National Guide

Chapter 6 | Child health

Childhood kidney disease







National Guide to preventive healthcare for Aboriginal and <br/>Torres Strait Islander people
Download PDF
      3. Childhood kidney disease

Child health | Childhood kidney disease

Prof Hasantha Gunasekera 

Key messages

  • The high prevalence and risk of chronic kidney disease (CKD) in Aboriginal and Torres Strait Islander populations is explained by the impact of colonisation, systemic racism and social determinants of health, and is not intrinsic to being Aboriginal and Torres Strait Islander.1–6
  • Addressing these determinants, including housing improvements, ensuring food security and creating better access to culturally safe healthcare, is key to preventing CKD in this population.6–10
  • To be effective, strategies to prevent CKD need to be led by Aboriginal and Torres Strait Islander people.1,11
  • Primary care has a key role in optimising maternal health and in the early identification and treatment of risk factors for CKD throughout the life course.1,11
  • There is no evidence to recommend routine urinalysis and blood pressure screening in children,12 except where a child has a high-risk condition such as overweight and obesity, diabetes, congenital heart disease, low birth weight or a strong family history of CKD.13,14
Type of preventive activity - Screening
Who/target population What When Strength of recommendation Key source(s) and reference(s) Rationale/key considerations informing recommendation
All children without a high-risk condition Do not routinely screen children for kidney disease using urinalysis or blood pressure measurement N/A Strong Aboriginal and Torres Strait Islander-specific specific single study2
International guideline15		 No evidence of benefit
Children with a high-risk condition: obesity, congenital heart disease, strong family history of CKD and history of low birth weight

For children with diabetes, see below		 Routine urinalysis and blood pressure surveillance is recommended Opportunistically Good practice point International guideline16 Low risk and potential benefit
Children with asymptomatic proteinuria Do not routinely investigate with renal ultrasound N/A Strong National and international guidelines17,18 Asymptomatic proteinuria is often transient
Children living in communities with a high prevalence of skin infections (scabies and impetigo) Check skin for scabies and impetigo, and treat according to management guidelines (see Useful resources) Opportunistically Good practice point Jurisdictional and national guidelines19,21 Low risk and potential benefit
Children with first episode of urinary tract infection (UTI) Assess the need for imaging tests based on treatment response within 48 hours and whether sepsis, atypical organism, poor urinary stream, abdominal mass or renal impairment are present As clinically indicated Conditional National and international guidelines17,18 Requires targeted approach based on clinical indications to avoid over investigation
Children with type 1 and type 2 diabetes Check the albumin to creatinine ratio using single voided specimen; morning specimen preferred

Abnormal screening tests should be repeated because microalbuminuria may be transient

Check blood pressure annually		 At age 10 years or at puberty (whichever is earlier), after two to five years diabetes duration, then annually thereafter Strong National and international guidelines13,14 Standard management for early detection of diabetes-related kidney disease
Type of preventive activity - Behavioural
Who/target population What When Strength of recommendation Key source(s) and reference(s) Rationale/key considerations informing recommendation
Children who have had one or more UTIs Identify and address predisposing factors for recurrence (including constipation, dysfunctional voiding, poor fluid intake and delays in voiding) As clinically indicated Strong International guidelines18 Low risk and potential benefit
Children living in communities with a high prevalence of skin infections (scabies and impetigo) Recommend access to community swimming pools Opportunistically Conditional Systematic review20 Some evidence of benefit
Type of preventive activity - Medication
Who/target population What When Strength of recommendation Key source(s) and reference(s) Rationale/key considerations informing recommendation
Children with UTI Treat as per guidelines (see Box 1) As clinically indicated Strong National guideline17 As per guidelines
Household contacts of children with scabies Treat with 5% permethrin cream if aged ˃2 months, and sulfur 5% or crotamiton cream if aged <2 months As clinically indicated Conditional National guideline21 As per guidelines
Children with recurrent UTIs Do not routinely recommend probiotic therapy or cranberry products for the prevention of recurrent UTIs N/A Strong Systematic reviews22,23 Insufficient evidence of health benefit
Children living in communities with a high prevalence of skin infections (scabies and impetigo) Community-based interventions that use screening and immediate treatment of skin sores and scabies in targeted age groups may be combined with simultaneous treatment of the whole community or scabies (see Useful resources) As required Conditional Aboriginal and Torres Strait Islander-specific national and jurisdictional guidelines19,21 Community-wide treatment requires consultation and agreement with the community, health service and public health unit
Type of preventive activity - Environmental
Who/target population What When Strength of recommendation Key source(s) and reference(s) Rationale/key considerations informing recommendation
Health services and practices in settings where environmental and living conditions have a strong contribution (environmental attribution) to communicable disease transmission, including skin infections, and other conditions such as mental health issues Know about diseases with a high environmental attribution

