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.
The Arthroplasty Surgical Antibiotic Prophylaxis (ASAP) Study
Funder
National Health and Medical Research Council
Funding Amount
$3,509,985.00
Summary
The demand for total joint replacement surgery will double over the next decade. Infection involving the surgical wound is a devastating complication of this surgery. Half of all infections are due to methicillin resistant Staphylococcus (such as MRSA) and Enterococcus. This multicentre randomised controlled trial aims to investigate whether the addition of vancomycin at the time of surgery reduces the incidence of surgical wound infections; is safe and is cost-effective.
Group A Streptococcal Human Challenge Study: Accelerating Vaccine Development
Funder
National Health and Medical Research Council
Funding Amount
$2,018,741.00
Summary
Infection with group A streptococcus (GAS) is a major cause of morbidity and mortality worldwide, including in the Aboriginal population of Australia. Concerted efforts for vaccine development have been hampered by the absence of a suitable animal model. To address this critical knowledge gap we propose to develop a controlled human infection model of GAS infection. This model will provide a direct pathway for the future appraisal of novel GAS vaccines.
A Randomised Trial To Control Sexually Transmitted Infections In Remote Aboriginal Communities.
Funder
National Health and Medical Research Council
Funding Amount
$1,847,403.00
Summary
This project will trial strategies for attaining clinical best practice in sexual health with an overall objective of reducing the high rates of sexually transmitted infection in remote Aboriginal communities in central and northern Australia. The trial will take place in 21 communities of which seven will be randomly assigned in each of the three years of the trial. This trial will determine whether strengthening primary health services can reduce the level of these infections.
The Clinical Value Of Serology And Molecular Tests For Diagnosing Invasive Aspergillosis In At-risk Hematology Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,095,500.00
Summary
Aspergillus is a fungus found in soil, on farms and on construction sites. In those whose immune system is impaired it causes severe infection. The people who are particularly at high-risk of Aspergillus infection (called Invasive Aspergillosis) are those with acute leukaemia on chemotherapy or post bone marrow transplantation. Currently 15% of those at high-risk get Invasive Aspergillosis and 58-93% of those infected die. The main reason for this high death rate is that our current diagnostic t ....Aspergillus is a fungus found in soil, on farms and on construction sites. In those whose immune system is impaired it causes severe infection. The people who are particularly at high-risk of Aspergillus infection (called Invasive Aspergillosis) are those with acute leukaemia on chemotherapy or post bone marrow transplantation. Currently 15% of those at high-risk get Invasive Aspergillosis and 58-93% of those infected die. The main reason for this high death rate is that our current diagnostic tests are not good at detecting infection or often only detect the infection at advanced stages when treatment is ineffective. Because of the limitations of current diagnostic tests the current practice is to give empiric antifungal therapy (EAFT) early to treat Invasive Aspergillosis. However studies have demonstrated that this therapy has only resulted in a minor reduction in the mortality rates and it causes significant drug toxicity. It is a suboptimal treatment modality. New tests have been developed to diagnose Invasive Aspergillosis. These tests are for the detection of an Aspergillus protein in blood and for the detection of Aspergillus DNA in the blood. Available data suggests that these new tests are sensitive in the detection of Invasive Aspergillosis. Also other studies suggest that these new tests make an early diagnosis and seem to be able to monitor responses to treatment. However no study has been performed to date which demonstrates that the use of these tests can impact on important patient outcomes. This trial is designed to determine whether the use of the new tests to guide therapy will help improve treatment of Invasive Aspergillosis, reduce drug toxicity and reduce the death rate in the high-risk patients as compared with the current standard method of diagnosis and treatment with EAFT. If the trial is successful then this represents a significant advancement in the treatment and survival of leukaemic and bone marrow transplantation patients.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
A Randomised Open-label Study Comparing The Safety And Efficacy Of Two Alternative Treatment Options In The Management Of HIV-1 Infected Participants Who Have Virologically Failed A Standard First-line Combination ART Regimen
Funder
National Health and Medical Research Council
Funding Amount
$457,676.00
Summary
For the past decade there has been an unprecedented international effort to provide access to care for all HIV-infected people as a basic human right. Most of these people are treated with a simple combination of drugs that are well proven to control HIV. However, what to do when this first drug combination stops working is unknown. This study aims to fill that knowledge gap so that patients failing the first drug combination can be offered a second combination with a maximal chance of success.
An In Depth Analysis Of Clinical And Virological Outcomes Of 2 Strategies For The Antiretroviral Salvage Of First-line Regimen Virological Failure For HIV-1 Infection Tested In An Australian-led Randomised, International, Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$421,747.00
Summary
The recently completed Australian-led SECOND-LINE trial is the first high quality study to provide reliable evidence for policy recommendations for the composition of anti-HIV drug cocktails after standard initial treatment has failed. This award will support the researcher in further refining our understanding of how to manage second-line therapy including proposals to test the use of low-cost technologies for application in resource-limited settings where the majority of people with HIV live.
Australian Partnership (for) Preparedness Research On InfectiouS (disease) Emergencies (APPRISE)
Funder
National Health and Medical Research Council
Funding Amount
$4,996,416.00
Summary
We have assembled national experts in clinical, laboratory and public health research to ensure Australia is equipped for a coordinated, effective and evidence based response to infectious diseases. This multidisciplinary team will create and share new knowledge to detect, prevent and manage emerging infection threats. We will train a robust cross-sectoral work force and develop sustainable research capacity integrated within the health system to ensure national and regional health security.
Economic, social and cross cultural issues in non-pharmaceutical protection of front line responders to pandemic influenza and emerging infections. The protection of front line responders in a pandemic is essential to underpin an effective response. This research is the only work internationally which will address a key gap in evidence. This research has major implications for the national stockpile and for management of front line responders in a pandemic. These data are urgently needed, not ju ....Economic, social and cross cultural issues in non-pharmaceutical protection of front line responders to pandemic influenza and emerging infections. The protection of front line responders in a pandemic is essential to underpin an effective response. This research is the only work internationally which will address a key gap in evidence. This research has major implications for the national stockpile and for management of front line responders in a pandemic. These data are urgently needed, not just in Australia, but globally to inform pandemic planning and disease control policy around emerging infections and bioterrorism.Read moreRead less