Hospitalisation for gastroenteritis in Western Australia

Abstract

Aims: To document gastroenteritis hospitalisations of the 1995-96 cohort of infants born in Western Australia to mid-2002, and to assess factors associated with their hospitalisations and readmissions. Methods: Retrospective analysis of the State's hospitalisation data, Midwives' Notification of Births data, the Australian Bureau of Statistics mortality data and clinical and demographic information. Results: Aboriginal infants were hospitalised for gastroenteritis eight times more frequently than their nonAboriginal peers, and were readmitted more frequently and sooner for diarrhoeal illnesses than the other group. They also stayed in hospital for twice as long and many Aboriginal patients were hospitalised on numerous occasions. Hospitalisation rates were higher in remote areas and were significantly associated with co-morbidities such as undernutrition, anaemia, co-existing infections, and intestinal carbohydrate intolerance. Conclusions: Gastroenteritis is very prevalent in Australian Aboriginal infants and children and is a major cause of their hospitalisation in Western Australia. It is often associated with undernutrition, anaemia, intestinal parasitic infestations, other infections, intestinal carbohydrate intolerance, and, in some instances, with low birth weight. This is often due to unhygienic living conditions and behaviours and presents major challenges to public health, health promotion, and clinical personnel, particularly paediatric services. Childhood diarrhoeal diseases occur commonly in other indigenous groups but have not received the attention that they deserve.

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study

“…Respiratory and infectious conditions were the most common reasons for avoidable hospitalization among all children in the cohort, with Aboriginal children more likely to be admitted for all conditions. These findings are consistent with other Australian data on common conditions resulting in pediatric emergency department presentations [ 34 ] and higher hospitalization rates for respiratory diseases [ 35 – 39 ] and gastroenteritis [ 38 , 40 – 42 ] among Aboriginal children in Western Australia. Although we were unable to ascertain the burden of these conditions outside of the hospital setting, other studies have previously reported a high burden of respiratory diseases [ 43 – 46 ], skin infections [ 47 ] and otitis media [ 48 – 50 ] in Aboriginal children, particularly in remote communities.…”

Potentially Avoidable Pediatric Hospitalizations as Defined by the Agency for Healthcare Research and Quality: What Do They Tell Us About Disparities in Child Health?

“…Significant differences in PAHs among a particular racial or insurance subgroup could indicate differences in the use of ambulatory care in community settings and provide insights into opportunities for improving the quality of primary care. 2,[17][18][19][20][21][22] …”

Tropical sprue in Far North Queensland

“…Admission rates for gastroenteritis in Australia are nearly seven times higher in Indigenous communities than in non‐Indigenous communities. Rates are also higher in regional and remote areas than in urban settings 5 . Our own analysis of hospital separation data from Queensland's northern zone for 1996–2001 shows an age‐standardised hospital separation rate for gastrointestinal infection 2.32 times higher for Indigenous patients than non‐Indigenous patients (95% CI, 2.17–2.48).…”