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
Otitis Media In Indigenous And Non-Indigenous Children: Microbiological And Immunological Risk Factors
Funder
National Health and Medical Research Council
Funding Amount
$534,400.00
Summary
Otitis media (middle ear infections) is a major health problem in children. Many children suffer repeated attacks requiring frequent courses of antibiotics, some need surgery and some suffer serious consequences, particularly hearing loss. This can affect performance at school, hence employment and social circumstances in adulthood. Indigenous children suffer much higher rates of disease with more complications than non-Indigenous children. Many factors predispose to the heavy burden of disease. ....Otitis media (middle ear infections) is a major health problem in children. Many children suffer repeated attacks requiring frequent courses of antibiotics, some need surgery and some suffer serious consequences, particularly hearing loss. This can affect performance at school, hence employment and social circumstances in adulthood. Indigenous children suffer much higher rates of disease with more complications than non-Indigenous children. Many factors predispose to the heavy burden of disease. In the Kalgoorlie-Boulder area we are following Indigenous and non-Indigenous children from birth to 24 months to look at a broad range of factors in order to proceed as soon as possible to appropriate intervention programs. Samples from the back of the nose are collected to find out the relationship between carriage of a range of bacteria or viruses and risk of getting otitis media. Information on antibiotic resistance of the bacteria we isolate will assist in ensuring appropriate treatment of otitis media. We also collect a sample of breast milk from mothers and several samples of saliva to find out about the immune system of babies and how this relates to disease to assist in an ongoing program of vaccine development for prevention of otitis media. We will find out how environmental factors such as crowding or passive smoking relate to carriage of bacteria and whether a combination of different factors increase risk of disease. A new vaccine called pneumococcal conjugate vaccine, recently licensed in Australia, is highly effective in preventing severe diseases such as pneumonia and meningitis and affords some protection against ear infections. It is likely to be offered first to Indigenous children because they suffer very high rates of pneumococcal disease. The vaccine may alter the types of bacteria in the nose. This needs to be monitored carefully which will be possible during this study.Read moreRead less
Ear Health, Hearing, Speech And Language Development In Urban Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$445,617.00
Summary
Studies from the Northern Territory and Western Australia have established that Aboriginal children experience earlier, more frequent and more severe middle ear disease than any other children worldwide. There is little information on Aboriginal communities in urban setings or those living in NSW. This study will fill this knowledge gap by examining the burden of middle ear disease, hearing impairment and consequent speech and language delays in urban Aboriginal children in NSW.
Judicious Use Of Antibiotics For Acute Otitis Media In Aboriginal Children: A Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$614,840.00
Summary
Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important ....Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important implications for their education. The aim of this study is to determine whether a new longer-acting antibiotic will be more effective in treating young Aboriginal children with new ear infections and therefore prevent the progression to chronic suppurative otitis media. The involvement of up to 20 Aboriginal communities in this well-designed clinical trial represents a major advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide training in ear examination and appropriate medical management. Swabs from the nose will be taken to monitor the effect of antibiotics on the rates of antibiotic resistance. The results from this study will be directly relevant to evidence-based guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.Read moreRead less
Community-based Surveillance Of Bacterial Respiratory Pathogens In The NT And WA
Funder
National Health and Medical Research Council
Funding Amount
$782,905.00
Summary
This surveillance project is a continuation of previous work that describes the strains of respiratory bacterial pathogens in the various community groups - Indigenous and non-Indigenous - across the NT and in WA (urban and remote areas). New vaccines are complex and whilst overall benefits are considerable, there are potential influences on microbiology that may be unwanted. Detailed knowledge of these effects will assist in selection of the best vaccines for use in Australia.