High burden of infectious disease and antibiotic use in early life in Australian Aboriginal communities

Aust N Z J Public Health. 2019 Apr;43(2):149-155. doi: 10.1111/1753-6405.12876. Epub 2019 Feb 6.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: antibiotic use; infectious disease; remote Aboriginal communities.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Communicable Diseases / drug therapy*
  • Communicable Diseases / epidemiology
  • Drug Utilization / statistics & numerical data
  • Female
  • Health Services, Indigenous
  • Humans
  • Male
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / statistics & numerical data*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Rural Population
  • Skin Diseases / drug therapy
  • Skin Diseases / epidemiology

Substances

  • Anti-Bacterial Agents