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Su JY, Leach AJ, Cass A, Morris PS, Kong K. An evaluation of the quality of ear health services for Aboriginal children living in remote Australia: a cascade of care analysis. BMC Health Serv Res 2023; 23:1186. [PMID: 37907905 PMCID: PMC10617165 DOI: 10.1186/s12913-023-10152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND In the Northern Territory (NT) the prevalence of otitis media (OM) in young Aboriginal children living in remote communities has persisted at around 90% over the last few decades. OM-associated hearing loss can cause developmental delay and adversely impact life course trajectories. This study examined the 5-year trends in OM prevalence and quality of ear health services in remote NT communities. METHODS A retrospective analysis was performed on de-identified clinical data for 50 remote clinics managed by the NT Government. We report a 6-monthly cascade analysis of the proportions of children 0-16 years of age receiving local guideline recommendations for surveillance, OM treatment and follow-up at selected milestones between 2014 and 2018. RESULTS Between 6,326 and 6,557 individual children were included in the 6-monthly analyses. On average, 57% (95%CI: 56-59%) of eligible children had received one or more ear examination in each 6-monthly period. Of those examined, 36% (95%CI: 33-40%) were diagnosed with some type of OM, of whom 90% had OM requiring either immediate treatment or scheduled follow-up according to local guidelines. Outcomes of treatment and follow-up were recorded in 24% and 23% of cases, respectively. Significant decreasing temporal trends were found in the proportion diagnosed with any OM across each age group. Overall, this proportion decreased by 40% over the five years (from 43 to 26%). CONCLUSIONS This cascade of care analysis found that ear health surveillance and compliance with otitis media guidelines for treatment and follow-up were both low. Further research is required to identify effective strategies that improve ear health services in remote settings.
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Affiliation(s)
- Jiunn-Yih Su
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Amanda Jane Leach
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Peter Stanley Morris
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Royal Darwin Hospital, Darwin, NT, Australia
| | - Kelvin Kong
- John Hunter Children's Hospital, Newcastle, NSW, Australia
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Leach AJ. What does microbiology have to do with the Hearing for Learning Initiative (HfLI)? MICROBIOLOGY AUSTRALIA 2022. [DOI: 10.1071/ma22035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Where would we be without microbiology in tackling the high prevalence of otitis media (OM; middle ear infection) and disabling hearing loss that disadvantage Australian First Nations children living in remote communities? Understanding the microbiology of OM in this population has been critical in directing innovative clinical trials research and developing appropriate evidence-based practice guidelines. While these processes are critical to reducing disadvantage associated with OM and disabling hearing loss, a remaining seemingly insurmountable gap has remained, threatening progress in improving the lives of children with ear and hearing problems. That gap is created by the crisis in primary health care workforce in remote communities. Short stay health professionals and fly-in fly-out specialist services are under-resourced to manage the complex needs of the community, including prevention and treatment of otitis media and hearing loss rehabilitation. Hence the rationale for the Hearing for Learning Initiative – a workforce enhancement model to improve sustainability, cultural appropriateness, and effectiveness of evidence-based ear and hearing health care for young children in remote settings. This paper summarises the role of microbiology in the pathway to the Hearing for Learning Initiative.
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Flemington T, Fraser J, Gibbs C, Shipp J, Bryant J, Ryan A, Wijetilaka D, Marks S, Scarcella M, Tzioumi D, Ramanathan S, Clague L, Hartz D, Lonne B, Lock (Ngiyampaa) M. The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5381. [PMID: 35564775 PMCID: PMC9102959 DOI: 10.3390/ijerph19095381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 02/01/2023]
Abstract
The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced "Dahl-beer-weer gum-um-be-goo" in the Gumbaynggirr language means 'safe children') model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment.
