Honours | Masters | PhD
Burnet Institute 2018 Student Research Projects
For more information: burnet.edu.au/education_and_training burnet.edu.au [email protected] DISEASE ELIMINATION Characterising sexual risk among early adopters of HIV pre-exposure prophylaxis (PrEP)
Honours, Masters by Research
Associate Professor Mark Stoové [email protected]
Professor Edwina Wright
In Australia, more than three quarters of new HIV dia
Life Sciences 2
2018 Project Summary Please note: It is advised that all students include a copy of their most recent CV and official/unofficial academic transcript when Life Sciences contacting potential supervisors.
Healthy Mothers, Healthy Babies Antibody engineering to study in Papua New Guinea – The impact responses mediating protective of nutrition, malaria and STIs on immunity to malaria and other pregnant women and infants Pg. 3 infectious diseases Pg. 7
To examine genetic variants of Nfkb1 Understanding the acquisition and as a biomarker of poor maternal maintenance of antibodies against health Pg. 3 malaria Pg. 7
Healthy Mothers, Healthy Babies: Novel serological and molecular Maternal nutrition and inflammation tools for malaria surveillance and and their impact on pregnancy intervention Pg. 8 outcomes Pg. 3 Developing new antimalarial drugs Discovery of a new drug class for HIV that block protein trafficking and host treatment and prevention Pg. 4 cell modification in malaria parasites Pg. 8 Impact of microbiota metaobolites on the cervicovaginal mucosa and STI A universal prophylactic vaccine susceptibility Pg. 4 against HCV Pg. 8
Immune modulatory effects of B cell response to HCV infection Pg. 9 microbiotia metabolites and female sex hormones on cervicovaginal Development of autoimmune disease epithelial cells Pg. 4 through impaired follicular helper CD4+ T cells Pg. 9 Killing HIV-infected macrophages as part of a strategy to achieve HIV cure Novel HIV-1 glycoprotein vaccines Pg. 5 with enhanced presentation of broad neutralisation epitopes Pg. 9 Discovering the mechanisms and targets of immunity against malaria Characterisation of retroviruses in Pg. 5 bats Pg. 10
Developing vaccines against malaria Characterisation of bat intracellular Pg. 5 restriction factors Pg. 10
Development of novel point-of-care diagnostics tests and surveillance tools Pg. 6
Understanding malaria transmission and immunity to inform malaria elimination Pg.6
The impact of malaria control measures on the acquisition of immunity to malaria Pg. 6
Developing new diagnostic tests for malaria and other infectious diseases Pg. 7
PROJECTS ARE COLOUR CODED TO THE APPROPRIATE PROGRAM:
Maternal and Disease Behaviours and Healthy Ageing Health Security Child Health Elimination Health Risks 3
2018 Projects Life Sciences
MATERNAL AND CHILD HEALTH Healthy Mothers, Healthy Babies To examine genetic variants of Nfkb1 Healthy Mothers, Healthy Babies: in Papua New Guinea – The impact as a biomarker of poor maternal Maternal nutrition and inflammation of nutrition, malaria and STIs on health and their impact on pregnancy pregnant women and infants outcomes Honours , Masters Honours, PhD Dr Raffi Gugasyan Honours, PhD Professor James Beeson [email protected] Professor James Beeson Contact: [email protected] Contact: [email protected] Dr Philippe Boeuf Associate Professor Freya Fowkes Associate Professor Freya Fowkes Dr Philippe Boeuf Dr Philippe Boeuf Healthy Mothers, Healthy Babies (HMHB) The level of mortality and disease among In resource-poor regions globally, aims to define the major causes of poor newborns and children in Papua New pregnant women experience high rates maternal, newborn, and child health. Guinea is very high. Every year, 5,000 of malaria, under-nutrition and sexually Poor pregnancy outcomes, including newborns die and almost half of those transmitted infections (STIs) which can anaemia, low birth weight, premature who survive have poor growth and lead to maternal morbidity and mortality delivery and stillbirths are quite common. development (known as stunting). Low and in infants, low birth weight (LBW) To identify feasible, acceptable and birthweight is a major cause of both resulting in a significant number of infant effective interventions it will be important newborn death and poor growth and deaths each year. In these settings, to recognise those at highest risk. development of young children and is LBW is due to fetal growth restriction largely due to poor fetal growth. and preterm delivery. However the link The transcription factor Nuclear The single strongest determinant of fetal between nutrition, malaria and STIs and Factor-kappaB1 (NF-kB1) is an essential growth is nutrient supply to the fetus and these birth outcomes have yet to be protein that regulates key physiological largely depends on maternal nutritional elucidated. processes such as ageing, growth and immune competence. Insufficient status and on the nutrient transport Burnet has a research program in rural production of NF-kB1 may lead to capacity of the placenta. Poor maternal PNG, called Healthy Mothers, Healthy severe complications that become most nutrition and infectious causes of Babies, in partnership with the PNG prevalent during the fertile years of a maternal inflammation (such as malaria) Institute of Medical Research, East New woman’s life. Moreover, recent evidence restrict the nutrient transport capacity of Britain Provincial Government, University suggests that genetic variants of NFKB1 the placenta, contributing to poor fetal of PNG, the National Department of alter protein levels that can affect growth. Health, and others. We have undertaken idiopathic recurrent miscarriages. This project is part of our flagship Healthy a longitudinal study of 700 pregnant Mothers, Healthy Babies program ongoing women attending antenatal care, and This project will involve the genetic in Papua New Guinea in which we are followed them through to delivery. Among screening of NFKB1 variants to establish following 700 pregnant women and their these women, we will measure markers whether such variants correlate with infants until 12 months after delivery. of nutrition and evaluate micronutrient the increased risk of poor pregnancy This project will use a combination of deficiencies, determine malaria and STIs. outcomes. The student will learn established assays (e.g. ELISA kits) and The association of nutrition, malaria, conventional PCR technology to screen new powerful metabolomics/proteomic and STIs during pregnancy with respect for genetic variants of NFKB1 in 700 approaches to identify nutritional and to birth outcomes will then be assessed women from rural PNG. CRISPR/Cas9 inflammatory markers predictive of poor using epidemiological techniques. will be used to examine these variants in cell lines and establish how they pregnancy outcomes, especially low The objective of this project is to alter protein levels. We will determine birthweight. Currently, the major causes determine the major preventable causes whether variants of NFKB1 are a suitable of low birthweight in PNG are poorly of poor maternal health and LBW to biomarker for poor health and pregnancy understood. enable the development of future outcomes, including miscarriages, which Identifying signatures of maternal interventions to improve health and may facilitate early intervention and malnutrition and inflammation could pregnancy outcomes. This project is appropriate treatment regimens. allow the identification of women at risk offered as a laboratory or epidemiological of delivering low birthweight babies to project, or a combination of the two direct the limited health care resources depending on student interests. to these at-risk pregnancies, as well as understanding the key causes of poor FOR MORE INFORMATION GO TO burnet.edu.au pregnancy outcomes. 4
2018 Projects Life Sciences
DISEASE ELIMINATION Discovery of a new drug class for Impact of microbiota metabolites Immune modulatory effects of HIV treatment and prevention on the cervicovaginal mucosa and microbiotia metabolites and female STI susceptibility sex hormones on cervicovaginal Honours, PhD epithelial cells Honours, PhD Professor Gilda Tachedjian Honours, PhD [email protected] Professor Gilda Tachedjian Dr George Mbogo [email protected] Professor Gilda Tachedjian Dr Anna Hearps [email protected] Dr David Chalmers (Monash University) Dr Joshua Hayward Dr Anna Hearps There is a real threat that drug resistance, Dr Raffi Gugasyan toxicity and intolerance will eventually Epithelium lining the lower female lead to exhaustion of antiretroviral reproductive tract (FRT) acts as a barrier Epithelium lining the lower female drug options for both HIV treatment to pathogens and is the sentinel of the reproductive tract (FRT) acts as a and prevention, as there are little in innate immune response. In particular, barrier to pathogens and is the sentinel the way of new drug classes in the inflammation and breaks in epithelium of the innate immune response. In pipeline. We have initiated a drug integrity at the genital mucosa can promote particular, inflammation and breaks discovery program targeting HIV reverse infection with HIV and other sexually in epithelium integrity at the genital transcriptase (RT), a proven drug target, transmitted infections (STIs). mucosa can promote infection with to identify compounds that inhibit this sexually transmitted infections (STIs) essential viral enzyme. We are using an While there are several studies including HIV. innovative and validated paradigm for describing the immune modulatory drug discovery called fragment-based effects of short chain fatty acids (SCFAs) Vaginal eubiosis, characterised by the drug design (FBDD) that uses very and lactic acid in the context of the gut presence of lactobacillus-dominated small compounds called ‘fragments’ and cancer, respectively little is known microbiota is noninflammatory while to discover inhibitors with novel regarding their impact on epithelium vaginal dysbiosis, typified by a high mechanisms of action against HIV RT. integrity and immune mediators released load and diversity of anaerobic bacteria, by vaginal, ecto- and endocervical promotes a proinflammatory Using FBDD means screening far fewer epithelial cells of the FRT. cervicovaginal environment that increases compounds than conventional drug susceptibility to HIV and other STIs. screens since fragments are so small, We have discovered lactic acid, apart and can be developed into more potent from its direct antimicrobial activities We have shown that lactic acid, produced drugs. We’ve discovered fragments with has anti-inflammatory effects on by beneficial lactobacilli, elicits an mechanisms that are distinct to drugs cervicovaginal epithelial cells. anti-inflammatory effect and inhibits used in the clinic with their analogues production of proinflammatory cytokines To understand the global effects of and chemokines induced by components binding to novel sites on the enzyme. lactic acid we have undertaken RNASeq The aim of this study is to progress one of viral and bacterial pathogens in a analysis of cervicovaginal cells treated cervicovaginal epithelial transwell model. of the fragment hits into more potent RT with lactic acid alone and in the presence inhibitors or drug leads. However, the impact of female sex of TLR ligands that mimic pathogen- hormones on the immune modulatory Compounds that are structurally related associated molecular patterns to effects of lactic acid on cervicovaginal to the fragment hit will be evaluated for determine effects on gene expression. epithelial cells is unknown. their ability to bind and inhibit wild-type This study aims to determine the and drug-resistant RT, as well as inhibit This study aims to determine the impact mechanism of action of lactic acid of female sex hormones on immune HIV-1 replication. This study will identify informed by the RNASeq data. Findings leads for the development of a novel mediators elicited by cervicovaginal cells could lead to the development of strategies and if they augment or attenuate the class of RT inhibitor for specific use in to treat and prevent vaginal inflammation HIV treatment and prevention. anti-inflammatory effects of lactic acid and consequently susceptibility to HIV, that could potentially lead to modulation other sexually transmitted infections, of infection with STIs. Findings could and adverse reproductive health lead to development of strategies to treat outcomes. and prevent vaginal inflammation to prevent susceptibility to STIs and adverse reproductive health outcomes. 5
2018 Projects Life Sciences
