Tom Snelling
Head, Infectious Disease Implementation Research
BMBS DTMH GDipClinEpid PhD FRACP
tom.snelling@thekids.org.au
+61 8 6319 1817
Professor Tom Snelling is Head of the Infectious Disease Implementation research team at The Kids Research Institute Australia's Wesfarmers Centre of Vaccines & Infectious Diseases, and a NHMRC Career Development Fellow.
His research addresses the implementation of health policy and clinical practice, in particular the evaluation of vaccination and other public health strategies to minimise the burden of childhood infectious diseases. This work integrates clinical trials with case-control and cohort studies and disease modelling. His current work is investigating how best to prevent and treat gastroenteritis, pneumonia, pertussis and other lower respiratory infections, and congenital rubella. Tom was awarded a Medical Research Future Fund (MRFF) grant from NHMRC earlier this year and leads this Bayesian Evidence-Adaptive Trial to optimise management of cystic fibrosis.
His work has a strong focus on Aboriginal and international child health. He is also investigating the safety of vaccination in early childhood.
Projects
PATRIC: Pragmatic Adaptive Trial for Respiratory Infections in Children
The pathogen specific burden of hospitalisation for enteric and blood stream infection in children and young people in Western Australia
Pneumo-BNA: Using Bayesian network models to facilitate a microbiological diagnosis in childhood pneumonia: development of a clinical decision support tool
Linkage of the Australian Childhood Immunisation Register (ACIR) and state-based registers to evaluate and inform Australia’s immunisation program
Evaluating the use and effectiveness of passive immunization in reducing RSV-associated morbidity in high risk infants
The END RHD CRE: Developing an end game for rheumatic heart disease in Australia
PneumoWA: A case-control study of the role of viral and bacterial pathogens in causing pneumonia among Western Australian children
AusVaxSafety
August 2020
CASSETTE: Clindamycin Adjunctive therapy for Severe Staphylococcus aurEus Treatment Evaluation, a multi-centre, pilot randomised controlled trial
Towards the establishment of the PREVAIL Centre, a Centre for PREcision in VAccine ImpLmentation at The Kids Research Institute Australia
The ORVAC Trial - A phase IV, double-blind, randomised, placebo-controlled clinical trial to optimise the delivery of RV1 rotavirus vaccine to Northern Territory Aboriginal infants
The NICE GUT Trial
July 2020
The Effect of SMS Reminders on Vaccine Hesitancy in New Parents
TESTOV Pneumo
July 2020
Prediction of Causative Pathogen of Osteomyelitis Using Bayesian Network Modelling
PIFA - Pertussis and Food allergy, a case-cohort study of the association between pertussis vaccination in infancy and the risk of IgE-mediated food allergy
OPTIMUM: OPTimising IMmunisation Using Mixed schedules
FeBRILe3– Fever, Blood cultures and Readiness for discharge in Infants Less than 3 months’ old
Evaluation of PLATINUM C: PLATform IN the Use of Medicines to treat chronic hepatitis C
Determinants of incomplete vaccination and non-vaccination among WA children
AuTOmatic: Adaptive Trial of MessAging to improve Immunisation Coverage
Characterization of “bystander” effects of the diphtheria-pertussis-tetanus (DTP) vaccine on the IgE system
We are seeking more detailed information on how the immune system of infants responds to the vaccine, with the aim of identifying which aspects of the immune r
Paediatric Active Enhanced Diseases Surveillance (PAEDS)
PAEDS monitors for key vaccine preventable conditions and severe side effects from vaccine in 5 paediatric hospitals in Australia.
Published research
Short-Term Active Safety Surveillance of the Spikevax and Nuvaxovid Priming Doses in Australia
Australia commenced administration of the Spikevax (Moderna mRNA-1273) COVID-19 vaccine in August 2021 and Nuvaxovid (Novavax NVX-CoV2373) in January 2022. This study describes the short-term safety profile of priming doses of the Spikevax and Nuvaxovid vaccines given between September 2021 and September 2023.
