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
The Macroderma initiative: conserving ghost bats and informing development. This project aims to improve methods for capturing biological information required for environmental assessments of highly mobile species and enable strategic environmental planning in Northern Australia. Using Australia’s iconic ghost bat as a focus, the project will test and apply emerging technologies to obtain key information on a species’ population status and its critical resources to inform assessments of ecologic ....The Macroderma initiative: conserving ghost bats and informing development. This project aims to improve methods for capturing biological information required for environmental assessments of highly mobile species and enable strategic environmental planning in Northern Australia. Using Australia’s iconic ghost bat as a focus, the project will test and apply emerging technologies to obtain key information on a species’ population status and its critical resources to inform assessments of ecological impacts of industry development. Important benefits of the project include information and tools for streamlining development approvals and accurately assessing risks to threatened species to improve outcomes for both our economy and our natural environment.Read moreRead less
Building An Indigenist Health Humanities Collective. This proposal aims to develop Indigenist Health Humanities as a new and innovative field of inquiry, building an intellectual collective capable of bridging the knowledge gap that hinders current efforts to close the gap in Indigenous health inequality. Bringing together health and the humanities through the particularity of Indigenous scholarship, a deeper understanding of the human experience of health will be developed alongside a greater u ....Building An Indigenist Health Humanities Collective. This proposal aims to develop Indigenist Health Humanities as a new and innovative field of inquiry, building an intellectual collective capable of bridging the knowledge gap that hinders current efforts to close the gap in Indigenous health inequality. Bringing together health and the humanities through the particularity of Indigenous scholarship, a deeper understanding of the human experience of health will be developed alongside a greater understanding of the enablers to building a transdisciplinary collective of Indigenous health researchers. The potential benefits include a more sustainable, relational and ethical approach to advancing new knowledge, advancing research careers and advancing health outcomes for Indigenous people. Read moreRead less
Incentivising On Country Aboriginal Employment: Anangu Futures. . This project aims to investigate the changing face of cultural tourism in central Australia and examine pathways towards sustainable aboriginal employment in and around Uluru-Kata Tjuta National Park. The project is significant because it brings together Aboriginal community members, industry and government stakeholders to identify micro-business opportunities, youth training initiatives, better relations across cultural divides, ....Incentivising On Country Aboriginal Employment: Anangu Futures. . This project aims to investigate the changing face of cultural tourism in central Australia and examine pathways towards sustainable aboriginal employment in and around Uluru-Kata Tjuta National Park. The project is significant because it brings together Aboriginal community members, industry and government stakeholders to identify micro-business opportunities, youth training initiatives, better relations across cultural divides, and the economic value of Aboriginal knowledge. Outcomes include a model for sustainable Aboriginal employment in remote and very remote contexts, and the development of culturally relevant and sustainable governing guidelines for regional investment. Benefits include more sustainable jobs for Aboriginal people.Read moreRead less
Special Research Initiatives - Grant ID: SR120100005
Funder
Australian Research Council
Funding Amount
$3,198,392.00
Summary
National Indigenous Research and Knowledges Network. The National Indigenous Research and Knowledges Network will capacity build and increase Indigenous higher degree, early and mid career researchers to develop new approaches to undertaking research and producing outcomes. NIRAKN's members include a number of universities, AIATSIS, and partner organisations.
Aboriginal place names and ethnobiology: enhancing interpretation of Indigenous culture and heritage. This project looks at how Indigenous people’s knowledge of place names and bush tucker can create opportunities for Indigenous communities in areas such as tourism. The project aims to do this by harnessing new advances in digital media which offer new ways of passing on this knowledge to both Indigenous and intercultural audiences.
Yarning with our mob about human papillomavirus (HPV) vaccination uptake. This project aims to identify a range of modifiable factors that affect the participation of Indigenous adolescents in human papillomavirus (HPV) vaccination school programs. The project expects to generate new knowledge by combining Indigenous methodologies and a socioecological model to explore policy, community, interpersonal and intrapersonal factors impacting HPV vaccination uptake for this population. Expected outcom ....Yarning with our mob about human papillomavirus (HPV) vaccination uptake. This project aims to identify a range of modifiable factors that affect the participation of Indigenous adolescents in human papillomavirus (HPV) vaccination school programs. The project expects to generate new knowledge by combining Indigenous methodologies and a socioecological model to explore policy, community, interpersonal and intrapersonal factors impacting HPV vaccination uptake for this population. Expected outcomes include a more comprehensive understanding of the factors behind the low rates of HPV vaccination among Indigenous adolescents. This information should provide significant benefits including the identification of modifiable factors to increase HPV vaccination rates for Indigenous adolescents.Read moreRead less
Where migrants go: A study of immigrants' post-arrival moves in Australia . The project aims to establish the geographical and occupational trajectories of different migrant groups after arrival in Australia. Migration within Australia is a key driver of economic, demographic and social change. Recognising the growing diversity of immigrants, including the rapid rise in temporary migration, the project examines post-arrival moves of immigrants by visa type, country of birth and year of arrival. ....Where migrants go: A study of immigrants' post-arrival moves in Australia . The project aims to establish the geographical and occupational trajectories of different migrant groups after arrival in Australia. Migration within Australia is a key driver of economic, demographic and social change. Recognising the growing diversity of immigrants, including the rapid rise in temporary migration, the project examines post-arrival moves of immigrants by visa type, country of birth and year of arrival. It seeks to improve understanding of the incidence, spatial patterns and drivers of migrants’ movement within Australia and the socio-demographic impact on regions and individuals. Such understanding is an essential first step to the formulation of effective immigration and settlement policies and programs.Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less