DISEASE ELIMINATION Killing HIV-infected macrophages Discovering the mechanisms Developing vaccines against as part of a strategy to achieve HIV and targets of immunity against malaria cure malaria Honours, PhD Honours, PhD Honours, PhD Professor James Beeson Associate Professor Anthony Jaworowski Professor James Beeson Contact: [email protected] [email protected] Contact: [email protected] Malaria is one of the world’s leading Dr Anna Hearps Antibodies are an important component causes of death and illness, particularly of acquired immunity against malaria, among young children. There remains a The persistence of HIV in infected cells as demonstrated in pivotal studies in strong need for highly effective vaccines is the most significant barrier to HIV which immunoglobulin G (IgG) from to reduce the burden of malaria and cure. Macrophages are an important HIV immune adults was transferred to progress towards eventual malaria reservoir as they are long lived cells which malaria-infected children and resulted in elimination. To date, most vaccines are relatively resistant to HIV-induced cell clearance of infection. The mechanisms have achieved only modest levels of death and can harbor for long periods of of protection and specific target epitopes efficacy, emphasising the need for novel time. Current HIV cure strategies invoke a of protective immunity are not well approaches in vaccine design that can ‘shock and kill’ approach in which silent understood, yet this knowledge is crucial induce potent immune responses. HIV reservoirs are stimulated to ‘wake up’ for developing highly effective vaccines and produce virus, and the reactivated against malaria. In recent studies, we This project will focus on identifying cells are killed by immunological have begun to uncover important roles key antigens and specific epitopes mechanisms. However, the mechanism for antibodies that can directly inhibit that are targets of protective immunity responsible for killing HIV-infected host-cell infection, interact with immune against malaria and understanding the macrophages is not known, and must be cells to kill and clear malaria, or recruit mechanisms mediating immunity, which uncovered if HIV cure strategies are to be complement to neutralise infection. includes antibodies and cell-mediated successful. responses. This knowledge is crucial for The aims of this project include the development of effective vaccines Natural killer (NK) cells are important identifying the key targets of protective against malaria. The project will also effectors against infected cells, preliminary immunity and the quantifying the involve using knowledge of immunity evidence suggesting NK cells might be importance of specific mechanisms to malaria for informing vaccine design, able to kill HIV-infected macrophages. In mediating immunity. The project and the expression and testing of novel this project, the student will use novel combines detailed studies of immune vaccine candidates. These studies will live-cell video microscopy and established responses with clinical studies of use novel approaches in molecular immunological techniques to: children and adults who live in biology, cell biology and immunology to malaria-endemic regions. address these aims, and will build on • Determine whether NK cells kill recent major advances generated from HIV-infected macrophages, and The studies would particularly focus our malaria vaccine program. whether this occurs via natural on using innovative approaches to cytotoxicity (NC) or antibody- understand how antibodies neutralise The project will primarily involve dependent cellular cytotoxicity (ADCC) and clear malaria parasites in the blood, laboratory-based research, • Visualise and characterise the including interactions with monocytes/ including western blotting, imaging, NK cell-induced apoptosis of macrophages and dendritic cells, and standard immunoassays, functional HIV-infected macrophages using identifying specific epitopes targeted immunoassays (e.g neutralisation real-time fluorescent video microscopy by protective antibodies. Skills may assays, cell-mediated immunity), cell culture and protein expression. • Identify the type of NK cell responsible involve assays of functional immunity, The project could also include bio- for killing of HIV-infected macrophages cell culture, isolation and analysis of immune cells, flow cytometry, western informatics, structural modelling of • Screen a panel of ADCC antibodies to blotting, ELISA, and epitope mapping. vaccine antigens, or modelling vaccine identify those which may be beneficial The project will be tailored to best match impact depending on the student’s in therapeutic HIV cure strategies. the student’s interests and training interest. The specific activities and focus of the project will be refined to suit the Suits a student with a keen interest in HIV background. interests and training background of the virology and immunology. The student student. will acquire unique skills in livec ell video microscopy, as well as standard techniques in cell culture, immunology, virology (including under PC3 conditions) and multicolour flow cytometry. 6
2018 Projects Life Sciences
DISEASE ELIMINATION Development of novel point-of-care Understanding malaria The impact of malaria control diagnostics tests and surveillance transmission and immunity to measures on the acquisition of tools inform malaria elimination immunity to malaria Honours, PhD Honours, PhD Honours, Masters, PhD Professor James Beeson Professor James Beeson Professor James Beeson Contact: [email protected] Contact: [email protected] Contact: [email protected] Dr Philippe Boeuf Associate Professor Freya Fowkes Associate Professor Freya Fowkes Associate Professor David Anderson Malaria transmission in populations Dr Philippe Boeuf There is an urgent need for diagnostic involves interactions between infection Malaria caused by Plasmodium and surveillance tests that could be rates and prevalence that drive falciparum remains a major cause of used in resource-poor settings. These transmission, and the presence of malaria morbidity and mortality globally. It include vaccine antibody testing (malaria, immunity that has the potential to reduce has decreased substantially over the measles, HBV, pneumonia and others) to transmission. Malaria immunity can act to past decade due to increased control assess vaccine coverage in populations, reduce infection rates and levels of malaria measures and access to efficacious and sero-surveillance tools for monitoring parasitemia, and specific components of treatments. People living in these areas and tracking major infectious diseases. immunity can also function to directly block are less exposed to malaria over time due transmission of malaria. This is known as to declining transmission. Limited resources and health care transmission-blocking immunity. infrastructure in many disease-endemic Currently, very little is known about the Naturally-acquired blood-stage immunity countries mean that tools for evaluating develops to malaria after repeated the vaccine status of patients, vaccine interactions between malaria infection rates and patterns and malaria immunity exposure that controls bloodstage coverage in populations and for disease parasitaemia, thereby reducing surveillance need to be simple to perform in populations, and how these interact. Malaria control programs face the challenge clinical symptoms and life-threatening without a requirement for laboratory complications. Antibodies are important facilities or advanced equipment. The that as malaria transmission declines, malaria immunity also declines, which mediators of this acquired immunity, tests need to be semi-quantitative, have however it is unclear how declining a long shelf life, be stable for periods places the population at higher risk of malaria transmission and rebound malaria transmission impacts on the at ambient temperature, and easy to acquisition of malarial immunity. perform epidemics. and interpret to ensure their This project will investigate the impact of The overall objective of this project suitability for the specific conditions in malaria immunity on malaria infection rates is to quantify the impact of declining resource-poor settings. The development and transmission of malaria in populations. transmission on the acquisition of of new low cost point-of-care tests for The student will analyse various parameters malarial immunity in a malaria endemic major diseases would facilitate major to define the patterns of infection and area of Thailand, both in the context of advances in disease control in immunity, with a particular focus on clinical disease and malaria transmission. resource-limited settings. defining the interaction between immunity and malaria transmission. Laboratory techniques will include ELISA This project will work towards the and functional antibody assays and/ development of novel semi-quantitative The findings of this project will be or epidemiological analyses. Findings point-of-care rapid tests and investigate highly relevant to informing malaria will help us understand how immunity different approaches to improve elimination efforts and understanding develops and is maintained against sensitivity and quantitation. This will the value of incorporating vaccines into infectious diseases in populations with build on Burnet’s extensive expertise in elimination strategies. Skills acquired declining transmission. diagnostic test development and strong may include established high-throughput links to communities that experience immunoassays, assays that quantify the a high burden of disease and have an functional activity of immune responses urgent need for new point-of-care tests. (e.g. flow cytometry, Fc-receptor mediated immunity, complement activation, western blots, ELISA, neutralisation assays). This could be expanded to include modelling of the interaction between infection and immunity, and how this may impact on malaria elimination and control. FOR MORE INFORMATION GO TO burnet.edu.au 7
2018 Projects Life Sciences
DISEASE ELIMINATION Developing new diagnostic tests Antibody engineering to study Understanding the acquisition and for malaria and other infectious responses mediating protective maintenance of antibodies against diseases immunity to malaria and other malaria infectious diseases Honours, Masters, PhD Honours, Masters, PhD Honours, Masters, PhD Dr Jack Richards Dr Jack Richards [email protected] Dr Jack Richards [email protected] Associate Professor David Anderson [email protected] Dr Leanne Robinson Professor James Beeson New tests are required to diagnose Professor James Beeson malaria and other infectious diseases Antibodies are key effector molecules Antibody responses to malaria, or in resource-poor settings to enable responsible for mediating protection other infectious diseases, are dynamic prompt treatment and to strengthen against many other infectious diseases. and fluctuate over time. Traditionally, public health disease surveillance. A most studies of immunity only measure This project will involve engineering wide range of projects is available to antibody levels at a single time point, novel recombinant antibodies against develop new diagnostic tests with and fail to capture the dynamic nature malaria parasite proteins and those of technologies including lateral flow of these responses and changes over other infectious diseases organisms. cartridges for point-of-care testing, time that may alter people’s susceptibility These will then be used in a range of in isothermal nucleic acid amplification to infection and disease. for high sensitivity testing, and high vitro immunological assays to determine throughput serological assays for their precise functional mechanisms and This study will measure antibody population-based surveillance. efficacy in protective immunity. responses to a range of malaria antigens at regular time points in children living Projects will involve laboratory experience in malaria-endemic countries. in developing new diagnostic tests, validation of tests with clinical samples Statistical analysis and modelling and field studies, engagement with approaches will be used to examine the industry partners, and the processes of relationship between these responses commercialisation. and subsequent protection from symptomatic malaria in these children. These findings will be especially important in identifying threshold antibody concentrations that are required for protection against malaria, and in developing new serological surveillance tools to determine the prevalence of malaria infection within study populations.