Applying causal inference and Bayesian statistics to understanding vaccine safety signals using a simulation study
Community perception of vaccine safety influences vaccine uptake. Our objective was to assess current vaccine safety monitoring by examining factors that may influence the availability of post-vaccination survey data, and thereby the specificity and sensitivity of existing signal detection methods.
Whole-of-Life Inclusion in Bayesian Adaptive Platform Clinical Trials
There is a recognized unmet need for clinical trials to provide evidence-informed care for infants, children and adolescents. This Special Communication outlines the capacity of 3 distinct trial design strategies, sequential, parallel, and a unified adult-pediatric bayesian adaptive design, to incorporate children into clinical trials and transform this current state of evidence inequity. A unified adult-pediatric whole-of-life clinical trial is demonstrated through the Staphylococcus aureus Network Adaptive Platform (SNAP) trial.
SMS-based interventions for improving child and adolescent vaccine coverage and timeliness: a systematic review
The aim of this review was to investigate the impact of short message service (SMS)-based interventions on childhood and adolescent vaccine coverage and timeliness.
Same-visit hepatitis C testing and treatment to accelerate cure among people who inject drugs (the QuickStart Study): A cluster randomised cross-over trial protocol
Despite universal access to government-funded direct-acting antivirals in 2016, the rate of hepatitis C treatment uptake in Australia has declined substantially. Most hepatitis C is related to injecting drug use; reducing the hepatitis C burden among people who inject drugs is, therefore, paramount to reach hepatitis C elimination targets.
Immunogenicity, reactogenicity, and IgE-mediated immune responses of a mixed whole-cell and acellular pertussis vaccine schedule in Australian infants: A randomised, double-blind, noninferiority trial
In many countries, infant vaccination with acellular pertussis (aP) vaccines has replaced use of more reactogenic whole-cell pertussis (wP) vaccines. Based on immunological and epidemiological evidence, we hypothesised that substituting the first aP dose in the routine vaccination schedule with wP vaccine might protect against IgE-mediated food allergy. We aimed to compare reactogenicity, immunogenicity, and IgE-mediated responses of a mixed wP/aP primary schedule versus the standard aP-only schedule.
Infant Whole-Cell Versus Acellular Pertussis Vaccination in 1997 to 1999 and Risk of Childhood Hospitalization for Food-Induced Anaphylaxis: Linked Administrative Databases Cohort Study
Evidence suggests that children who had received an initial priming dose of whole-cell pertussis (wP) vaccine, rather than acellular pertussis (aP) vaccine, had a lower risk of developing IgE-mediated food allergy, the most common cause of anaphylaxis-related hospital presentations of childhood.
Pragmatic Adaptive Trial for Respiratory Infection in Children (PATRIC) Clinical Registry protocol
Acute respiratory infections (ARI) are the most common cause of paediatric hospitalisation. There is an urgent need to address ongoing critical knowledge gaps in ARI management. The Pragmatic Adaptive Trial for Respiratory Infections in Children (PATRIC) Clinical Registry will evaluate current treatments and outcomes for ARI in a variety of paediatric patient groups.
A blueprint for a multi-disease, multi-domain Bayesian adaptive platform trial incorporating adult and paediatric subgroups: the Staphylococcus aureus Network Adaptive Platform trial
The Staphylococcus aureus Network Adaptive Platform (SNAP) trial is a multifactorial Bayesian adaptive platform trial that aims to improve the way that S. aureus bloodstream infection, a globally common and severe infectious disease, is treated. In a world first, the SNAP trial will simultaneously investigate the effects of multiple intervention modalities within multiple groups of participants with different forms of S. aureus bloodstream infection.
A single blinded, phase IV, adaptive randomised control trial to evaluate the safety of coadministration of seasonal influenza and COVID-19 vaccines (The FluVID study)
We evaluated the frequency of moderate and severe adverse events following coadministration of seasonal influenza vaccine (SIV) versus placebo with COVID-19 vaccines among adults to support practice guidelines.
FeBRILe3: Safety Evaluation of Febrile Infant Guidelines Through Prospective Bayesian Monitoring
Despite evidence supporting earlier discharge of well-appearing febrile infants at low risk of serious bacterial infection (SBI), admissions for ≥48 hours remain common. Prospective safety monitoring may support broader guideline implementation.