Develop a safe clinical relationship in order to ask sensitively about housing and living conditions (inadequate housing facilities, access to health hardware such as working plumbing for clean drinking water and washing facilities, access to hygiene and sanitation supplies)

Know about local arrangements for environmental health referral

Offer an environmental health referral according to local arrangements, ensuring consent is obtained when a home visit is involved

Advocate with Aboriginal and Torres Strait Islander leaders for adequate housing, facilities for washing and general living conditions

Provide community-based health promotion about environmentally attributable diseases

Check local guidelines		 Opportunistically, in response to any diagnosis or condition with an environmental attribution and as part of general healthcare Good practice point International and Aboriginal and Torres Strait Islander-specific narrative reviews24,25 Household crowding and quality of housing and environments exacerbate conditions promoting communicable disease transmission, including COVID-19, Group A streptococcus infections, otitis media, trachoma, tuberculosis and other respiratory tract infections

Aboriginal and Torres Strait Islander peoples have long recognised the links between human health, animal health and the environment; general practitioners can advocate for environmental living conditions and housing equity
 

Box 1. Acute management of children with urinary tract infection/pyelonephritisA,B (CARI guidelines17)
Child with asymptomatic bacteriuria (ie bacterial growth in urine with no symptoms)
  • No treatment is required17,18,22
Child with presumed UTI (ie symptoms and positive leucocytes and/or nitrites on urinalysis)
  • Low risk (not septic, can tolerate oral medications)
Age No pyelonephritis (eg cystitis) Pyelonephritis (fever >38oC with loin pain/tenderness)
<1 month Intravenous antibiotics Intravenous antibiotics
≥1 month Oral antibiotics for 2–4 days Oral antibiotics for 7–10 days
  • High risk (septic, dehydrated or cannot tolerate oral medications)
Age No pyelonephritis Pyelonephritis (fever >38oC with loin pain/tenderness)
All ages Intravenous antibiotics Intravenous antibiotics
AThe National Institute for Heath and Care Excellence guidelines18 are very similar but use an age cut-off of three months rather than one month and include referral to a paediatrician.
BThe American Academy of Paediatrics guidelines22 are similar but use an age cut-off of two months and recommend a minimum seven-day antibiotic course for all children with a urinary tract infection (UTI).

Background

Aboriginal and Torres Strait Islander adults have a much higher rate of CKD than other Australians.1 There is insufficient evidence to recommend population-level primary prevention programs among children at this stage. Since the publication of the previous version of these guidelines, there have been no large-scale studies investigating primary or secondary screening strategies for Aboriginal and Torres Strait Islander populations, despite the high and disproportionate burden of adult CKD.