FOR MORE INFORMATION GO TO burnet.edu.au 8
2018 Projects Life Sciences
DISEASE ELIMINATION Novel serological and molecular Developing new antimalarial drugs A universal prophylactic vaccine tools for malaria surveillance and that block protein trafficking and against HCV intervention host cell modification in malaria Honours, Masters, PhD parasites Honours, Masters, PhD Associate Professor Heidi Drummer Honours, Masters , PhD [email protected] Dr Leanne Robinson [email protected] Dr Paul Gilson Dr Rob Center [email protected] As malaria transmission continues to HCV chronically infects approximately three decline, even the most sensitive methods Dr Ben Dickerman per cent of the human population causing for determining prevalence via detection Malaria is a devastating parasitic liver disease, cirrhosis and hepatocellular of the parasite become inefficient for risk disease that infects hundreds of millions carcinoma. The most cost-effective means stratification and informing programmatic of people each year, tragically killing of controlling infectious disease is through interventions. In addition, the need to about half a million, mainly children. vaccination, however a prophylactic or identify individuals at risk ofPlasmodium Antimalarial drugs are the main weapons therapeutic vaccine for HCV is not available. vivax relapse from hypnozoites increases. used to combat infection but alarmingly Essential to the success of an HCV vaccine Validated markers of recent exposure to parasites are starting to become resistant will be an ability to confer broad protection Plasmodium spp. may be able to play to the latest frontline drugs. For this against seven circulating HCV genotypes an important role, particularly rapidly reason new drug targets need to be (≥33 per cent nucleotide variation). advancing technologies for quantitative identified and new medicines developed. point-of-care testing. By applying Our laboratory has developed a vaccine novel validated serological markers of Thankfully thousands of potent parasite candidate that elicits high titres of broadly exposure and novel validated molecular killing compounds have been discovered, neutralising antibody, able to prevent markers capable of detecting ultra-low but their targets in the parasite are replication of HCV in cell culture. This density Plasmodium infections to well unknown. One potential suite of targets is activity is dependent on the production characterised existing sample sets from the protein trafficking pathways used by of a high molecular weight form of the epidemiological surveys and surveillance parasites to shuttle proteins around not vaccine that possesses a unique disulfide programs conducted in Papua New only their own cells, but also those bonding arrangement. Using our current Guinea (PNG), this project will identify of the human red blood host cells (RBC) method of expression only low yields the best marker for identifying and they infect. These so-called exported of this protein are obtained, limiting its effectively targeting these infections proteins modify the RBCs so the utility as a vaccine candidate. efficiently and within programmatically parasite can evade host immunity The aims of this project: realistic timeframes. and rapidly reproduce. • Generate efficiently expressed forms We have discovered several drugs that of the vaccine that are structurally not only block parasite protein trafficking, analogous to the high molecular but also prevent the parasite from taking weight form up nutrients via the RBC. These drugs • Assess alternative formulations of cause parasite death and the aim of this the vaccine for their ability to elicit project is to help evaluate the biological broadly neutralising antibodies. targets of these drugs and how to make the drugs more potent and specific for Commonly used techniques include potential clinical applications. virus infection, western blotting, Blue- native PAGE, affinity purification, protein Techniques and methods will include expression, ELISA, receptor binding Parasite cell culture, drug assays, assays, antibody neutralisation assays, fluorescence microsopy, functional RNA transcription and transfection, assays, molecular biology skills gene cloning and expression and DNA (eg, PCR and cloning), parasite sequencing. transfection. This project will involve handling of infectious organisms (HCV) and animal experimentation. All procedures will be carried out in a PC2 level laboratory following appropriate standard operating procedures. Appropriate training in PC2 level procedures, virological techniques and animal handling will be provided. 9
2018 Projects Life Sciences
DISEASE ELIMINATION B cell response to HCV infection Development of autoimmune Novel HIV-1 glycoprotein vaccines disease through impaired follicular with enhanced presentation of Honours, Masters, PhD helper CD4+ T cells broad neutralisation epitopes Associate Professor Heidi Drummer [email protected] Honours, Masters, PhD Honours, PhD Professor Margaret Hellard Dr Raffi Gugasyan Dr. Andy Poumbourios [email protected] [email protected] Dr Andy Poumbourios Dr George Grigoriadis Associate Professor Heidi Drummer Injecting drug use and the sharing of Dr Menno van Zelm contaminated equipment represents a The most effective means of controlling human viral diseases is through major driver of the HCV pandemic. As a Chronic immune disorders are caused vaccine-mediated induction of result, People Who Inject Drugs (PWID) are at by an irregular immune response that neutralising antibodies to viral surface constant risk of infection and reinfection. ultimately leads to immunodeficiency proteins. Extensive variation in the HIV-1 or immune hyperactivity, whereby the glycoproteins (gp120-gp41) means that an In a longitudinal study of PWID we have individual’s own tissues are destroyed. HIV-1 vaccine must elicit antibodies able identified three individuals who possess The Gugasyan Laboratory and colleagues to neutralize diverse viral strains. high titres of broadly neutralising antibodies work on unique mouse models that (brNAbs). Notably, they do not possess resemble immune disorders in humans. A number of monoclonal antibodies characteristic specificities associated with We have shown that mutations in a brNAbs isolated from chronically infected capable of neutralizing diverse gene called Nfkb1 in mice resembles HIV-1 isolates (broadly neutralising patients in that their sera do not block E2- the human condition called Chronic CD81 interactions and are not directed to antibodies, bNAbs) have been isolated Variable Immunodeficiency (CVID). from HIV-1-infected humans and define two major antigenic regions. Two of the three These individuals develop late onset individuals have not developed chronic HCV conserved neutralisation targets. Passive autoimmune disease with the immune immunisation of macaques with such for almost 10 years despite regular episodes system attacking several target organs. of re-exposure, while the third remained free bNAbs provides protective efficacy. The WHO-UNAIDS Vaccine Advisory Committee of chronic disease for the five years that they NFkB1 is a member of the NFkB family has therefore prioritised the development were enrolled in the study. We hypothesise of transcription factors, key regulators of glycoprotein vaccines that evoke strong that long-term protection from chronic of the cell survival, proliferation and bNAb responses capable of neutralising HCV in these individuals is associated inflammation. This project will determine diverse HIV-1 strains. with elicitation of unique protective NAb the key roles of NFkB1 in the immune specificities. We will: system, particularly in B and T cells, to We have discovered a novel HIV-1 gp120-gp41 understand how the impaired function of mutant that enhances the exposure of • Define the antibody signature in the NFkB1 leads to a break down in immune immune serum of protected individuals major bNAb epitopes, which represents a tolerance with ensuing autoimmune major advance for HIV-1 vaccine design. • Mine the B cell repertoire to identify disease. Emphasis will be placed on In this project, candidate vaccines will novel IgG specificities that confer broad studying novel mouse models, viral be optimised using genetic and protein neutralisation. immunity, CRISPR/Cas9 technology, cell engineering technologies. The vaccines culture, flow cytometry and molecular will be produced in multi-milligram • Define the epitopes of mined IgGs and biology techniques, including real time their mechanism of neutralisation. quantities using mammalian cell culture PCR and western blotting. and protein purification technologies • Examine whether these mined IgGs in Burnet Institute’s protein production The student will gain experience in a can control HCV replication and prevent facility. The immunogenicity of the range of immunological techniques, neutralisation escape. candidate vaccines will be tested in studying mouse models to help identify guinea pigs. The efficacy of immune sera This information will be used to inform the roles of NF-kB1 in B cells and T cells, will be examined in HIV-1 neutralisation prophylactic vaccine design to favour particularly follicular helper CD4+ T cells. and other immunological assays. the elicitation of protective antibody The findings will help define the potential The hypothesis that a multivalent specificities. utility of NFkB1 as a prognostic marker vaccine formulation (comprising HIV-1 in individuals with CVID and provide subtypes covering 85 per cent of the Commonly used techniques include insights into other immune-mediated global pandemic) will induce broader virus infection, western blotting, affinity diseases. purification, protein expression, ELISA, neutralising antibody responses than receptor binding assays, antibody those elicited by a single-strain will neutralisation assays, RNA transcription and be tested. transfection, gene cloning and expression, DNA sequencing, and FACS. 10
2018 Projects Life Sciences
HEALTH SECURITY PROGRAM Characterisation of retroviruses in Characterisation of bat intracellular bats restriction factors
Honours, PhD Honours, PhD
Professor Gilda Tachedjian Professor Gilda Tachedjian [email protected] [email protected] Dr Joshua Hayward Bats are a major reservoir of viruses such Bats are a major reservoir for many viral as Hendra virus and Ebola virus that are pathogens, however retroviruses are yet pathogenic in humans but not in bats. to be isolated from bats. Retroviruses The reason bats can coexist with these such as gammaretroviruses have simple viral pathogens is unknown. However, genomes in contrast to HIV and are one explanation is that the coevolution known to infect a wide variety of species of bats and their viruses have led them including mice, cats, koalas and to an effective ‘peace treaty’, a biological non-human primates, and cause equilibrium in which viral replication is leukemias, lymphomas, neurological regulated such that both host and virus diseases and immunodeficiencies can co-exist without undue antagonism. in these species. Retroviruses are The role of the host’s immune system found in the genome of mammals and is to control infections, and intrinsic can be transmitted vertically through intracellular restriction factors are the the germ line (e.g. endogenous) or front line of the innate immune response transmitted horizontally (e.g. exogenous). that target viruses. Endogenous retroviral sequences are present as a critical part of eukaryotic These factors have been discovered genomes and normally represent the to restrict retroviruses such as HIV fossil record of extinct viruses. however, some of these factors, for example tetherin, can also restrict Our analysis of the transcriptome paramyxoviruses, coronaviruses of bat species has revealed the and filoviruses. We are currently presence of retroviral transcripts that, characterising the intracellular restriction at the amino acid level, demonstrate factor repertoire of megabats and homology to extant (currently existing) microbats by mining their genomes and gammaretroviruses and betaretroviruses . transcriptomes, validating the expression However, whether infectious retroviruses of these factors in bat tissues and can be produced from intact endogenous evaluating their inhibitory activity against retroviruses and if exogenous retroviruses viral pathogens. are currently circulating in bats are unknown. This study will focus on characterising a class of restriction factor found in The study aims to identify and characterise megabats and microbats, their antiviral retroviral sequences found in bat activity and mechanism of action specimens. Reconstitution of an compared to human homologues. infectious bat endogenous retrovirus from consensus proviral sequences will This is a joint project between the also be performed. It will also increase Tachedjian Lab and CSIRO Australian our fundamental understanding of bat Animal Health Laboratory. retroviruses and could have public health implications since bats are hunted for bush meat in many countries. Public Health 11
2018 Project Summary Please note: It is advised that all students include a copy of their most recent CV and official/unofficial academic transcript when Public Health contacting potential supervisors.
