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The epidemic of chronic kidney disease among indigenous Australians may be partly due to a preventable skin infection.
The disturbing finding comes from a study led by doctors at the Menzies School of Health Research in Darwin, Northern Territory.
Dr Andrew White and colleagues followed a group of 472 Indigenous people from remote communities for up to 18 years. All were children during two epidemics in the 1980s of a kidney disease known as post-streptococcal glomerulonephritis (PSGN), which may follow skin infections by a class of bacteria called streptococci.
Patients with PSGN usually recover within weeks and were not thought to suffer any long-term consequences. But the Darwin study found those who had PSGN during the epidemics had a three to six times greater chance of urinary abnormalities, markers for chronic renal disease later in life, compared to people who did not have PSGN.
In fact, 24% of cases of overt albuminaria -a condition characterised by a kind of protein in the urine - in the group studied were attributable to PSGN in childhood. The report is published in today's Medical Journal of Australia.
'This is alarming, particularly as the Aboriginal population has an end-stage renal failure 10 times greater than that of the non-Aboriginal population of Australia,' wrote Professor Robert Atkins, from Monash Medical Centre, in an accompanying editorial. 'It is even more distressing when we realise that streptococcal disease should theoretically be preventable, ' he said.
Since there is no simple treatment for PSGN, preventing streptococcal infections through improved economic and living conditions remains the most important control strategy.
Professor Atkins said the real tragedy was that little had changed in the 20 years since the children in the study were infected. 'Skin infections still occur in up to 70% of Aboriginal children, with the major pathogens being group A streptococci. The challenge at this time of reconciliation is to restore social equity and health to Indigenous Australians,' he said.
Source: ABC Science Online