However, analysis of 20 Aboriginal and Torres Strait Islander communities across Australia showed the likelihood of low glomerular filtration rate was associated (ie more likely) with lower socioeconomic status (lowest versus highest age/gender adjusted odds ratio 3.2; 95% confidence interval [CI] 1.3–8.2).2 Age-standardised disability-adjusted life years (DALY) lost for CKD increased between 2003 and 2018 (from 11 to 13 DALY per 1000 people) with a rate ratio of 6.3 between Aboriginal and Torres Strait Islander and non-Indigenous Australians.3 However, it is not clear at what age range we should target prevention programs. Aboriginal primary school-aged children from across New South Wales (NSW) had the same prevalence of persistent CKD risk factors (haematuria, proteinuria, obesity and hypertension [systolic or diastolic]) as non-Aboriginal children.4 Of the children with CKD in Australia, 3% are Aboriginal, consistent with their population proportion,1 although there is a risk of under-reporting bias. The increased burden of CKD may start in young adulthood because proteinuria has been found to be more common in Aboriginal people aged ˃20 years than in those aged 5–19 years.5

CKD prevention strategies may need to commence from pregnancy, even if risk factor prevalence is not evident until adulthood. The fetal origins of adult disease hypothesis would suggest screening for, and addressing, pre/periconception and in utero influences causing low birthweight, which is itself associated with fewer nephrons at birth (due to in utero epigenetic mechanisms).28 In a study based in Townsville, among normally grown premature (<32 weeks gestation) neonates, when they reached term, despite comparable weights at that time, Aboriginal and Torres Strait Islander neonates had smaller total renal volumes.29 There was no significant difference in the estimated glomerular filtration rate (eGFR). The authors surmised this may be due to hyperfiltration, which would increase the risk of CKD later in life. In an autopsy study, at risk of selection bias, Aboriginal people from a remote community setting had fewer nephrons and glomeruli than non-Aboriginal people, particularly when there was a history of hypertension, consistent with increased CKD risk.30 Subsequent insults (eg streptococcal infections and UTIs) would then increase the vulnerability to postnatal renal injury.31 The major determinants of end-stage kidney disease (ESKD) in Aboriginal and Torres Strait Islander adults continue to be cardiovascular disease (13% prevalence), diabetes (11% prevalence) and obesity (37% prevalence),6 all of which are strongly associated with social determinants, so the best solution would be to address those determinants rather than specific renal screening.

Risk factors for CKD seen in children, such as haematuria and proteinuria, are often transient,3,7,32 other than the persistent microalbuminuria seen among pre-pubertal- and pubertal-onset childhood diabetes.13,14 Baseline CKD risk factors are frequent in both Aboriginal and Torres Strait Islander and non-Indigenous primary school-aged children, although there is evidence that, at a single test, Aboriginal and Torres Strait Islander children have a greater risk of haematuria than non-Indigenous Australian children.3 Higher rates of transient haematuria may reflect the higher incidence of acute post-streptococcal glomerulonephritis (APSGN).3,7,32 A recent review of APSGN notifications in the NT from 2009 to 2016 reported 19-fold higher rates among Aboriginal than non-Aboriginal people (95% CI 11–33), with a heavy skew towards children (median age eight years; range 0–62 years).33 In some remote Aboriginal and Torres Strait Islander communities, children who had APSGN had a six-fold greater risk of developing renal disease as adults.19 However, in general, children appear to fully recover from APSGN. Although the link between APSGN and CKD could be associative, rather than causative, it would be sensible to adopt strategies to prevent APSGN. This requires addressing social determinants such as housing, health infrastructure (water and sanitation), food security and better accessibility to universal healthcare, although specific data on how best to do this are lacking.

Although tertiary prevention of ESKD is one of the goals of UTI investigation and management, epidemiological data suggest only a very small association between UTI and ESKD. This association is probably not causal,34 and there has been no significant decrease in ESKD attributable to pyelonephritic scarring/reflux nephropathy since more aggressive UTI investigation and treatment in the 1960s.35

In summary, despite the very large burden of CKD among Aboriginal and Torres Strait Islander adults, data on how best to prevent CKD through primordial prevention strategies addressing social determinants, and primary or secondary screening in the childhood age range, are lacking.