Strategies to reduce malnutrition Rapid scale-up of HIV pre-exposure Understanding and responding among children with allocative prophylaxis (PrEP): Implications for to alcohol and other drug use among efficiency analyses Pg. 12 the future of HIV prevention Pg. 16 people from culturally and linguistically diverse communities Allocative efficiency in child nutrition Trends in STI testing and positivity in Pg. 19 Pg. 12 priority populations in Australia Pg. 16 Understanding the role of stigma as Immunity to malaria in children and Understanding and reducing the a barrier to alcohol and other drug pregnant women Pg.12 barriers to community-based and mental health help-seeking point-of -care hepatitis C testing in and care for people from culturally Hepatitis B infection in Australian people who inject drugs Pg. 16 and linguistically diverse communities prisons Pg. 13 Pg. 20 Examining hepatitis C reinfection Barriers to hepatocellular carcinoma following treatment among HIV #cleaneating #detox : Assessing the screening uptake in Victoria Pg. 13 co-infected, gay and bisexual men quality of nutrition advice in popular Pg. 17 Hepatitis B virus infection and social media trends Pg. 20 immunisation status among gay, Predicting and reducing hepatitis C Apps for Harm Reduction: Help or bisexual and other men who have sex reinfection following treatment among Hindrance Pg. 20 with men attending primary health people who injecting drugs Pg. 17 clinics Pg. 13 The outcomes of transitioning Eliminating hepatitis C infection in between prison and community for Estimation of hepatitis B virus among Victoria through treatment scale up: people with a history of injecting pregnant women Pg. 13 Helping prescribers initiate treatment drug use Pg. 21 Pg. 17 Validation of name classification Sexting, porn, and Tinder: An software for use in Australia to Hepatitis B screening and investigation of education and health identify culturally and linguistically antiviral prophylaxis during promotion Pg. 21 diverse communities Pg. 14 immunosuppression: Understanding current clinical practice and Alcohol advertising on public Investigating the limitations acceptability of clinical guidelines transport: level of exposure among associated with the snowball model Pg. 18 children and young people Pg. 21 “Bring your friends”/ “Treat your friends” in context of the TAP study How can countries reach HIV/AIDS Sex, drugs and rock’n’roll: Young Pg. 14 elimination targets by 2030? Pg.18 people and risk behaviours Pg. 22
Exploring the similarities and Epidemic and economic modelling Using simulation modelling to differences of hepatitis C treatment to optimise resources for global perform alcohol policy and opiate substitution treatment health Pg. 18 experiments Pg. 22 therapy in people who inject drugs to inform increasing access to HCV Systematic review of HIV and Understanding risky single occasion treatment in this population Pg. 14 other STIs among transgendered drinking and links to harms in a populations in middle to cohort of young Melburnians Pg. 22 Modeling the syphilis epidemic in high-income countries Pg. 19 Victoria Pg. 15 Taking a punt: Exploring gambling Epidemiology of malaria transmission attitudes and behaviours among a Investigating blood/blood product in Papua New Guinea Pg. 19 sample of young Victorians Pg. 23 donation practices among Australian people who inject drugs (PWID) Pg. 15
Characterising sexual risk among early adopters of HIV pre-exposure prophylaxis (PrEP) Pg. 15
PROJECTS ARE COLOUR CODED TO THE APPROPRIATE PROGRAM:
Maternal and Disease Behaviours and Healthy Ageing Health Security Child Health Elimination Health Risks 12
2018 Projects Public Health
MATERNAL AND CHILD HEALTH Strategies to reduce malnutrition Allocative efficiency in Immunity to malaria in children and among children with allocative child nutrition pregnant women efficiency analyses Honours, Masters by Research Honours, Masters by Research, PhD Honours, Masters by Research Associate Professor Freya Fowkes Dr Ruth Pearson Dr Nick Scott [email protected] Contact: [email protected] [email protected] Dr Nick Scott Malaria caused by the parasite Malnutrition is responsible for over three Plasmodium falciparum is a leading million child deaths each year with 36 Optima Nutrition is a mathematical model cause of mortality and morbidity globally, countries carrying the bulk of the burden. of child nutrition written in the computer particularly among young children and There are proven community-based programming language Python. The pregnant women. After repeated exposure, interventions to target malnutrition; model tracks cohorts of children from individuals develop effective immunity however, resources are limited, so funds birth to five years of age. It incorporates that controls blood-stage parasitaemia, must be allocated to programs that health effects including the incidence of thereby reducing clinical symptoms and achieve the maximum impact. diarrhoea, breastfeeding, and stunting life-threatening complications. due to poor nutrition. Cost and coverage Optima Nutrition is an allocative efficiency data for interventions targeting nutritional Antibodies are important mediators of this model that quantifies the benefits of health are incorporated in the model to acquired immunity. Very little is known providing nutrition-based interventions to derive an optimal allocation of funding for about antibody acquisition, maintenance target stunting and mortality in children the various intervention programs. and boosting of antibody responses with under-five. Some possible projects respect to exposure to parasites during include: This project will involve applying the childhood and pregnancy. Furthermore Optima model to a specific area of little is known about maternal transfer • Applying the Optima model to a research or development, for example of antibodies and subsequent maternal specific country case study. This could application in a specific country. This antibody decay and infant antibody involve performing analysis of the research will require quantitative data acquisition in infants born in malaria effects of scaling up an intervention(s) analysis from a range of sources. For endemic areas. We have access to samples to best meet the needs of local example, when applying the model in a from several established longitudinal governments surrounding child country setting, the available data is often cohorts of pregnant women and children malnutrition, or performing a resource incomplete or may contain errors which living in malaria endemic areas that can optimisation to determine the most must be identified and accounted for. address questions of antibody acquisition cost-effective allocation of projected and maintenance through antibody assays budgets. There will be opportunities to conduct and epidemiological analyses. • Developing analytical expression mathematical and statistical analysis for complex interactions between using Python. The student may learn to Findings will help us understand how nutrition-based interventions and write code to perform analyses to address immunity develops and is maintained incorporating them into the model. research questions. They will interpret against infectious diseases. and present results, usually in the form • Including the effects of interventions of figures and tables. There will also be such as hygiene programs or family- opportunities to contribute to the general planning into the model. code base, and/or to the underlying • Extending the model to include mathematical model, as well as to produce additional risk factors for stunting or policy documents and present findings. mortality, such as anemia, wasting and child obesity. Prospective students will be expected to Prospective students will be expected to have skills in quantitative data analysis have skills in quantitative data analysis, as as well as good communication skills. A well as written and verbal communication. keen interest in developing mathematical A keen interest in health outcomes, and modelling and programming skills is developing mathematical modelling and essential. Some background in applied programming skills is essential. Some mathematics, physics, computer science, background in epidemiology, public economics, or public health is preferred. health, mathematics, economics, physics, or computer science is preferred.
