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Effect of swimming pools on antibiotic use and clinic attendance for infections in two Aboriginal communities in Western Australia

Desiree T Silva, Deborah Lehmann, Mary T Tennant, Peter Jacoby, Helen Wright and Fiona J Stanley
Med J Aust 2008; 188 (10): 594-598.

Summary

Objective: To determine whether installation of swimming pools in remote Aboriginal communities reduces infection-related outpatient attendances and prescription of antibiotics.

Design and setting: Swimming pools were opened in Jigalong and Mugarinya, Western Australia, in September 2000. We examined local clinic records to document illnesses occurring in children and adolescents under 17 years of age between 1998 and 2005. In Jigalong, we examined records of those enrolled in an ongoing study evaluating the effect of swimming pools on health. In Mugarinya, we examined clinic records of those residing there permanently.

Main outcome measures: Clinic attendance rates for skin, middle-ear and respiratory tract infections and trauma, and prescription rates for antibiotics were analysed by using a community-based selection method in Jigalong, and a clinic-based selection method in both communities for comparison of the two communities and the two methods.

Results: We examined records of 131 children in Jigalong and 128 children in Mugarinya. After the pools had been installed, clinic attendance rates for skin infections declined by 68% in Jigalong and by up to 77% in Mugarinya. In Jigalong (where the pre-pool prevalence of infections was higher than in Mugarinya), rates of antibiotic prescription declined by 45%, as did clinic attendance for middle-ear infections (61% reduction) and respiratory tract infections (52% reduction).

Conclusion: Swimming pools in remote communities are associated with reduced prevalence of skin infections. Where disease prevalence is high, pools are also associated with reduced rates of antibiotic prescriptions and middle-ear and respiratory tract infections. In communities with resident health staff, examination of clinic records is an efficient method of monitoring the effects of public health interventions on the burden of infectious diseases.

  • Desiree T Silva1
  • Deborah Lehmann1
  • Mary T Tennant1
  • Peter Jacoby1
  • Helen Wright2
  • Fiona J Stanley1

  • 1 Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA.
  • 2 Rural Clinical School of Western Australia, University of Western Australia, Kalgoorlie, WA.

Correspondence: desiree.silva@bigpond.com

Acknowledgements: 

We thank Helen Wright and Jenny Smith for assistance with data extraction from the notes and data entry, and Kirsten Alpers for editorial assistance. We thank the nursing and medical staff at Jigalong and Mugarinya and Kylie Carville for assisting us in obtaining the clinic records. This study was funded by the Western Australian Department of Housing and Works and the Western Australian Health Promotion Foundation (Healthway). Peter Jacoby and Deborah Lehmann are funded through National Health and Medical Council program grant 353514.

Competing interests:

None identified.

  • 1. Anderson I, Crengle S, Kamaka ML, et al. Indigenous health in Australia, New Zealand, and the Pacific. Lancet 2006; 367: 1775-1785.
  • 2. Carville K, Lehmann D, Hall G, et al. Infection is the major component of the disease burden in Aboriginal and non-Aboriginal Australian children. Pediatr Infect Dis J 2007; 26: 210-216.
  • 3. Freemantle CJ, Read AW, de Klerk NH, et al. Patterns, trends, and increasing disparities in mortality for Aboriginal and non-Aboriginal infants born in Western Australia, 1980–2001: population database study. Lancet 2006; 367: 1758-1766.
  • 4. Reid J, Trompf P, editors. The health of Aboriginal Australia. Sydney: Harcourt Brace Jovanovich, 1991.
  • 5. Currie BJ, Carapetis JR. Skin infections and infestations in Aboriginal communities in northern Australia. Australas J Dermatol 2000; 41: 139-145.
  • 6. Lehmann D, Tennant MT, Silva DT, et al. Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study. BMJ 2003; 327: 415-419.
  • 7. Morris PS, Leach AJ, Silberberg P, et al. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMC Pediatr 2005; 5: 27.
  • 8. Turnidge JD, Bell JM, Collignon PJ. Rapidly emerging antimicrobial resistances in Streptococcus pneumoniae in Australia. Pneumococcal Study Group. Med J Aust 1999; 170: 152-155.
  • 9. Trewin D. Population distribution, Aboriginal and Torres Strait Islander Australians, 2001. Canberra: Australian Bureau of Statistics, 2002. (ABS Cat. No. 4705.0.) http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/85AB4A6668629B77CA256BE400026A25/$File/47050_2001.pdf (accessed Dec 2007).
  • 10. van Asperen IA, de Rover CM, Schijven JF, et al. Risk of otitis externa after swimming in recreational fresh water lakes containing Pseudomonas aeruginosa. BMJ 1995; 311: 1407-1410.
  • 11. van Balen FA, Smit WM, Zuithoff NP, Verheij TJ. Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial. BMJ 2003; 327: 1201-1205.
  • 12. McKenzie GA, Carapetis JR, Leach AJ, et al. Pneumococcal vaccination and otitis media in Australian Aboriginal infants [abstract PO 1210]. 5th International Symposium on Pneumococci and Pneumococcal Diseases; 2006 Apr 2–6; Alice Springs.
  • 13. Grimwood K, Collignon PJ, Currie BJ, et al. Antibiotic management of pneumococcal infections in an era of increased resistance. J Paediatr Child Health 1997; 33: 287-295.
  • 14. Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005; 366: 155-168.
  • 15. Steer AC, Danchin MH, Carapetis JR. Group A streptococcal infections in children. J Paediatr Child Health 2007; 43: 203-213.
  • 16. Streeton CL, Hanna JN, Messer RD, Merianos A. An epidemic of acute post-streptococcal glomerulonephritis among aboriginal children. J Paediatr Child Health 1995; 31: 245-248.
  • 17. Carapetis JR, Currie BJ, Kaplan EL. Epidemiology and prevention of group A streptococcal infections: acute respiratory tract infections, skin infections, and their sequelae at the close of the twentieth century. Clin Infect Dis 1999; 28: 205-210.
  • 18. Carapetis JR, Currie BJ. Clinical epidemiology of rheumatic fever and rheumatic heart disease in tropical Australia. Adv Exp Med Biol 1997; 418: 233-236.
  • 19. Taylor J. Short-term Indigenous population mobility and service delivery. CAEPR discussion paper 118. Canberra: Centre for Aboriginal Economic Policy Research, Australian National University, 1996.

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