Shu Qin Li

Cause of death in patients with end-stage renal disease: assessing concordance of death certificates with registry reports.

Objectives:To assess concordance in reporting, in two Australian national datasets, of cause of death of patients with end‐stage renal disease (ESRD).

Dementia prevalence and incidence among the Indigenous and non-Indigenous populations of the Northern Territory.

Objective: To estimate the prevalence and incidence of dementia in Northern Territory Indigenous and non‐Indigenous populations.

Does relative remoteness affect chronic disease outcomes? Geographic variation in chronic disease mortality in Australia, 2002–2006

Objective: To examine the variation of chronic disease mortality by remoteness areas of Australia, including states and territories.

Renal-related deaths in Australia 1997−1999

Abstract

Trends in chronic disease mortality in the Northern Territory Aboriginal population, 1997-2004: using underlying and multiple causes of death

Objective: To assess trends in chronic disease mortality in the Aboriginal population of the Northern Territory (NT), using both underlying and multiple causes of death.

The end of the Australia antigen? An ecological study of the impact of universal newborn hepatitis B vaccination two decades on

BACKGROUND A universal newborn hepatitis B (HBV) vaccination program was introduced in the Northern Territory of Australia in 1990, followed by a school-based catch-up program. We evaluated the prevalence of hepatitis B infection in birthing women up to 20 years after vaccination and compared this to women born before the programs commenced. METHODS A cohort of birthing mothers was defined from Northern Territory public hospital birth records between 2005 and 2010 and linked to laboratory confirmed notifications of chronic HBV, based principally on a record of hepatitis B surface antigen detection. Prevalence of HBV was compared between women born before or after implementation of the newborn and catch-up vaccination programs. FINDINGS Among 10797 birthing mothers, 138 (1.3%) linked to a chronic HBV record. HBV prevalence was substantially higher in Aboriginal women compared to non-Indigenous women (2.4% versus 0.04%; p<0.001). Among 5678 Aboriginal women, those eligible for catch-up and newborn HBV vaccination programs had a significantly lower HBV prevalence than older women born prior to the programs: HBV prevalence respectively 2.2% versus 3.5%, (OR 0.61, 95%CI 0.43-0.88) and 0.8% versus 3.5% (OR 0.21, 95%CI 0.11-0.43). This represents a risk reduction of respectively 40% and 80% compared to unvaccinated women. INTERPRETATION The progressively greater reduction in the prevalence of chronic HBV in adult Aboriginal women co-inciding with eligibility for catch-up and newborn vaccination programs is consistent with a significant impact from both programs. The use of data derived from antenatal screening to track ongoing vaccine impact is applicable to a range of settings globally.

Avoidable mortality trends in Aboriginal and non‐Aboriginal populations in the Northern Territory, 1985‐2004

Objectives: To analyse rates of avoidable mortality in Aboriginal and non‐Aboriginal residents of the Northern Territory (NT) from 1985 to 2004, in order to assess the contribution of health care to life expectancy improvements.

Impact of perinatal health and socio-demographic factors on school education outcomes: A population study of Indigenous and non-Indigenous children in the Northern Territory

This study investigated the association between early‐life risk factors and school education outcomes.

Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population

Background Indigenous populations globally are disproportionately affected by chronic hepatitis B virus (HBV) infection however contemporary sero-prevalence data are often absent. In the Indigenous population of the Northern Territory (NT) of Australia the unique C4 sub-genotype of HBV universally circulates. There are no studies of the sero-prevalence, nor the impact of the vaccination program (which has a serotype mismatch compared to C4), at a population-wide level. Methods We examined all available HBV serology results obtained from the three main laboratories serving NT residents between 1991 and 2011. Data were linked with a NT government database to determine Indigenous status and the most recent test results for each individual were extracted as a cross-sectional database including 88,112 unique individuals. The primary aim was to obtain a contemporary estimate of HBsAg positivity for the NT by Indigenous status. Results Based on all tests from 2007–2011 (35,633 individuals), hepatitis B surface antigen (HBsAg) positivity was 3·40% (95%CI 3·19–3·61), being higher in Indigenous (6·08%[5·65%-6·53%]) than non-Indigenous (1·56%[1·38%-1·76%]) Australians, p<0·0001. Birth cohort analysis showed HBsAg positivity fell over time for Indigenous people, with this decrease commencing prior to universal infant vaccination (which commenced in 1990), with an ongoing but slower rate of decline since 1990, (0·23% decrease per year versus 0·17%). Conclusions HBsAg positivity is high in the NT, particularly in the Indigenous population. HBsAg positivity has fallen over time but a substantial part of this decrease is due to factors other than the universal vaccination program.

Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: The DRUID follow-up study

To assess the relationships of diabetes and albuminuria with all‐cause mortality and cardiovascular disease outcomes in a population without prior cardiovascular disease using data from the Darwin Region Urban Indigenous Diabetes (DRUID) study.