A5050768046- Streptococcal Infections and Treatments
- Antimicrobial Resistance in Staphylococcus
- Infective Endocarditis Diagnosis and Management
- Otolaryngology and Infectious Diseases
- Pneumonia and Respiratory Infections
- Neonatal and Maternal Infections
- Dermatological diseases and infestations
- Respiratory viral infections research
- Bacterial Identification and Susceptibility Testing
- Inflammasome and immune disorders
- Ultrasound in Clinical Applications
- Influenza Virus Research Studies
- Rheumatoid Arthritis Research and Therapies
- Emergency and Acute Care Studies
- Child and Adolescent Health
- Phonocardiography and Auscultation Techniques
- Rabies epidemiology and control
- Metabolism and Genetic Disorders
- Neonatal Respiratory Health Research
- Systemic Lupus Erythematosus Research
- Nosocomial Infections in ICU
- Cervical Cancer and HPV Research
- Herpesvirus Infections and Treatments
- Primary Care and Health Outcomes
- Chronic Disease Management Strategies
The Kids Research Institute Australia
2018-2025
The University of Western Australia
2018-2025
Ministry Of Health
2014-2024
Fiji National University
2015-2022
Colonial War Memorial Hospital
2007-2020
Kagando Hospital
2020
Royal Children's Hospital
2015
Murdoch Children's Research Institute
2008-2015
Secretariat of the Pacific Community
2015
Australian National University
2015
Background Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these is poorly understood areas, particularly Pacific. Methodology/Principal Findings We conducted three epidemiological studies 2006 2007 to determine burden disease due impetigo children Fiji using simple easily reproducible methodology. Two were performed primary school (one study was a cross-sectional other prospective cohort over ten months) one infants (cross-sectional). The...
Abstract The indigenous populations of the South Pacific experience a high burden rheumatic heart disease (RHD). Here we report genome-wide association study (GWAS) RHD susceptibility in 2,852 individuals recruited eight Oceanian countries. Stratifying by ancestry, analysed genotyped and imputed variants Melanesians (607 cases 1,229 controls) before follow-up suggestive loci three further ancestral groups: Polynesians, Asians Mixed or other (totalling 399 617 controls). We identify novel...
To describe the implementation of bubble-CPAP in a referral hospital developing country and to investigate: feasibility nurses implementing impact on need for mechanical ventilation mortality. Retrospective evaluation prospectively collected data from two time periods: 18 months before after introduction bubble-CPAP. The was associated with 50 per cent reduction ventilation; 113 1,106 (10.2 cent) prior 70 1,382 (5.1%) CPAP (chi2, p<0.001). In there were 79 deaths (case fatality 7.1 cent). 74...
BackgroundEchocardiographic screening for rheumatic heart disease (RHD) can identify individuals with subclinical who could benefit from antibiotic prophylaxis. However, most settings have inadequate resources to implement conventional echocardiography and require a feasible, accurate method. We aimed investigate the accuracy of by non-expert operators using focused cardiac ultrasound (FoCUS).MethodsIn this prospective study diagnostic accuracy, we recruited schoolchildren aged 5 15 years in...
BackgroundThe indirect effects of pneumococcal conjugate vaccines (PCVs) are mediated through reductions in carriage vaccine serotypes. Data on PCVs Asia and the Pacific scarce. Fiji introduced ten-valent PCV (PCV10) 2012, with a schedule consisting three priming doses at 6, 10, 14 weeks age no booster dose (3 + 0 schedule) without catch-up. We investigated PCV10 introduction using cross-sectional nasopharyngeal surveys.MethodsWe did four annual surveys (one pre-PCV10 post-PCV10) greater...
Rheumatic heart disease poses a huge burden for developing countries, with Pacific Island nations having among the highest prevalence reported in world. It is recognised that echocardiography much more sensitive than clinical examination detection of rheumatic disease, but resource and cost limitations are delaying implementation screening programmes nations. Rapid using low-cost portable machines non-expert operator may be useful compromise, allowing widespread control countries.In-school...
We designed a pilot study of training module for nurses to perform rheumatic heart disease echocardiography screening in resource-poor setting. The aim was determine whether given brief, focused, basic could follow an algorithm potentially identify cases requiring clinical referral, by undertaking two-dimensional and colour Doppler scans. Training consisted week-long workshop, followed 2 weeks supervised field experience. nurses' skills were tested on blinded cohort 50 children, the results...
Background Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD Fiji during 2008–2012 people aged 5–69 years. Methods and Findings Using 1,773,999 records derived multiple sources of routine clinical administrative data, used probabilistic record-linkage define cohort 2,619 persons diagnosed with RHD, observed for all-cause over 11,538 person-years....
Echocardiography is a sensitive test for rheumatic heart disease (RHD) screening; however the natural history of RHD detected on screening has not been established. We aimed to evaluate progression screening-detected in Fiji.All young people previously diagnosed with through screening, echocardiograms available review, were eligible. All baseline reported again. Participants underwent follow-up echocardiography. A paediatric cardiologist determined diagnosis using World Heart Federation...
