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Paediatric urolithiasis in a remote Australian aboriginal community
W M Williams1, J J Nicholas, P B Nungurrayi
1Pintupi Homelands Health Service, Northern Territory, Australia.
Insights
Urolithiasis (kidney stones) is exceptionally common in Aboriginal children under 5 in remote Australia. High attack rates in the youngest children highlight urgent needs for improved environmental conditions and health services.
Area of Science:
- Pediatric Nephrology
- Public Health
- Indigenous Health
Background:
- Urolithiasis (kidney stones) is a recognized health issue.
- Data on pediatric urolithiasis in remote Indigenous communities are limited.
Purpose of the Study:
- To determine the incidence and associated factors of urolithiasis in Aboriginal children under 5 years in a remote Central Australian community.
Main Methods:
- Retrospective review of Community Health Service patient records.
- Analysis of data over a 4-year period for children under 5 years of age.
Main Results:
- Ten cases of urolithiasis were identified in Aboriginal children under 5.
- The highest attack rate was observed in the 0-2 age group (nearly 1 in 10 children per year).
- All affected children had significant associated morbidity; two required pyelolithotomy.
Conclusions:
- Aboriginal children in this remote arid zone community experience exceptionally high rates of urolithiasis.
- Potential contributing factors include inadequate diet, dehydration, and recurrent infectious diseases.
- Urgent improvements in environmental conditions and health service delivery are indicated.
Abstract:
A retrospective study of Community Health Service patient records revealed 10 cases of urolithiasis in Aboriginal children under 5 years of age in a remote central Australian Aboriginal community over a 4 year period, out of a total under-5 population estimate of 62. The highest attack rate was in the 0-2 age group, where nearly one in 10 children presented per year. All children had significant associated morbidity. Two children underwent pyelolithotomy. Aboriginal children in the remote arid zone study community suffer exceptionally high rates of urolithiasis. Inadequate diet, dehydration and recurrent infectious disease are factors in pathogenesis. Further study may elucidate aetiology, but the implications of these data for improving environmental conditions and health service delivery in Aboriginal communities are urgent.