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Biomedical subjects

V Nossar

Publications and source records attributed to V Nossar.

11 recordsLinked to original sources

A population-based survey of immunization coverage in children aged 2 years and younger in New South Wales.

OBJECTIVE: To provide a population-based baseline of immunization rates in children aged 2 years and younger in New South Wales (NSW) in 1992, permitting more accurate evaluation of the efficacy of current programmes. METHODS: A cross-sectional population-based survey of 622 households from areas resident to over 73% of all children aged 4 years and younger in NSW. RESULTS: Of the 322 households with children aged 3-24 months, 212 (66%; confidence interval (CI): 57-75%) were up-to-date with the recommended immunization schedule, 68 (21%; CI: 15-27%) had not commenced any immunization, and 42 (13%; CI: 9-17%) were partially immunised. Ability to read English (odds ratio (OR): 5.43; CI: 2.37-12.44) and receipt of hepatitis B immunization (OR; 2.54; CI: 1.27-5.07%) were highly associated with up-to-date immunization; whilst a history of any illnesses, frequent doctor visits in the past 12 months (OR: 0.47; CI: 0.27-0.85%) and older age (16-24 months) (OR: 0.26; CI: 0.12-0.50%) were less likely to be associated with up-to-date immunization. CONCLUSIONS: In 1992 NSW had low levels of up-to-date immunization. Significantly, one-fifth of NSW families with children aged 3-24 months did not have a record of any immunizations. This could not be explained by delay in commencing immunization. Poor competency in reading English was strongly associated with failure to immunise, suggesting that there had been inadequate targeting of immunization campaigns in non-English-speaking communities.

Child Health Services

School screening in remote aboriginal communities--results of an evaluation.

As part of ongoing quality assurance, the effectiveness of the school screening program in meeting the health needs of Aboriginal children in a rural district in the Northern Territory Top End was evaluated. The major health problems of Aboriginal children were analysed for their suitability for screening programs. A prospective cross-sectional study used routinely collected field data from the school screening program in 1993. To ascertain follow-up, children who had failed screening tests had their clinic notes reviewed. A total of 774 children from 11 remote communities were screened. The results confirmed high level of disease, with rates for anaemia, malnutrition and trachoma reaching 39%, 22% and 26% respectively. Nearly one-third failed the hearing screening, urinalysis was abnormal in 19%, 3% failed visual acuity and 6% were considered to have abnormal heart auscultation. Many of the major health problems did not meet the recommended criteria for screening programs and others would be better dealt with by ongoing surveillance rather than a single screening. Some abnormalities found on screening were inadequately investigated and/or treated. This evaluation has demonstrated a limited role for school screening in identifying and meeting the health needs of Aboriginal children living in remote areas. In collaboration with the NT Department of Education, a school-age child health policy, including a new school-age child health surveillance program, is being developed. This promotes greater participation by communities, families and schools with the aim of improving the health and learning outcomes for all school-age children in the NT.

Adolescent

Prevalence of tuberculosis infection among primary school-entry children in Sydney.

A cross-sectional survey of 2044 Year I children enrolled in 24 primary schools was performed to determine the prevalence of tuberculosis (TB) infection. Of the 2044 children, 1458 (71 per cent) were Mantoux-tested and 1452 Mantoux reactions were read. Of the total, 6.5 per cent were Mantoux-positive; 17.8 per cent of overseas-born children and 2.8 per cent of Australian-born children were Mantoux-positive (relative risk for overseas-born 6.9, 95 per cent confidence interval 4.2 to 9.6). In the areas of Sydney where the study was conducted, there is a high prevalence of TB infection (non-contagious) among overseas-born children in the five- to seven-year age group. This indicates that there may be a large pool of infected children, a proportion of whom are at risk of developing active (contagious) adult-type TB in the future. These data, with other published data on TB infection rates in other age groups, can contribute to the estimation of the size of the infected pool in Australia to allow rational decisions regarding control of TB in Australia, including the possibility of introducing Mantoux screening and preventive therapy programs for high-risk groups.

BCG Vaccine

Retention and use of personal health records: a population-based study.

A parent-held record has been issued to all children born in New South Wales (NSW), Australia since 1988. Five years after its introduction, an evaluation was undertaken to determine its retention rate over time, rate of documentation of immunization status and other important child health information, and its perceived usefulness to parents. The cross-sectional study comprised an interviewer administered questionnaire to 622 households derived from a stratified random sample of 25 local government areas, representative of 73% of all households containing children under 5 years of age in NSW. A concurrent postal survey assessed the attitudes and use of the Personal Health Record (PHR) among a stratified random sample of 911 health care providers. Results showed that the PHR was well retained, with 89% claimed retention at 4 years, and over 78% of parents able to produce the record for inspection at interview. Of the records examined, 91% had at least one immunization recorded while 68% had a complete regimen documented by age 4 years. Overall, 93% of parents expressed satisfaction with the PHR, while 64% of all health care providers also felt that the PHR was 'beneficial to the health care children received', although only 53% of these used it regularly to record their findings. It is concluded that the PHR currently issued in NSW is well retained and valued by parents, and used by and useful to a range of health professionals.

Attitude of Health Personnel

A comparative study of the growth of South-East Asian children in south-west Sydney born in Australia and overseas.

The height and weight of two groups of South-East Asian children between the ages of 1 and 10 years living in south-west Sydney were compared to determine the effects of environment on growth and development. One group of these children was born overseas and the other in Australia. The children who were born in Australia were found to be significantly taller (1-2%) and heavier (10%) than those born overseas. This would suggest that ecological factors including health and nutrition contribute to these differences.

Asia, Southeastern

'From little things, big things grow'--a history of the development of cooperation between Aboriginal health services and the South Western Sydney Area Health Service.

Aboriginal people suffer from the worst health of any identifiable group in Australia due to profound disadvantages experienced by them since European colonisation of Australia. The Aboriginal community of south-west Sydney represents almost 25 per cent of Sydney's Aboriginal population. Since 1990 the Tharawal Aboriginal Corporation, the South Western Sydney Area Health Service and staff of the Office of Aboriginal Health (NSW Department of Health) have been cooperating to improve the health of Aboriginal people in south-west Sydney. The Working Group on Aboriginal Health has produced a Strategic Plan for Aboriginal Health in South Western Sydney. This cooperation has come from the development of trust, the identification of local needs and the elaboration of local solutions.

Community Health Services

Epidemic of acute poststreptococcal glomerulonephritis in aboriginal communities.

During 1980, an epidemic of acute glomerulonephritis occurred in a number of Aboriginal communities in the Northern Territory, affecting several hundred people. Clinical and laboratory studies of children admitted to the paediatric wards of Darwin Hospital, and of a larger number of individuals in the communities, have established that the nephritis was preceded by a streptococcal infection, and a recognised nephritogenic streptococcal strain was isolated from a number of children. The clinical course of the disease was mild in the majority of those affected and none had had serious complications. Serological results indicate the importance of measuring antideoxyribonuclease B levels as well as antistreptolysin O titres when seeking evidence of antecedent streptococcal infection.

Acute Disease