High burden of infectious disease and antibiotic use in early life in Australian Aboriginal communities.

ABSTRACT

OBJECTIVE: To quantify the childhood infectious disease burden and antibiotic use in the Northern Territory's East Arnhem region through synthesis and analysis of historical data resources. METHODS: We combined primary health clinic data originally reported in three separate publications stemming from the East Arnhem Healthy Skin Project (Jan-01 to Sep-07). Common statistical techniques were used to explore the prevalence of infectious conditions and the seasonality of infections, and to measure rates of antibiotic use. RESULTS: There was a high monthly prevalence of respiratory (mean 32% [95% confidence interval (CI) 20%, 34%]) and skin (mean 20% [95%CI 19%, 22%]) infectious syndromes, with upper respiratory tract infections (mean 29% [95%CI 27%, 31%]) and skin sores (mean 15% [95%CI 14%, 17%]) the most common conditions. Antibiotics were frequently prescribed with 95% (95%CI 91%, 97%) of children having received at least one antibiotic prescription by their first birthday, and 47% having received six antibiotic prescriptions; skin sores being a key driver. CONCLUSIONS: Early life infections drive high antibiotic prescribing rates in remote Aboriginal communities. Implications for public health Eliminating skin disease could reduce antibiotic use by almost 20% in children under five years of age in this population.