Every which way you look at renal disease in Aboriginal people, the only solutions that will work in the long term are those that are Aboriginal-led, culturally responsive, located in Aboriginal organisations and evaluated through an Aboriginal lens.

Pat Turner CEO, National Aboriginal Community Controlled Health Organisations11

Immunisation

There are no immunisations for the causative agents in UTIs or skin infections. This also includes no vaccines for Group A streptococcus, which causes APSGN and rheumatic heart disease.

Screening

Observational study data suggest the prevention and treatment of skin infection prevent APSGN, so children with skin sores, and their household contacts, should be given targeted treatment with antiscabies medication and benzathine penicillin.36 However, population-level recommendations for children in communities with a high prevalence of skin conditions are less clear. Regular community-based programs may be useful to screen and treat all children in a target age group (eg ages 0–3 years) for both scabies and infected sores.19 Simultaneous treatment of the whole community to remove scabies (a common precursor to streptococcal skin infection), followed by regular ongoing surveillance and treatment of scabies and skin sores (at least three times per year), may prevent streptococcal skin infections.19 Community-wide treatment requires consultation and agreement between the community, health service and public health unit. These interventions reduce skin sores, scabies and APSGN,19,36,37 and it would be reasonable to assume this could reduce CKD, but data are lacking. A small study with low response rates from six remote Aboriginal communities across the NT found a willingness to adopt the No Germs On Me television health promotion recommendations, but only if the cost barriers were addressed.38 The findings are interesting, but studies are needed that directly examine health outcomes and are designed and delivered within each community.38

Single estimations of urinary blood and protein in children vary according to posture, illness, exercise and time of day. Screening urinalysis is costly to the community, may result in physical and psychological costs to the patients and their families and is prone to misinterpretation. Therefore, population-level urinalysis screening is not recommended for children.12

Similarly, there is no high-quality evidence to recommend routine blood pressure screening of Aboriginal children specifically to prevent CKD. However, blood pressure measurement is often part of a general health check and, if done, there are published gender-, age- and height-specific normal values for systolic blood pressure among children in the US (see Useful resources). Given the high rates of CKD and high rates of hypertension among Aboriginal children from urban settings in Australia, particularly when their parents had hypertension,39 family-based health promotion strategies are likely to be beneficial. Examples of such programs for child health outcomes generally, rather than specifically for kidney disease, include the Strong Mother Strong Baby programs and Aboriginal and Torres Strait Islander home visiting programs.40 Although kidney outcomes were not measured and evidence quality was low/moderate, a recent systematic review found family-centred primary care interventions had various benefits for Aboriginal and Torres Strait Islander children, including increased birthweights, reduced obesity, improved home safety and increased immunisation and primary screening rates.40

Behavioural

The CARI guidelines currently recommend screening for ‘red flags’ of CKD among children and young people aged <18 years.1 These red flags include:

  • family history of CKD
  • clinical history of diabetes
  • hypertension
  • obesity
  • smoking
  • cardiovascular disease
  • acute kidney injury
  • past history of low birth weight
  • recurrent childhood infections.

This could be most children in some communities. The recommendation is also to consider socioeconomic and housing status, education level and setting (remote, regional or urban) and to undertake a kidney health check (blood pressure, eGFR and urine albumin to creatinine ratio) if concerned. Although the lack of evidence meant the certainty was very low, it would be reasonable to include these elements in any history taking during health checks and address modifiable determinants among the other health and social priorities for the family.

Medications, probiotics and surgery

There are no data to support the use of renin–angiotensin–aldosterone inhibitors in the primary care setting to prevent CKD.

