{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:17:01Z","timestamp":1778761021697,"version":"3.51.4"},"reference-count":47,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,6,12]]},"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We hypothesise that rising prevalence rates of non-communicable diseases (NCDs) increase infection risk and worsen outcomes among socially disadvantaged Indigenous Australians undergoing a rapid epidemiological transition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Available pathology, imaging and discharge morbidity codes were retrospectively reviewed for a period of 5\u2005years prior to admission with a bloodstream infection (BSI), 1 January 2003 to 30 June 2007.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>558 Indigenous and 55 non-Indigenous community residents of central Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>The effects of NCDs on risk of infection and death were determined after stratifying by ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean annual BSI incidence rates were far higher among Indigenous residents (Indigenous, 937\/100\u2005000; non-Indigenous, 64\/100\u2005000 person-years; IRR=14.6; 95% CI 14.61 to 14.65, p&lt;0.001). Indigenous patients were also more likely to have previous bacterial infections (68.7% vs 34.6%; respectively, p&lt;0.001), diabetes (44.3% vs 20%; p&lt;0.001), harmful alcohol consumption (37% vs 12.7%; p&lt;0.001) and other communicable diseases (human T-lymphotropic virus type 1, 45.2%; strongyloidiasis, 36.1%; hepatitis B virus, 12.9%). Among Indigenous patients, diabetes increased the odds of current<jats:italic>Staphylococcus aureus<\/jats:italic>BSI (OR=1.6, 95% CI 1.0 to 2.5) and prior skin infections (adjusted OR=2.1, 95% CI 1.4 to 3.3). Harmful alcohol consumption increased the odds of current<jats:italic>Streptococcus pneumoniae<\/jats:italic>BSI (OR=1.57, 95% CI 1.02 to 2.40) and of previous BSI (OR=1.7, 95% CI 1.1 to 2.5), skin infection (OR=1.7, 95% CI 1.1 to 2.6) or pneumonia (OR=4.3, 95% CI 2.8 to 6.7). Twenty-six per cent of Indigenous patients died at a mean (SD) age of 47\u00b115\u2005years. Complications of diabetes and harmful alcohol consumption predicted 28-day mortality (non-rheumatic heart disease, HR=2.9; 95% CI 1.4 to 6.2; chronic renal failure, HR=2.6, 95%CI 1.0 to 6.5; chronic liver disease, HR=3.3, 95% CI 1.6 to 6.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a socially disadvantaged population undergoing a rapid epidemiological transition, NCDs are associated with an increased risk of infection and BSI-related mortality. Complex interactions between communicable diseases and NCDs demand an integrated approach to management, which must include the empowerment of affected populations to promote behavioural change.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003070","type":"journal-article","created":{"date-parts":[[2013,7,20]],"date-time":"2013-07-20T00:20:37Z","timestamp":1374279637000},"page":"e003070","source":"Crossref","is-referenced-by-count":24,"title":["Non-communicable diseases, infection and survival in a retrospective cohort of Indigenous and non-Indigenous adults in central Australia"],"prefix":"10.1136","volume":"3","author":[{"given":"Lloyd","family":"Einsiedel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liselle","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheela","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J","family":"Woodman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,7,18]]},"reference":[{"key":"2024051504491336000_3.7.e003070.1","doi-asserted-by":"publisher","DOI":"10.2307\/3349375"},{"key":"2024051504491336000_3.7.e003070.2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.077891"},{"key":"2024051504491336000_3.7.e003070.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60914-4"},{"key":"2024051504491336000_3.7.e003070.4","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/4.1.29"},{"key":"2024051504491336000_3.7.e003070.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00172-1"},{"key":"2024051504491336000_3.7.e003070.6","unstructured":"United Nations. 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