Transplacental transfer of RSV antibody in Australian First Nations infants.

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infection hospitalisations in Aboriginal infants specifically those aged <6 months. Maternally derived RSV antibody (Ab) can protect against severe RSV disease in infancy. However, the efficiency of transplacental transfer of maternal anti-RSV Ab remains unknown in Aboriginal infants. We characterised RSV Ab in Australian First Nations mother-infant pairs (n = 78). We investigated impact of covariates including low birthweight, gestational age (GA), sex of the baby, maternal age and multiparity of the mother on cord to maternal anti-RSV Ab titre ratio (CMTR) using multivariable logistic regression model. All (n = 78) but one infant was born full term (median GA: 39 weeks, interquartile range: 38-40 weeks) and 56% were males. The mean log2 RSV Ab titre was 10.7 (SD± 1.3) in maternal serum and 11.0 (SD ± 1.3) in cord serum at birth; a ratio of 1.02 (SD ± 0.06). One-third of the pairs had a CMTR of <1 indicating impaired transfer. Almost 9% (7/78) of the term infants had cord RSV Ab levels below

Health status and health service use of urban Aboriginal children attending an Aboriginal community child health service in Sydney.

AIM: There is limited information on the health status of urban Australian Aboriginal children and young people attending community-based child health services. Such information is vital to plan appropriate services. The objective of the study is to describe the health status and service use of children and young people presenting to an urban Aboriginal Community Paediatric Service in Sydney, Australia. METHODS: Cross-sectional analysis of routinely collected data extracted from electronic medical records and the Australian Immunisation Register for urban Aboriginal children and young people aged 0-18 years who visited the service between January 2013 and December 2017. RESULTS: A total of 273 Aboriginal children and young people had 609 occasions of service. Almost all (97.35%) were fully immunised. Forty-six percent of occasions of service noted >3 diagnoses; 55% of the consultations were for mental health and behavioural disorders. The most frequent diagnoses were speech and language delay, attention deficit hyperactivity disorder and school difficulty. Psychosocial concerns were noted in 61.2% of occasions of service, and 19.4% of children had a history of prematurity. Eighty-five percent of consultations had an onward referral to additional services. The most common referrals were for audiology, ear-nose and throat specialists and speech therapy. There were low numbers of referrals to mental health services relative to the high number of mental health diagnoses. CONCLUSION: It is essential that we address the mental, developmental and psychosocial needs of Aboriginal children and young people who attend urban Community Child Health services. Integrated service models should be developed in partnership with Aboriginal community to do this.

Demographic and clinical characteristics of hospitalised unintentional poisoning in Aboriginal and non-Aboriginal preschool children in New South Wales, Australia: a population data linkage study.

OBJECTIVES: To investigate differences in demographic and clinical characteristics of Aboriginal and non-Aboriginal children aged 0-4 years hospitalised for unintentional poisoning in New South Wales (NSW), Australia. DESIGN AND SETTING: Retrospective whole-of-population cohort analysis of linked hospital and mortality data for 2000-2014. PARTICIPANTS: All children (Aboriginal and non-Aboriginal) under the age of 5 years who were born in a hospital in NSW from 2000 to 2009. OUTCOMES: The primary outcome was hospitalisation for unintentional poisoning. Logistic regression was used to estimate odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children. Poisoning agents and clinical outcomes were compared by Aboriginality. RESULTS: The cohort included 767 119 children, including 28 528 (3.7%) Aboriginal children. Aboriginal children had approximately three times higher rates of hospitalised poisoning (1.34%) compared with non-Aboriginal children (0.41%). Poisoning incidence peaked at 2-3 years of age. Male sex, socioeconomic disadvantage and geographical remoteness were associated with higher odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children, but associations with disadvantage and remoteness were statistically significant only for non-Aboriginal children. Most (83%) poisonings were caused by pharmaceutical agents. Few Aboriginal and non-Aboriginal children had repeat admissions for poisoning; most had a length of stay of 1 day or less. Only 8% of poisoning admissions involved contact with a social worker. CONCLUSION: Commonly used medications in the general population contribute to poisonings among both Aboriginal and non-Aboriginal preschool-aged children. This study highlights a need to develop culturally safe poisoning prevention strategies and policies.