This study evaluated a community-driven animal health and management program in the remote community of Wadeye, Northern Territory. This evaluation used a pre-post design to assess changes in animal and human health outcomes over a 12-month period of program implementation, from June 2018 to June 2019. The evaluation assessed the program by comparing animal health outcomes before versus one year after program implementation and comparing human health outcomes before versus during the first 12 months of the program. Outcome measures included the desexing status of dogs and cats, body condition and hair score of dogs, and rates of people presenting to the health clinic for a dog bite. Animal health outcomes significantly improved after program implementation. From pre to post program, there was a 77% increase in the prevalence of good body condition score among dogs and a 9% increase in the prevalence of good hair score among dogs, and the prevalence of desexed dogs and cats more than doubled. There was no significant change in the number of people presenting to the health clinic for a dog bite. Consideration on how to further incorporate human and environmental health aspects into the program could be useful for future One Health programs.
To determine if optimal fluoridation of public water supplies influences bone mass and fractures, we studied 2076 non-black women, all aged 265 years recruited into the Study of Osteoporotic Fractures at the Pittsburgh clinic. Information on fluoride exposure was limited to community water supplies. The variable used in the analysis was years of exposure to fluoridated water in community drinking water supplies. Bone mineral density (BMD) was measured at the spine and hip using dual energy X-ray absorptiometry and at the midpoint and ultradistal radius and calcaneus using single photon absorptiometry. Prevalent and incident vertebral fractures were determined by morphometry. Incident nonspine fractures were ascertained every 4 months and confirmed by radiographic report. Exposure to residential fluoridated water had no effect on bone mass. Women exposed to fluoride for >20 years had similar axial and appendicular bone mass to women not exposed or women exposed for 520 years. There was some suggestion that women exposed to fluoride for >20 years had a lower relative risk of nonspine fractures (relative risk, RR, = 0.73; 95% confidence interval [CI] 0.48-1.12), osteoporotic fractures, RR = 0.74 (CI 0.46-1.19), and hip fractures, RR = 0.44 (CI 0.10-1.86), compared with women not exposed, but none of these relative risks was statistically significant. There was no association with wrist or spinal fractures. Our results do not support the findings from recent ecological studies which showed an increased risk of hip fracture among individuals exposed to fluoridated public water. (J Bone Miner Res 1995;101076-1086)
Indigenous populations around the world face disproportionately high rates of disease related to the environment and animals. One Health is a concept that has been used effectively to understand and address these health risks. One Health refers to the relationships and interdependencies between animal, human, and environmental health and is an emerging research field that aligns with indigenous views of health. To understand the applicability of One Health in indigenous communities, a critical review was undertaken to investigate evidence of One Health research in indigenous communities internationally, assess the strength of evidence, and understand what gaps are present. This review included the appraisal of twenty-four studies based in five regions: Canada, Africa, Australia, South America, and Central America. The review found that there is a need for studies of high strength, with rigorous methods, local leadership, and active involvement of indigenous viewpoints, to be undertaken in indigenous communities internationally that focus on One Health. It highlights the need to further consider indigenous viewpoints in research to reduce limitations, increase effectiveness of findings, consider appropriateness of recommendations, and benefit communities.
Objective: This study investigated chronic disease risk markers among a cohort of Aboriginal children in New South Wales. Methods: Distributions of body mass index (BMI), blood lipids and haemoglobin A1c (HbA1c) among Aboriginal children aged 5‐<19 years were investigated. Prevalence ratios (PR) were calculated for borderline/high total cholesterol, low‐density lipoprotein (LDL) cholesterol and HbA1c, and low high‐density lipoprotein (HDL) cholesterol, by age group, sex and BMI. Results: Almost half (46.8%) of the cohort, had a normal BMI and 53.3% had overweight or obesity. Prevalence of chronic disease risk markers was low, with no individuals having high total cholesterol (0.0%) and few having high LDL (3.0%) or borderline/high HbA1c (2.6%); 85.5% of the cohort had normal HDL. There was no significant variation in the prevalence of chronic disease risk markers by age group or sex. The prevalence of borderline total cholesterol was 28% higher (PR 1.28, 95%CI 1.06‐1.54), and the prevalence of low HDL was double (2.00, 1.19‐3.35) for participants with obesity versus normal BMI. Conclusions: Dyslipidaemia and elevated HbA1c prevalence was low in the cohort, increasing with high BMI. Overweight and obesity were common, which increase the risk of developing chronic disease later in life. Implications for public health: Findings indicate few Aboriginal children have dyslipidaemia and hyperglycaemia, supporting screening for chronic disease risk factors from 18 years of age. Opportunities to reduce overweight and obesity among children should be considered to decrease the future risk of chronic disease.
With limited access to animal health services, and high disease burdens among domesticated animals, Aboriginal and Torres Strait Islander communities in Australia face higher risk of disease including zoonoses. However, we lack understanding of the contribution of often preventable zoonoses to the health of these communities, which would enable us to enhance public health strategies and improve health outcomes. We conducted a scoping review to identify the current state of evidence on zoonoses in the Aboriginal and Torres Strait Islander population. We examined the size, scope and characteristics of the evidence base and analysed the zoonoses detected in the studies within a One Health framework. We identified 18 studies that detected 22 zoonotic pathogens in animals, people, and the environment, with most studies detecting pathogens in a single One Health sector and no studies investigating pathogens in all three sectors. Findings indicate that despite the strong conceptual foundations of One Health throughout the evidence base, evidence is lacking in application of this concept. There is a need to undertake further research that prioritises Aboriginal and Torres Strait Islander leadership, considers the contribution of human, animal and environmental health factors, and investigates the prevalence and impact of zoonoses in communities through a One Health approach.
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