FOR MORE INFORMATION GO TO burnet.edu.au 13
2018 Projects Public Health
DIESEASE ELIMINATION Hepatitis B infection in Australian Barriers to hepatocellular Estimation of hepatitis B virus prisons carcinoma screening uptake in among pregnant women Victoria Honours, Masters by Research Honours, Masters by Research Dr Joseph Doyle Honours, Masters by Research Ms Caroline van Gemert [email protected] [email protected] Dr Joseph Doyle Dr Jessica Howell [email protected] Dr Jessica Howell Dr Jessica Howell Risks for hepatitis B transmission are Pregnant women are recommended common among prisoners, and routine Hepatocellular carcinoma (HCC) is the to have hepatitis B virus (HBV) testing hepatitis B vaccination is recommended sixth most common cancer and incidence conducted as part of routine antenatal for all incarcerated individuals. However, is increasing worldwide, including in testing. This study involves developing the exact prevalence of current and past Australia. Currently, people with risk a strategy to identify pregnant women hepatitis B infection and related liver factors for hepatocellular carcinoma are in laboratory surveillance datasets, disease is unknown in prisons within recommended to have twice-yearly cancer and using this strategy to estimate HBV Victoria. Vaccination coverage among screening with liver ultrasound to detect prevalence among pregnant women. prisoners is also currently unknown. cancer when it is small enough to provide This study involves quantitative analysis Finally, prevalence of hepatitis D, a virus effective treatment. However, in Victoria of retrospective and longitudinal data that requires hepatitis B to replicate, is only half of HCC are diagnosed through collected in a surveillance system. Data also unknown among prisoners. screening, therefore treatment options already collected and no further data are often limited and mortality is high. In this study, the seroprevalence of collection is required. current and past hepatitis B and D In this study, we explore barriers to HCC infection among prisoners and screening adherence. We will examine associated clinical risks for disease will barriers to HCC screening attendance be determined by retrospective analysis by quantitative analysis of retrospective Hepatitis B virus infection and of a clinical database. Estimates of demographic, socioeconomic and immunisation status among gay, vaccine coverage within prisons will clinical data. We will collect and analyse bisexual and other men who have also be made, with a view to informing qualitative data from a small sample sex with men attending primary health policy. of patients with liver disease, with and health clinics without HCC, to determine perceived and This study involves quantitative analysis actual barriers to screening adherence. of data from a clinical database (data Honours, Masters by Research Finally, we will collect cost data for the already collected but will require process of HCC screening to inform Ms Caroline van Gemert cleaning). cost-effectiveness models. [email protected]
This study involves quantitative analysis Dr Jessica Howell of retrospective data from clinical Gay, bisexual and other men who have databases (data already collected). There sex with men (GBM) are at increased risk will also be a qualitative component, with of hepatitis B virus (HBV) in Australia and data collection using questionnaires, unvaccinated GBM are recommended structured interviews and, potentially, to have annual HBV testing. This study focus groups. Limited fieldwork to collect involves analysis of data to determine data for cost-effectiveness models will the proportion of GBM who have been also be required. vaccinated and HBV testing among GBM.
This study involves quantitative analysis of retrospective and longitudinal data collected in a surveillance system. Data is already collected and no further data collection is required.
FOR MORE INFORMATION GO TO burnet.edu.au 14
2018 Projects Public Health
DISEASE ELIMINATION Validation of name classification Investigating the limitations Exploring the similarities and software for use in Australia to associated with the snowball differences of hepatitis C treatment identify culturally and linguistically model “Bring your friends”/ “Treat and opiate substitution treatment diverse communities your friends” in context of the TAP therapy in people who inject drugs study to inform increasing access to HCV Honours, Masters by Research treatment in this population Honours, Masters by Research Ms Caroline van Gemert Honours, Masters by Research [email protected] Dr Peter Higgs Dr Jessica Howell [email protected] Dr Peter Higgs Dr Rachel Sacks-Davis [email protected] Most people living with chronic HBV Professor Margaret Hellard in Australia are from culturally and The Treatment and Prevention study linguistically diverse (CALD) communities (TAP) is a world-first clinical trial of DAA Pharmacotherapy, when used with regard and were born in areas endemic for HBV, treatment for a group of people who inject to substance dependence, refers to the mostly from the Asia–Pacific region and drugs (PWID). Individuals are treated replacement of a person’s drug of choice Africa. It is important that people born for hepatitis C together with people with a legally prescribed and dispensed in these countries are tested, however with whom they inject drugs, in order substitute. Known as opioid substitution recording of ethnicity and/or country to prevent reinfection after successful therapy (OST), in Victoria over 14,000 people of birth in general practice settings is treatment. TAP study participants are are currently dosed daily with methadone or low in Australia. This study involves the asked how many people they have suboxone for their heroin dependency. validation of name classification software injected with (same time and place) over for use in Australia and assessment of its the past six months and how many in the Hepatitis C is a major cause of liver-related use as a screening tool to identify people past month. diseases including cirrhosis, liver failure and who should be screened for HBV. hepatocellular carcinoma globally. About Despite often reporting injecting with 230,000 Australians are living with chronic Diagnostic test accuracy methodology many people, participants have mostly hepatitis C (HCV), with people who inject will be used to calculate the accuracy only brought a couple of friends into the drugs (PWID) the group at greatest risk of HCV. of the name classification software, study. which will be applied to a dataset that Currently few PWID receive treatment, but includes cases of chronic HBV and From a PWID perspective: the advent of new direct-acting antiviral controls. Sensitivity and specificity will (DAA) treatment provides opportunities for be calculated to describe how successful • What were the limitations to TAP increased uptake of therapy which will have the name classification software is to participants bringing their whole the dual benefit of curing the PWID’s HCV accurately identify people from CALD injecting networks to receive DAA and potentially reducing HCV transmission backgrounds. therapy as offered in the TAP study? (through treatment as prevention (TAP)) • If they were willing to participate, leading to HCV elimination in Australia. what factors limited their friends from participating in DAA treatment? Working with participants from the Treatment and Prevention (TAP) Study, • What changes could be made or a world-first study of community-based what services could be offered to treatment for PWID, and HCV elimination, facilitate the full network in seeking/ this honours project will explore the PWID’s participating in treatment? attitudes and understandings of the new • What attitude shifts or behavioural DAA HCV treatment, the best mechanism to changes must take place to make provide DAAs to the separate to or with OST. seeking DAA favourable? What The overall aim is to identify mechanisms promotion strategies or changes to increase PWID’s access to DAAs and could the health system implement compliance with DAA treatment so as to to facilitate these shifts? inform HCV elimination in Australia and globally. This study involves a mixed method approach. A commitment to working with The study will use qualitative methods marginalised and vulnerable populations including in-depth semi-structured would be an advantage. interviews to achieve the research aims. A commitment to working with marginalised and vulnerable populations would be an advantage. 15
2018 Projects Public Health
DISEASE ELIMINATION Modelling the syphilis epidemic in Investigating blood/blood Characterising sexual risk among Victoria product donation practices among early adopters of HIV pre-exposure Australian people who inject drugs prophylaxis (PrEP) Honours, Masters by Research Honours, Masters by Research Honours, Masters by Research Ms Carol El-Hayek [email protected] Professor Margaret Hellard Associate Professor Mark Stoové [email protected] Dr Nick Scott Dr Brendan Quinn [email protected] Professor Edwina Wright In Victoria 80 per cent of infectious syphilis cases are in men who have sex In Australia, potential blood donors are In Australia, more than three-quarters with men (MSM). Mathematical modelling ‘deferred’ permanently if they report a of new HIV diagnoses are made among of syphilis transmission in Australian history of injecting drug use (IDU). This gay and bisexual men (GBM). Annual MSM suggests an effective way to reduce is due to IDU being a key transmission diagnoses of HIV in the population syphilis is to increase the frequency of route of various transfusion-transmissible in Australia continue to increase. HIV testing and treatment of MSM. infections, particularly hepatitis C. A pre-exposure prophylaxis (PrEP), the recent review of the appropriateness use of HIV treatment medication by In recent years, we have seen a sustained of this policy was conducted by Burnet people at risk of HIV to reduce their risk increase in routine syphilis testing among Institute in collaboration with the of acquisition, has emerged over recent MSM at high caseload clinics alongside a Australian Red Cross Blood Service. years as a highly-effective HIV prevention decline in infectious syphilis incidence. One key finding was that more research tool. PrEP has been approved in several How much testing needs to occur in needs to be conducted to address various jurisdictions around the world for use by Victoria’s MSM community to eradicate knowledge gaps – including on the high-risk populations and was recently infectious syphilis? prevalence of blood donation practices approved for HIV prevention in Australia by the Therapeutic Goods Administration. This project will involve the design of a among people who inject drugs – before However, access to PrEP has been syphilis transmission schema and model any changes can be made to the current restricted to clinical demonstration for mathematically predicting infection IDU-related blood donation criteria. Burnet projects or through self-importation. rates. Running the model will require Institute collected data from PWID in defining input parameters which should Victoria and across Australia 2015. This project is the first of its kind in Australia. An opportunity exists for students be based on an extensive literature interested in exploring issues around review. Findings will be vital for informing any potential changes to the Blood Service’s the effectiveness of new biomedical HIV prevention strategies to work with PrEP Students will be expected to have IDU-related guidelines. The study will also clinical and behavioural data collected an interest in and understanding of inform targeted education of PWID about from early (pre-registration) adopters infectious diseases, and a proficiency blood donation. of PrEP, through off-label prescription/ in mathematics. This project will involve analysis of self-import and demonstration projects. quantitative data collected during 2015 Detailed baseline (PrEP initiation) and from the Illicit Drug Reporting System follow-up behavioural data is available to (IDRS), an annual, national cross-sectional examine risk profiles and trajectories of survey of PWID in Australia, in addition early PrEP adopters, and inform ongoing to data from the Melbourne Injecting policy and practice in HIV prevention. Cohort Study (MIX), a prospective cohort study running since 2008 with over 700 PWID as participants. Findings will provide an indication of the prevalence of lifetime blood donation practices among Australian PWID and the characteristics of those who report doing so.
