Asthma management in indigenous children of a remote community using an indigenous health model

Abstract

Objective: To describe the management of asthma in children in a remote indigenous community and the delivery of subspecialist service through the indigenous health-care model. Methodology: Children referred by indigenous health-care workers were evaluated prospectively by paediatric respiratory physicians, based on a standardized protocol, at a primary health care setting at Thursday Island, Queensland. Results: Forty of the 54 children referred with a provisional diagnosis of asthma did have asthma, with 30% having persistent asthma. Only 59% of parents knew the dose of the medication prescribed and 80% had minimal knowledge of the medications. In 88% of children, the management of asthma was improved by introduction of an appropriate spacer device and changing the dose and type of medications. Conclusions: The management of children with asthma in the Torres region can be improved substantially by the use of age appropriate delivery devices and medications, and improving knowledge of asthma. Specialist delivery service to remote indigenous communities can be effectively delivered in partnership with the indigenous health service. The high proportion of persistent asthma in the Torres Straits community in comparison to urbanised Australia raises issues of inequity of appropriate medical service delivery to remote indigenous communities.