There is lack of certainty regarding the usefulness of routine antibiotic prophylaxis following the first UTI. A large double-blind placebo-controlled trial found a modest 6% reduction in febrile UTI after one year of prophylactic daily co-trimoxazole and that children with vesicoureteric reflux (VUR) were no more likely to benefit from prophylactic antibiotics than those without VUR.41 Guidelines from CARI, the National Institute for Health and Care Excellence in the UK (NICE) and the American Academy of Paediatrics currently do not recommend using prophylactic antibiotics after the first UTI.17,18,22 Prophylactic antibiotics remain an option for recurrent and complicated UTI. Asymptomatic bacteriuria in infants and children should not be treated with prophylactic antibiotics.17,18,22

There is no current evidence to support the use of cranberry juice22,23 or probiotics to prevent UTIs.42 Circumcision reduces the risk of UTI in boys,43 but is associated with some risk and so is not recommended routinely to prevent UTIs.17 CARI guidelines recommend circumcision in boys with recurrent UTI or high-grade VUR (Grade 2C).17 CARI guidelines do not recommend surgical correction of VUR to prevent UTI.17

Environmental

There is evidence inadequate housing facilities and overcrowding enhance the risk of skin, ear, respiratory and gastrointestinal infections among Aboriginal children.8,9 The NSW Housing for Health program was a collaborative effort between Aboriginal community groups, land councils and NSW Health to upgrade essential housing needs for healthy living. People who received assistance from the Housing for Health program had a 38% reduction in hospitalisations for infections (skin, gut, respiratory and otitis media) in 2008 compared with 1998, whereas there was a 3% increase over the same time period for people with no Housing for Health assistance.10 A study from Bangladesh found that poor-quality housing and a lack of electricity were associated with scabies.44 A reduction in the prevalence of skin sores in Aboriginal children has been reported in several pre–post studies as a beneficial effect of swimming pools and may be due to cleaning of the skin.20 Although these are infection-related outcomes, it is likely improvements in water, sanitation, housing and overcrowding would also lead to improved kidney health outcomes. A qualitative examination in a remote setting found Aboriginal community members were aware of the link between hygiene, infections and later kidney disease,45 but formal evaluations of interventions were lacking.

Community-based programs

CARI guidelines do not currently recommend specific screening for children to prevent CKD, but they do recommend early detection with adult CKD screening programs for Aboriginal and Torres Strait Islander people that are community controlled, co-designed with the community, and use an integrated multidisciplinary approach.1