The in-vivo plasma concentration of penicillin needed to prevent Streptococcus pyogenes pharyngitis, recurrent acute rheumatic fever, and progressive heart disease is not known. We used a human challenge model assess the minimum required streptococcal pharyngitis. In CHIPS, randomised, double-blind, placebo-controlled, trial, healthy adult volunteers were randomly assigned by computer-generated random sequence target steady-state concentrations (placebo, 3, 6, 9, 12, or 20 ng/mL). study was...
Objectives: To determine the incidence and clinical features of acute rheumatic fever (ARF) in Fiji, patients presenting to hospital Fiji with heart disease (RHD). Design setting: A prospective surveillance study at Colonial War Memorial Hospital Suva over a 23-month period from December 2005 November 2007. Main outcome measures: Incidence ARF; ARF RHD. Results: The average annualised definite cases children aged 5–15 years was 15.2 per 100 000 (95% CI, 9.0–22.6). were similar those classic...
Background: Acute rheumatic fever and heart disease cause a high burden of in Fiji surrounding Pacific Island countries, but little is known about the epidemiology group A streptococcal (GAS) pharyngitis region. We designed study to estimate prevalence carriage beta-hemolytic streptococci (BHS) incidence BHS culture-positive sore throat school aged children Fiji. Methods: conducted twice-weekly prospective surveillance 5 14 years 4 schools during 9-month period 2006, after an initial phase...
ABSTRACT Group A streptococcal (GAS) serology is used for the diagnosis of post-streptococcal diseases, such as acute rheumatic fever, and occasionally pharyngitis. Experts recommend that upper limits normal be determined individual populations because differences in epidemiology GAS between populations. Therefore, we performed a study to determine values limit anti-streptolysin O (ASO) anti-DNase B (ADB) titers Fiji. Participants with history disease, including pharyngitis or impetigo, were...
ABSTRACT We designed a study to investigate the molecular epidemiology of group A streptococcal (GAS) and C G (GCS GGS) disease in Fiji, country which is known have high burden disease. Molecular typing N-terminal portion ( emm typing) M protein was performed with 817 isolates (535 GAS 282 GCS/GGS). also genotyping C-repeat region 769 these identify J14 sequence types. The profile types for Fiji very different from that found United States Europe. There were no dominant large number...
Group A Streptococcus (GAS) skin infections are particularly prevalent in developing nations. The GAS M protein, by which strains differentiated into >220 different emm types, is immunogenic and elicits protective antibodies. major obstacle for vaccine development has been the traditional understanding that immunity following infection restricted to a single type. However, recent evidence led hypothesis of immune cross-reactivity between types.We investigated human serological response...
Since 1955, the recommended strategy for rheumatic heart disease (RHD) secondary prophylaxis has been benzathine penicillin G [BPG; 1.2 MU (900 mg)] injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It previously demonstrated that BPG delivered subcutaneously at a standard dose safe tolerable favorable pharmacokinetics, setting scene improved regimens with less frequent administration. The safety,...
The duration of antibody response following reduced human papillomavirus (HPV) vaccine doses has not been determined. We compared the responses in girls previously vaccinated with zero, 1, 2, or 3 quadrivalent HPV (4vHPV; Gardasil, Merck) 6 years previously.A prospective cohort study was undertaken 200 Fijian 15-19 age. Approximately equal numbers from 2 main ethnic groups (Fijians Indian descent [FID] and Indigenous Fijians [iTaukei]) Fiji were recruited for each dosage groups. Blood drawn...
Echocardiographic screening for rheumatic heart disease (RHD) has the potential to detect subclinical cases secondary prevention, but is constrained by inadequate human resources in most settings. Training non-expert health workers perform focused cardiac ultrasound (FoCUS) may enable at a population-level. We aimed evaluate quality and agreement of FoCUS valvular regurgitation briefly trained workers. Seven nurses participated an eight week training program Fiji. Nurses performed on 2018...
Scabies is an important predisposing factor of impetigo which can lead to serious bacterial complications. Ivermectin-based mass drug administration substantially reduce scabies and prevalence in endemic settings, but the impact on complications not known.We conducted a before-after trial Northern Division Fiji (population: 131,914) for control. Prospective surveillance was from 2018 2020. Mass took place 2019, involving two doses oral ivermectin or topical permethrin, delivered alongside...
Secondary prophylaxis to prevent rheumatic heart disease (RHD) progression, in the form of four-weekly intramuscular benzathine benzylpenicillin G (BPG) injections, has remained unchanged since 1955. Qualitative investigations into patient preference have highlighted need for long-acting penicillins be delivered less frequently, ideally with reduced pain. We describe experience healthy volunteers participating a phase-I safety, tolerability and pharmacokinetic trial subcutaneous infusions...