Date of Award

2009

Degree Type

Thesis

Degree Name

Bachelor of Science Honours

School

School of Psychology and Social Sciences

Faculty

Faculty of Computing, Health and Science

First Advisor

Dr Sonya Girdler

Second Advisor

Jenny Bourke

Abstract

Background: Children with Down syndrome experience an array of medical conditions and health care problems. Although there have been vast improvements in the medical management of these conditions, they still significantly impact on quality of life for families and children with Down syndrome. However, despite the magnitude of this problem limited literature has described the overall health status of children with Down syndrome. Aim: The purpose of this review was to describe the medical conditions commonly experienced by children with Down syndrome and to consider the clinical implications of this knowledge. Methods: Databases Medline, CINHAL and PsychINFO were electronically searched to identify relevant articles from 1990 to 2009. Inclusion criteria were children aged 18 years or younger with a diagnosis of Down syndrome, who had one or more medical comorbidity. Articles were excluded at the title or abstract level if they were not peer reviewed, English articles, or did not meet the inclusion criteria. A narrative review of this research was possible. Results: Common medical conditions experienced by children with Down syndrome include: cardiac and gastrointestinal disorders, musculoskeletal disorders, respiratory problems, eye and visual defects, ear and hearing impairments, frequent episodic illnesses and infections, and a greater risk of leukaemia and thyroid conditions. Prevalence estimates for these conditions varied depending on the diagnostic criteria or study methodologies. Conclusion: Knowledge of the high levels of co-morbidities experienced by children with Down syndrome will lead to the development of more effective interventions for teachers and health care professionals, and also assist in the provision and resource allocation of disability services. Background: Children with Down syndrome commonly experience a variety of medical conditions and health care problems. Although vast improvements in the medical management of these conditions has occurred, changes in the overall health status of children with Down syndrome over time, is yet to be explored. Furthermore, research is limited which examines service utilisation for children with Down syndrome or the impact of socio-demographic factors on access to services. Aim: To compare the prevalences of parent reported medical conditions, and use of services, by school aged children with Down syndrome in Western Australia between 1997 and 2004. In addition this study aims to describe the impact of socio-demographic factors on medical service utilisation in 2004. Methods: This study involved the comparison of two cross sectional surveys completed by parents of children with Down syndrome in 1997 and 2004. The surveys collected information of family demographics, medical conditions, health issues and service utilisation. Frequency distributions were used to describe medical conditions in 2004 and formal tests of association were based on chi-square tests. Regression analyses were used to compare medical conditions and service use between the 1997 and 2004 cohorts. Results: Children with Down syndrome in 2004 had significantly greater odds of having a bowel condition than children in 1997 (OR 1.68, 95% CI 1.16 - 2.45). In 2004 children had approximately 50% less likelihood of having a current problem due to their cardiac condition (OR 0.52, 95% CI 0.28-1.00). An overall reduction in the incidence rates of episodic illnesses and infections was seen in 2004. The use of GP services (IRR=0.91, 95% CI 0.83, -1.00) and combined medical specialist visits (IRR=0.92, 95% CI 0.84- 1.01) were reduced in 2004. Overnight hospital admissions (IRR 0.60, 95% CI 0.37 - 0.96) and length of stay (IRR 0.33 95% CI 0.24- 0.44) were also reduced in 2004. Conclusion: The health status of children with Down syndrome has varied over time. Most importantly, children in 2004 experienced a significant reduction in current cardiac problems and episodic illnesses that may contribute to improvements in overall health and impact quality of life. In addition, children with Down syndrome are using less medical services in 2004. These findings have implications for parents, health professionals and in the provision and resource allocation of disability services in Western Australia.

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