A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
Evaluation Of The Effectiveness Of Mobile Preschool For Child Health And Development In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$456,369.00
Summary
This project is a retrospective study of the effectiveness of the NT Mobile Preschool Program using assessment data for children's emergent literacy, social and emotional competencies and health status. Effectiveness will be established by comparison with achievement and health status data for children not attending preschool and those in communities with no preschool service. The study will identify and describe the key factors influencing the health and learning outcomes of the three groups.
A Study To Investigate Alternative Regimens For Pneumococcal Vaccination Of Infants In A Developing Country
Funder
National Health and Medical Research Council
Funding Amount
$1,622,210.00
Summary
Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver thi ....Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver this vaccine, which are safe and effective. A recent WHO-GAVI meeting to address impediments to the introduction of these vaccines in developing countries recognized the need to evaluate other regimens of Pnc conjugate vaccine as an important research priority. This study has been deliberately formulated with that need in mind. The site for this research is Fiji. Although health services are good, Pnc disease, particularly pneumonia, remains the commonest cause of childhood morbidity and mortality. Fiji has good vaccine coverage and was the first Pacific country to introduce Hib vaccine. The arrival of the new, expensive Pnc conjugate vaccine presents a dilemma for Fiji and many similar countries. The expense of this vaccine would consume a large portion of the health budget. This study has two components: 1. A Phase 2 immunogenicity study (involving 750 infants) to evaluate regimens using reduced numbers of doses of Pnc conjugate vaccine, and using timing of dosing and combinations with the Pnc polysaccharide (PS) vaccine that may be more suited to the epidemiology of Pnc disease in developing countries. 2. An epidemiological study will measure the burden of invasive Pnc disease and pneumonia in Fiji. This will be part of a global effort to address these issues, and will be used to develop rapid assessment tools for these diseases in developing countries. We will seek cofounding for this component.Read moreRead less
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster
Funder
National Health and Medical Research Council
Funding Amount
$2,651,687.00
Summary
This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
Community Foundations of Resilience of Young People. Understanding and promoting resilience in young people is one of the most important health priorities of the Federal Government. The proposed project advances resilience research in a new direction. It is highly innovative in bringing together a research team from disciplines and professional knowledge domains that generally do not inform each other, to fill the conceptual gap in current knowledge around care, control and social resilience usi ....Community Foundations of Resilience of Young People. Understanding and promoting resilience in young people is one of the most important health priorities of the Federal Government. The proposed project advances resilience research in a new direction. It is highly innovative in bringing together a research team from disciplines and professional knowledge domains that generally do not inform each other, to fill the conceptual gap in current knowledge around care, control and social resilience using an applied community development project and a methodology of engagement with young people, to bring about social change.Read moreRead less
A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. Th ....A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. The findings will inform effective multidisciplinary collaboration and service integration, address service gaps and duplication and lead to increased access to services. This study will generate new knowledge about characteristics of organisations, service delivery and professions that facilitate or hinder innovation.Read moreRead less
Modelling the Causes of Regional Disparities across Australia. This project aims to explain the changing patterns of regional economic performance across Australia between 2001-2011 in the context of two developments: major structural shifts in world trade and commodity prices spawning massive mining growth and negative exchange rate impacts elsewhere (for example, manufacturing); and the financial crisis ending the credit boom leaving east coast economies struggling. The resulting regional disp ....Modelling the Causes of Regional Disparities across Australia. This project aims to explain the changing patterns of regional economic performance across Australia between 2001-2011 in the context of two developments: major structural shifts in world trade and commodity prices spawning massive mining growth and negative exchange rate impacts elsewhere (for example, manufacturing); and the financial crisis ending the credit boom leaving east coast economies struggling. The resulting regional disparities have policy implications for education and skills training, housing affordability, infrastructure provision, and community sustainability. These issues will be investigated using a new functional economic regions geography and state of art spatial modelling tools supplemented by regional case studies.Read moreRead less
Impact Of An Ivermectin Mass Drug Administration Program Against Endemic Scabies And Strongyloidiasis
Funder
National Health and Medical Research Council
Funding Amount
$1,289,786.00
Summary
Overseas studies suggest sustainable and long term benefits can be obtained through the use of ivermectin in mass drug administration programs to control parasitic infections. Our study will be a critical first step in establishing if such a program can be successful in a remote Indigenous community setting, where the disease burden from scabies and strongyloidiasis (threadworm infections) is very high.
Telling it like it is: Aboriginal perspectives on Aborigines, Euro-Australians and race relations. This project will make an important contribution to reconciliation by identifying Aboriginal views on how to improve race relations in Australia. By challenging stereotypes and analysing Aboriginal perspectives, this project will provide a robust evidence base for effective service provision.