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Affiliation(s)
- Tara Flemington
- Nursing, Midwifery and Service Reform, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jennifer Fraser
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
- Nursing, Midwifery and Education, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia
| | - Clinton Gibbs
- Health Reform, Opportunities and Transition, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joanne Shipp
- Integrated Child, Youth and Family Wellbeing, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joe Bryant
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Amanda Ryan
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Devika Wijetilaka
- Paediatrics, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Susan Marks
- Child Protection Unit, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Mick Scarcella
- Aboriginal Health, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Dimitra Tzioumi
- Child Protection Unit, The Sydney Children’s Hospitals Network, Randwick, NSW 2031, Australia;
- Child Protection and Wellbeing, Ministry of Health, St Leonards, NSW 2065, Australia
- Faculty of Medicine, School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Shanthi Ramanathan
- Health Research Economics, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Liesa Clague
- School of Nursing, Midwifery, Health Science and Physiotherapy, The University of Notre Dame, Darlinghurst, NSW 2010, Australia;
| | - Donna Hartz
- School of Nursing and Midwifery, College of Medicine Health & Wellbeing, University of Newcastle, Gosford, NSW 2250, Australia;
| | - Bob Lonne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | - Mark Lock (Ngiyampaa)
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
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Walsh R, Reath J, Gunasekera H, Leach A, Kong K, Askew D, Girosi F, Hu W, Usherwood T, Lujic S, Spurling G, Morris P, Watego C, Harkus S, Woodall C, Tyson C, Campbell L, Hussey S, Abbott P. INFLATE: a protocol for a randomised controlled trial comparing nasal balloon autoinflation to no nasal balloon autoinflation for otitis media with effusion in Aboriginal and Torres Strait Islander children. Trials 2022; 23:309. [PMID: 35421984 PMCID: PMC9009496 DOI: 10.1186/s13063-022-06145-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 03/04/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Otitis media with effusion (OME) is common and occurs at disproportionately higher rates among Indigenous children. Left untreated, OME can negatively affect language, development, learning, and health and wellbeing throughout the life-course. Currently, OME care includes observation for 3 months followed by consideration of surgical ventilation tube insertion. The use of a non-invasive, low-cost nasal balloon autoinflation device has been found beneficial in other populations but has not been investigated among Aboriginal and Torres Strait Islander children. METHODS/DESIGN This multi-centre, open-label, randomised controlled trial will determine the effectiveness of nasal balloon autoinflation compared to no nasal balloon autoinflation, for the treatment of OME among Aboriginal and Torres Strait Islander children in Australia. Children aged 3-16 years with unilateral or bilateral OME are being recruited from Aboriginal Health Services and the community. The primary outcome is the proportion of children showing tympanometric improvement of OME at 1 month. Improvement is defined as a change from bilateral type B tympanograms to at least one type A or C1 tympanogram, or from unilateral type B tympanogram to type A or C1 tympanogram in the index ear, without deterioration (type A or C1 to type C2, C3, or B tympanogram) in the contralateral ear. A sample size of 340 children (170 in each group) at 1 month will detect an absolute difference of 15% between groups with 80% power at 5% significance. Anticipating a 15% loss to follow-up, 400 children will be randomised. The primary analysis will be by intention to treat. Secondary outcomes include tympanometric changes at 3 and 6 months, hearing at 3 months, ear health-related quality of life (OMQ-14), and cost-effectiveness. A process evaluation including perspectives of parents or carers, health care providers, and researchers on trial implementation will also be undertaken. DISCUSSION INFLATE will answer the important clinical question of whether nasal balloon autoinflation is an effective and acceptable treatment for Aboriginal and Torres Strait Islander children with OME. INFLATE will help fill the evidence gap for safe, low-cost, accessible OME therapies. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry ACTRN12617001652369 . Registered on 22 December 2017. The Australia New Zealand Clinical Trials Registry is a primary registry of the WHO ICTRP network and includes all items from the WHO Trial Registration data set. Retrospective registration.
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Affiliation(s)
- Robyn Walsh
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Jennifer Reath
- School of Medicine, Western Sydney University, Sydney, Australia
| | | | - Amanda Leach
- Menzies School of Health Research, Darwin, Australia
| | - Kelvin Kong
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Deborah Askew
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Federico Girosi
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Timothy Usherwood
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sanja Lujic
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Geoffrey Spurling
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service) Queensland Health, Brisbane, Australia
| | - Peter Morris
- Menzies School of Health Research, Darwin, Australia
| | - Chelsea Watego
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | | | | | - Claudette Tyson
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | | | - Sylvia Hussey
- Townsville Aboriginal and Islander Health Service, Townsville, Australia
| | - Penelope Abbott
- School of Medicine, Western Sydney University, Sydney, Australia.