Association between pertussis vaccination in infancy and childhood asthma: A population-based record linkage cohort study
Asthma is among the commonest noncommunicable diseases of childhood and often occurs with other atopic comorbidities. A previous case-control study found evidence that compared to children who received acellular pertussis (aP) vaccines in early infancy, children who received one or more doses of whole-cell pertussis (wP) vaccine had lower risk of developing IgE-mediated food allergy. We hypothesized that wP vaccination in early infancy might protect against atopic asthma in childhood.
Using causal directed acyclic graphs (DAGs) to select patient-important outcomes in transplantation trials—interventions to treat polyomavirus infection as an example
Randomised controlled trial of perinatal vitamin D supplementation to prevent early-onset acute respiratory infections among Australian First Nations children: the 'D-Kids' study protocol
Globally, acute respiratory infections (ARIs) are a leading cause of childhood morbidity and mortality. While ARI-related mortality is low in Australia, First Nations infants are hospitalised with ARIs up to nine times more often than their non-First Nations counterparts.
Modeling COVID-19 disease processes by remote elicitation of causal Bayesian networks from medical experts
COVID-19 is a new multi-organ disease causing considerable worldwide morbidity and mortality. While many recognized pathophysiological mechanisms are involved, their exact causal relationships remain opaque. Better understanding is needed for predicting their progression, targeting therapeutic approaches, and improving patient outcomes. While many mathematical causal models describe COVID-19 epidemiology, none have described its pathophysiology.
among children with pneumonia using a causal Bayesian network
Pneumonia remains a leading cause of hospitalization and death among young children worldwide, and the diagnostic challenge of differentiating bacterial from non-bacterial pneumonia is the main driver of antibiotic use for treating pneumonia in children. Causal Bayesian networks (BNs) serve as powerful tools for this problem as they provide clear maps of probabilistic relationships between variables and produce results in an explainable way by incorporating both domain expert knowledge and numerical data.
The AuTOMATIC trial: a study protocol for a multi-arm Bayesian adaptive randomised controlled trial of text messaging to improve childhood immunisation coverage
While most Australian children are vaccinated, delays in vaccination can put them at risk from preventable infections. Widespread mobile phone ownership in Australia could allow automated short message service (SMS) reminders to be used as a low-cost strategy to effectively 'nudge' parents towards vaccinating their children on time.
The Impact of a Multifaceted Tertiary Pediatric Hospital's Antimicrobial Stewardship Service
Antimicrobials are the most commonly prescribed drug class in children. Overuse through inappropriate prescribing is a key driver of antimicrobial resistance and is recognized as one of the top 10 threats to global health by the World Health Organization.
Urinary tract infections in children: building a causal model-based decision support tool for diagnosis with domain knowledge and prospective data
Diagnosing urinary tract infections (UTIs) in children in the emergency department (ED) is challenging due to the variable clinical presentations and difficulties in obtaining a urine sample free from contamination.
Prevalence of respiratory viruses in community-acquired pneumonia in children: a systematic review and meta-analysis
Respiratory viruses are increasingly detected in children with community-acquired pneumonia but prevalence estimates vary substantially. We aimed to systematically review and pool estimates for 22 viruses commonly associated with community-acquired pneumonia.
Pertussis Disease and Antenatal Vaccine Effectiveness in Australian Children
Population-level studies of severe pertussis extending beyond infancy are sparse, and none in the context of antenatal vaccination. We compared hospitalized pertussis cases from birth to 15 years of age before and after introduction of antenatal immunization.
Pertussis burden and acellular pertussis vaccine effectiveness in high risk children
Pertussis hospitalisation is more common among infants born prematurely, who have significant comorbidities, or are Indigenous, but acellular pertussis (aP) vaccine effectiveness (VE) estimates in these sub-groups are lacking. We measured aP VE by Indigenous status, and policy-relevant categories of prematurity and comorbidity, in a population-based Australian cohort.
