A Computer Alert To Increase Chlamydia Testing Of High Risk Women In General Practice: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$182,575.00
Summary
Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose ....Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose with urine tests and easy to treat with single dose antibiotics. Over 65% of infections diagnosed in women are among those aged 16 to 24 years. Internationally, screening programs for chlamydia have reduced the number of people with the infection and have also reduced the rate of complications arising from infection. However, Australia does not have a screening program and only tests about 4% of 16 to 24 year old women, the largest group at risk of infection, each year. We propose to conduct a study which tests the effect of using a computer based alert. This alert is designed to prompt doctors to discuss chlamydia testing with sexually active women aged 16 to 24 years. A group of general practices will be selected. We will randomly allocate some practices to have the alert installed on their computers and the remaining practices will receive no intervention. We will observe both groups of general practices over 12 months and compare their chlamydia testing rates among women aged 16 to 24 years. We estimate that the alert will increase testing rates from the 4% currently tested to 10%. By testing and treating more women with the infection, we can reduce the number of people in the community with the infection. We will also be collecting information about the dollar cost of chlamydia infection to the community. This study will produce valuable information which can be used by government to inform the design of future chlamydia screening and control programs.Read moreRead less
Innate Immunity And Chlamydia Infection: Bacterial:epithelial Cell Cross-talk At The Mucosal Surface.
Funder
National Health and Medical Research Council
Funding Amount
$593,340.00
Summary
Chlamydial infections are the most common sexually transmitted disease in Australia. Infection induces short term immunity that is only partially protective. Furthermore, in many infected individuals the immune response causes inflammation of the fallopian tubes leading to pelvic inflammatory disease, ectopic pregnancy and infertility. In these individuals the initial chlamydial infection may not be cleared and a chronic infection may develop that can be reactivated, perhaps many times, contribu ....Chlamydial infections are the most common sexually transmitted disease in Australia. Infection induces short term immunity that is only partially protective. Furthermore, in many infected individuals the immune response causes inflammation of the fallopian tubes leading to pelvic inflammatory disease, ectopic pregnancy and infertility. In these individuals the initial chlamydial infection may not be cleared and a chronic infection may develop that can be reactivated, perhaps many times, contributing to the ongoing inflammatory response. Evidence from in vitro studies suggests that antibiotics routinely used to treat Chlamydia infection may actually contribute to the development of chronic infection. The stage of menstrual cycle at the time of exposure and oral contraceptive use can also influence susceptibility to infection suggesting that sex hormones influence infection outcomes. The innate or early immune response to infection by reproductive tract epithelial cells, the target cells of chlamydial infection, is believed to initiate the pro-inflammatory immune responses that will develop in some individuals following primary infection, however very little is known regarding this early epithelial cell immune response. In the proposed studies we will use reproductive tract epithelial cell lines, freshly isolated epithelial cells and cervical biopsy explant cultures to define this early innate immune response to chlamydial infection. Using gene-profiling techniques we will identify the types of innate immune response that predispose to long-term inflammatory sequelae. Gene-profiling techniques will also be used to determine why chronic chlamydial infections develop in some individuals and whether antibiotics influence this. Our ultimate aim is to be able to predict which infected individuals are likely to develop long term inflammatory disease and may therefore need more intensive antibiotic therapy or treatments such as therapeutic vaccination.Read moreRead less
Characterisation Of Antigenic Variation Of Neisserial Cell Surface Adhesins, And Their Role In Infection
Funder
National Health and Medical Research Council
Funding Amount
$556,983.00
Summary
A group of bacteria called Neisseria cause human-specific infections. They produce two types of surface proteins termed adhesins, which allow the bacteria to adhere to, and invade, human cells. There is circumstantial evidence to suggest the bacteria can rapidly vary the structure of these adhesins, even within a single infection. This project will determine whether, and how, this variation is occurring, and what effect it has on the ability of the bacteria to cause disease.
Development Of A Vaccine For Genital Chlamydial Infection
Funder
National Health and Medical Research Council
Funding Amount
$207,551.00
Summary
Genital Chlamydia infections are the most common sexually transmitted infection in Australia with annual health costs of 90-160 million dollars. Infection rates in 15-29 olds are increasing at 15-20% per year. Antibiotics are currently the treatment of choice, however antibiotic resistance is increasing and most infections are asymptomatic and not treated in the absence of screening programs. This project aims to develop a genital Chlamydia vaccine using a combination of novel antigens.
Pelvic organ prolapse in women is associated with poor quality of life. The standard treatment currently available for prolapse is surgery. The evidence for conservative management with physiotherapy is not clear. This randomised controlled trial will examine the effect of physiotherapy treatment, including pelvic floor muscle training, on prolapse symptoms and severity, compared with lifestyle advice only. Appropriate conservative management may reduce the need for surgery and associated costs.
A group of bacteria called Neisseria cause human-specific infections. To initiate infection, the bacteria must produce a hair-like surface structure, the pilus. The pilus consists mainly of a protein called pilin, and we now understand how pilin production is controlled. However 20 other genes are also involved in pilus production. This project aims to understand how these other genes are controlled and coordinated to assemble this structure that is central to the ability to cause disease.
Regulation Of Immune And Inflammatory Responses By Short Chain Fatty Acids And GPR43
Funder
National Health and Medical Research Council
Funding Amount
$549,092.00
Summary
Innate immune mechanisms provide essential signals that determine the outcome of immune responses. The identity of these innate mechanisms may provide opportunities for manipulating immune responses, or controlling inflammatory responses. This proposal centers around a new and little-studied receptor, GPR43, which binds products of bacterial metabolism. This molecular pathway may explain how diet affect immune responses.
Natural Killer (NK) Cells And Development Of Atherosclerosis: Cellular And Molecular Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$729,571.00
Summary
Atherosclerosis, the accumulation of fat and white cells in the blood vessel wall is the major cause of heart attacks, stroke and death. Cholesterol lowering drugs reduce the risk by only 40%. Targeting cells that promote inflammation is one approach to further reduce risk. We have shown that a specific cell type called a natural killer (NK) cells contributes greatly to development of atherosclerosis. Our aim is to understand how these cells promote development of atherosclerosis.
Isolation And Pre-clinical Evaluation Of Small Molecule Anti-inflammatory Compounds From Hookworms
Funder
National Health and Medical Research Council
Funding Amount
$320,891.00
Summary
This project will harness the unique ability of hookworm small molecules (<10 kDa) to modulate inflammation, and exploit these properties to develop novel modalities to treat inflammatory bowel diseases, using millennia of host-parasite coevolution as a guide. The excretory/secretory and somatic extracts will be assessed for their anti-inflammatory properties using TNBS mouse model. Compounds will be separated using HPLC and identified using MS and NMR spectroscopy.
Protease Activated Receptor 2 Antagonist In Inflammatory Disease
Funder
National Health and Medical Research Council
Funding Amount
$621,347.00
Summary
The immune response to infection involves a network of proteins that produce an inflammatory response. Sometimes this response is prolonged or uncontrolled and can lead to a large number of inflammatory and other diseases. We have discovered a class of drugs that can bind to a particular protein on the surface of human cells and control this inflammatory response. This property has the potential to treat a wide range of inflammatory and other diseases in humans.