Infectious Diseases - Research Publications

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Author: Biggs, Beverley-Ann × Author: Leder, Karin × End date: 2019 × Start date: 2010 ×

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    Refugee health update
    Schulz, TR ; Leder, K ; Maloof, T ; Biggs, BA (Medicine Today, 2012-03-01)
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    Incidence and seroprevalence of dengue virus infections in Australian travellers to Asia
    Ratnam, I ; Black, J ; Leder, K ; Biggs, B-A ; Matchett, E ; Padiglione, A ; Woolley, I ; Panagiotidis, T ; Gherardin, T ; Pollissard, L ; Demont, C ; Luxemburger, C ; Torresi, J (SPRINGER, 2012-06)
    The purpose of this study was to estimate the incidence density and prevalence of dengue virus infection in Australian travellers to Asia. We conducted a multi-centre prospective cohort study of Australian travellers over a 32-month period. We recruited 467 travellers (≥ 16 years of age) from three travel clinics who intended to travel Asia, and 387 (82.9%) of those travellers completed questionnaires and provide samples pre- and post-travel for serological testing for dengue virus infection. Demographic data, destination countries and history of vaccinations and flavivirus infections were obtained. Serological testing for dengue IgG and IgM by enzyme-linked immunosorbent assay (ELISA) (PanBio assay) was performed. Acute seroconversion for dengue infection was demonstrated in 1.0% of travellers, representing an incidence of 3.4 infections per 10,000 days of travel (95% confidence interval [CI]: 0.9-8.7). The seroprevalence of dengue infection was 4.4% and a greater number of prior trips to Asia was a predictor for dengue seroprevalence (p = 0.019). All travellers experienced subclinical dengue infections and had travelled to India (n = 3) and China (n = 1). This significant attack rate of dengue infection can be used to advise prospective travellers to dengue-endemic countries.
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    Low Risk of Japanese Encephalitis in Short-Term Australian Travelers to Asia
    Ratnam, I ; Leder, K ; Black, J ; Biggs, B-A ; Matchett, E ; Padiglione, A ; Woolley, I ; Panagiotidis, T ; Gherardin, T ; Luxemburger, C ; Torresi, J (WILEY-BLACKWELL, 2013)
    The risk of Japanese encephalitis (JE) in travelers is unknown. In this prospective study, we investigated the incidence of JE in 387 short-term Australian travelers visiting Asia over a 32-month period from August 2007 to February 2010 by performing pre- and post-travel antibody testing. No travelers were infected with JE virus during travel, indicating a low risk of infection for short-term travelers.
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    Improvements in patient care: videoconferencing to improve access to interpreters during clinical consultations for refugee and immigrant patients
    Schulz, TR ; Leder, K ; Akinci, I ; Biggs, B-A (CSIRO Publishing, 2015)
    OBJECTIVE: To demonstrate the suitability of accessing interpreters via videoconference for medical consultations and to assess doctor and patient perceptions of this compared with either on-site or telephone interpreting. METHODS: We assessed the suitability and acceptability of accessing interpreters via videoconference during out-patient clinical consultations in two situations: (i) when the doctor and patient were in a consulting room at a central hospital and the interpreter sat remotely; and (ii) when the doctor, patient and interpreter were each at separate sites (during a telehealth consultation). The main outcome measures were patient and doctor satisfaction, number of problems recorded and acceptability compared with other methods for accessing an interpreter. RESULTS: Ninety-eight per cent of patients were satisfied overall with the use of an interpreter by video. When comparing videoconference interpreting with telephone interpreting, 82% of patients thought having an interpreter via video was better or much better, 15% thought it was the same and 3% considered it worse. Compared with on-site interpreting, 16% found videoconferencing better or much better, 58% considered it the same and 24% considered it worse or much worse. CONCLUSIONS: The present study has demonstrated that accessing an interpreter via videoconference is well accepted and preferred to telephone interpreting by both doctors and patients.
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    SIRCLE: a randomized controlled cost comparison of self-administered short-course isoniazid and rifapentine for cost-effective latent tuberculosis eradication (vol 47, pg 1433, 2017)
    Denholm, JT ; McBryde, ES ; Eisen, D ; Street, A ; Matchett, E ; Chen, C ; Schulz, TR ; Biggs, B ; Leder, K (WILEY, 2018-04)
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    SIRCLE: a randomised controlled cost comparison of self-administered short-course isoniazid and rifapentine for cost-effective latent tuberculosis eradication
    Denholm, JT ; McBryde, ES ; Eisen, D ; Street, A ; Matchett, E ; Chen, C ; Shultz, T ; Biggs, B ; Leder, K (WILEY, 2017-12)
    BACKGROUND: Currently, treatment of latent tuberculosis infection (LTBI) in Australia consists most commonly of a 9-month course of isoniazid (9H). A 3-month course of weekly isoniazid and rifapentine (3HP) has been shown to be as effective as 9 months of daily isoniazid, and associated with less hepatotoxicity; however, rifapentine is not currently available in Australia. Introduction of this regimen would have apparent advantages for people with LTBI in Victoria by safely shortening duration of LTBI therapy. However, the cost benefit of this new therapeutic approach is uncertain. AIM: Cost-analysis of standard and short-course therapy for LTBI in an Australian context. METHODS: Single-centre randomised controlled trial conducted between December 2013-March 2016. Participants underwent 1:1 randomisation to either a 9-month course of daily isoniazid or a 12-week course of weekly isoniazid and rifapentine. The primary outcome measure was total healthcare system costs (in Australian dollars; AUD) per completed course of LTBI therapy. Secondary cost analyses were performed to consider varying assumptions regarding commercial cost of rifapentine. RESULTS: Overall, 34 of 40 (85%) participants in the 9H group and 36/40 (90%) in the 3HR group completed therapy. One patient in the 3HP group was hospitalised for a febrile illness; no hospitalisations were recorded in the 9H group. The cost per completed course of 9H was 601 AUD, while that of 3HP was significantly lower at 511 AUD (P < 0.01). CONCLUSIONS: This study provides cost analysis evidence to support the use of 3HP for the treatment of LTBI in Australia.