Pertussis immunisation in infancy and atopic outcomes: A protocol for a population-based cohort study using linked administrative data
The burden of IgE-mediated food allergy in Australian born children is reported to be among the highest globally. This illness shares risk factors and frequently coexists with asthma, one of the most common noncommunicable diseases of childhood.
Whole-cell pertussis vaccine in early infancy for the prevention of allergy in children
Atopic diseases are the most common chronic conditions of childhood. The apparent rise in food anaphylaxis in young children over the past three decades is of particular concern, owing to the lack of proven prevention strategies other than the timely introduction of peanut and egg.
Whole‐cell pertussis vaccine in early infancy for the prevention of allergy in children
Atopic diseases are the most common chronic conditions of childhood. The apparent rise in food anaphylaxis in young children over the past three decades is of particular concern, owing to the lack of proven prevention strategies other than the timely introduction of peanut and egg.
Bridging the gaps in test interpretation of SARS-CoV-2 through Bayesian network modelling
In the absence of an established gold standard, an understanding of the testing cycle from individual exposure to test outcome report is required to guide the correct interpretation of SARS-CoV-2 reverse transcriptase real-time polymerase chain reaction (RT-PCR) results and optimise the testing processes.
Nasopharyngeal density of respiratory viruses in childhood pneumonia in a highly vaccinated setting: findings from a case-control study
Detection of pneumonia-causing respiratory viruses in the nasopharynx of asymptomatic children has made their actual contribution to pneumonia unclear. We compared nasopharyngeal viral density between children with and without pneumonia to understand if viral density could be used to diagnose pneumonia.
Infant, maternal and demographic predictors of delayed vaccination: A population-based cohort study
Receiving vaccines at or close to their due date (vaccination timeliness) is a now key measure of program performance. However, studies comprehensively examining predictors of delayed infant vaccination are lacking. We aimed to identify predictors of short and longer-term delays in diphtheria-tetanus-pertussis (DTP) vaccination by dose number and ethnicity.
Core Outcome Measures for Trials in People With Coronavirus Disease 2019: Respiratory Failure, Multiorgan Failure, Shortness of Breath, and Recovery
Respiratory failure, multiple organ failure, shortness of breath, recovery, and mortality have been identified as critically important core outcomes by more than 9300 patients, health professionals, and the public from 111 countries in the global coronavirus disease 2019 core outcome set initiative. The aim of this project was to establish the core outcome measures for these domains for trials in coronavirus disease 2019. Three online consensus workshops were convened to establish outcome measures for the four core domains of respiratory failure, multiple organ failure, shortness of breath, and recovery.
Topical versus systemic antibiotics for chronic suppurative otitis media
Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection (involving more than one micro-organism) of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Antibiotics are the most common treatment for CSOM, which act to kill or inhibit the growth of micro-organisms that may be responsible for the infection.
OPTIMUM study protocol: an adaptive randomised controlled trial of a mixed whole-cell/acellular pertussis vaccine schedule
Combination vaccines containing whole-cell pertussis antigens were phased out from the Australian national immunisation programme between 1997 and 1999 and replaced by the less reactogenic acellular pertussis (aP) antigens. In a large case-control study of Australian children born during the transition period, those with allergist diagnosed IgE-mediated food allergy were less likely to have received whole-cell vaccine in early infancy than matched population controls (OR: 0.77 (95% CI, 0.62 to 0.95)). We hypothesise that a single dose of whole-cell vaccine in early infancy is protective against IgE-mediated food allergy.
Predictors of hospital readmission in infants less than 3 months old
To examine rates and predictors of 7-day readmission in infants hospitalised before 3 months of age with infectious and non-infectious conditions. A retrospective population-based data-linkage study of 121 854 infants from a 5-year metropolitan birth cohort (2008-2012). Cox proportional hazard models were used to examine associations between infant and maternal factors with 7-day readmission.
Retrospective Case-Control Study of 2017 G2P[4] Rotavirus Epidemic in Rural and Remote Australia
A widespread G2P[4] rotavirus epidemic in rural and remote Australia provided an opportunity to evaluate the performance of Rotarix and RotaTeq rotavirus vaccines, ten years after their incorporation into Australia's National Immunisation Program.
