Hasantha Gunasekera

The epidemiology of health conditions of newly arrived refugee children: A review of patients attending a specialist health clinic in Sydney

Aim:  To determine the prevalence of common diseases in newly arrived refugee children, resettled in Sydney, by region of birth. To identify health needs of refugee children in Australia.

The spectrum and management of otitis media in Australian indigenous and nonindigenous children: a national study.

Background: Indigenous children have the highest reported prevalence and severity of otitis media in the world, but whether their clinical management varies accordingly is unknown. Methods: Using a representative Australia-wide cluster survey of consecutive primary healthcare consultations, we compared practitioners’ investigation, treatment, and referral practices for otitis media in indigenous and nonindigenous children (0–18 years), after adjusting for clustering. Results: Over 8 years (1998–2006), 7991 practitioners managed 141,693 problems during 119,503 consultations with children, including 2856 (2%) with indigenous children. Ear problems were the fourth most common problems managed overall, with otitis media seen more commonly in indigenous than in nonindigenous children (10% versus 7% consultations, P < 0.001). Indigenous children were significantly more likely to have severe otitis media (chronic and/or suppurative and/or perforation, 8% versus 2%, P < 0.001); discharging ears (4% versus 0.1%, P < 0.001); ear swabs [4%, 95% confidence interval (CI): 2%–6% versus 0.8%, 95% CI: 0.6%–0.9%]; and topical eardrops administered (11%, 95% CI: 7%–15% versus 5%, 95% CI: 4%–5%); but not more likely to receive oral antibiotics (72% versus 76%); have ear syringing (1% versus 0.2%); be referred to an otolaryngologist (6% versus 3%) or audiologist (2% versus 1%); all P > 0.05. Conclusions: In the Australian primary healthcare setting, indigenous children are 5 times more likely to be diagnosed with severe otitis media than nonindigenous children, but reported management is not substantially different, which is inconsistent with established national guidelines. This spectrum-management discordance may contribute to continued worse outcomes for indigenous children with otitis media.

Vitamin D and tuberculosis status in refugee children

Vitamin D deficiency and tuberculosis (TB) are associated in adults, but data in children are scarce. We screened refugee children routinely for vitamin D status and TB. Vitamin D values were significantly lower in latent TB (n = 81) and TB infection (n = 11) than in children without TB (n = 236). We conclude that refugee children with TB have reduced vitamin D levels.

Management of children with otitis media: a summary of evidence from recent systematic reviews.

Health‐care professionals who manage children are regularly confronted with clinical questions regarding the management of the full spectrum of otitis media: acute otitis media; otitis media with effusion; and chronic suppurative otitis media. Given the variety of potential therapies available, the wide spectrum of middle ear disorders, and the lack of consensus about management strategies, clinicians are in a difficult position when managing these children. In this review, we seek to summarise the current best evidence for answering otitis media management questions by collating existing systematic reviews.

Training in general paediatrics: Is it time for change?

Objective:  To determine current Australian general paediatricians perceptions regarding the adequacy of their training particularly in the new morbidity (NM) area (developmental, behavioural and psychosocial). To ascertain if there is a perceived need to change training in this area, the level of support for change and to canvass opinion on how to achieve change.

Otitis media in Aboriginal children: the discordance between burden of illness and access to services in rural/remote and urban Australia.

Objective:  To compare the burden of otitis media (OM) managed by Aboriginal Medical Service (AMS) practitioners and the availability of specialist ear health services in rural/remote versus urban Australian settings.

Management of children with otitis media: A survey of Australian Aboriginal Medical Service practitioners

Aim:  To determine whether Australian Aboriginal Medical Service (AMS) practitioners treat otitis media (OM) more aggressively in Aboriginal than non‐Aboriginal children and the factors influencing their management decisions.

Safety and efficacy of blood glucose management practices at a diabetes camp

Aim:  Camps are an important part of diabetic management in children yet data on the safety and efficacy of camps are limited. We assessed the safety and efficacy of blood glucose management guidelines at summer camps for diabetic children.

Perspective: ‘The forgotten children: National inquiry into children in immigration detention (2014)’

Perspective: ‘The forgotten children: National inquiry into children in immigration detention (2014)’ Georgia Paxton, Shidan Tosif, Hamish Graham, Andrea Smith, Colette Reveley, Jane Standish, Kate McCloskey, Grant Ferguson, David Isaacs, Hasantha Gunasekera, Ben Marais, Philip Britton, Ameneh Khatami, Karen Zwi, Shanti Raman, Elizabeth Elliott, David Levitt, Joshua Francis, Paul Bauert, Peter Morris, Annie Whybourne, Sarah Cherian, Raewyn Mutch, David Forbes, David Rutherford and Suzanne Packer

Australia's treatment of refugee and asylum seeker children: the views of Australian paediatricians

Objective: Australias response to refugees and people seeking asylum is a matter of national debate. We sought to determine the knowledge and attitudes of paediatricians about refugee and asylum seeker issues (both onshore and offshore).