ABSTRACT
INTRODUCTION: The Western Desert Kidney Health Project (WDKHP) aimed to determine the prevalence of type 2 diabetes (T2DM), kidney disease and associated risk factors in Aboriginal and non-Aboriginal people in a remote area of Western Australia. METHODS: The project, featuring whole-of-community cross-sectional surveys and health assessments using point-of-care testing, was conducted in five small towns and six remote Aboriginal communities in the Goldfields of Western Australia between 2010 and 2014. Initial health assessments were completed by 597 adults (424 Aboriginal) and 502 children (393 Aboriginal). This included almost 80% of the Aboriginal population. All non-Aboriginal people residing in the six remote Aboriginal communities participated. RESULTS: Risk factors for renal disease and T2DM were present in participants of all ages, including children as young as 2 years. There was no significant difference between Aboriginal and non-Aboriginal children. Aboriginal and non-Aboriginal adult participants had twice the burden of T2DM than the standard Australian population. More than 12% of all children had elevated albumin-creatinine ratio (ACR). Adults had markers of kidney disease at higher rates than expected: 51% of Aboriginal adults and 27% of non-Aboriginal adults had at least one marker of kidney disease (haematuria, proteinuria or elevated ACR). Aboriginal women were the highest risk group (32% T2DM, 40% elevated ACR). Haematuria and low urine pH were common findings, 21% of people had haematuria (greater than trace) and 71% had urine pH of 6 or less; there was no difference in this finding between Aboriginal and non-Aboriginal people. CONCLUSION: The WDKHP found higher than expected rates of risk factors for T2DM and renal disease compared with Australian Bureau of Statistics rates for Australian Aboriginal and non-Aboriginal adults and children, with Aboriginal women the highest risk group. The rates for non-Aboriginal participants were higher than expected, suggesting exposures in common might be more important than ethnicity.The high prevalence of aciduria and haematuria found in both Aboriginal and non-Aboriginal participants in this study suggests that factors contributing to a chronic metabolic acidosis and inflammation or irritation of the urinary tract need to be explored. Drinking water quality in this remote area is known to be poor and may be an important contributing factor. Many of the contributing factors are potentially modifiable - such as water quality, food supply, exercise opportunities and living conditions - offering scope for interventions to reduce the risk and burden of these diseases.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Kidney Diseases/epidemiology , Adolescent , Adult , Australia/epidemiology , Biomarkers , Blood Pressure , Body Mass Index , Body Weights and Measures , Child , Creatinine/blood , Cross-Sectional Studies , Diabetes Mellitus, Type 2/ethnology , Female , Hematuria/epidemiology , Humans , Hydrogen-Ion Concentration , Kidney Diseases/ethnology , Male , Middle Aged , Native Hawaiian or Other Pacific Islander , Risk Factors , Rural Population , Serum Albumin , Western Australia/epidemiology , Young AdultSubject(s)
Health Policy , Immunization/statistics & numerical data , Registries , Australia , Child , HumansSubject(s)
Drug Labeling , Drug Prescriptions , Drug Utilization Review , Australia , Clinical Trials as Topic , Consensus , Humans , SafetySubject(s)
Antiviral Agents/therapeutic use , Disease Outbreaks/prevention & control , Homes for the Aged , Infection Control/methods , Influenza A virus , Influenza, Human/prevention & control , Acetamides/therapeutic use , Adult , Aged , Aged, 80 and over , Amantadine/therapeutic use , Female , Guanidines , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Influenza, Human/epidemiology , Middle Aged , Oseltamivir , Pyrans , Sialic Acids/therapeutic use , Vaccination , Victoria/epidemiology , ZanamivirABSTRACT
Despite improving childhood coverage of the measles-mumps-rubella vaccine (MMR) in Victoria during the 1990s, mumps and rubella notifications in age groups eligible for vaccination persisted. This study reviewed the mumps and rubella surveillance data from 1993 to 2000 with a specific focus on method of diagnosis. There were 474 notifications of mumps over the seven-year period (annual median 61, range 40 to 77) and 3,544 notifications of rubella (annual median 297, range 66 to 1,165). The highest notifications rates for mumps were consistently among the 1-4 and 5-9 year age groups, whereas there was a marked change in the age distribution of rubella notifications during this interval. A large rubella outbreak occurred in 1995 with 1,165 notifications; the highest notification rates were males aged 15-24 years, infants under one year of age (males and females), and those aged 5-14 years (males and females), respectively. The susceptibility of 5-24 year olds reflects historical changes to the Australian Standard Vaccination Schedule. Rubella notifications returned to baseline levels in 1998 with the highest notification rates in infants aged under one year, and children aged 1-4 years. For both mumps and rubella, the majority of notifications for all age groups were clinically diagnosed, and were most common in children.
