Publications by authors named "Kaldor J"

Australia is the only high-income country where trachoma has been endemic, defined as an overall trachoma prevalence in Aboriginal and Torres Strait Islander children aged 5-9 years of 5% or more. The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. This report presents data submitted from 2014 to 2022.

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Rapid antigen diagnostic tests (Ag-RDTs) that quickly and accurately identify SARS-CoV-2 are an essential part of the COVID-19 response, but multiple factors can affect the validity of Ag-RDTs results. In Cambodia, several commercial Ag-RDTs have become available since the COVID-19 outbreak, but quality control (QC) and external quality assurance (EQA) of these rapid tests have yet to be fully and systematically implemented. We collaborated with laboratory experts in Australia and piloted an EQA programme of the commonly used COVID-19 Ag-RDTs at the University of Health Sciences' MERIEUX Laboratory (Tier 1 site-responsible for the in-country receipt and distribution of QA material) and four other participating laboratories (Tier 2-healthcare facility based) between November 2021 and November 2022.

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Objectives: Globally, there is a lack of evidence regarding access to and utilisation of antigen rapid diagnostic tests (Ag-RDTs). This might hinder public health interventions to increase testing. We conducted a survey to understand access to and utilisation of COVID-19 Ag-RDT among residents in Phnom Penh, Cambodia.

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Objectives: This study aimed to describe the prevalence of lymphatic filariasis (LF), soil-transmitted helminthiasis (STH) and schistosomiasis (SC) in Indonesia before and after PC implementation through a systematic review and meta-analysis.

Methods: Embase, MEDLINE, PubMed, Scopus, Web of Science and Google Scholar were searched for articles published between 1 January 1992 and 31 December 2022, reporting LF, STH and SC in Indonesia. Using the Ministry of Health lists of districts receiving PC programs, we identified whether data collection was conducted before or after PC implementation in that particular district.

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Background: The World Health Organization has endorsed single-dose human papillomavirus (HPV) vaccination, but data on the impact on HPV prevalence in high HIV burden settings are limited.

Methods: A single-dose bivalent HPV vaccine was delivered to adolescent girls in grade 10 in a schools-based campaign in 1 district in South Africa. Impact on HPV 16 and 18 prevalence was evaluated using repeat cross-sectional surveys.

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Introduction: There are no longitudinal HIV incidence data among men who have sex with men (MSM) and transgender women (TGW) in Indonesia. We aimed to estimate HIV prevalence and incidence and identify associated factors among clinic attendees in Jakarta and Bali.

Methods: We conducted a retrospective cohort study using medical records from five clinics.

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The coronavirus disease 2019 (COVID-19) pandemic has highlighted that preparedness for and responsiveness to pandemics requires public health platforms and processes which are nimble and evidence-based and a research ecosystem which is rapidly responsive to the evolving needs of society and decision-makers. The national BEAT COVID-19 research consortium was funded in 2020 by the Snow Medical Research Foundation (Snow Medical). Its Expert Advisory Committee met with the consortium post-pandemic to summarise the research undertaken and to consider lessons learned through the research response to COVID-19 in Australia.

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Combined education and counselling can contribute to person-centred care for tuberculosis (TB), improving uptake, adherence, and outcomes of treatment for TB disease and TB infection. Though strongly recommended by the World Health Organization for all people diagnosed with TB, education and counselling is not widely implemented in TB programs around the world. In 2016, a pilot TB education and counselling program, delivered by trained professionals and peers, was initiated to support people on TB treatment in the South Fly District of Papua New Guinea.

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Background: The World Health Organization is committed to strengthening access to pre-exposure prophylaxis (PrEP) for HIV prevention and its integration into primary care services. Unfortunately, the COVID-19 pandemic has disrupted the delivery of primary care, including HIV-related services. To determine the extent of this disruption, we conducted a systematic review and meta-analysis of the changes in access to PrEP services during the pandemic and the reasons for these changes.

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Article Synopsis
  • In 2014, South Africa launched an HPV vaccination program for girls aged 9 and older, but this study focused on 17-18 year old girls who weren't vaccinated, assessing HPV prevalence and related risk factors.
  • From June to December 2019, the study surveyed adolescents at primary care clinics and collected data on HPV testing, HIV status, and sexual history from 900 participants, with a focus on understanding the link between these factors and HPV detection.
  • Results showed that 56.5% had high-risk HPV, with a higher prevalence in those living with HIV, underscoring the need for increased HPV vaccination efforts in populations with high HIV rates.
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  • Scabies and related bacterial skin infections are common in tropical and low-income areas, significantly raising healthcare costs and straining health systems.
  • The "Big SHIFT" trial in Fiji analyzed scabies and SSTIs from 2018 to 2019, aiming to estimate the healthcare costs associated with these conditions before a mass drug treatment campaign.
  • The study found that healthcare costs for scabies and SSTIs in Fiji totaled approximately $3 million annually, with an estimated cost of $3.3 per person, highlighting the economic impact and the potential benefits of prevention efforts.
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Introduction: Non-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies in Indonesia.

Methods: A pre-post quasi-experimental study was carried out in Semarang city from January to August 2022 to evaluate a 7-month long intervention comprising: (1) online educational sessions for pharmacists; (2) awareness campaign targeting customers; (3) peer visits; and (4) pharmacy branding and pharmacist certification.

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Background: Prevalence of hepatitis C virus (HCV) antibody (Ab) on dried blood spot (DBS) samples in the Australian Needle and Syringe Program Survey (ANSPS) decreased nationally from 57 % in 2015 to 32 % in 2022. We aimed to investigate potential explanations for this decline.

