The world's largest study of gastroenteritis trends in children, conducted by Perth's The Kids for Child Health Research, has shown the disparity between Aboriginal and non-Aboriginal health may be improving.
The study, published recently in the Pediatric Infectious Diseases Journal, examined gastroenteritis hospitalisation trends in almost 600,000 West Australian Aboriginal and non-Aboriginal children over two decades.
Gastroenteritis or infectious diarrhoea is a leading cause of illness and death globally, causing more than 800,000 deaths in children under five, mainly in the developing world.
The study results show that, between the periods 1983-1994 and 1995-2006, the hospitalisation rate for gastroenteritis dropped significantly in young Aboriginal children with a 42% decline in those aged 12-17 months and a 36% decline in those aged 18-23 months.
In contrast, over the same time periods, the rates of gastroenteritis hospitalisation increased significantly in non-Aboriginal children with a 34% increase in those aged 18-23 months and 25% increase in those aged 2-4 years.
Lead author Dr Hannah Moore said while the rate of gastroenteritis in Aboriginal children has declined substantially, the gap between Aboriginal and non-Aboriginal children continues.
"The gap has closed over two decades but rates of gastroenteritis in Aboriginal children under five were still 3-8 times higher than non-Aboriginal children of the same age."
Dr Moore said there were several possible reasons for the observed decline in hospitalisations for gastroenteritis.
"Although much remains to be done, there have been general improvements in Aboriginal health and hygiene including water quality and sanitation, and reduced overcrowding, which are likely to have contributed to a reduction in infections in Aboriginal children," said Dr Moore.
Furthermore, Dr Moore said that a decline in severity of the disease may have led to more children being treated as outpatients rather than being admitted to hospital.
The observed increase in non-Aboriginal children being hospitalised for gastroenteritis may in part be due to the decline of the availability of bulk-billing GP services.
The study results also showed gastroenteritis hospitalisations rates varied between different climatic zones and geographical regions. For Aboriginal children under five living in the tropical Kimberley and Pilbara-Gascoyne regions, rates were around 3.5 times higher than in metropolitan Perth. For non-Aboriginal children under 5, rates were 30-60% higher in rural and remote regions than in Perth.
"This highlights the continuing need to address poor health outcomes in all children living in remote areas and provide them with better access to medical and health services," says Dr Moore.
Among the most important causes of gastroenteritis is rotavirus. In 2007, rotavirus vaccine was introduced into the routine childhood immunisation schedule in Western Australia. It is now necessary to document the impact of this program on hospitalisation rates for gastroenteritis.
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Citation:
Moore HC, Raj Manoharan K, Lim FJ, Shellam G, Lehmann D. Diverging trends in gastroenteritis hospitalizations during two decades in Western Australian Aboriginal and non-Aboriginal children. Pediatr Infect Dis J. 2013;32(11): 1169-1174.
The study results show that, between the periods 1983-1994 and 1995-2006, the hospitalisation rate for gastroenteritis dropped significantly in young Aboriginal children with a 42% decline in those aged 12-17 months and a 36% decline in those aged 18-23 months.
In contrast, over the same time periods, the rates of gastroenteritis hospitalisation increased significantly in non-Aboriginal children with a 34% increase in those aged 18-23 months and 25% increase in those aged 2-4 years.
Lead author Dr Hannah Moore said while the rate of gastroenteritis in Aboriginal children has declined substantially, the gap between Aboriginal and non-Aboriginal children continues.
"The gap has closed over two decades but rates of gastroenteritis in Aboriginal children under five were still 3-8 times higher than non-Aboriginal children of the same age."
Dr Moore said there were several possible reasons for the observed decline in hospitalisations for gastroenteritis.
"Although much remains to be done, there have been general improvements in Aboriginal health and hygiene including water quality and sanitation, and reduced overcrowding, which are likely to have contributed to a reduction in infections in Aboriginal children," said Dr Moore.
Furthermore, Dr Moore said that a decline in severity of the disease may have led to more children being treated as outpatients rather than being admitted to hospital.
The observed increase in non-Aboriginal children being hospitalised for gastroenteritis may in part be due to the decline of the availability of bulk-billing GP services.
The study results also showed gastroenteritis hospitalisations rates varied between different climatic zones and geographical regions. For Aboriginal children under five living in the tropical Kimberley and Pilbara-Gascoyne regions, rates were around 3.5 times higher than in metropolitan Perth. For non-Aboriginal children under 5, rates were 30-60% higher in rural and remote regions than in Perth.
"This highlights the continuing need to address poor health outcomes in all children living in remote areas and provide them with better access to medical and health services," says Dr Moore.
Among the most important causes of gastroenteritis is rotavirus. In 2007, rotavirus vaccine was introduced into the routine childhood immunisation schedule in Western Australia. It is now necessary to document the impact of this program on hospitalisation rates for gastroenteritis.
--ends--
Citation:
Moore HC, Raj Manoharan K, Lim FJ, Shellam G, Lehmann D. Diverging trends in gastroenteritis hospitalizations during two decades in Western Australian Aboriginal and non-Aboriginal children. Pediatr Infect Dis J. 2013;32(11): 1169-1174.