Environmental And Genetic Factors In Childhood Acute Lymphoblastic Leukaemia: A Case-control Study.
Funder
National Health and Medical Research Council
Funding Amount
$1,788,500.00
Summary
In most countries, acute lymphoblastic leukaemia is the commonest cancer in children. One in 2000 children will develop this disease before their 15th birthday. New methods of treatment introduced over the last 30 years have resulted in cure for many children. However, one third of children diagnosed with this type of leukaemia still die and, even in those whose lives are saved, cure is achieved at a significant cost to the child, the family and the community. Greater understanding of the develo ....In most countries, acute lymphoblastic leukaemia is the commonest cancer in children. One in 2000 children will develop this disease before their 15th birthday. New methods of treatment introduced over the last 30 years have resulted in cure for many children. However, one third of children diagnosed with this type of leukaemia still die and, even in those whose lives are saved, cure is achieved at a significant cost to the child, the family and the community. Greater understanding of the development of childhood leukaemia may lead to preventive measures. Most children with this type of leukaemia are very young, suggesting that factors to which parents are exposed may affect future children. For this reason, as well as investigating the health and lifestyle of the child, it is essential to study the parents. Recent research suggests an association between the mother's intake of folate during pregnancy and her child's risk of developing the most common type of childhood leukaemia. It is also apparent that genetic differences result in varying abilities to deal with toxins, which may alter the risk of developing some cancers. Diet and lifestyle probably also affect this risk. These observations and interactions need to be examined in greater detail. In this large Australia-wide study specific genes will, for the first time, be examined and analysed in conjunction with rigorous assessment of exposures thought to be related to the development of childhood leukaemia. Results obtained from children with leukaemia and their parents will be compared with those from healthy children and their parents. This study is unique in its attempt to assess gene-environment interactions in Australian children and their parents. It will clarify the role of folate and other potential environmental agents in the development of childhood leukaemia and examine gene variations that may affect cancer risk.Read moreRead less
Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less
Defining Risk And Mechanisms Of Permucosal Transmission For Acute HCV Infection Within High-risk Populations.
Funder
National Health and Medical Research Council
Funding Amount
$395,182.00
Summary
Hepatitis C virus (HCV) is usually transmitted by blood-to-blood contact. The risk of transmission by sexual contact has been thought to be low. However, in recent years increasing hepatitis C infection has been documented among HIV-positive gay men, with sexual contact the most most likely means of infection in the majority of cases. This grant will use established cohorts to define levels of hepatitis C risk through sexual contact among homosexual men to inform public health strategies.
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
Aetiology, Burden And Causal Pathways Of Acute Lower Respiratory Infections Using Population Linked Data
Funder
National Health and Medical Research Council
Funding Amount
$437,476.00
Summary
Lower respiratory, or chest infections, are a problem for many children. This project will investigate the impact of chest infections on hospitals and emergency departments, the viruses and bacteria that cause them, identify those children who are at an increased risk of having chest infections and investigate the impact of routine immunisations on specific types of infections. This project will greatly add to our understanding of chest infections so appropriate interventions can be developed.
PneuMum: An RCT Of Maternal Pneumococcal Vaccination For Protection Of Indigenous Children From Ear Disease
Funder
National Health and Medical Research Council
Funding Amount
$591,291.00
Summary
Ear disease starts in the first few months of life for most Indigenous children. By school entry, 2 out of every 3 Indigenous children in the NT have hearing problems. This proposal is to renew funding of the PneuMum study, which aims to find out whether the protection that a mother gets when she receives a pneumococcal vaccine late in pregnancy or soon after delivery can help to protect her child from getting ear disease.