research

international child health

summary

The core aims of this group are to address the inequity in global child mortality, to assist countries to achieve their Millennium Development Goals in child health, and to develop strong child health systems.

group leader(s)

A/Professor Steve Graham
International Child Health
Murdoch Childrens Research Institute
Royal Children's Hospital
Flemington Road
Parkville Victoria 3052

T +61 3 9345 5968
E steve.graham@rch.org.au

current research projects

Project 1: A prospective evaluation of the health impact of skin infections in the tropics

Skin infections in the tropics are common and the combination of scabies plus Group A Streptococcal infection, is associated with:

Invasive infections
Acute glomerulonephritis (AGN) and unexplained adult chronic renal disease
Acute rheumatic fever (ARF)
We will conduct a randomized trial in several Pacific Islands. Units of randomization will be islands or geographically defined communities. Management of skin infections will be undertaken in the intervention group. Outcome measures will be:
Skin disease rates, ARF, AGN
Cardiac and renal disease rates
If successful, this would be the first significant breakthrough in the prevention of rheumatic heart disease for many years, and would revolutionize the role of skin disease management in primary health programs around the world.

Project 2: Fiji pneumococcal research program

Although Fiji has good health services, pneumococcal disease, particularly pneumonia, remains an important problem. Fiji has good vaccine coverage and was the first Pacific country to introduce Hib vaccine. The arrival of the new, expensive pneumococcal conjugate vaccine presents a dilemma for Fiji and many similar countries. This study has two components:
A phase two immunogenicity study (involving 750 infants) will evaluate regimens of pneumococcal vaccine that use involve fewer doses of vaccine and may be more suited to the epidemiology of pneumococcal disease seen in developing countries.
An epidemiological study will be set up to measure the burden of invasive pneumococcal disease, pneumonia, and otitis media in Fiji. This will be part of a global effort to address these issues co-ordinated by WHO.

Project 3: A prospective evaluation of an algorithm for management of sick young infants in PNG

Despite reductions in infant mortality in many parts of the world, neonatal mortality rates in most developing countries have barely changed. In developing countries most sick newborns do not reach hospitals where specialist neonatal or pediatric services may exist. However a high proportion present to primary level health services where health workers may have little training in the triaging and care of neonates. Facilities are often rudimentary and drug supplies sporadic. This project aims to determine the aetiology and risk factors associated with neonatal and young infant death. An algorithm of care for newborn and young infants will be evaluated.

team members

  • Barakat Alsuwayyid - Masters Laboratory Medicine(RMIT MedSci)
  • Ciara Baker - Research Assistant
  • Samantha Colquhoun - Program Manager
  • Trevor Duke - HONORARY FELLOW MANAGER
  • Caitlyn Henry - Administrative Assistant
  • Sophie La Vincente - Epidemiologist/ Research Fellow
  • Eleanor Neal - Administrative Coordinator
  • Andrew Steer - HONORARY FELLOW MANAGER

publications

  • Chisti MJ., Duke T., Robertson CF., Ahmed T., Faruque AS., Ashraf H., La Vincente S., Bardhan PK., Salam MA. Clinical predictors and outcome of hypoxaemia among under-five diarrhoeal children with or without pneumonia in an urban hospital, Dhaka, Bangladesh. Tropical Medicine & International Health (2011) PubMed
  • Chisti MJ., Duke T., Robertson CF., Ahmed T., Faruque ASG., Bardhan PK., La Vincente S., Salam MA. Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh. ANNALS OF TROPICAL PAEDIATRICS 31 (4) : 311 - 319(2011) PubMed
  • Dunne EM., Ong EK., Moser RJ., Siba PM., Phuanukoonnon S., Greenhill AR., Robins-Browne RM., Mulholland EK., Satzke C. Multilocus Sequence Typing of Streptococcus pneumoniae by Use of Mass Spectrometry. JOURNAL OF CLINICAL MICROBIOLOGY (2011) PubMed
  • Molyneux EM., Graham SM. Community management of severe pneumonia in children. LANCET 378 (9805) : 1762 - 1764(2011)
  • Triasih R., Duke T., Robertson CF. Outcomes following admission to intensive care for asthma. ARCHIVES OF DISEASE IN CHILDHOOD 96 (8) : 729 (2011) PubMed
  • Vernet G., Saha S., Satzke C., Burgess DH., Alderson M., Maisonneuve JF., Beall BW., Steinhoff MC., Klugman KP. Laboratory-based diagnosis of pneumococcal pneumonia: state of the art and unmet needs. CLINICAL MICROBIOLOGY AND INFECTION 17 : 1 - 13(2011) PubMed