A platform in the use of medicines to treat chronic hepatitis C (PLATINUM C): protocol for a prospective treatment registry of real-world outcomes for hepatitis C
Safe, highly curative, short course, direct acting antiviral (DAA) therapies are now available to treat chronic hepatitis C. DAA therapy is freely available to all adults chronically infected with the hepatitis C virus (HCV) in Australia. If left untreated, hepatitis C may lead to progressive hepatic fibrosis, cirrhosis and hepatocellular carcinoma.
RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013: a record linkage cohort study
The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown.
Whole-cell pertussis vaccine in early infancy for the prevention of allergy
This is a protocol for a Cochrane Review (intervention). The objectives were to assess the efficacy and safety of whole‐cell pertussis (wP) vaccinations in comparison to acellular pertussis (aP) vaccinations in early infancy for the prevention of atopic diseases in children.
Predicting the causative pathogen among children with osteomyelitis using Bayesian networks – improving antibiotic selection in clinical practice
We have demonstrated the potential use of Bayesian Networks in improving antibiotic selection for children with osteomyelitis
Whole-Cell Pertussis Vaccination and Decreased Risk of IgE-Mediated Food Allergy: A Nested Case-Control Study
Australian infants who received whole-cell pertussis vaccines were less likely to be diagnosed with food allergy in childhood
10-Valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine versus 13-valent pneumococcal conjugate vaccine (PCV13) as a booster dose
18 months of age infants receiving 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine will have higher antibody levels
Feasibility and acceptability of the multi-component P3-MumBubVax antenatal intervention to promote maternal and childhood vaccination: A pilot study
The P3-MumBubVax intervention is feasible and acceptable in the Australian public antenatal setting
Safety of live attenuated herpes zoster vaccine in adults 70–79 years: A self-controlled case series analysis using primary care data
No new safety concerns were identified for live attenuated herpes zoster vaccine in this study based on a novel, Australian primary care data source
FeBRILe3 Project: protocol for a prospective study and safety evaluation assessing Fever, Blood cultures and Readiness for discharge in Infants Less than 3 months old
Assess the safety and impact of the introduction of a guideline recommending early discharge of infants with fever without source at low risk of serious bacterial infection
Timeliness of signal detection for adverse events following influenza vaccination in young children: a simulation case study
Active vaccine safety surveillance leading to rapid detection of a safety signal would likely have resulted in earlier suspension of Fluvax from the vaccination programme
Birth outcomes in Aboriginal mother–infant pairs from the Northern Territory, Australia, who received 23-valent polysaccharide pneumococcal vaccination during pregnancy
We found a numerically higher rate of preterm births among women who received 23vPPV in pregnancy compared to unvaccinated pregnant women
Choosing primary endpoints for clinical trials of health care interventions
This narrative review describes the evolution, range and relative strengths and weaknesses of endpoints used in late phase trials
Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis
Palivizumab appeared effective for reducing virologically confirmed respiratory syncytial virus in this high-risk cohort
An introduction to clinical trial design
This manuscript will give a brief overview of clinical trial design including the strengths and limitations of various approaches
Effectiveness of pneumococcal conjugate vaccine against hospital admissions for pneumonia in Australian children
Reductions in pneumonia-coded hospital admissions in unvaccinated children predominated in non-Aboriginal children with low incidence of pneumonia
Effectiveness of rotavirus vaccines in an Australian population: A case-control study
RV1 and RV5 were both effective in preventing laboratory confirmed and notified rotavirus infections among children aged <5 years
Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study
Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher
Discrete choice experiment to evaluate preferences of patients with cystic fibrosis among alternative treatment-related health outcomes: A protocol
The aim of this study is to identify and quantify the preferences of patients with cystic fibrosis regarding treatment outcomes
Influenza vaccination in pregnancy among a group of remote dwelling Aboriginal and Torres Strait Islander mothers in the Northern Territory
We examined uptake of inactivated influenza vaccination in pregnancy and report adverse birth outcomes amongst a predominantly unvaccinated group
RD-RAP: Beyond rare disease patient registries, devising a comprehensive data and analytic framework
We introduce and describe the concept of a Rare Disease Registry and Analytics Platform
Agreement between units of measure for paediatric antibiotic utilisation surveillance using hospital pharmacy supply data
Agreement between the DDD and vial-based measures of use supports the use of DDD for select antibiotics that may be targeted by antimicrobial stewardship programs
Links2HealthierBubs' cohort study: Protocol for a study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women
Multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions
Impact of influenza on hospitalization rates in children with a range of chronic lung diseases
This large population-based study suggests a significant healthcare burden associated with influenza in children with a range of chronic lung diseases
Identification of the determinants of incomplete vaccination in Australian children
Most parents are supportive of vaccination. Sociodemographic factors may contribute more to the risk of incomplete vaccination than attitudes or beliefs.