Methods: Changes in DBS HCV Ab prevalence were investigated by redefining positive cases as those with those with either a positive HCV Ab test result or a self-reported history of ever having HCV treatment (modified prevalence), examining HCV Ab prevalence by birth and age cohorts, and assessing trends in key risk behaviours.

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  • Fiji has a high prevalence of scabies, and mass drug administration (MDA) is being considered as an effective control strategy, but its acceptability has not been fully explored.
  • A qualitative study involved 44 community members and 12 key informants to identify barriers and facilitators of MDA acceptability, highlighting prior experiences, community attitudes, and leader endorsements as positive influences, while distrust and limited community outreach were significant barriers.
  • This study is the first to qualitatively examine MDA acceptability for scabies globally, suggesting that future programs should include better community engagement, tailored approaches for different areas, and involve local communities in planning and implementation.
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Background: Prevalence of hepatitis C virus (HCV) antibody (Ab) on dried blood spot (DBS) samples in the Australian Needle and Syringe Program Survey (ANSPS) decreased nationally from 57% in 2015 to 32% in 2022. We aimed to investigate potential explanations for this decline.

Methods: Changes in DBS HCV Ab prevalence were investigated by redefining positive cases as those with those with either a positive HCV Ab test result or a self-reported history of ever having HCV treatment (modified prevalence), examining HCV Ab prevalence by birth and age cohorts, and assessing trends in key risk behaviours.

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Disease surveillance data was critical in supporting public health decisions throughout the coronavirus disease 2019 (COVID-19) pandemic. At the same time, the unprecedented circumstances of the pandemic revealed many shortcomings of surveillance systems for viral respiratory pathogens. Strengthening of surveillance systems was identified as a priority for the recently established Australian Centre for Disease Control, which represents a critical opportunity to review pre-pandemic and pandemic surveillance practices, and to decide on future priorities, during both pandemic and inter-pandemic periods.

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Global methylation analysis of gene promoters is promising for detection of high-grade squamous intraepithelial lesions or worse (HSIL+) in high-risk human papillomavirus (hrHPV)-positive women. However, diagnostic performance of methylation data at individual CpG-sites is limited. We explored methylation for predicting HSIL+ in self- and clinician-collected samples from Papua New Guinea.

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Article Synopsis
  • A national program integrated molecular point-of-care (POC) testing for chlamydia, gonorrhoea, and trichomonas in 49 primary care clinics in Australia to improve diagnostic access and treatment speed for First Nations peoples.
  • Between 2016 and 2022, the program showed a significant increase in monthly testing, and treated a higher percentage of patients within two to seven days compared to previous practices, resulting in thousands of infectious days averted.
  • The evaluation revealed high test concordance rates and low failure rates, indicating that the POC testing was effective and of high quality, contributing to both individual health benefits and potentially reducing disease transmission in First Nations communities.
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Background And Objectives: Tattooing is one of the leading donor deferral reasons in Australia. Until September 2020, donors were deferred from all donation types for 4 months after a tattoo. At this time, our guideline changed such that donations of plasma for further manufacture were accepted immediately, provided the tattoo was administered in a licensed or regulated Australian establishment.

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Objective: WHO recommends human papillomavirus (HPV) testing for cervical screening, with triage of high-risk HPV (hrHPV) positive women. However, there are limitations to effective triage for low-resource, high-burden settings, such as Papua New Guinea. In this exploratory study, we assessed the performance of host methylation as triage tools for predicting high-grade squamous intraepithelial lesions (HSIL) in self-collected and clinician-collected samples.

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Introduction: In Indonesia, a country with around 280 million people and the second-highest tuberculosis (TB) incidence rate in the world, the impact of the COVID-19 pandemic on TB care needs careful assessment so that future response strategies can be strengthened. We conducted a study comparing TB testing and treatment rates before and during the first 2 years of the COVID-19 pandemic in Indonesia, and the reasons for any disruptions to care.

Methods: We conducted retrospective secondary data analysis and qualitative interviews in Yogyakarta and Bandung, Indonesia.

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  • The study investigated the impact of antenatal point-of-care testing and immediate treatment for infections like Chlamydia and Gonorrhea on maternal and perinatal outcomes, comparing it against the current standard of care which is symptom-based treatment.
  • The research involved a randomized trial with women attending antenatal clinics in Papua New Guinea, where clusters were switched between the intervention and control groups after a washout period.
  • The primary focus was on measuring outcomes like preterm birth and low birthweight among the participants, with data collected from 4,526 enrolled women from 2017 to 2021.
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Background: Ivermectin mass drug administration (MDA) is effective for controlling onchocerciasis and scabies, with evidence supporting its role in some species of soil-transmitted helminth (STH) infections. In the context of RISE, a cluster-randomised trial for scabies, this study evaluated the effectiveness of ivermectin MDA in reducing STH burden in the Western Province of Solomon Islands.

Methods: Twenty villages were randomised 1:1 to receive ivermectin MDA as one dose (IVM-1) or two doses (IVM-2) for scabies.

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Background: Data on SARS-CoV-2 vaccine effectiveness to reduce transmission of infection in household settings are limited. We examined the effects of SARS-CoV-2 vaccines on Delta variant transmission within households in an infection-naïve population.

Methods: This was a population-based data linkage cohort study in the Greater Sydney Metropolitan Area, New South Wales, Australia based on cases observed in June-November 2021.

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