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 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 Case-control Study Of Rotavirus Vaccine Effectiveness Against Gastroenteritis Hospitalisation Of Children In The NT
Funder
National Health and Medical Research Council
Funding Amount
$465,859.00
Summary
Almost 1 out of 5 children in remote Aboriginal communities are hospitalised with diarrhoea caused by rotavirus. This study will evaluate the impact of rotavirus vaccination in preventing these hospitalisations. In addition to making sure that vaccination works and that those at highest risk are receiving the benefits, it will assess the indirect impact against other causes of diarrhoea providing, critical information relevant to the vaccine's broader introduction in developing country settings.
Diseases caused by the pneumococcus represent the largest cause of vaccine preventable death in the world today, mainly pneumonia and meningitis. In 2011, 16 developing countries will introduce pneumococcal conjugate vaccines, none in east Asia. Lack of research has been a major barrier to their use in the region. We have established an international centre of excellence in the field and we seek support to extend the capacity of this group and to transfer the technology to Vietnam.
Criminalisation of poverty and homelessness in Australia: A national study. The project aims to assess the policing and enforcement of public order crimes and related offences (e.g. obstruct/disobey police, breach of bail, and minor property offences) on individuals experiencing poverty and homelessness. The project endeavours to collect and analyse qualitative data from across Australia on the lived experience of people who are homeless or at risk of homelessness, regarding the impact of crimin ....Criminalisation of poverty and homelessness in Australia: A national study. The project aims to assess the policing and enforcement of public order crimes and related offences (e.g. obstruct/disobey police, breach of bail, and minor property offences) on individuals experiencing poverty and homelessness. The project endeavours to collect and analyse qualitative data from across Australia on the lived experience of people who are homeless or at risk of homelessness, regarding the impact of criminal laws and police powers concerned with presence in, and movement around public places. It will particularly focus on the impact on women, children and Indigenous peoples. The outcomes will seek to reduce the criminalisation of homeless people, by identifying law and policy reform options, and comparing their cost with that of 'business as usual'.Read moreRead less
Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster
Funder
National Health and Medical Research Council
Funding Amount
$2,651,687.00
Summary
This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
Linkage Infrastructure, Equipment And Facilities - Grant ID: LE0989147
Funder
Australian Research Council
Funding Amount
$950,000.00
Summary
Advanced high throughput genomics facility for biological, medical, agricultural, environmental and evolutionary research. Infrastructure requested will expand the capacity of researchers in NSW/NT to undertake environmental, medical and evolutionary studies using state-of-the-art technologies based on the recent advances in DNA sequencing analyses. It will ensure the retention of leading researchers in the exciting areas of genomics and Systems Biology and make a significant contribution to bi ....Advanced high throughput genomics facility for biological, medical, agricultural, environmental and evolutionary research. Infrastructure requested will expand the capacity of researchers in NSW/NT to undertake environmental, medical and evolutionary studies using state-of-the-art technologies based on the recent advances in DNA sequencing analyses. It will ensure the retention of leading researchers in the exciting areas of genomics and Systems Biology and make a significant contribution to biomolecular research in medicine, agriculture and environmental biology, thereby providing major benefits to the wider community. The application will enhance existing genomic technologies by substantially increasing the scope of experiments that can be performed leading to important advances in gene discovery.Read moreRead less
Traditional knowledge and intellectual property: A comparison of current approaches in Australia, Indonesia and the Philippines. The concepts of 'indigenous cultural and intellectual property rights' and 'traditional resource rights' have sparked a debate between resource-rich developing countries and technology rich industrialised nations, because of their importance for biotechnology and pharmaceutical research. This comparative study combines legal analysis and fieldwork to critically examine ....Traditional knowledge and intellectual property: A comparison of current approaches in Australia, Indonesia and the Philippines. The concepts of 'indigenous cultural and intellectual property rights' and 'traditional resource rights' have sparked a debate between resource-rich developing countries and technology rich industrialised nations, because of their importance for biotechnology and pharmaceutical research. This comparative study combines legal analysis and fieldwork to critically examine cultural assumptions about the relationship of indigenous communities to their symbols and their environment. The examination will extend to Southeast Asia to discover different concepts of 'indigenous' and different mechanisms for the interaction between state and customary law. Asian experiences with legislation in this field will provide useful insights for legislators in Australia.Read moreRead less