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Chronic Diseases and Cancer

Chronic diseases and cancer

Chronic diseases greatly impact on the health of Aboriginal and Torres Strait Islander people – with 50 per cent having a chronic condition or disability. Conditions such as heart disease (22%), diabetes (12%) and liver disease (11%) account for 80% of the mortality gap (in terms of potential years of life lost) between Aboriginal and Torres Strait Islander and other Australians.

$2.5m cancer CRE sparked by Institute Roundtable

A Cancer Roundtable hosted by the Lowitja institute in December 2010 was the spark that led to the recent award of $2.5 million for the establishment of a new Centre of Research Excellence (CRE) focused on improving outcomes for Aboriginal and Torres Strait Islander people affected by cancer.

The CRE will be led by Associate Professor Gail Garvey, Program Leader for the Institute’s Healthy Start, Healthy Life research program and a long-time advocate for an increased research focus on issues surrounding cancer among Australia’s First Peoples.

A Cluster of Melioidosis Cases from an Endemic Region Is Clonal and Is Linked to the Water Supply Using Molecular Typing of Bukholderia Pseudomallei Isolates

Nine cases of melioidosis with four deaths occurred over a 28-month period in members of a small remote Aboriginal community in the top end of the Northern Territory of Australia. Typing by pulsed-field gel electrophoresis showed isolates of Burkholderia pseudomallei from six of the cases to be clonal and also identical to an isolate from the community water supply, but not to soil isolates. The clonality of the isolates found in this cluster contrasts with the marked genetic diversity of human and environmental isolates found in this region which is hyperendemic for B. pseudomallei.

A collaborative and international study of Bronchiectasis in Indigenous children

Aboriginal children in remote Australia have extremely high rates of pneumonia; some get better while others develop bronchiectasis (a chronic suppurative lung disease characterised by chronic wet cough). This study, which is being carried out internationally in New Zealand, Alaska and Australia, will be visiting communities in Central Australia and the Top End.

A Coordinated Healthy Skin Program for the Top End: Feasibility study report

This paper reports on the findings of the Top End Healthy Skin Feasibility Study, which ran from September to December 2000. The study found that a broad-based approach to scabies and skin health across the Northern Territory was not feasible, and that instead a region-by-region approach should be used to support existing community initiatives. It also recommended dissemination of skin disease literature to remote health services, and identified options for future research into the key skin conditions of scabies and group A streptococcal infections.

A DNA Fingerprinting System for the Ectoparasite Sarcoptes Scabiei

We describe multiple hypervariable microsatellites that will provide a highly informative genetic marker system for the sarcoptid mite Sarcoptes scabiei. Eighteen positive clones containing the highly repetitive sequence (GA)n were isolated from a partial genomic library of S. scabiei. Ten of these clones were characterised by sequencing and primers were designed from the unique sequences flanking eight microsatellite loci. Genomic DNA was subsequently extracted from individual mites and the repeat blocks were amplified by way of [?33P] ATP end-labelled polymerase chain reaction.

A Framework for Developing Standard Operating Procedures for Pre-licensure Vaccine Trials in the Northern Territory

The authors of this paper have developed a manual for those involved in preparing implementation plans for industry-sponsored paediatric vaccine trials, particularly those in the pre-licensure phases. The manual provides a framework for the development of Standard Operating Procedures for any particular trial, taking account of the core requirements of vaccine trials and the steps which must be taken through all stages of a study.

A Promoter Polymorphism in the Gene Encoding Interleukin-12 p40 (IL12B) is Associated with Mortality from Cerebral Malaria and with Reduced Nitric Oxide Production

Interleukin-12 (IL-12) is an important regulatory cytokine in infection and immunity. Administration of IL-12 may reduce complications of severe malaria in rodents. Polymorphisms in IL12B, the gene encoding the IL-12 p40 subunit, influence the secretion of IL-12 and susceptibility to Type 1 diabetes. We therefore investigated whether IL12B polymorphisms may affect the outcome of severe malaria. Homozygosity for a polymorphism in the IL12B promoter was associated with increased mortality in Tanzanian children having cerebral malaria but not in Kenyan children with severe malaria.

A Regional Initiative to Reduce Skin Infections amongst Aboriginal Children Living in Remote Communities of the Northern Territory, Australia

Background: Linked to extreme rates of chronic heart and kidney disease, pyoderma is endemic amongst Aboriginal children in Australia’s Northern Territory (NT). Many of those with pyoderma will also have scabies. We report the results of a  community-based collaboration within the East Arnhem Region, which aimed to reduce the prevalence of both skin infections in Aboriginal children.

