The infant mortality rate at Cherbourg aboriginal community: an update.

The infant mortality rate (IMR) at Cherbourg Aboriginal Community in south-eastern Queensland remained high from 1906 to about 1955-60, but since then has dropped from over 200/1000 live births in 1956-60 to 16/1000 live births in 1986-90, compared with the 1987 rate for Queensland (9.2/1000) and Australia (8.6/1000). The rapid improvement in the IMR was associated with the installation of a piped and chlorinated water supply, sewerage and an intensive campaign to eradicate intestinal worms. There has also been a change in community attitudes towards routine health practices and it is likely that this has been a major factor in the changes.

The changing growth of aboriginal children.

We have used data from children at an Aboriginal settlement in Queensland to demonstrate the changing patterns of growth over the last 30 years. In cohorts of children born during the early 1950s and 1960s the mean weight-for-age value was satisfactory for the first three months of life, but then fell until aged 12 months and remained at about 92% of the NCHS median value until 5 years old. In the cohort born in 1972-73 there was some improvement and in the 1982-83 cohort the mean weight-for-age value was close to international levels from 1 to 5 years. The decline in weight-for-age between 3 and 12 months was still present. Length-for-age values were not available in the 1950s and 1960s but the mean value increased from the 1972-73 cohort to the 1982-83 cohort, which was close to international levels. The mean weight-for-length was close to international levels in the 1972-73 cohort, but in the 1982-83 cohort was high from 3 to 12 months and then fell close to the international level. These data indicate that the children at this Aboriginal settlement are now growing satisfactorily. The impaired growth between 3 and 12 months needs further investigation, but most of the earlier concerns about poor growth appear to have been resolved.

Evaluation of a new antihelminthic for trichuriasis, hookworm, and stronglyloidiasis.

Mebendazole was tested in a double-blind trial for its efficacy in the treatment and control of enteric helminths. One hundred and twenty-two children from a community near the Gulf of Carpentaria, and from a community in Cape York Peninsula in northern Queensland were divided into two equal groups to receive a course of either mebendazole or placebo after the identification of one or more intestinal helminths in a single pretreatment specimen of faeces. Between the tenth and twentieth days after a four-day course of treatment, three specimens of faeces were collected from each child. Mebendazole cured trichuriasis in 75% of cases, and over-all egg reduction rate was 96%. The drug also cured hookworm in 13 out of 15 cases and Strongyloides sterocoralis infestation in 14 out of 21 cases. Mebendazole was ineffective against Hymenolepis nana. No cases of Ascaris lumbricoides infestation were present. No side effects or adverse reactions to the drug were noted and patient acceptance was excellent. Mebendazole appears to be a safe drug for use in the treatment of human parasitic intestinal nematode infestations, and should be especially useful in the treatment and control of trichuriasis.

PIP: Mebendazole was tested in a double-blind trial for its efficacy in the treatment and control of enteric helminths. 122 children from a community near the Gulf of Carpentaria, and from a community in Cape York Peninsula in northern Queensland were divided into 2 equal groups to receive a course of either mebendazole or placebo after the identification of 1 or more intestinal helminths in a single pretreatment specimen of feces. Between days 10-20 following a 4-day course of treatment, 3 specimens of feces were collected from each child. Mebendazole cured trichuriasis in 75% of the cases, and the overall egg reduction rate was 96%. The drug also cured hookworm in 13 of 15 cases and Strongyloides sterocoralis infestation in 14 of 21 cases. Mebendazole was ineffective against Hymenolepsis nana. No cases of Ascaris lumbricoides infestation were present. No side effects or adverse reactions to the drug were noted and patient acceptance was excellent. Mebendazole appears to be a safe drug for use in the treatment of human parasitic intestinal nematode infestations and should be especially useful in the treatment and control of trichuriasis.