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Kong K, Cass A, Leach AJ, Morris PS, Kimber A, Su JY, Oguoma VM. A community-based service enhancement model of training and employing Ear Health Facilitators to address the crisis in ear and hearing health of Aboriginal children in the Northern Territory, the Hearing for Learning Initiative (the HfLI): study protocol for a stepped-wedge cluster randomised trial. Trials 2021; 22:403. [PMID: 34134736 PMCID: PMC8207498 DOI: 10.1186/s13063-021-05215-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/21/2021] [Indexed: 02/03/2023] Open
Abstract
Background Almost all Aboriginal children in remote communities have persistent bilateral otitis media affecting hearing and learning throughout early childhood and school years, with consequences for social and educational outcomes, and later employment opportunities. Current primary health care and specialist services do not have the resources to meet the complex needs of these children. Method/design This stepped-wedge cluster randomised trial will allocate 18 communities to one of five 6-monthly intervention start dates. Stratification will be by region and population size. The intervention (Hearing for Learning Initiative, HfLI) consists of six 20-h weeks of training (delivered over 3 months) that includes Certificate II in Aboriginal Primary Health Care (3 modules) and competencies in ear and hearing data collection (otoscopy, tympanometry and hearScreen), plus 3 weeks of assisted integration into the health service, then part-time employment as Ear Health Facilitators to the end of the trial. Unblinding will occur 6 months prior to each allocated start date, to allow Community Reference Groups to be involved in co-design of the HfLI implementation in their community. Relevant health service data will be extracted 6-monthly from all 18 communities. The primary outcome is the difference in proportion of children (0 to 16 years of age) who have at least one ear assessment (diagnosis) documented in their medical record within each 6-month period, compared to control periods (no HfLI). Secondary outcomes include data on sustainability, adherence to evidence-based clinical guidelines for otitis media, including follow-up and specialist referrals, and school attendance. Structured interviews with staff working in health and education services, Ear Health Trainees, Ear Health Facilitators and families will assess process outcomes and the HfLI broader impact. Discussion The impact of training and employment of Ear Health Facilitators on service enhancement will inform the health, education and employment sectors about effectiveness of skills and job creation that empowers community members to contribute to addressing issues of local importance, in this instance ear and hearing health of children. Trial registration ClinicalTrials.gov NCT03916029. Registered on 16 April 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05215-7.
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Affiliation(s)
- Kelvin Kong
- University of Newcastle, John Hunter Children's Hospital, Newcastle, NSW, 2300, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia
| | - Amanda Jane Leach
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia.
| | - Peter Stanley Morris
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia.,Royal Darwin Hospital, Darwin, NT, Australia
| | - Amy Kimber
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia
| | - Jiunn-Yih Su
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia
| | - Victor Maduabuchi Oguoma
- Menzies School of Health Research, Charles Darwin University, 58 Rocklands Drive, Darwin, NT, 0810, Australia.,Health Research Institute, University of Canberra, Canberra, ACT, Australia
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Lloyd-Johnsen C, Eades S, McNamara B, D'Aprano A, Goldfeld S. A global perspective of Indigenous child health research: a systematic review of longitudinal studies. Int J Epidemiol 2021; 50:1554-1568. [PMID: 33864092 DOI: 10.1093/ije/dyab074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children. METHODS A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950. RESULTS From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as 'good' quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research. CONCLUSIONS We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally.
