Implications Of Bacterial Load For Vaccine Efficacy And Antibiotic Treatment Outcomes In High-risk Populations
Funder
National Health and Medical Research Council
Funding Amount
$345,000.00
Summary
Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in t ....Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in these children results from infection with the bacteria Streptococcus pneumoniae, Haemophilus influenzae and-or Moraxella catarrhalis. Therefore the types of interventions we are using to combat the high prevalence of ear disease are antibiotic therapy, Streptococcus pneumoniae vaccination, and hygiene interventions. However we fear that the high load of bacteria carried by these children compromises the treatment and prevention strategies. The current proposal will test this hypothesis, and if found to be true, there will be implications for the management of otitis media. For example, dose, frequency and choice of antibiotic treatment, and vaccine schedule changes including an early dose or a booster dose.Read moreRead less
Improving Aboriginal Children's Access To Better Ear And Hearing Health Through Telehealth ENT
Funder
National Health and Medical Research Council
Funding Amount
$1,123,450.00
Summary
Aboriginal children experience the highest rates of chronic ear disease in the world, with access to specialist ENT care limited by cultural issues as well as long travel distances, if they live in rural areas. This results in children developing hearing loss that could have been prevented with early childhood ENT treatment. This Indigenous led telehealth research, based in NSW, will create an efficient, culturally appropriate hearing health care model for all Indigenous Australians.
Azithromycin Versus Placebo In The Treatment Of Asymptomatic Acute Otitis Media In Young Aboriginal Children : A RCT
Funder
National Health and Medical Research Council
Funding Amount
$1,357,460.00
Summary
Remote Aboriginal children have the highest rates of severe ear infection reported in the medical literature. At any time, large numbers of children have a bulging eardrum (acute otitis media) but most are completely asymptomatic. In our previous antibiotic study, acute otitis media (AOM) persisted in 50% of children after 1 week of treatment. In terms of clinical success, it didn't make any difference whether azithromycin or amoxicillin was used (although azithromycin seemed to be better at red ....Remote Aboriginal children have the highest rates of severe ear infection reported in the medical literature. At any time, large numbers of children have a bulging eardrum (acute otitis media) but most are completely asymptomatic. In our previous antibiotic study, acute otitis media (AOM) persisted in 50% of children after 1 week of treatment. In terms of clinical success, it didn't make any difference whether azithromycin or amoxicillin was used (although azithromycin seemed to be better at reducing the level of infection). Currently local clinicians are: i) uncertain whether antibiotics make any difference at all; and ii) reluctant to devote resources to case-finding without good evidence of substantial benefit. In this randomised controlled trial, we will determine the benefits of 2 doses of azithromycin given 1 week apart in children with asymptomatic acute otitis media will improve health outcomes. The results of the trial will become the best available evidence to guide the medical management of asymptomatic AOM in high-risk children. We anticipate that it will make an important contribution in the shift toward more effective prevention and management of otitis media in Australian Aboriginal children. It will also have implications for all disadvantaged populations where adverse outcomes are common and compliance with recommended treatment is poor.Read moreRead less
Centre Of Research Excellence In Indigenous Children's Healthy EARs (ICHEAR)
Funder
National Health and Medical Research Council
Funding Amount
$2,615,897.00
Summary
The overwhelming burden of otitis media (middle ear inflammation, OM) and the consequences of hearing loss on social and educational outcomes in Indigenous children are indisputable. Our CRE_ICHEAR is a multidisciplinary group of Australia’s experts in OM research, policy and practice guidelines. The CRE will derive better value in terms of discovery, translation and sustainability. Increased Indigenous leadership will raise awareness and advocacy, with greater efficiency of research translation