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 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.
Intermittent Preventive Treatment In Pregnancy With Sulphadoxine-pyrimethamine Plus Dihydroartemisinin-piperaquine To Reduce Adverse Pregnancy Outcomes And Prevent Malaria In Papua New Guinea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,938,453.00
Summary
Millions of pregnancies are complicated by malaria worldwide. Monthly sulphadoxine-pyrimethamine (SP) treatments, the current treatment strategy, no longer protects from malaria but improves birth outcomes through non-malarial effects. Dihydroartemisinin-piperaquine clears malaria but babies are smaller compared to women who received SP. A clinical trial of their combination has potential to substantially improve health outcomes for women and babies in Papua New Guinea and beyond.
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
Centre Of Research Excellence On Sitting Time And Chronic Disease Prevention – Mechanisms, Measurement And Interventions
Funder
National Health and Medical Research Council
Funding Amount
$2,657,874.00
Summary
Australian research has identified serious health consequences arising from the 7 to 10 hours of daily sitting that most people do, especially in relation to ‘diseases of inactivity’ – type 2 diabetes, coronary heart disease and breast and colon cancer – that are an unwelcome burden on individuals, families and health systems. This new research examines the practical feasibility and the preventive-health benefits of changing children’s and adults’ sitting time in schools, workplaces and the home ....Australian research has identified serious health consequences arising from the 7 to 10 hours of daily sitting that most people do, especially in relation to ‘diseases of inactivity’ – type 2 diabetes, coronary heart disease and breast and colon cancer – that are an unwelcome burden on individuals, families and health systems. This new research examines the practical feasibility and the preventive-health benefits of changing children’s and adults’ sitting time in schools, workplaces and the home environment.Read moreRead less
Evaluation Of The Effectiveness Of Mobile Preschool For Child Health And Development In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$456,369.00
Summary
This project is a retrospective study of the effectiveness of the NT Mobile Preschool Program using assessment data for children's emergent literacy, social and emotional competencies and health status. Effectiveness will be established by comparison with achievement and health status data for children not attending preschool and those in communities with no preschool service. The study will identify and describe the key factors influencing the health and learning outcomes of the three groups.
Minimum sizes and habitat areas for viable populations. This project will address two critical issues in conservation biology: How large do wildlife populations need to be to ensure long-term persistence? How large an area needs to be preserved? At present, no such estimates exist for most species. I will develop realistic population viability analysis (PVA) models (encompassing all threats to persistence) on many bird, mammal, reptile, amphibian, invertebrate and plant species, and estimate the ....Minimum sizes and habitat areas for viable populations. This project will address two critical issues in conservation biology: How large do wildlife populations need to be to ensure long-term persistence? How large an area needs to be preserved? At present, no such estimates exist for most species. I will develop realistic population viability analysis (PVA) models (encompassing all threats to persistence) on many bird, mammal, reptile, amphibian, invertebrate and plant species, and estimate the minimum population sizes and habitat areas required for long-term survival. My prior research has validated the predictive accuracy of PVA. This research will deliver practical guidelines for managing threatened species.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
Innovative Health Programs To Reduce Inequality In Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$876,005.00
Summary
As part of his Senior NHMRC Fellowship, Prof Simon Stewart, a world-renowned health services researcher, will lead an internationally linked team of researchers from a broad range of health disciplines to undertake a program of research designed to improve the lives of those most vulnerable to heart disease and poor health outcomes. His program of research will focus on Indigenous Australians, patients with complex forms of heart disease and urban African communities in economic transition.
Demographic change, ageing and the workforce: An integrated model to inform workforce development and planning in Australia. This project will greatly extend our understanding of the impact of demographic change and ageing on the workforce. It will develop a conceptual framework to strategically inform workforce development and a workforce planning model to assist Australian workplaces to respond to the challenge of demographic change and ageing. The need to develop a better understanding of, an ....Demographic change, ageing and the workforce: An integrated model to inform workforce development and planning in Australia. This project will greatly extend our understanding of the impact of demographic change and ageing on the workforce. It will develop a conceptual framework to strategically inform workforce development and a workforce planning model to assist Australian workplaces to respond to the challenge of demographic change and ageing. The need to develop a better understanding of, and respond to, the implications of demographic change and ageing for workforce development in Australia has been recognised nationally through the National Strategy for Ageing and is of direct relevance to the ARC's national research priority Ageing Well, Ageing Productively. Read moreRead less