"Let's not talk about sex": reconsidering the public health approach to sexually transmissible infections in remote Indigenous populations in Australia

Michael S. Gracey and Randolph M. Sparg

Alcohol consumption and its correlates in a remote aboriginal population. by Ernest Hunter, Wayne Hall, and Randolph M. Spargo

During the Royal Commission into Aboriginal Deaths in Custody, alcohol consumption and its consequences was a central issue throughout those investigations

Patterns of alcohol consumption in the Kimberley Aboriginal population. by Ernest M. Hunter, Wayne D. Hall and Randolph M. Spargo

Alcohol is a major contributor to the premature death and excess morbidity among Aboriginal Australians as indicated by the high rates of Aboriginal deaths from external causes in Western Australia, the Northern Territory and New South Wales. Provided by MICAH, Canberra

Acetylation phenotype and genotype in aboriginal leprosy patients from the north-west region of western Australia

N-Acetyltransferases (NAT1, NAT2) play an important role in biotransformation of a number of drugs and carcinogens. A polymorphism in the metabolism of such compounds by NAT2 has been known for many years but it is only recently that the underlying molecular genetics has been elucidated. In the present study, we have correlated acetylation phenotype and genotype in a group of 49 Australian Aborigines (26 males and 23 females; mean age = 50.5 yr) from the Derby region of Western Australia. Phenotype was determined using caffeine and genotype by an allele-specific polymerase chain reaction. The percentages of slow and rapid phenotypes were 36.7 and 63.3%, respectively, while the distribution of alleles for the NAT2 gene was 41% for the wildtype and 2, 17 and 40% for the Ml, M2 and M3 mutations, respectively. This is the highest proportion of M3 mutations reported for any ethnic population. The observed genotype proportions were not significantly different from those predicted by the Hardy-Weinberg Law (x= 1.07, p > 0.05). Phenotype was predictable from genotype in 100% of patients. At the time of study, 29 of the Aborigines were receiving acedapsone intramuscularly for control of leprosy. Plasma dapsone concentrations in these patients were similar for both slow (n = 11) and rapid (n = 18) acetylators, suggesting that phenotype is unlikely to influence treatment outcome. The data show that Aborigines have a similar phenotype distribution to that of some Asian populations, but that there are differences in the frequencies of the Ml, M2 and M3 mutant alleles. We suggest that acetylation genotyping may be a useful tool for investigation of the anthropological links between population groups around the Asia-Pacific rim

The prevalence of hookworm infection, iron deficiency and anaemia in an Aboriginal community in north-west Australia

Hookworm infestation affects an estimated 900 million people worldwide

Predictors of Type 2 Diabetes and Diabetes-Related Hospitalisation in an Australian Aboriginal Cohort

Predictors of diabetes and diabetes-related hospitalisations were examined in 15-88-year-old Aboriginal Australians (256 women, 258 men), surveyed in 1988-1989. Linkage to death records and hospitalisations to 2002 allowed proportional hazards or negative binomial modelling. Forty-five men (18%) and 59 women (24%) developed diabetes. Risk of diabetes was predicted positively by waist girth (hazard ratio (HR) 1.08, 95% CI 1.04, 1.13), smoking (HR 2.05, 95% CI 1.23, 3.39) and eating processed meats > 4 times/month (HR 1.58, 95% CI 1.05, 2.40) and negatively by lower alcohol intake (HR 0.69, 95%CI 0.49, 0.99), preferring wine (HR 0.13,95% CI 0.02,0.97) and eating bush meats > 4 times/month (HR 0.34,95% CI 0.13,0.90). Hospitalisation was predicted positively by smoking (Incidence rate ratio (IRR) 3.72, 95% CI 1.70, 8.18) and eating processed meats (IRR 1.03, 95% CI 1.01, 1.06), and negatively by exercise > once/week (IRR 0.23, 95% CI 0.08, 0.65), eating bush meats (IRR 0.95, 95% CI 0.91, 0.99) and trimming fat from meats (IRR 0.53, 95% CI 0.30, 0.94). Length of hospital stay was predicted positively by eating processed meats (HR 1.76, 95% CI 1.23, 2.53) and added salt (HR 1.52, 95% CI 1.02, 2.26) and negatively by lower alcohol intake (HR 0.90, 95% CI 0.40, 0.92) and exercise (HR 0.66, 95% CI 0.46, 0.95). Central obesity and adverse lifestyle increase risk for diabetes or related hospitalisation among Aboriginal Australians. (c) 2007 Elsevier Ireland Ltd. All rights reserved

Alcohol use and incarceration in a police lockup among Aboriginals in the Kimberley region of Western Australia

Data from a general population survey of a stratified random sample of 516 Aboriginal men and women over the age of 1.5 years in the Kimberley region of Western Australia were used to estimate patterns of incarceration in police lockups and their relationship to self-reported alcohol consumption. Participants in the survey were asked about their lifetime experience of incarceration in police cells, and about their frequency and quantity of alcohol consumption. Estimates of the population risk of incarceration indicated that 81% of Kimberley Aboriginal men, and 37% of Kimberley Aboriginal women have been locked up in police cells. Alcohol use was strongly related to the risk of being locked up in police cells, and the risk was higher among current drinkers who were of full rather than mixed Aboriginal descent. Urgent action is required to reduce rates of incarceration in police cells among Kimberley Aboriginals. In addition to the decriminalisation of public drunkenness, action needs to be taken to reduce the prevalence of heavy alcohol use, and to improve the social and economic conditions in which Kimberley Aboriginals live