Students will be expected to have skills in communication and quantitative data analysis. A commitment to working with marginalised and vulnerable populations would be an advantage. 16
2018 Projects Public Health
DISEASE ELIMINATION Rapid scale-up of HIV pre-exposure Trends in STI testing and positivity Understanding and reducing the prophylaxis (PrEP): Implications for in priority populations in Australia barriers to community-based the future of HIV prevention point-of-care hepatitis C testing Honours, Masters by Research in people who inject drugs Honours, Masters by Research Ms Carol El Hayek Honours, Masters by Research Associate Professor Mark Stoové [email protected] [email protected] Professor Margaret Hellard In the past decade, communicable [email protected] Professor Edwina Wright disease notification systems have seen a dramatic increase in the number of Dr Joseph Doyle In Australia, more than three quarters notifications for chlamydia and several of new HIV diagnoses are made among Hepatitis C predominantly infects people other STIs. Higher prevalence is common gay and bisexual men (GBM). Annual who inject drugs (PWID) with around 50 in populations that have higher sexual diagnoses of HIV in Australia continue to per cent becoming infected within five risk practices (such as men who have increase. HIV pre-exposure prophylaxis years. sex with men, Aboriginal and Torres (PrEP), the use of HIV treatment Strait Islander People, sex workers). medication by people at risk of HIV to New hepatitis C treatment that can cure It is important to monitor rates of STI reduce their risk of acquisition, has the infection in around 95 per cent of testing and positivity in these priority emerged over recent years as a people is available to all Australians, populations, as well as the general highly-effective HIV prevention tool. but many will not undergo treatment in a population, in order to identify emerging PrEP has been approved in several timely way because they have not been patterns and trends in STI epidemiology. jurisdictions around the world for screened (hepatitis C antibody test) or had the appropriate follow up test use by high-risk populations and was The Australian Collaboration for (hepatitis C RNA test) to confirm ongoing recently approved for HIV prevention in Chlamydia and other STI Enhanced infection. Australia by the Australian Government Sentinel Surveillance (ACCESS) project Department of Health Therapeutic Goods is a sentinel surveillance system that There are many barriers to PWID being Administration. monitors STI testing and positivity in a tested for HCV including limited range of priority populations. This project Preceding the anticipated public engagement with health services due to will use existing data collected in the subsidisation of PrEP through Medicare, stigma and discrimination and the lack ACCESS project to explore STI testing the Victorian government has funded a of a licensed rapid point-of-care HCV test and positivity in priority populations and program (PrEPX) to rapidly scale-up PrEP in Australia despite them being available identify factors with testing and positivity. access to GBM through high-caseload elsewhere in the world. clinics. An opportunity exists to work with This project will involve quantitative The project will identify the best the PrEPX team on a number of important analysis of data collected through the rapid point-of-care HCV tests for hepatitis research questions related to the uptake ACCESS project, from laboratories or C antibody and RNA available and and ongoing use of PrEP by GBM at risk general practices and family planning licensed worldwide. It will examine of HIV. Behavioural data collected at clinics, and supplemented with PWID’s attitudes to rapid point-of-care baseline and three-monthly clinic visits behavioural data collected in the tests administered in the community is available to explore the potential Victorian Primary Care Network for by peers or outreach workers, or self- prevention impact of PrEP. Sentinel Surveillance of STIs. Data administered, through a series of analysis will involve calculation of qualitative interviews with PWID and testing and positivity rates for a range of staff at the health services. It will also STIs and factors associated with these pilot rapid point-of-care testing in a (such as age, gender and other relevant community-based clinic seeing a large characteristics) in priority populations number of PWID. The project will involve a (including men who have sex with men, mixed method approach using analysis of Aboriginal and Torres Strait Islander data collected during an existing clinical People, sex workers). trial, and qualitative data collection.
Applicants require a capacity to work autonomously in a field-based setting, and an understanding of the importance of a harm reduction approach to health care. 17
2018 Projects Public Health
DISEASE ELIMINATION Examining hepatitis C reinfection Predicting and reducing hepatitis C Eliminating hepatitis C infection in following treatment among HIV reinfection following treatment Victoria through treatment scale co-infected, gay and bisexual men among people who inject drugs up: Helping prescribers initiate treatment Honours, Masters by Research Honours, Masters by Research Dr Joseph Doyle Dr Joseph Doyle Honours, Masters by Research [email protected] [email protected] Dr Joseph Doyle Professor Margaret Hellard Professor Margaret Hellard [email protected] New hepatitis C treatments can cure The availability of new direct-acting Professor Margaret Hellard 95 per cent of people, including people antiviral (DAA) treatment for hepatitis C with HIV coinfection. Statewide efforts in has led to global targets to eliminate Hepatitis C affects 230,000 people in Victoria to eliminate hepatitis C among the public health impact of hepatitis C Australia. Currently, only one to two HIV infected individuals are underway through treatment delivery, in conjunction per cent of people with chronic HCV and aim to deliver treatment to 75 per with harm reduction services that are treated annually. In 2016, the World cent of HCV/HIV gay and bisexual men minimise risk-taking behaviour. Health Organization (WHO) set targets over the next two years. to reduce new HCV infections by 80 per A key concern for individuals, population cent, reduce deaths due to HCV Hepatitis C transmission among gay health, and health economics, is by 65 per cent, and eliminate HCV as a and bisexual men can occur via sexual whether hepatitis C reinfection will occur public health problem by 2030. and injecting risk-taking behaviour. at higher rates after DAA treatment. With new, effective non-interferon-based Ongoing risk taking behaviour, such as Changes in risk-taking behaviour may treatments, it should be possible for unprotected sex, may undermine efforts lead to reinfection and negate successful Australia to achieve these to eliminate hepatitis C in this group. hepatitis C treatment. elimination targets.
This project will examine gay and bisexual This project aims to understand hepatitis C Key to our success in reducing men’s knowledge, attitudes and practice reinfection following treatment among HCV-related deaths and new infections toward risk taking and hepatitis C key populations at risk of hepatitis C, in Australia will be the upscaling of prevention. Behavioural data collected namely people who inject drugs. It will treatment for all people with chronic as part of the HCV/HIV coinfection use behaviour data collected with the HCV infection, including those currently elimination project, together with a hepatitis C Treatment and Prevention transmitting HCV who are chiefly people series of qualitative interviews with Study, with in-depth interviews of who inject drugs. New community-based gay and bisexual men, will be used to participants who have become reinfected treatment programs in primary care, drug describe and understand steps to post-treatment. and alcohol services, and community reduce HCV reinfection. organisations are being rolled out locally. The outcomes will be used to better The project will involve a mixed method design clinical services and health The project will aim to explore the approach using analysis of data promotion for people at the time they are supports needed for prescribers to collected during an existing clinical trial, undertaking HCV treatment. The project start treatment, and the expectations of and qualitative data collection. will involve a mixed method approach people living with HCV from their medical using analysis of data collected during an services. The outcomes will help facilitate Applicants require a capacity to work existing clinical trial, and qualitative data treatment uptake and improve the quality autonomously in a field-based setting, collection. Applicants require a capacity of care. and an understanding of the importance to work autonomously in a field-based of a harm reduction approach to setting, and an understanding of the The project will involve a mixed method health care. importance of a harm reduction approach approach using analysis of routinely to health care. collected surveillance data, and qualitative data collection with health care providers and people living with HCV infection. Applicants require a capacity to work autonomously in a field-based setting, and an understanding of the importance of a harm reduction approach to health care. 18
2018 Projects Public Health
DISEASE ELIMINATION Hepatitis B screening How can countries reach HIV/ Epidemic and economic modelling to and antiviral prophylaxis AIDS elimination targets by optimise resources for global health during immunosuppression: 2030? Modelling for policy Understanding current clinical recommendations and operational Honours, Masters by Research practice and acceptability of clinical guidelines Professor David Wilson guidelines [email protected] Honours, Masters by Research Honours, Masters by Research We are seeking exceptional research Professor David Wilson students to join the interdisciplinary Optima Dr Joseph Doyle [email protected] team at the forefront of infectious disease [email protected] modelling and health systems financing. The Countries around the world have set Optima research team works in partnership Professor Anton Peleg ambitious targets to virtually eliminate (Monash University, Alfred Health) with the World Bank, international health HIV/AIDS by 2030 as a public health agencies, governments, and universities threat, supported by UNAIDS and other Approximately 225,000 Australians are to develop mathematical models of agencies. These targets will not be met living with chronic hepatitis B virus (HBV), diseases, health, and financing systems with current approaches. This project will with individuals born overseas at higher to assist governments and their partners involve conceptualising innovative policy risk of infection. Individuals with chronic allocate health finances in the most questions, collating data and applying HBV or past exposure to HBV infection cost-effective manner. model frameworks to address specific have a substantial risk of reactivation policy-relevant or operational questions during immunosuppressive cancer Successful students will work with a team around how to get as close as possible to chemotherapy. of mathematical modellers, economists, HIV/AIDS elimination in Australia computer scientists, epidemiologists, and Oral antiviral therapy for HBV is and overseas. health policy experts on the conceptual highly effective and known to prevent development of new models and This research project will build on reactivation when used appropriately. application of existing epidemiological research conducted by the ‘Optima’ and economic mathematical models for Clinical concordance with screening and modelling team, in collaboration with the communicable and non-communicable treatment guidelines can be inconsistent World Bank, to provide practical guidance diseases, predominantly in low- and in clinical practice. Overuse of HBV to national decision-makers, program middle-income countries, but also with antivirals can increases medication managers, and funding partners to applications in Australia. side effects; underuse of HBV antivirals achieve maximum impact with the funding can increase HBV reactivation risk. available. Given expansion of the Optima model into Inconsistency in practice also increases HIV/AIDS, tuberculosis, non-communicable Students will work with a team of potential for errors between health care disease, hepatitis B and hepatitis C, mathematical modellers, economists, providers. maternal and child health, and nutrition, computer scientists, epidemiologists, and and there is ample opportunity for students This project will examine prescribers’ health policy experts on the conceptual to contribute to novel research. knowledge and attitude towards development of new models and clinical guidelines that aspire to best application of the existing Optima-HIV There will be opportunity to conduct practice HBV screening and treatment epidemiological and economic model. mathematical and statistical analysis, among immunocompromised patients. costing exercises, analyses and write-up Prospective research students will be The project will survey a sample of for policy purposes. expected to have strong analytical prescribers (haematologists, oncologists, skills, a keen interest in developing infectious diseases physicians and Prospective research students will be mathematical modelling, and computer gastroenterologists), and conduct a expected to have strong analytical skills, a programming skills are desirable but not series of in depth interviews locally. keen interest in developing mathematical essential. It is preferred the student(s) The outcomes will inform new HBV modelling, and computer programming have some background in public health/ screening and antiviral management skills are desirable but not essential. epidemiology, mathematics, physics, guidelines for the Australian context. computer science, or economics. It is preferred the student(s) have The project will involve qualitative some background in public health/ research methodologies including epidemiology, mathematics, physics, questionnaires and interviews of health computer science, or economics. care providers. A capacity to work autonomously in a clinical setting is important. FOR MORE INFORMATION GO TO burnet.edu.au 19
