ICU study
highlights infection risk for Indigenous children

When Prime Minister Malcolm Turnbull handed down the ninth annual Closing the Gap report in February, Indigenous child mortality was among the targets ‘not on track’.

Indigenous children were still twice as likely to die before the age of five as non-Indigenous Australian children. The target set by the Council of Australian Governments (COAG) in 1998 was to halve the gap in child mortality rates by 2018.

Progress has been made – Indigenous child mortality has declined by a third since 1998 – but there has been no real improvement since 2008.

Among those who support government calls for progress to be accelerated are medical professionals caring for critically ill children.

Associate Professor Luregn Schlapbach is part of the Paediatric Critical Care Research Group at Mater Research Institute – University of Queensland, and works as a paediatric intensivist at the Lady Cilento Children’s Hospital. He is leading research on life-threatening childhood infections and inflammation in critically ill children.

Dr Luregn Schlapbach

Dr Luregn Schlapbach

Dr Schlapbach led a major study which showed Indigenous children are three times more likely to be admitted to intensive care units with life-threatening infections than non-Indigenous Australian children. The study also found that population-based mortality rates from severe infections were more than double for Indigenous children compared to their non-Indigenous counterparts.

Published in the Australian Medical Journal, the research analysed data for the 82,750 child admissions to ICUs in Australia over a 12-year period, including 4864 Indigenous children. “We focussed on the most severe infections,” Dr Schlapbach explains, “such as sepsis, pneumonia, and other invasive infections requiring life support in intensive care facilities.”

Staphylococcus aureus

Staphylococcus aureus

Children of Aboriginal and Torres Strait Islander background were seven times more likely to suffer from life-threatening Staphylococcus aureus infections – the leading cause of sepsis or septic shock in children. Sepsis and other life-threatening infections have been the focus of campaigns to improve survival for children around the world.

“The study shows that despite progress made, there remains a major difference between rates of severe infections in Indigenous and non-Indigenous children.”

“We believe this is the largest study reporting on life-threatening infections in Indigenous children, and it highlights an important area of health inequity in a high-income country that requires urgent attention.”

Dr Luregn Schlapbach

Dr Schlapbach would like to see further research to define risk factors and to develop and assess appropriately targeted interventions. “Risk factors may include those associated with social disadvantage, including overcrowded housing, poor access to clean water and sanitation, and the challenges accessing health care from remote locations. It is known that delays in initiating appropriate treatments can allow these infections to progress from mild to severe.”

The Australian Government remains hopeful of achieving its Closing the Gap target on Indigenous child mortality. It says better integration of services across health, child care, early childhood education and school will result in better access to the right services for Indigenous children.