  1. Tunnicliffe DJ, Bateman S, Arnold-Chamney M, et al. Recommendations for culturally safe clinical kidney care for First Nations Australians: A guideline summary. Med J Aust 2023;219(8):374–85. doi: 10.5694/mja2.52114.
  2. Ritte RE, Lawton P, Hughes JT, et al. Chronic kidney disease and socio-economic status: A cross sectional study. Ethn Health 2020;25(1):93–109. doi: 10.1080/13557858.2017.1395814.
  3. Australian Institute of Health and Welfare (AIHW). Australian burden of disease study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018. AIHW, 2022 [Accessed 26 April 2024].
  4. Haysom L, Williams R, Hodson EM, et al. Natural history of chronic kidney disease in Australian Indigenous and non-Indigenous children: A 4-year population-based follow-up study. Med J Aust 2009;190(6):303–06. doi: 10.5694/j.1326-5377.2009.tb02417.x.
  5. Singh GR, White AV, Hoy WE. Renal ultrasound findings in an Australian Aboriginal population with high rates of renal disease. Nephrology (Carlton) 2005;10(4):358–61. doi: 10.1111/j.1440-1797.2005.00432.x.
  6. Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples: 2015. AIHW, 2015 [Accessed 26 April 2024].
  7. Haysom L, Williams R, Hodson E, Roy LP, Lyle D, Craig JC. Early chronic kidney disease in Aboriginal and non-Aboriginal Australian children: Remoteness, socioeconomic disadvantage or race? Kidney Int 2007;71(8):787–94. doi: 10.1038/sj.ki.5002099.
  8. Couzos S, Murray R. Aboriginal primary health care: An evidence-based approach. Oxford University Press, 2008.
  9. Quinn EK, Massey PD, Speare R. Communicable diseases in rural and remote Australia: The need for improved understanding and action. Rural Remote Health 2015;15(3):3371. doi: 10.22605/RRH3371.
  10. NSW Health. Closing the gap: 10 years of Housing for Health in NSW. NSW Health, 2010 [Accessed 26 April 2024].
  11. National Indigenous Kidney Transplantation Taskforce. Cultural bias initiatives to improve kidney transplantation for Aboriginal and Torres Strait Islander people. Policy brief. National Indigenous Kidney Transplantation Taskforce, 2020 [Accessed 30 April 2024]
  12. Wilkinson J, Bass C, Diem S, et al. Preventative services for children and adolescents. Institute for Clinical Systems and Improvement, 2013 [Accessed 17 May 2024].
  13. Bjornstad P, Dart A, Donaghue KC, et al. ISPAD clinical practice consensus guidelines 2022: Microvascular and macrovascular complications in children and adolescents with diabetes. Pediatr Diabetes 2022;23(8):1432–50. doi: 10.1111/pedi.13444.
  14. Caring for Australians with Renal Impairment (CARI) Steering Committee. Proteinuria – CARI guidelines. Aust Fam Physician 2005;34(11):942–43.
  15. Moyer VA; U.S. Preventive Services Task Force. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Pediatrics 2013;132(5):907–14. doi: 10.1542/peds.2013-2864.
  16. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140(3):e20171904. doi: 10.1542/peds.2017-1904.
  17. McTaggart S, Danchin M, Ditchfield M, et al. KHA-CARI guideline: Diagnosis and treatment of urinary tract infection in children. Nephrology (Carlton) 2015;20(2):55–60. doi: 10.1111/nep.12349.
  18. National Institute for Health Care and Excellence (NICE). Urinary tract infections in under 16s: Diagnosis and management. NICE, 2022 [Accessed 26 April 2024].
  19. Centre for Disease Control. Healthy skin program: Guidelines for community control of scabies, skin scores, tinea and crusted scabies in the Northern Territory. Northern Territory Department of Health, 2015. Available
  20. Hendrickx D, Stephen A, Lehmann D, et al. A systematic review of the evidence that swimming pools improve health and wellbeing in remote Aboriginal communities in Australia. Aust N Z J Public Health 2016;40(1):30–36. doi: 10.1111/1753-6405.12433.
  21. The Australian Healthy Skin Consortium. National healthy skin guideline: For the diagnosis, treatment and prevention of skin infections for Aboriginal and Torres Strait Islander children and communities in Australia. 2nd edn. Telethon Kids Institute, 2023 [Accessed 26 April 2024].
  22. Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021;147(2):e2020012138. doi: 10.1542/peds.2020-012138.
  23. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD001321. doi: 10.1002/14651858.CD001321.pub5.