2018 Projects Public Health
DISEASE ELIMINATION BEHAVIOURS AND HEALTH RISKS Systematic review of HIV and Epidemiology of malaria Understanding and responding to other STIs among transgendered transmission in Papua New Guinea alcohol and other drug use among populations in middle to people from culturally and Honours, Masters by Research, PhD high-income countries linguistically diverse communities Dr Leanne Robinson Honours, Masters by Research [email protected] Honours, Masters by Research
Ms Carol El Hayek The scale-up of malaria control Dr Danielle Horyniak [email protected] interventions in Papua New Guinea [email protected] has resulted in a significant overall Dr Peter Higgs Associate Professor Mark Stoové reduction in the nationwide prevalence One fifth of the Australian population is Transmission risk of HIV and STIs and incidence of malaria. However, this comprised of people from culturally and has not been estimated in Australia effect has not been uniform across the linguistically diverse (CALD) communities. among gender diverse populations. country and considerable heterogeneity Victoria, in particular, has a highly diverse Only recently has there been a shift in transmission exists in different areas, population; regions such as Dandenong to improve the completion of gender despite a standardised approach to the and Maribyrnong have over 50 per cent identity and sexuality when collecting implementation of the control measures. of the population was born outside risk behaviour locally, and other STI Minimal data currently exists on the Australia, in over 150 different countries. surveillance data. Understanding how determinants of heterogeneity and residual malaria transmission in PNG and which the data has been used and interpreted, Emerging evidence suggests alcohol human, vector and/or parasite behaviour/ in other similar settings will be important and illicit drug use are growing concerns characteristics are the most important when developing and measuring our among some CALD communities, obstacles to elimination. own indicators for disease risk among particularly among young people. Limited transgendered people. This project will involve analysing data on uptake of professional support such as prevention and treatment services is a The project will involve a systematic the prevalence and distribution of malaria key issue with potential community and review of existing literature to find other infection and together with vector and service-related barriers to care. estimates of STI prevalence, and methods human behavioral data, generate spatial risk maps and investigate the use of clinical used to derive these. This project aims to improve our foci to identify asymptomatic reservoirs of understanding of professional support infection. Understanding the extent of local for alcohol and drug use among CALD heterogeneity in malaria transmission and populations and inform strategies to the driving factors is critical to be able to improve engagement with health services. identify and implement targeted control strategies to ensure the ongoing success of This project may involve: malaria control in PNG and make progress • A review and content analysis of towards elimination. available AOD education, health promotion and support resources for people from CALD backgrounds • A review of AOD policy documents to assess how the unique needs of CALD communities are incorporated and addressed • A review of multicultural health policy documents to identify strategies and responses to AOD use • In-depth interviews with service providers from a range of sectors and representatives of CALD communities to examine barriers and facilitators to delivering AOD services to people from CALD backgrounds.
This project would suite a student interested in health policy, health service delivery and/or health disparities. Prospective students will be expected to have strong skills in communication, critical thinking and analysis. 20
2018 Projects Public Health
BEHAVIOURS AND HEALTH RISKS Understanding the role of stigma as #cleaneating #detox: Assessing the Apps for harm reduction: Help or a barrier to alcohol and other drug quality of nutrition advice in Hindrance? and mental health help-seeking and popular social media trends care for people from culturally and Honours, Masters by Research Honours, Masters by Research linguistically diverse communities Dr Danielle Horyniak Honours, Masters by Research Dr Megan Lim [email protected] [email protected] Dr Megan Lim Dr Danielle Horyniak Dr Karen Klassen (Monash University) [email protected] Professor Paul Dietze Dr Peter Higgs Social media has seen the proliferation of pages dedicated to health trends such The use of mobile phones and other technology Dr Charles Livingstone (Monash Uni) as clean eating, fitspiration, paleo and to promote health (mHealth) is an emerging detoxes. Some of these social media approach for providing health education, Australia is a multicultural society, with pages are developed by qualified experts. interventions and linkage to care for a one quarter of the population born However many are created by celebrities wide range of health conditions. mHealth overseas, and one fifth comprised of or for-profit companies with a vested approaches may be particularly useful for people from culturally and linguistically interest in promoting specific products or marginalised populations who may be hard diverse (CALD) communities. Although plans. This project aims to systematically to reach using traditional health promotion migrants are commonly impacted review the content and health claims and care approaches. by social and health inequities, made by popular social media nutrition Studies of mHealth, and in particular the use they are often under-represented in pages and content associated with of mobile phone apps, have identified some health research, resulting in limited popular health trends and hashtags. understanding of the most effective ways concerns however, including promotion of to improve health for this population. The student will first develop a sampling health-harming behaviours, inaccurate strategy for systematically selecting information and limited real-world utility. Alcohol, illicit drug use and poor mental posts from popular social media tends. Although emerging evidence suggests health, particularly among young people, They will develop a framework by which people who use drugs report high levels of are growing concerns among some to objectively analyse posts included in interest in mHealth technologies, little is CALD communities. Stigma is commonly the sample. For example, this will include known about available mHealth programs identified as an important barrier to variables describing the source of posts, and how they are being used. help-seeking and uptake of professional the evidence base for the information The project aims to review the availability, support and it is often unclear what presented, the types of food mentioned, characteristics and potential usefulness researchers are referring to. and follower reactions to the posts. They of harm reduction apps for people who will conduct qualitative and quantitative This project aims to conduct a systematic use drugs. It will utilise a mixed methods analysis of the post content. review of literature examining stigma approach. A review will be conducted to as a barrier to help-seeking and care identify available apps which provide for alcohol and other drug use or harm reduction to people who use drugs. mental health among people from CALD Apps will be downloaded and tested to communities. The goal is to examine identify key characteristics e.g. target the ways in which stigma has been population, purpose of the app etc.. Quality conceptualised and measured in the will then be assessed (e.g. whether the literature, and to identify the most salient app was designed by experts, whether types of stigma that impact people the messaging is consistent with evidence from CALD communities’ help-seeking and best practice). Focus groups may also behaviours. This information will be be conducted with people who use drugs used to inform the development of future to explore their attitudes towards harm stigma reduction interventions. reduction apps, potential usefulness and recommendations for future apps. This project may incorporate both quantitative and qualitative analysis, and Prospective students will be expected to will be informed by the available evidence have strong skills in communication and base. This project would be suited to a analysis. A commitment to working with student with an interest in social theory, marginalised and vulnerable populations the social and cultural determinants of would be an advantage. health and health behaviour. Prospective students will be expected to have strong communication and critical thinking skills and excellent attention to detail. 21
2018 Projects Public Health
BEHAVIOURS AND HEALTH RISKS The outcomes of transitioning Sexting, porn, and Tinder: An Alcohol advertising on public between prison and community for investigation of education and transport: Level of exposure among people with a history of injecting health promotion children and young people drug use Honours, Masters by Research Honours, Masters by Research Honours, Masters by Research Dr Megan Lim Dr Megan Lim Associate Professor Mark Stoové [email protected] [email protected] [email protected] Dr Nick Scott Professor Paul Dietze Access to new technologies could present novel risks to young people’s Alcohol advertising is associated Injecting drug use disproportionately sexual health. The emerging popularity with increased alcohol consumption, contributes to the health and social burden of sexting, online pornography use, and particularly among young people. Current of illicit drug use in Australia. Initiation and dating apps has been linked in some regulations attempt to limit exposure of ongoing injecting drug use is influenced studies to sexual risk behaviours e.g. not alcohol marketing to children, however, by a complex interaction of social, health, using condoms. There is very little known no restrictions are in place regarding structural, and policy factors, including the about educating young people about advertising on public transport. ongoing criminalisation of drug use and the these topics. Many previous programs routine incarceration of people for drug- have taken a fear-based approach which This project will include an audit of related crime. As a result people who inject tends to exaggerate the risks of these alcohol advertising on public transport. drugs (PWID) are vastly over-represented behaviours and promote abstinence Basic modelling will be conducted using in the prison and broader criminal justice as the only option. This project will publically available public transport system. investigate previous campaigns and usage data. The project will result in a provide recommendations for future policy document advising on the potential Transition out of prison represents a campaigns. level of exposure of children to these particularly vulnerable period for PWID with advertisements. challenges in social reintegration, housing, A mixed methods approach will involve employment, accessing health and other content analysis and review of existing Note: This project is preferred for mid-year support services, and relationships with health promotion relating to sexting, candidature. significant others. Return to dependent pornography, and other new sexual patterns of drug use is also common, media. resulting in very high rates of mortality, morbidity, recidivism and re-incarceration.
Burnet Institute is undertaking Australia’s first prison-to-community prospective cohort study of people with injecting drug histories. This study provides the opportunity for ease analysis of data collected from ~400 participants across two years.
A range of post-release outcomes are available for investigation including patterns of drug use, engagement and retention in treatment and health care, self-report overdose, significant other relationships, housing stability and blood borne virus risk. Univariate descriptive and prospective analyses examining the pre- and post- release predictors of outcomes would be undertaken to describe the burden of various outcomes and their association with exposures to inform policy and practice.
