Paediatrics (RCH) - Research Publications

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Author: O'Brien, Daniel × Start date: 2010 ×

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    The location of Australian Buruli ulcer lesions-Implications for unravelling disease transmission
    Yerramilli, A ; Tay, EL ; Stewardson, AJ ; Kelley, PG ; Bishop, E ; Jenkin, GA ; Starr, M ; Trevillyan, J ; Hughes, A ; Friedman, ND ; O'Brien, DP ; Johnson, PDR ; Pluschke, G (PUBLIC LIBRARY SCIENCE, 2017-08)
    BACKGROUND: Buruli ulcer (BU), caused by Mycobacterium ulcerans, is increasing in incidence in Victoria, Australia. To improve understanding of disease transmission, we aimed to map the location of BU lesions on the human body. METHODS: Using notification data and clinical records review, we conducted a retrospective observational study of patients diagnosed with BU in Victoria from 1998-2015. We created electronic density maps of lesion locations using spatial analysis software and compared lesion distribution by age, gender, presence of multiple lesions and month of infection. FINDINGS: We examined 579 patients with 649 lesions; 32 (5.5%) patients had multiple lesions. Lesions were predominantly located on lower (70.0%) and upper (27.1%) limbs, and showed a non-random distribution with strong predilection for the ankles, elbows and calves. When stratified by gender, upper limb lesions were more common (OR 1·97, 95% CI 1·38-2·82, p<0·001) while lower limb lesions were less common in men than in women (OR 0·48, 95% CI 0·34-0·68, p<0·001). Patients aged ≥ 65 years (OR 3·13, 95% CI 1·52-6·43, p = 0·001) and those with a lesion on the ankle (OR 2·49, 95% CI 1·14-5·43, p = 0·02) were more likely to have multiple lesions. Most infections (71.3%) were likely acquired in the warmer 6 months of the year. INTERPRETATION: Comparison with published work in Cameroon, Africa, showed similar lesion distribution and suggests the mode of M. ulcerans transmission may be the same across the globe. Our findings also aid clinical diagnosis and provide quantitative background information for further research investigating disease transmission.
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    Manual of Travel Medicine Fourth Edition
    Torresi, J ; McGuinness, S ; Leder, K ; O'Brien, D ; Ruff, T ; Starr, M ; Gibney, K (Springer Singapore, 2019)
    The fourth edition of this well received book provides an authoritative and up-to-date resource to support good practice in travel medicine, a field that has evolved substantially in recent years. Concretely, there has been intensified monitoring of health problems among travelers, as well as extensive research efforts, which have led to the development of evidence-based approaches to the field. The book includes expert recommendations regarding e.g. immunizations, malaria prophylaxis, travelers’ diarrhea, altitude sickness, emerging infections, and non-infectious health issues encountered by travelers. It provides a practical approach to the pre-travel consultation and management of most issues that arise in medical care for travelers. In addition, it provides expert advice for high-risk travelers, e.g. those with immunosuppression, the elderly, pregnant women and young children. The text offers a user-friendly, practical handbook for healthcare practitioners during their clinical consultations, as well as nurses and pharmacists.