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Affiliation(s)
- Catherine Lloyd-Johnsen
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette McNamara
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anita D'Aprano
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Leach AJ, Mulholland EK, Santosham M, Torzillo PJ, McIntyre P, Smith-Vaughan H, Wilson N, Arrowsmith B, Beissbarth J, Chatfield MD, Oguoma VM, Morris PS. Otitis media outcomes of a combined 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine and 13-valent pneumococcal conjugate vaccine schedule at 1-2-4-6 months: PREVIX_COMBO, a 3-arm randomised controlled trial. BMC Pediatr 2021; 21:117. [PMID: 33685411 PMCID: PMC7938290 DOI: 10.1186/s12887-021-02552-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal children living in Australian remote communities are at high risk of early and persistent otitis media, hearing loss, and social disadvantage. Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the primary pathogens. We compared otitis media outcomes in infants randomised to either a combination of Synflorix™ (PHiD-CV10, with protein D of NTHi) and Prevenar13™ (PCV13, with 3, 6A, and 19A), with recommended schedules for each vaccine alone. We previously reported superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months. METHODS In an open-label superiority trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P) at 2-4-6 months (_PPP), Synflorix™ (S) at 2-4-6 months (_SSS), or Synflorix™ at 1-2-4 months plus Prevenar13™ at 6 months (SSSP). Ears were assessed using tympanometry at 1 and 2 months, combined with otoscopy at 4, 6, and 7 months. A worst ear diagnosis was made for each child visit according to a severity hierarchy of normal, otitis media with effusion (OME), acute otitis media without perforation (AOMwoP), AOM with perforation (AOMwiP), and chronic suppurative otitis media (CSOM). RESULTS Between September 2011 and September 2017, 425 infants were allocated to _PPP(143), _SSS(141) or SSSP(141). Ear assessments were successful in 96% scheduled visits. At 7 months prevalence of any OM was 91, 86, and 90% in the _PPP, _SSS, and SSSP groups, respectively. There were no significant differences in prevalence of any form of otitis media between vaccine groups at any age. Combined group prevalence of any OM was 43, 57, 82, 87, and 89% at 1, 2, 4, 6, and 7 months of age, respectively. Of 388 infants with ear assessments at 4, 6 and 7 months, 277 (71.4%) had OM that met criteria for specialist referral; rAOM, pOME, or CSOM. CONCLUSIONS Despite superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months, there were no significant differences in prevalence of otitis media nor healthy ears throughout the first months of life. TRIAL REGISTRATION ACTRN12610000544077 registered 06/07/2010 and ClinicalTrials.gov NCT01174849 registered 04/08/2010.
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Affiliation(s)
- Amanda Jane Leach
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
| | - Edward Kim Mulholland
- Murdoch Children’s Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Australia
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Paul John Torzillo
- Prince Alfred Hospital, Sydney, NSW Australia
- University of Sydney, NSW, Australia
| | - Peter McIntyre
- National Centre for Immunization Research and Surveillance, Sydney, NSW Australia
| | - Heidi Smith-Vaughan
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
| | - Nicole Wilson
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
| | - Beth Arrowsmith
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
| | - Jemima Beissbarth
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
| | - Mark D. Chatfield
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
- Centre for Health Services Research Faculty of Medicine, University of Queensland, Brisbane QLD, Australia
| | - Victor M. Oguoma
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
- Health Research Institute University of Canberra, Canberra, ACT Australia
| | - Peter Stanley Morris
- Child Health Division, Menzies School of Heath Research, Casuarina, Northern Territory Australia
- Charles Darwin University, Casuarina Northern Territory, Australia
- Department of Paediatrics , Royal Darwin Hospital, Darwin, Northern Territory Australia
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Guest Editorial: Hearing Care for All-An Opportunity to Globally Unite to Address Inequities in Hearing Health. Ear Hear 2021; 42:487-491. [PMID: 33657575 DOI: 10.1097/aud.0000000000001047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Xie O, Markey PG, Draper ADK, Krause VL. Physical distancing and non-respiratory notifiable diseases in the Northern Territory, March-May 2020. ACTA ACUST UNITED AC 2020; 44. [PMID: 33278872 DOI: 10.33321/cdi.2020.44.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Strict physical distancing measures and border controls have been introduced in the Northern Territory (NT), and across Australia, to reduce the spread of coronavirus disease 2019 (COVID-19). These measures have been associated with reduced incidence of other respiratory illnesses such as influenza. It is currently unclear what effect these measures have on non-respiratory communicable diseases. The incidence of notifiable non-respiratory communicable diseases within the NT, from 15 March to 15 May 2020, the period of most restrictive physical distancing, was monitored and is here compared with two control periods: (i) the 4 months immediately prior and (ii) the same two-month period from the preceding 5 years. During the study period, there was a decline in incidence of communicable enteric illnesses, particularly in shigellosis and rotavirus where person-to-person spread is the main transmission route. There was an increase in chlamydial conjunctivitis in areas with endemic trachoma, which is under further investigation. There was no observed increase in conditions associated with crowding, such as those related to group A streptococcal infection.
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Affiliation(s)
- Ouli Xie
- Centre for Disease Control, Public Health Unit, Top End Health Service, Darwin, Northern Territory, Australia.,Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Peter G Markey
- Centre for Disease Control, Public Health Unit, Top End Health Service, Darwin, Northern Territory, Australia
| | - Anthony D K Draper
- Centre for Disease Control, Public Health Unit, Top End Health Service, Darwin, Northern Territory, Australia.,Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Vicki L Krause
- Centre for Disease Control, Public Health Unit, Top End Health Service, Darwin, Northern Territory, Australia
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