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Skin infections in children in a New Zealand primary care setting: exploring beneath the tip of the iceberg

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Authors:
Summary:

This article describes the epidemiology of childhood skin infections presenting to primary care in the Tairawhiti (Gisborne) region, compared to hospitalised cases during the same period. The 9 participating general practitioners recorded 110 incident cases of skin infections in 0–14 year old children over a 10-week period in 2008, equivalent to an annual incidence rate of 106.7 (95% CI, 85.2 to 127.2) cases per 1000 children in the region. For every one hospitalisation there were an estimated 14 primary care cases. Three-quarters of skin infections in both primary care and hospital settings occurred in Māori children. Hospitalised cases of serious skin infections were more likely to occur in the preschool age group whereas the majority of cases at the primary care level consisted of children aged 5–9 years.

Comment:
Skin infections are one of the most common causes for hospitalisation in Aotearoa; across all age groups (although more a paediatric problem, it is also common in adults); and particularly an issue for Māori. As shown in these 3 studies, skin infections often follow skin injury, frequently recur for some people, are associated with overcrowding and deprivation; and are contagious. As a result of this work, a number of interventions or strategies are being developed. These include a health literacy resource by MoH, health promotion messages for radio and television and reviewing/treating the whole whānau rather than the individual. Wider determinants will also require focussed effort.
Reference: N Z Med J. 2012;125(1351):70-9.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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