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.
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 Structured Systems Approach For Improving Health Promotion Practice For Chronic Diseases In Indigenous Communities
Funder
National Health and Medical Research Council
Funding Amount
$666,592.00
Summary
This project will trial a model for continuous improvement, with the aim of assisting health services and community based organisations to improve the services they deliver to promote health and prevent chronic disease in Indigenous communities.
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
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.
Digestive Physiology of Crocodilians: Towards an Improved Diet and Feeding Regime for Use by the Farming Industry. Crocodile farming promotes the sustainable production and consumption of crocodile products without harming natural populations. The industry grosses over $15 million per year in Australia and $200 million worldwide. Costs associated with transporting and storing food are the single largest expense that crocodile farms have. Increases in the efficiency of converting food into growth ....Digestive Physiology of Crocodilians: Towards an Improved Diet and Feeding Regime for Use by the Farming Industry. Crocodile farming promotes the sustainable production and consumption of crocodile products without harming natural populations. The industry grosses over $15 million per year in Australia and $200 million worldwide. Costs associated with transporting and storing food are the single largest expense that crocodile farms have. Increases in the efficiency of converting food into growth will have positive economic benefits to the industry. Efficiencies can be produced by (1) increasing food absorption, (2) decreasing the energetic costs of digestion, and (3) producing a new food that is less expensive to ship and store. This project will directly address the first two of these and will lay the foundation for the development of the third. 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
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.
The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the co ....The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the country. The project aims to inform consumers, health practitioners, health service planners and policy-makers about the impact of FIFO, as well as to contribute to the development of strategies designed to stabilise the remote health workforce.Read moreRead less
Assessing the development, well-being, and community connectedness of children in the middle years: The Middle Development Instrument for Australia. This project develops the Middle Development Instrument (MDI) which gives children a voice, an opportunity to communicate to adults about what their experiences are inside and outside of school. The MDI has great potential to provide educators, parents, researchers, and policy makers with much needed information about the psychological and social wo ....Assessing the development, well-being, and community connectedness of children in the middle years: The Middle Development Instrument for Australia. This project develops the Middle Development Instrument (MDI) which gives children a voice, an opportunity to communicate to adults about what their experiences are inside and outside of school. The MDI has great potential to provide educators, parents, researchers, and policy makers with much needed information about the psychological and social worlds of children.Read moreRead less