Combination of clinical symptoms and blood biomarkers can improve discrimination between bacterial or viral community-acquired pneumonia in children
Combining elevated CRP with the presence or absence of clinical signs/ symptoms differentiates definite bacterial from presumed viral pneumonia better than CRP alone
Research Note: Adaptive trials
This Research Note has explored the strengths, risks and potential complexity of adaptive trials
Factors associated with adherence to antimicrobial stewardship after-hours
Restricted antimicrobials acquired after-hours are not routinely antimicrobial stewardship adherent at the time of acquisition or the next standard working day
Trial refresh: A case for an adaptive platform trial for pulmonary exacerbations of cystic fibrosis
This review will discuss the necessary steps required for a Bayesian adaptive platform trial to optimize treatment of pulmonary exacerbations of cystic fibrosis
The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: A case - Control study
Respiratory viruses, particularly respiratory syncytial virus and human metapneumovirus, are major contributors to pneumonia in Australian children
Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012)
Given the beneficial effect of infant rotavirus vaccination efforts should be taken to optimize rotavirus vaccine coverage in those at highest risk
Baseline incidence of adverse birth outcomes and infant influenza and pertussis hospitalisations prior to the introduction of influenza and pertussis vaccination
These baseline data are essential to assess the safety and effectiveness of influenza and pertussis vaccinations in pregnant women from the NT
Midwives’ attitudes, beliefs and concerns about childhood vaccination: A review of the global literature
The majority of midwives supported vaccination, although a spectrum of beliefs and concerns emerged
Sharing knowledge about immunisation (SKAI): An exploration of parents' communication needs to inform development of a clinical communication support intervention
The Sharing Knowledge About Immunisation project aims to develop effective communication tools to support primary health care providers' consultations with parents
Hesitant compliers': Qualitative analysis of concerned fully-vaccinating parents
Parents interpreted pivotal vaccine-related events in the community as requiring them to take personal responsibility for vaccine decisions
Active surveillance of 2017 seasonal influenza vaccine safety: An observational cohort study of individuals aged 6 months and older in Australia
AusVaxSafety surveillance demonstrated comparable and expected safety outcomes for the 2017 quadrivalent inactivated influenza vaccine brands used in Australia
Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study
On-time coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk
Topical versus systemic antibiotics for chronic suppurative otitis media
To assess the relative effectiveness of topical versus systemic antibiotics for people with chronic suppurative otitis media
The influence of incomplete case ascertainment on measures of vaccine efficacy
A biologically active vaccine may produce a low measured vaccine efficacy under a range of epidemiological, vaccine-related and logistical conditions
Effectiveness of a 3 + 0 pneumococcal conjugate vaccine schedule against invasive pneumococcal disease among a birth cohort of 1.4 million children in Australia
Our population-based cohort study demonstrates that >90% coverage in the first year of a universal 3 + 0 PCV program provided high population-level protection
Paediatric antimicrobial stewardship and safe prescribing: An assessment of medical staff knowledge and behaviour
Participants demonstrated a good understanding of safe prescribing and antimicrobial stewardship
Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study
To determine the contribution of RSV to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.
Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: A case-control study protocol
We aim to determine the contribute of bacteria and virus to childhood CAP to inform further development of effective strategies.
The NICE-GUT trial protocol: A randomised, placebo controlled trial of oral nitazoxanide for the empiric treatment of acute gastroenteritis among Australian Aboriginal children
Diarrhoeal disease is the second leading cause of death in children under 5 years globally, killing 525 000 annually. Australian Aboriginal and Torres Strait Islander (hereafter Aboriginal) children suffer a high burden of disease.
Protocol for Pertussis Immunisation and Food Allergy (PIFA): a case-control study of the association between pertussis vaccination in infancy
We therefore speculate that removal of wP from the vaccine schedule contributed to the observed rise in IgE-mediated food allergy among Australian infants
Advances in Vaccines to Prevent Viral Respiratory Illnesses in Children
Childhood vaccination has played a critical role in the reduction of morbidity and mortality from communicable diseases, including specific respiratory pathogens
Paediatrician beliefs and practices around influenza vaccination
We aimed to determine Australian paediatricians' beliefs and practices around the influenza vaccination of children.
A 15-Year Old Burmese Girl With Hemoptysis: A Case Report
A 15 year old girl, born in Hakha, Myanmar, presented with 2 months of intermittent hemoptysis 3 years after immigrating to Australia, via Malaysia.
Comprehending the Health Informatics Spectrum: Grappling with System Entropy and Advancing Quality Clinical Research
We outline three scenarios from across the health spectrum where issues with health informatics are exemplified.
Predictors of pneumococcal carriage and the effect of the 13-valent pneumococcal conjugate vaccination the Western Australian Aboriginal population
The PCV7 was introduced to prevent IPD in WA Aboriginal people in 2001 to a lesser extent in older people.
Probabilistic linkage of national immunisation and state-based health records for a cohort of 1.9 million births to evaluate Australia’s childhood immunisation program
To describe the process for assembling a linked study that will enable the conduct of population-based studies related to immunisation and immunisation policy.
Dose-Banding of Intravenous Piperacillin-Tazobactam in Pediatric Surgical Inpatients
Dosing errors are the most commonly reported medication error in children. Dosing is often prescribed per weight or based on body area.
Nurses are underutilised in antimicrobial stewardship - Results of a multisite survey in paediatric and adult hospitals
Nurses consider antimicrobial stewardship activities within their roles, but are underutilised in antimicrobial stewardship programs
Population-based estimates of the effectiveness of pneumococcal vaccination in Australia
Australia’s Childhood Immunisation Register (ACIR) is one of only a handful of national immunisation registers world-wide.
Informing rubella vaccination strategies in East Java, Indonesia through transmission modelling
A single dose of rubella vaccine will take longer to reduce the burden of rubella and will be less robust to lower vaccine coverage
Transiently increased IgE responses in infants and pre-schoolers receiving only (DTaP) vaccines compared to those initially receiving at least one dose of DTwP vaccine
Confirm the generalised IgE-trophic activity of the DTaP vaccine in pre-schoolers and demonstrate similar (albeit transient) effects in infants
Risk factors associated with RSV hospitalisation in the first 2 years of life, among different subgroups of children in NSW
Data on risk factors for respiratory syncytial virus (RSV)-associated hospitalisation in Australian children may be informative for preventive measures.
High burden of RSV hospitalization in very young children: a data linkage study
RSV was associated with substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and pre-term children
Australian trachoma surveillance annual report, 2013
National Trachoma Surveillance and Reporting Unit to collate, analyse and report trachoma prevalence data and document trachoma control strategies in Australia
Respiratory syncytial virus is present in the neonatal intensive care unit
The results suggest that though the risk for RSV in the NICU remains low, personnel clothing are contaminated with RSV-RNA and may have a role in transmission
Whither pertussis?
This article discusses the rising prevalence of pertussis disease in countries which have switched to acellular vaccines.
November 2015
Real-time safety surveillance of seasonal influenza vaccines in children, Australia, 2015
This paper reports the results from the safety surveillance of influenza vaccines in children in Australia, in 2015.