A Report on the Feasibility Study of the Proposed NT Pneumococcal Vaccine Trial

This report describes the findings of a feasibility study for a proposed pneumococcal conjugate vaccine trial in the Northern Territory. The study was conducted between February and September 2000. At its conclusion, the Cooperative Research Centre for Aboriginal & Tropical Health (CRCATH) agreed to support a trial proceeding in three regions in the Northern Territory. An agreement was reached with the sponsor, SmithKline Beecham Biologicals (SB), for funding of a preparatory phase.

A Review of Polymorphisms in the Human Gene for Inducible Nitric Oxide Synthase (NOS2) in Patients with Malaria

Significant variability exists in host responses to malaria in different human populations. These epidemiological data have prompted a search for genetic variations that determine host responses to malaria. This review focuses on polymorphisms in the promoter region of inducible nitric oxide synthase (NOS2) as a source of genetic differences in the response of patients to infection with malaria. Nitric oxide (NO), a lipid soluble free radical, mediates host resistance to infectious organisms including parasites. NO is produced by three different NO synthases (NOS) in humans.

A Review of Psychosocial Stress and Chronic Disease for 4th World Indigenous Peoples and African Americans

Public health literature indicates that psychosocial stress is an important contributor to chronic disease development. However, there is scant research on the health effects of stress for minority groups, who suffer from a high burden of chronic disease. This paper provides a review of studies that examine the relationship between psychosocial stress and chronic disease for 4th world indigenous groups and African Americans. A total of 50 associational and 15 intervention studies fit the inclusion criteria for this review.

A Scabies Mite Serpin Interferes with Complement-Mediated Neutrophil Functions and Promotes Staphylococcal Growth

Scabies is an infectious skin disease caused by the mite Sarcoptes scabiei and has been classified as one of the six most prevalent epidermal parasitic skin diseases infecting populations living in poverty by the World Health Organisation. The role of the complement system, a pivotal component of human innate immunity, as an important defence against invading pathogens has been well documented and many parasites have an arsenal of anti-complement defences.

A structured systems approach to improving health promotion practice for chronic disease in Indigenous communities

This research explores the feasibility of quality improvement methods for health promotion by investigating the impact of a continuous quality improvement intervention, similar to the model used in the ABCD (Audit and Best Practice for Chronic Disease) Project. While the ABCD Project has a clinical focus, this research will develop and test a number of tools and a range of strategies relevant to quality improvement for health promotion.

ABCD (Audit and Best Practice for Chronic Disease)

This continuous quality improvement (CQI) project aims to enhance health outcomes by assisting Indigenous primary health care centres to improve their systems for delivery of best practice care.

ABCDE project achievements

A final report on the work and outcomes of the Audit and Best Practice in Chronic Disease (ABCD) Extension project is about to be published, providing a comprehensive analysis of one of the most significant research efforts ever undertaken by our predecessor, the CRC for Aboriginal Health.

The report will be disseminated to participating health centres, government agencies and Lowitja Institute stakeholders, and will shortly be available for download from our website, along with a Policy Brief summarising the report’s key findings.

Aboriginal Health Workers and Diabetes Care in Remote Community Health Centres: A mixed method analysis

Objective: To assess the effect of employing Aboriginal health workers (AHWs) on delivery of diabetes care in remote community health centres, and to identify barriers related to AHWs involvement in diabetes and other chronic illness care. Design, setting and participants: Three-year follow-up study of 137Aboriginal people with type 2diabetes in seven remote community health centres in the Northern Territory.

Aboriginal Health: Time to listen

I clearly remember what a strong impression the first edition of Binan Goonj. Bridging cultures in Aboriginal health made on me at the outset of my career in Indigenous health research. This second edition retains much of the balanced and erudite style of the feted first edition. With Binan Goonj meaning hearing but not listening, cross-cultural communication is the raison d'etre of this book.

Aboriginal smoking rates down but Govt target a tough ask

A recently published paper has confirmed earlier findings that smoking rates among Aboriginal and Torres Strait Islander people are in decline, but says that the rate of decline will need to increase substantially if the Federal Government’s goal of halving smoking prevalence among Aboriginal and Torres Strait Islander Australians by 2018 is to be achieved.

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