had no secondary schooling or could not recall their level of educational attainment. Child age was reasonably spread over the target age-range and there were no significant differences between communities by sex. Approximately one-third of children were reported to have had their teeth checked every year by a dental therapist and most children were reported to use a toothbrush. While most children were also reported to use toothpaste, only 20% of such children reportedly used it every day. Time of toothpaste use was evenly distributed between morning and evening, with a small proportion of children reportedly using it twice a day. The most common age that toothpaste use began was 4 years and most children had never taken fluoride supplements. Over three-quarters of children who reportedly consumed softdrinks, cordial, milk or flavoured milk in the evenings drank such beverages at least a few evenings each week. Over 90% of children across the three communities who reportedly drank tea, and approximately three-quarters of those who consumed sweet snacks, did so at least a few evenings each week. Almost all houses were connected to the community water supply. Most children sourced their drinking water from a tap and approximately two-thirds were reported to drink more than 4 cups of water a day. Our study showed there were low levels of preventive dental care, irregular use of dentrifices, negligible implementation of alternative fluoride sources, high consumption of sweetened snacks and drinks in the evenings, and almost universal connection of houses to the public water supply among remote-dwelling Indigenous children. The findings provide some insights into factors contributing to the poor and declining state of such children's dental health, and should aid in the planning and implementation of oral health promotion initiatives.

Skin infection, housing and social circumstances in children living in remote Indigenous communities: testing conceptual and methodological approaches.

BackgroundPoor housing conditions in remote Indigenous communities in Australia are a major underlying factor in poor child health, including high rates of skin infections. The aim of this study is to test approaches to data collection, analysis and feedback for a follow-up study of the impact of housing conditions on child health.MethodsParticipation was negotiated in three communities with community councils and individual participants. Data were collected by survey of dwelling condition, interviews, and audit health centre records of children aged under seven years. Community feedback comprised immediate report of items requiring urgent repair followed by a summary descriptive report. Multivariate models were developed to calculate adjusted incidence rate ratios (IRR) for skin infections and their association with aspects of household infrastructure.ResultsThere was a high level of participation in all communities. Health centre records were inadequate for audit in one community. The records of 138 children were available for development of multivariate analytic models. Rates of skin infection in dwellings that lacked functioning facilities for removing faeces or which had concrete floors may be up to twice as high as for other dwellings, and the latter association appears to be exacerbated by crowding. Younger children living in older dwellings may also be at approximately two-fold higher risk. A number of socioeconomic and socio-demographic variables also appear to be directly associated with high rates of skin infections.ConclusionThe methods used in the pilot study were generally feasible, and the analytic approach provides meaningful results. The study provides some evidence that new and modern housing is contributing to a reduction in skin infections in Aboriginal children in remote communities, particularly when this housing leads to a reduction in crowding and the effective removal of human waste.

Otitis Media, Learning and Community

This paper reviews selected literature relating to the medical condition and learning consequences of Otitis Media in Aboriginal children in remote communities and reports on a research project which aimed to develop a whole community approach to the problem. The model brings together health, education, medical professionals, paraprojessionals and the community in a structured and cohesive program based on the school as the lead and central agency. The special significance of community and paraprofessionals, for example teacher aides is considered.

Differences in growth among remote and town-dwelling Aboriginal children in the Kimberley region of Western Australia

AbstractThis paper documents the growth of Aboriginal children in remote communities and gazetted towns of the Kimberley region in the far north of Western Australia over the past 20 years. The study's specific aim was to compare the height and weight growth of children in different environments from birth to five years of age. From 1979 to 1983, children living in towns were significantly taller and heavier than their counterparts in remote communities. From 1984 to 1988 and thereafter, there were no significant differences in the growth patterns of children in towns and remote communities. Overall, weight-for-age and height-for-age of children in remote communities has improved since the 1970s relative to their town-dwelling counterparts. These changes in growth shed light on the quality of the social and physical environment over the past 20 years and may assist with the development of future programs for child health.