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.
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
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
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
Modelling and control of mosquito-borne diseases in Darwin using long-term monitoring. Management of mosquito populations is a high public health priority because these insects can spread diseases such as malaria, dengue, Ross River virus, Barmah Forest virus, Murray Valley encephalitis, Japanese encephalitis and Kunjin/West Nile virus. Our research into the effectiveness of mosquito control programs in Darwin is of immediate national relevance and priority given the need to Safeguard Australia ....Modelling and control of mosquito-borne diseases in Darwin using long-term monitoring. Management of mosquito populations is a high public health priority because these insects can spread diseases such as malaria, dengue, Ross River virus, Barmah Forest virus, Murray Valley encephalitis, Japanese encephalitis and Kunjin/West Nile virus. Our research into the effectiveness of mosquito control programs in Darwin is of immediate national relevance and priority given the need to Safeguard Australia from invasive diseases. There is an urgency to undertake our research because global environmental change and increasing movements of people (particularly military personnel) from overseas regions where these diseases are endemic is increasing the vulnerability of northern Australia to the (re)establishment of mosquito borne diseases.Read moreRead less
Defining the links between climate change, marine disease and food security. This project will deliver critical new knowledge on the causes of marine pathogen outbreaks that threaten Australia’s $1.6 billion aquaculture industry. Several members of the same genus of bacteria have been implicated in recent mass mortality events in aquaculture species, as well as human illness in consumers of seafood, yet the triggers for unprecedented outbreaks of these pathogens are unknown. By coupling a suite ....Defining the links between climate change, marine disease and food security. This project will deliver critical new knowledge on the causes of marine pathogen outbreaks that threaten Australia’s $1.6 billion aquaculture industry. Several members of the same genus of bacteria have been implicated in recent mass mortality events in aquaculture species, as well as human illness in consumers of seafood, yet the triggers for unprecedented outbreaks of these pathogens are unknown. By coupling a suite of sophisticated molecular biological tools and physiological measurements, this research will resolve the role of environmental disturbances including marine heat waves, floods and plastic pollution in stimulating marine pathogen outbreaks, thereby informing efforts to safeguard Australia’s food security and food safety.Read moreRead less
Immunising Aboriginal Mothers With Pneumococcal Polysaccharide Vaccine To Prevent Infant Ear Disease And Carriage
Funder
National Health and Medical Research Council
Funding Amount
$1,131,530.00
Summary
Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are nee ....Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are needed to eliminate, or at least delay, this early-onset pneumococcal colonisation. One such strategy is the administration to the mother of pneumococcal vaccine, which may protect the newborn infant by leading to higher titres of transplacental or breast milk pneumococcal antibodies and-or by reducing carriage (and transmission to the infant) of maternal pneumococci. Previous small studies using this strategy have been encouraging, but there have been no studies properly evaluating carriage or disease endpoints in infants. The polysaccharide pneumococcal vaccine is currently recommended for all Aboriginal and Torres Islander persons aged 15 years or more in the Northern Territory but uptake of the vaccine has been poor. We propose to conduct a pilot study to determine if maternal immunisation with this vaccine, either in the third trimester of pregancy of immediately following delivery, can reduce pneumococcal carriage and the prevalence of middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women who have uncomplicated pregnancies from Darwin and remote communities in the Top End of the Northern Territory. Each subject and their infant offspring will be followed-up after vaccination and at birth, one , two and seven months after birth.Read moreRead less
Transforming Cultural & Natural Resource Management workforce capabilities. This project aims to implement a transformative program of transdisciplinary cultural and natural resource management and workforce development research in Northern Australia’s Arnhem Plateau region. This project expects to create new knowledge in the areas of cultural knowledges, wildfire, feral animal, invasive plants, mine-site rehabilitation, and climate change, as well as Indigenous training effectiveness. Expected ....Transforming Cultural & Natural Resource Management workforce capabilities. This project aims to implement a transformative program of transdisciplinary cultural and natural resource management and workforce development research in Northern Australia’s Arnhem Plateau region. This project expects to create new knowledge in the areas of cultural knowledges, wildfire, feral animal, invasive plants, mine-site rehabilitation, and climate change, as well as Indigenous training effectiveness. Expected outcomes of the project include practical learnings for application in broader Indigenous community/First Nations capability and supportive policy development contexts. The expected benefits are a long-term platform for enhancing cultural and environmental landscape management and sustainable employment opportunities.Read moreRead less