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
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
Centre For Research Excellence In Malaria Elimination
Funder
National Health and Medical Research Council
Funding Amount
$2,470,291.00
Summary
The CRE will work to accelerate progress towards malaria elimination in our region, through Surveillance, to develop better ways to monitor malaria transmission and discover who is infected, and to track movement of malaria parasites and spread of drug resistance. Diagnosis, to develop and test new, more sensitive ways of detecting malaria. Treatment, to fast track development of new antimalarials, and improve access to ensure all infected people get highly effective drugs.
A Case-control Study Of Rotavirus Vaccine Effectiveness Against Gastroenteritis Hospitalisation Of Children In The NT
Funder
National Health and Medical Research Council
Funding Amount
$465,859.00
Summary
Almost 1 out of 5 children in remote Aboriginal communities are hospitalised with diarrhoea caused by rotavirus. This study will evaluate the impact of rotavirus vaccination in preventing these hospitalisations. In addition to making sure that vaccination works and that those at highest risk are receiving the benefits, it will assess the indirect impact against other causes of diarrhoea providing, critical information relevant to the vaccine's broader introduction in developing country settings.
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.
Surviving in a toad-colonised landscape: manipulating predator behaviour to reduce the impact of the cane toad invasion. Invasive species pose a major threat to biodiversity; and within Australia, cane toads are widely viewed as one of the biggest such problems. Vigorous attempts at toad control have failed to slow the invasion front, and toads are now entering the Kimberley region. If we can’t stop the toads, are there other ways to reduce the numbers of native predators killed by eating thes ....Surviving in a toad-colonised landscape: manipulating predator behaviour to reduce the impact of the cane toad invasion. Invasive species pose a major threat to biodiversity; and within Australia, cane toads are widely viewed as one of the biggest such problems. Vigorous attempts at toad control have failed to slow the invasion front, and toads are now entering the Kimberley region. If we can’t stop the toads, are there other ways to reduce the numbers of native predators killed by eating these poisonous invaders? Predators given nausea-inducing chemicals with their first toad meal rapidly learn to avoid cane toads as prey, enabling them to survive even where toads are present. The study will develop those methods for several vulnerable native species, including techniques for deployment of aversion-inducing baits in advance of the toad invasion.Read moreRead less
TELEPHONE COUNSELLING FOR MAINTENANCE OF PHYSICAL ACTIVITY, WEIGHT LOSS And GLYCAEMIC CONTROL IN TYPE 2 DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$1,285,894.00
Summary
Regular exercise, a healthy diet and weight loss are key to managing type 2 diabetes, yet these are major challenges for most people with diabetes. This study will evaluate the impact of a telephone counselling program to assist people with type 2 diabetes to exercise, eat a healthy diet and lose weight, with the goal of helping them to sustain these changes over the long-term. It is expected that these lifestyle changes will also result in improved blood glucose control and quality of life.
A multispecies approach to managing feral animals in tropical savanna landscapes. Controlling invasive species is important for maintaining healthy landscapes. Often, multiple invasive species occupy a landscape and simultaneous management of them is required. Our innovative management tool will allow land managers to develop and implement control strategies for environmentally invasive species in Northern Australia and globally.
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.
Cane toads in southern Australia: invasion dynamics and options for control. This project aims to investigate the spread of cane toads through southern Australia, an invasion front that has attracted far less research than the same species’ expansion through tropical regions, even though toads severely impact native wildlife in both areas. This project expects to generate new knowledge to determine why the rate of toad invasion is so much slower in New South Wales than in the tropics, and how be ....Cane toads in southern Australia: invasion dynamics and options for control. This project aims to investigate the spread of cane toads through southern Australia, an invasion front that has attracted far less research than the same species’ expansion through tropical regions, even though toads severely impact native wildlife in both areas. This project expects to generate new knowledge to determine why the rate of toad invasion is so much slower in New South Wales than in the tropics, and how best to modify newly-developed approaches to toad control to the conditions in southern Australia. Expected outcomes include predicting future trajectories of expansion, and identifying optimal approaches to toad control and impact mitigation. This should provide significant benefits for biodiversity conservation.Read moreRead less