Mathematical Modelling Of Bacterial Carriage In Children
Funder
National Health and Medical Research Council
Funding Amount
$421,746.00
Summary
Children exposed to larger numbers of other children are at risk of persistent bacterial infections. Such circumstances explain the high rates of ear and chest infections, and skin sores seen in children in historical times. Changing social circumstances (smaller families, better housing, nutrition and hygiene), as well as the introduction of antibiotics, explain the decline of such infections in affluent communities since the early 20th century. However, even today, in affluent countries, child ....Children exposed to larger numbers of other children are at risk of persistent bacterial infections. Such circumstances explain the high rates of ear and chest infections, and skin sores seen in children in historical times. Changing social circumstances (smaller families, better housing, nutrition and hygiene), as well as the introduction of antibiotics, explain the decline of such infections in affluent communities since the early 20th century. However, even today, in affluent countries, children attending group child care are at high risk of ear infections. As many bacteria are resistant, antibiotics are now much less effective than when they were first introduced. Furthermore, there is a continuing load of infection for children in Aboriginal communities, in PNG and other developing countries, causing hearing loss, chronic respiratory problems, and heart disease and renal disease in later life. Using data previously collected from other studies in Indigenous communities and children in child care, mathematical models allow us to ask what if?, and answer important public health questions: 1. What environmental and public health measures can reduce the cycle of cross-infection in child-care and high-risk populations? 2. What coverage rates with pneumococcal vaccine will eliminate the vaccine-specific bacteria from child care centres, from the wider community, and from high risk populations? 3. Will infections with bacteria not covered by vaccine then increase? 4. Will the resistant bacteria tend to disappear if antibiotic use is restricted? 5. Under what circumstances will antibiotics help to control infection? The modelling will promote understanding of the social and health costs of bacterial infection in Aboriginal communities and child care and use educational scenarios to promote uptake of the most cost-effective and socially acceptable interventions.Read moreRead less
CENTRE OF RESEARCH EXCELLENCE TO REDUCE INEQUALITY IN HEART DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$2,607,253.00
Summary
There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health ....There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health care services.Read moreRead less
A National Population-based Study Of Rheumatic Heart Disease In Pregnancy
Funder
National Health and Medical Research Council
Funding Amount
$877,826.00
Summary
Whilst overall a rare disease, Indigenous peoples have disproportionately high rates of rheumatic heart disease (RHD). This study explores the prevalence and distribution of RHD in pregnancy in Australia and New Zealand. It details current management, diagnostic and referral process and risk factors. Key attributes of culturally safe models of care for RHD in pregnancy are explored, particularly as they relate to Indigenous women. Findings will inform policy, guidelines and education resources.
Diseases caused by the pneumococcus represent the largest cause of vaccine preventable death in the world today, mainly pneumonia and meningitis. In 2011, 16 developing countries will introduce pneumococcal conjugate vaccines, none in east Asia. Lack of research has been a major barrier to their use in the region. We have established an international centre of excellence in the field and we seek support to extend the capacity of this group and to transfer the technology to Vietnam.
The Management To Optimise Diabetes And MEtabolic Syndrome Risk Reduction Via Nurse-led Intervention (MODERN) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,445,861.00
Summary
There is increasing recognition of society’s responsibility to provide effective and sustainable health care to the entire population and not just selected parts. This practical study will test the impact of a nurse-led, multidisciplinary prevention program to reduce the risk of future cardiovascular events in middle-aged individuals at a high risk of developing cardiovascular disease (CVD) living in regional Australia.
Improving Delivery Of Secondary Prophylaxis For Rheumatic Heart Disease: A Stepped-wedge, Community-randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,913,074.00
Summary
Rheumatic heart disease (RHD) is a major health problem in Indigenous communities. Continued progress in controlling RHD requires an understanding of how to improve delivery of regular injections of penicillin - secondary prophylaxis (SP). We will evaluate a systems-based approach to improving delivery of SP, using a stepped-wedge trial in 12 communities in NT and Qld. If successful, this model will provide a practical and transferable model.
