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Marshall H.S.,Womens and Childrens Hospital | Marshall H.S.,University of Adelaide | Proeve C.,University of Adelaide | Collins J.,Womens and Childrens Hospital | And 9 more authors.
Vaccine | Year: 2014

Objectives: Completion of adolescent immunisation schedules in Australia is sub-optimal despite a well-established school based delivery program. The aim of this study was to seek adolescent and adult views on how existing adolescent school based immunisation policy and program delivery could be improved to increase adolescent immunisation uptake. Method: Two citizens' juries held separately, one with adolescent participants and one with adult participants deliberated on recommendations for public policy. Jury members were selected using a stratified sampling technique and recruited from a standing panel of community research participants through a market research company in South Australia. Juries were conducted in Metropolitan South Australia over two days and used university facilities with all meals and refreshments provided. Results: Fifteen adults and 16 adolescents participated in the adult and youth juries respectively. Similar recommendations were made by both juries including increased ensuring the accuracy of information provided to adolescents and parents; employing a variety of formats for information delivery; and greater consideration of students' physical and emotional comfort in order to improve the experience for adolescents. While the youth jury recommended that it should be compulsory for adolescents to receive vaccines through the school based immunisation program, the adult jury recommended an 'opt-out' system of consent. Both juries also recommended the use of incentives to improve immunisation uptake and immunisation course completion. Conclusions: Eliciting adolescent views and including the perspectives of adolescents in discussions and development of strategies to improve engagement in the school based immunisation program provided valuable insight from the group most impacted by these policies and practices. Specifically, incorporation of adolescent and community views using citizens' juries may lead to greater overall support from the community as their values and needs are more accurately reflected. © 2014 Elsevier Ltd.


Chinnaratha M.A.,University of South Australia | Chinnaratha M.A.,Hepatology and Liver Transplantation Unit | Graham C.,Communicable Disease Control Branch | Fraser R.J.L.,University of South Australia | And 4 more authors.
Internal Medicine Journal | Year: 2016

Background: Chronic hepatitis B virus (HBV) infection is likely to be an important driver of increasing hepatocellular carcinoma (HCC) incidence in Australia. However, there is paucity of Australian data on HBV-related HCC incidence or outcomes. Aims: To determine the incidence rates and survival trends of HBV-related HCC in South Australia (SA) over 15 years. Methods: A population-based cohort study was performed in HBV patients notified to the SA Communicable Disease Control Branch between 1996 and 2010. The dataset was probabilistically linked with the SA Cancer Registry and death registry. Incidence rate trends and survival were determined for three 5-year time periods (1996–2000, 2001–2006 and 2006–2010). Results: Forty-seven of 3881 notifications with HBV were linked to a HCC record (median (interquartile range) age at diagnosis: 58.9 (13.4) years, 83% males, 8.5% born in Australia, 62% diagnosed between 51–69 years). The overall crude HCC incidence was 111.3/100 000 person-years with an age-standardised HCC incidence of 189.1/100 000 person-years, the rate for men was higher than for women: 241.7 versus 88.6/100 000 person-years. The age-standardised HCC incidence increased over time with an annual percentage increase of 20.8% (95% CI: 10.06–32.54, P = 0.001). Median survival following HCC diagnosis was 12.5 months (95% CI: 3.6–21.4), with a trend towards longer survival during the 2006–2010 time period (21.8 months) compared to the previous two time periods (9.2 and 10.2 months, P = 0.056). Conclusion: Both crude and age-standardised incidences of HBV-related HCC increased between 1996 and 2010 in SA. There was a trend to longer survival in the latter time-period. © 2016 Royal Australasian College of Physicians


PubMed | University of South Australia and Communicable Disease Control Branch
Type: Journal Article | Journal: Internal medicine journal | Year: 2016

Chronic hepatitis B virus (HBV) infection is likely to be an important driver of increasing hepatocellular carcinoma (HCC) incidence in Australia. However, there is paucity of Australian data on HBV-related HCC incidence or outcomes.To determine the incidence rates and survival trends of HBV-related HCC in South Australia (SA) over 15 years.A population-based cohort study was performed in HBV patients notified to the SA Communicable Disease Control Branch between 1996 and 2010. The dataset was probabilistically linked with the SA Cancer Registry and death registry. Incidence rate trends and survival were determined for three 5-year time periods (1996-2000, 2001-2006 and 2006-2010).Forty-seven of 3881 notifications with HBV were linked to a HCC record (median (interquartile range) age at diagnosis: 58.9 (13.4) years, 83% males, 8.5% born in Australia, 62% diagnosed between 51-69 years). The overall crude HCC incidence was 111.3/100000 person-years with an age-standardised HCC incidence of 189.1/100000 person-years, the rate for men was higher than for women: 241.7 versus 88.6/100000 person-years. The age-standardised HCC incidence increased over time with an annual percentage increase of 20.8% (95% CI: 10.06-32.54, P=0.001). Median survival following HCC diagnosis was 12.5months (95% CI: 3.6-21.4), with a trend towards longer survival during the 2006-2010 time period (21.8months) compared to the previous two time periods (9.2 and 10.2months, P=0.056).Both crude and age-standardised incidences of HBV-related HCC increased between 1996 and 2010 in SA. There was a trend to longer survival in the latter time-period.


O'Connor B.A.,Australian National University | Tribe I.G.,Communicable Disease Control Branch | Givney R.,Communicable Disease Control Branch | Givney R.,University of Newcastle
Epidemiology and Infection | Year: 2015

In December 2004, the Department of Human Services investigated an outbreak of Q fever in South Australia. A case-control study tested an association between attending a local saleyard and human illness. A case was defined as a person with clinical illness and evidence of seroconversion or high phase II IgM. Controls were selected from a database of community controls matched on sex, age group and postcode. Matched analysis of the first 15 cases with 45 controls indicated that contracting Q fever was associated with attending the saleyard on one particular day (adjusted odds ratio 15·3, 95% confidence interval 1·7-undefined, P = 0·014). Saleyard conditions were windy and conducive for airborne dispersal of contaminated particles. In total, 25 cases were detected. Of these, 22 cases had attended a local saleyard on the same day. This outbreak suggests cases were probably infected by a single exposure at a saleyard from infected sheep and dust. The investigation resulted in an increase in the local uptake of Q fever vaccination and extension of the Australian national vaccination programme. Copyright © Cambridge University Press 2014.

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