Keeping kids in school: modelling school-based testing and quarantine strategies during the COVID-19 pandemic in Australia

BackgroundIn 2021, the Australian Government Department of Health commissioned a consortium of modelling groups to generate evidence assisting the transition from a goal of no community COVID-19 transmission to ‘living with COVID-19’, with adverse health and social consequences limited by vaccination and other measures. Due to the extended school closures over 2020–21, maximizing face-to-face teaching was a major objective during this transition. The consortium was tasked with informing school surveillance and contact management strategies to minimize infections and support this goal.MethodsOutcomes considered were infections and days of face-to-face teaching lost in the 45 days following an outbreak within an otherwise COVID-naïve school setting. A stochastic agent-based model of COVID-19 transmission was used to evaluate a ‘test-to-stay’ strategy using daily rapid antigen tests (RATs) for close contacts of a case for 7 days compared with home quarantine; and an asymptomatic surveillance strategy involving twice-weekly screening of all students and/or teachers using RATs.FindingsTest-to-stay had similar effectiveness for reducing school infections as extended home quarantine, without the associated days of face-to-face teaching lost. Asymptomatic screening was beneficial in reducing both infections and days of face-to-face teaching lost and was most beneficial when community prevalence was high.InterpretationUse of RATs in school settings for surveillance and contact management can help to maximize face-to-face teaching and minimize outbreaks. This evidence supported the implementation of surveillance testing in schools in several Australian jurisdictions from January 2022

A cost-effectiveness analysis of the management of sore throat in children in Australia

For the first time a cost-effectiveness analysis of the management of sore throat in Australian children has been conducted using accurate epidemiological data generated from recent Australian studies.<br /

Potential clinical efficacy of the 10-valent pneumococcal-Protein D conjugate vaccine in children with chronic suppurative lung diseases: A double-blind randomised controlled trial

Background • Chronic suppurative lung diseases (CSLD) in children are important causes of morbidity and recurrent acute exacerbations are associated with long term lung function decline. • Non-­‐typeable H. influenzae (NTHi) and S. pneumoniae are commonly isolated from the lower airways of both children and adults with CSLD. • The potential clinical impact of a non-­‐typeable Haemophilus influenzae (NTHi) vaccine in children with CSLD has not been investigated. • We aimed to determine the clinical efficacy of the 10-­‐valent pneumococcal-­‐Protein D conjugate vaccine (10vPHiD-­‐CV) in children aged 18-­‐months to <18-­‐years with CSLD (Immunogenicity data are presented in Poster xxx). Primary clinical objective. • Determine the efficacy of 10vPHiD-­‐CV in reducing the incidence of acute exacerbations in the 12-­‐months following the 2nd dose of study vaccine. Secondary clinical objectives. • Determine the efficacy of 10vPHiD-­‐CV in reducing the incidence of any parent/carer-­‐reported respiratory symptoms in the 12 months following the second dose of study vaccine. • Determine the efficacy of 10vPHiD-­‐CV in reducing antibiotic use in the 12 months following the second dose of study vaccine

Nudging towards COVID-19 and influenza vaccination uptake in medically at-risk children : EPIC study protocol of randomised controlled trials in Australian paediatric outpatient clinics

Introduction: Children with chronic medical diseases are at an unacceptable risk of hospitalisation and death from influenza and SARS-CoV-2 infections. Over the past two decades, behavioural scientists have learnt how to design non-coercive ‘nudge’ interventions to encourage positive health behaviours. Our study aims to evaluate the impact of multicomponent nudge interventions on the uptake of COVID-19 and influenza vaccines in medically at-risk children. Methods and analyses: Two separate randomised controlled trials (RCTs), each with 1038 children, will enrol a total of approximately 2076 children with chronic medical conditions who are attending tertiary hospitals in South Australia, Western Australia and Victoria. Participants will be randomly assigned (1:1) to the standard care or intervention group. The nudge intervention in each RCT will consist of three text message reminders with four behavioural nudges including (1) social norm messages, (2) different messengers through links to short educational videos from a paediatrician, medically at-risk child and parent and nurse, (3) a pledge to have their child or themselves vaccinated and (4) information salience through links to the current guidelines and vaccine safety information. The primary outcome is the proportion of medically at-risk children who receive at least one dose of vaccine within 3 months of randomisation. Logistic regression analysis will be performed to determine the effect of the intervention on the probability of vaccination uptake. Ethics and dissemination: The protocol and study documents have been reviewed and approved by the Women’s and Children’s Health Network Human Research Ethics Committee (HREC/22/WCHN/2022/00082). The results will be published via peer-reviewed journals and presented at scientific meetings and public forums. Trial registration number: NCT05613751

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

A case for the introduction of a rotavirus vaccine in Papua New Guinea

[Extract] It is widely recognized that improving child health remains one of the great challenges facing Papua New Guinea (PNG). The poor health outcomes of the nation's children are often cited; nonetheless, the statistics are worthy of reiteration. PNG has an infant (children less than 1 year old) mortality rate of 50/1000 live births, and a childhood mortality rate (aged <5 years) of 60/1000 live births. These figures are the worst in the Pacific, and equate to the death of approximately 13,000 children each year (1). Collectively, infectious diseases such as pneumonia, malaria, tuberculosis, diarrhoeal diseases, meningitis and HIV(human immunodeficiency virus) infection are leading causes of morbidity in PNG, and account for approximately half of all deaths (2). The burden of many of these infectious diseases, particularly pneumonia and diarrhoea, is greater in children than in adults