Evaluating The Genetic Contribution To Rheumatic Heart Disease Pathogenesis In Australian Aboriginal And Torres Strait Islander Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,782,074.00
Summary
Rheumatic heart disease is highly prevalent in Aboriginal people in Australia and leads to early cardiac disease. Despite decades of research, the underlying genetic mechanisms for why it occurs are not well understood. We are conducting a genetic study to better understand why some people are susceptible to RHD and others are not. The study will involve substantial Aboriginal leadership and consultation and will be a model for the conduct of genetic studies in Aboriginal populations.
A New Model For The Pathogenesis Of Rheumatic Fever: Superantigen Priming Of The Immune Response To Group A Streptococci
Funder
National Health and Medical Research Council
Funding Amount
$248,820.00
Summary
Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, c ....Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, control of this ARF will partly depend on new and better treatment and prevention strategies. To achieve these goals a deeper understanding of the immune mechanisms underlying this disease is urgently needed. It is known that ARF is caused by an abnormal immune response following streptococcal infection. This leads to the production of cells called T cells that attack the body s own tissues rather than the bacteria itself. This autoimmune disease is responsible for the heart damage that underlies ARF. It is believed that this proces only occurs when susceptible individuals are infected with specific rheumatogenic strains of streptococci. However there are a number of deficiencies in this model and it is proposed that there is an additional factor responsible for the abnormal immune response in ARF. This project will explore the possibility that bacterial toxins called superantigens are the critical missing factor , by studying the immune response in ARF. Superantigens are produced by certain streptococci and staphylococci, and are potent in minute quantities causing widespread activation of the immune system. They have been found to play an important role in a number of autoimmune diseases and the type of immune response found in ARF fits well with that expected if superantigens were involved. If superantigens play an important role in causing the abnormal immune response in ARF then a number of new avenues would open for the treatment and prevention of this disease.Read moreRead less
Enabling three dimensional stochastic geological modelling. This project aims to develop technologies to mitigate three dimensional (3D) geological risk in resources management. This project expects to create new knowledge and methods in the field of 3D geological modelling through the innovative application of mathematical methods, structural geology concepts and probabilistic programming. The expected outcomes are an enhanced capability to model the subsurface, characterise model uncertainty a ....Enabling three dimensional stochastic geological modelling. This project aims to develop technologies to mitigate three dimensional (3D) geological risk in resources management. This project expects to create new knowledge and methods in the field of 3D geological modelling through the innovative application of mathematical methods, structural geology concepts and probabilistic programming. The expected outcomes are an enhanced capability to model the subsurface, characterise model uncertainty and test multiple geological scenarios. This enhanced capability is important for the future of Australia's subsurface management, including urban geology and our continuously growing sustainable resources industry.Read moreRead less
Can Skin Infection With Group A Streptococcus Cause Acute Rheumatic Fever?
Funder
National Health and Medical Research Council
Funding Amount
$459,450.00
Summary
It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of ....It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of the cause of ARF, and have important implications for prevention of ARF around the world. Presently, these approaches focus on diagnosing and treating sore throat, but no country has proven that such a program can be successful in substantially reducing new cases of ARF. If it was known that skin infection could lead to ARF, then countries (including Australia) could emphasise the importance of skin health programs. A further benefit of this knowledge would be to influence GAS vaccine development, which presently is largely focused on the prevention of sore throat. A different possibility has recently been raised - that the cause of ARF may not always be GAS, but instead that the related bacteria GCS and GGS may have the potential to cause this disease. Proof of this hypothesis would even more dramatically alter our understanding of disease causation, prevention, and vaccine development. We propose to determine the cause of ARF in Aboriginal communities by regularly swabbing families of people with a history of ARF, and using genetic fingerprinting of the bacteria from the skin and throat swabs. When cases of ARF occur, we will be able to determine the site and type of infection that precipitated the attack. We will conduct a related study in more communities, in which we will swab family members of people with ARF and of control families (without ARF) to determine the bacteria most commonly isolated from ARF families.Read moreRead less