Asthma management in indigenous children of a remote community using an indigenous health model

Objective: To describe the management of asthma in children in a remote ind igenous community and the delivery of subspecialist service through the ind igenous health-care model. Methodology: Children referred by indigenous health-care workers were evalu ated prospectively by paediatric respiratory physicians, based on a standar dized protocol, at a primary health care setting at Thursday Island, Queens land. Results: Forty of the 54 children referred with a provisional diagnosis of asthma did have asthma, with 30% having persistent asthma. Only 59% of pare nts knew the dose of the medication prescribed and 80% had minimal knowledg e of the medications. In 88% of children, the management of asthma was impr oved by introduction of an appropriate spacer device and changing the dose and type of medications. Conclusions: The management of children with asthma in the Torres region ca n be improved substantially by the use of age appropriate delivery devices and medications, and improving knowledge of asthma. Specialist delivery ser vice to remote indigenous communities can be effectively delivered in partn ership with the indigenous health service. The high proportion of persisten t asthma in the Torres Straits community in comparison to urbanised Austral ia raises issues of inequity of appropriate medical service delivery to rem ote indigenous communities.