  24. McMullen C, Eastwood A, Ward J. Environmental attributable fractions in remote Australia: The potential of a new approach for local public health action. Aust N Z J Public Health 2016;40(2):174–80. doi: 10.1111/1753-6405.12425.
  25. Prüss-Üstün A, Corvalán CF. Preventing disease through healthy environments: Towards an estimate of the environmental burden of disease. World Health Organization, 2006 [Accessed 25 April 2024].
  26. Communicable Disease Network Australia (CDNA). Trachoma: CDNA national guidelines for the public health management of trachoma. CDNA, 2014 [Accessed 26 April 2024].
  27. Warren JM, Birrell AL. Trachoma in remote Indigenous Australia: A review and public health perspective. Aust N Z J Public Health 2016;40(Suppl 1):S48–52. doi: 10.1111/1753-6405.12396.
  28. Boubred F, Saint-Faust M, Buffat C, Ligi I, Grandvuillemin I, Simeoni U. Developmental origins of chronic renal disease: An integrative hypothesis. Int J Nephrol 2013;2013:346067. doi: 10.1155/2013/346067.
  29. Kandasamy Y, Rudd D, Lumbers ER, Smith R. Female preterm indigenous Australian infants have lower renal volumes than males: A predisposing factor for end-stage renal disease? Nephrology (Carlton) 2019;24(9):933–37. doi: 10.1111/nep.13520.
  30. Hoy WE, Hughson MD, Singh GR, Douglas-Denton R, Bertram JF. Reduced nephron number and glomerulomegaly in Australian Aborigines: A group at high risk for renal disease and hypertension. Kidney Int 2006;70(1):104–10. doi: 10.1038/sj.ki.5000397.
  31. Newsome AD, Davis GK, Ojeda NB, Alexander BT. Complications during pregnancy and fetal development: Implications for the occurrence of chronic kidney disease. Expert Rev Cardiovasc Ther 2017;15(3):211–20. doi: 10.1080/14779072.2017.1294066.
  32. Haysom L, Williams R, Hodson E, et al. Risk of CKD in Australian Indigenous and Nonindigenous children: A population-based cohort study. Am J Kidney Dis 2009;53(2):229–37. doi: 10.1053/j.ajkd.2008.08.004.
  33. Chaturvedi S, Boyd R, Krause V. Acute post-streptococcal glomerulonephritis in the Northern Territory of Australia: A Review of data from 2009 to 2016 and comparison with the literature. Am J Trop Med Hyg 2018;99(6):1643–48. doi: 10.4269/ajtmh.18-0093.
  34. Craig JC, Williams GJ. Denominators do matter: It’s a myth – urinary tract infection does not cause chronic kidney disease. Pediatrics 2011;128(5):984–85. doi: 10.1542/peds.2011-2631.
  35. Craig JC, Irwig LM, Knight JF, Roy LP. Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy? Pediatrics 2000;105(6):1236–41. doi: 10.1542/peds.105.6.1236.
  36. Widaty S, Miranda E, Cornain EF, Rizky LA. Scabies: Update on treatment and efforts for prevention and control in highly endemic settings. J Infect Dev Ctries 2022;16(2):244–51. doi: 10.3855/jidc.15222.
  37. Johnston F, Carapetis J, Patel MS, Wallace T, Spillane P. Evaluating the use of penicillin to control outbreaks of acute poststreptococcal glomerulonephritis. Pediatr Infect Dis J 1999;18(4):327–32. doi: 10.1097/00006454-199904000-00003.
  38. McDonald E, Cunningham T, Slavin N. Evaluating a handwashing with soap program in Australian remote Aboriginal communities: A pre and post intervention study design. BMC Public Health 2015;15(1):1188. doi: 10.1186/s12889-015-2503-x.
  39. Larkins N, Teixeira-Pinto A, Banks E, et al. Blood pressure among Australian Aboriginal children. J Hypertens 2017;35(9):1801–07. doi: 10.1097/HJH.0000000000001401.
  40. McCalman J, Heyeres M, Campbell S, et al. Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: A systematic scoping review. BMC Pregnancy Childbirth 2017;17(1):71. doi: 10.1186/s12884-017-1247-2.
  41. Craig JC, Simpson JM, Williams GJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med 2009;361(18):1748–59. doi: 10.1056/NEJMoa0902295.
  42. Schwenger EM, Tejani AM, Loewen PS. Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev 2015;2015(12):CD008772. doi: 10.1002/14651858.CD008772.pub2.
  43. Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: A systematic review of randomised trials and observational studies. Arch Dis Child 2005;90(8):853–58. doi: 10.1136/adc.2004.049353.
  44. Stanton B, Khanam S, Nazrul H, Nurani S, Khair T. Scabies in urban Bangladesh. J Trop Med Hyg 1987;90(5):219–26.
  45. Hall NL. Australian Indigenous remote communities & water, sanitation & hygiene. Water e-journal 2018;3(2):014 [Accessed 26 April 2024]




 

Advertising