Impact of high coverage of monovalent human rotavirus vaccine on Emergency Department presentations for rotavirus gastroenteritis
The program was associated with a substantial decline in rotavirus attributable non-admitted AGE presentations to ED among children aged <5 years.
Characterization of G2P[4] rotavirus strains causing outbreaks of gastroenteritis in the Northern Territory, Australia, in 1999, 2004 and 2009
Outbreaks of rotavirus diarrhea cause a large disease burden in the Alice Springs region of the Northern Territory, Australia.
Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals
This study aimed to examine the uptake of influenza vaccination amongst a cohort of Australian children and factors associated with vaccine acceptance.
Management of invasive group A streptococcal infections
Invasive group A streptococcal disease in children includes deep soft tissue infection, bacteraemia, bacteraemic pneumonia, meningitis and osteomyelitis
Parental Tdap boosters and infant pertussis: a case-control study
Case households had fewer immunized mothers (22% vs 32%) or fathers (20% vs 31%) but were more likely to include additional and older children. After...
Waning vaccine immunity in teenagers primed with whole cell and acellular pertussis vaccine: Recent epidemiology
The recent epidemics of pertussis (whooping cough) in parts of the USA and Australia have led to the largest numbers of annual cases reported in over half a...
Assessing the effect of meningitis prevention and treatment.
In high-income countries serious bacterial infections such as meningitis are uncommon, but their severity has led to prompt adoption of vaccines for...
Nitazoxanide for the treatment of infectious diarrhoea in the Northern Territory, Australia 2007-2012
This paper examines the use of a new antibiotic to treat diarrhoea cause by Cryptosporidium infection in Australian Indigenous children.
Duration of protection after first dose of acellular pertussis vaccine in infants
Without a booster dose, the effectiveness of 3 doses waned more rapidly from 2 to 4 years of age than previously documented for children >6 years of age who...
Effectiveness of Palivizumab in Preventing RSV Hospitalization in High Risk Children: A Real-World Perspective
This review supports the recommended use of palivizumab for reducing RSV-associated hospitalisation rates in premature babies born at gestational age <33 weeks.
Characterization of a G1P[8] rotavirus causing an outbreak of gastroenteritis in the Northern Territory, Australia, in the vaccine era
In 2010, a large outbreak of rotavirus gastroenteritis occurred in the Alice Springs region of the Northern Territory, Australia.
Education and Qualifications
2014 - Summer Institute in Statistics for Clinical Research, University of Washington
2012 - Doctor of Philosophy, Menzies School of Health Research and Charles Darwin University
2012 - Summer Institute in Statistics and Modelling in Infectious Diseases, University of Washington
2010 - Epidemiology and Control of Infectious Disease course, Imperial College, London
2009 - Graduate Diploma in Clinical Epidemiology, University of Newcastle
2008 - Certificate in Advanced Vaccinology, Fondation Merieux, France
2007 - Diploma of Tropical Medicine & Hygiene, Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia and University of Alabama at Birmingham, Peru
2000-2005 - Fellowship, RACP (SAC infectious diseases)
1999 - Bachelor of Medicine, Bachelor of Surgery (Honours), Flinders University of South Australia
Awards/Honours
2016 - Shortlisted for the 2016 3M Eureka Prize for Emerging Leader in Science
2015 - University of Western Australia Vice-Chancellor's Early Career Investigators Award
2015 - WA Department of Health New Independent Researcher Infrastructure Support (NIRIS) Award
2013 - “Ten of the Best” NHMRC-funded projects in 2013 for NHMRC Project Grant: Case-control study of the effectiveness of rotavirus vaccination in preventing hospitalisations in the Northern Territory
2013-2015 - Fiona Stanley Investigator, The Kids Research Institute Australia
2008 - Alan Walker Scholarship in Indigenous Child Health, Menzies School of Health Research
1998 - Australian Medical Association Medal, Flinders University of South Australia
1998 - The WA Crammond Prize for Psychiatry, Flinders University
1998 - The Staff Prize for Surgery, Flinders University
1997 - Vice-Chancellor's Commendation, Flinders University