High prevalence of asthma in five remote indigenous communities in Australia

Abstract

Data on the prevalence of asthma in children residing in remote indigenous communities in Australia are sparse, despite the many reports of high prevalence in nonindigenous children of this country. Two previous Australian studies have had poor participation rates, limiting interpretation of their results.A study of children in the Torres Strait and Northern Peninsula Area of Australia was conducted to document the prevalence of asthma symptoms. Five indigenous communities were randomly selected and trained interviewers, who were local indigenous health workers, recruited participants using a house-by-house approach. Information was collected by a structured face-to-face interview based on a standardized questionnaire constructed from the protocol International Study of Asthma and Allergy in Childhood; 1,650 children were included in the study with a 98% response rate.Overall, the prevalence of self-reported ever wheezing was 21%; 12% reported wheezing in the previous year; and 16% reported ever having asthma. There was significant variation in the prevalence of asthma symptoms between communities.It is concluded that there are significant intercommunity variations in the prevalence of asthma symptoms in remote communities and that the prevalence in these communities is as high as in nonindigenous groups.

Asthma is not Prevalent in Aboriginal and Torres Strait Islander Children: A Myth

“…However, we believe that the current situation is different, particularly as there has been considerable passage of time since Veale et al ’s initial paper 3 . In addition, there might have been a true change in prevalence, regional differences (as we pointed out in our paper), 4 or one disease entity (asthma) may have become more obvious as there has been considerable reorganization of health structures, including vaccination programmes against bacterial organisms, undertaken in these communities. Whatever the reason, it is important to realize that asthma is prevalent in some Indigenous communities.…”

“…We believe that a health maintenance (chronic illness care) model with appropriate education programmes for the community, administrative and health staff, would greatly benefit these communities. It must be realized that considerable community differences may exist, and, given the disparities between the study by Veale et al 3 and ours, 4 further regional prevalence studies should be carried out in order to understand the extent of the problem. This would lead to the implementation of measures to improve the unacceptably high levels of health problems in Indigenous children.…”

“…With respect to children on Cape York, Veale et al found that the overall prevalence of wheeze in the last 12 months and asthma in those aged 5–19 years were, respectively, 4.6% and 0.0%. We have recently shown that the prevalence of childhood asthma in some remote Indigenous communities is similar to the national non‐Indigenous rates in Australia, 4 and that the primary health care model can be successfully used in these communities 5 . We conducted a study of children in the Torres Strait and Northern Peninsula areas to document the prevalence of asthma symptoms.…”

An education intervention for childhood asthma by Aboriginal and Torres Strait Islander health workers: a randomised controlled trial

“…As study enrolment was slower than anticipated, we modified the intervention allocation based on estimates of asthma prevalence 12 and guided by the sample size and power calculations. If a child was allocated to “additional education” but there was no trained IHCW in the child's community to administer the intervention, we changed the allocation to “no additional education” ( n = 7).…”

“…We have reported previously that children with asthma in the Torres Strait region of northern Australia have more severe disease than children in urban areas 11 . Building on our previous work in this community, 11 , 12 we conducted a randomised controlled trial of an education intervention by IHCWs for children with asthma.…”