Prospective students will need skills in quantitative data analysis and familiarity with key data analysis software such as Stata. FOR MORE INFORMATION GO TO burnet.edu.au 22
2018 Projects Public Health
BEHAVIOURS AND HEALTH RISKS
Sex, drugs and rock’n’roll: Young Using simulation modelling to Understanding risky single people and risk behaviours perform alcohol policy experiments occasion drinking and links Honours, Masters by Research to harms in a cohort of young Honours, Masters by Research Dr Megan Lim Melburnians [email protected] Dr Nick Scott [email protected] Professor Margaret Hellard Honours, Masters by Research Dr Megan Lim Sexually transmitted infections (STI) Professor Paul Dietze are on the rise among young Victorians. ‘SimDrink’ is an existing simulation [email protected] Since 2005, we have surveyed over 9,000 model of a population of 18-25 year-olds Young Australians frequently engage in people aged between 16 and 29 years age engaging in heavy drinking on a night out in risky single occasion drinking (RSOD). at Melbourne’s Big Day Out about sexual Melbourne. It has been designed to provide This drinking pattern is associated with risk behaviour and drug use. a means for conducting alcohol policy experiments to inform policy decisions. a variety of harms including increased From 2015, we moved the survey to an risk of accidents, exposure to violence online form. Questions have covered This project will gather data on current and risky sex. Most research on RSOD participants’ sexual histories, condom or proposed alcohol policies, develop/ has focused on normative drinking use, knowledge and perceptions of STIs, program additional model features as behaviours within the past year rather and STI testing histories. We ask about required, and compare the outcomes of than on the specific circumstances of alcohol and other drug use, and other simulated individuals under different policy RSOD. risks and behaviours such as gambling, scenarios. Policy examples that could be The aim of this study is to examine diet and exercise, contact with police, tested include the effects of happy hours, specific occasions of RSOD by young mental health and smoking. There is changes to the enforcement of responsible people to understand the specifics of also a series of questions concerning service of alcohol, changes to alcohol drinking contexts and links to harms. media use e.g. pornography, sexting, taxation, or gender based entrance policies for commercial venues.Students will: social media, smartphones and online The proposed study involves analysis of gambling. • Become familiar with alcohol policies quantitative data collected through the Young Risky Drinkers (YRD) study. The The student project could focus on one of and their effects on young people YRD is a representative sample of 802 these issues or a range of themes. These (literature review). young high-risk drinkers recruited across findings, in the context of current public • Gather or collate data on the metropolitan Melbourne using Computer health measures, will be used to advise relationships between specific alcohol Assisted Telephone Interviewing (CATI) on the design of future sexual health policies and the behavior and harms during 2012. Specific questions were promotion campaigns. experienced by young people. asked about their most recent episode • Develop/program features In this project the student will use the of high risk drinking. Findings from the into SimDrink to assist with data collected to investigate patterns of project will present a unique picture of experimentation. sexual risk behaviours, knowledge, and RSOD. attitudes. This will involve quantitative • Use available data to calibrate the Prospective students will be expected to analysis of the relationship between model. have skills in quantitative data analysis variables such as condom use, number • Analyse and interpret simulation and familiarity with key data analysis of sexual partners, drug and alcohol use, outcomes, including indirect effects software such as Stata or SPSS. and perceptions of risk. The project could among demographic groups and also involve in-depth qualitative data sub-populations in the model e.g. men collection via focus group discussions or compared to women, interviews. outer-urban compared to inner city residents etc. • Determine how these results can be applied to policy.
Prospective students will be expected to have skills in quantitative data analysis, as well as strong written and verbal communication skills. A keen interest in public health and developing mathematical modelling and programming skills is essential. 23
2018 Projects Public Health
BEHAVIOURS AND HEALTH RISKS Taking a punt: Exploring gambling attitudes and behaviours among a sample of young Victorians
Honours, Masters by Research
Dr Rebecca Jenkinson [email protected]
Dr Megan Lim
The gambling environment in Australia has changed markedly over recent years and young people are a high-risk group for experiencing gambling-related harm. While estimates of gambling prevalence among young people vary considerably, there is consensus that gambling participation is increasing among young people and that youth problem gambling rates are around two to three times those of adults. With increasing exposure to gambling promotion and greater opportunities to gamble, the ‘normalisation’ of gambling among young people is likely to continue.
In order to respond to increasing concern around these issues and inform future research and policy responses, this project will explore young people’s gambling behaviours and experience of negative consequences in more detail, especially with regard to participation in higher risk activities such as sports betting and pokies.
In this project the student could employ a mixed-methods approach to explore gambling attitudes, behaviours and experience of negative consequences among young people (aged 15-29 years) in Victoria. Quantitative data collected as part of Burnet’s online survey of young people’s health behaviours could be utilised. In addition to gambling, this annual, cross-sectional survey explores young people’s alcohol and other drug use, sexual health and behaviour, experiences of mental health problems, and social media use.
The student project could also involve in-depth qualitative data collection via focus group discussions or interviews. International Development 24
2018 Project Summary International Health
Profiling the health needs of adolescents within the Asia-Pacific region Pg. 25
Improving sexual and reproductive health of adolescents in Myanmar Pg. 25
Responding to newborn sepsis in resource-constrained settings Pg. 25
Innovative immunisation programs in resource-constrained settings Pg. 26
Assessment of non-communicable disease and associated risks among Indonesian adolescents Pg. 26
PROJECTS ARE COLOUR CODED TO THE APPROPRIATE PROGRAM:
Maternal and Disease Behaviours and Healthy Ageing Health Security Child Health Elimination Health Risks 25
2018 Projects International Development
MATERNAL AND CHILD HEALTH Profiling the health needs of Improving sexual and reproductive Responding to newborn sepsis in adolescents within the Asia-Pacific health of adolescents in Myanmar resource-constrained settings region Honours, Masters by Research Honours, Masters by Research Honours, Masters by Research, PhD Dr Elissa Kennedy Dr Christopher Morgan Dr Peter Azzopardi [email protected] [email protected] [email protected] Dr Peter Azzopardi Newborn sepsis in resource-constrained Dr Elissa Kennedy [email protected] settings of low- and middle-income [email protected] countries accounts for a significant Adolescents aged 10-19 years account proportion of newborn (and hence The Asia-Pacific region, which includes for almost 20 per cent of Myanmar’s child) deaths. The risk is greatest in the 57 countries, is home to more than half of population and have high unmet sexual first week of life, and in households the world’s adolescents. It is remarkably and reproductive health (SRH) needs. affected by economic poverty. New diverse, with countries at very different Poor access to quality information tools and guidelines are now available stages of epidemiological transition. and services contribute to higher risk for prevention and management, and Adolescents represent a large proportion sexual behaviour, sexually transmitted combined development and research of the population of this region, and infections, and early and unintended initiatives are required to support their represent significant opportunities for pregnancy. Burnet is currently introduction. population health gain. However, the undertaking a five-year project to health needs for adolescents in this improve the quality of school-based The aim of the project is to help collate region are yet to be described. comprehensive sexuality education evidence in settings such as Papua New (CSE), improve the delivery of adolescent- Guinea (PNG), Myanmar or Kenya and The project aims to describe national friendly health services (AFHS), and support the design of implementation health profile(s) of adolescent health increase community support for young research to improve newborn survival. need in a country/countries of the Asia- people in eight communities in Magway Pacific region of particular interest and Region, Myanmar. This work applies implementation relevance. research tools to improved service The project aims to describe SRH delivery, as well as tools for Engagement with relevant stakeholders knowledge and attitudes among policy-relevant evidence review, including will be sought. A conceptual framework adolescents, teachers and health literature reviews. Activities may include of health will be defined. Data will then providers and explore barriers to collation and analysis of grey and be sourced, and may include data from providing quality CSE and AFHS published literature, government and the Global Burden of Disease and/or NGO guidelines and data, with situational available country-specific primary data. This project could include analysis of analysis in selected sites, possibly This data will then be used to describe a baseline quantitative data to describe including design of survey instruments country profile identifying key needs for SRH knowledge and attitudes of and other data collection tools. adolescent health in that country. adolescents, teachers and health providers and satisfaction with / Projects could include analysis of The findings will be used for manuscripts confidence delivering CSE and AFHS. field data such as previously collected and policy briefs. Baseline qualitative data collected information on newborn care practices in through focus groups and interviews PNG. Timing and other details depend on with adolescents, teachers, parents and status of funded development activities health providers could also be analysed to be clarified in late 2017. to explore in-depth barriers to providing CSE and AFHS. The findings will be used for evidence review publication, research design and The findings will be used to inform research report. the design and delivery of project interventions, and will be published in manuscripts and policy briefs. 26
2018 Projects International Development
MATERNAL AND CHILD HEALTH HEALTHY AGEING Innovative immunisation programs Projects could include analysis of field Assessment of non-communicable data dependent on timing and other in resource-constrained settings disease and associated risks details relating to the status of funded among Indonesian adolescents Honours, Masters by Research development activities to be clarified in late 2017. Honours, Masters by Research, PhD Dr Christopher Morgan The findings will be used in evidence [email protected] review publication, research design, Dr Peter Azzopardi [email protected] Childhood immunisation is the most research report and policy briefs. cost-effective public health measure Associate Professor Stanley Luchters available, yet approximately one in five [email protected] children are not reached with vaccination, worse in resource-constrained settings of Ms Lisa Willenberg low- and middle-income countries. Burnet [email protected] Institute staff have been working with the World Health Organization (WHO) on new Adolescents represent an important approaches to service delivery such as population group in terms of responding the deployment of vaccines outside of the to non-communicable diseases (NCD). cold chain ‘Controlled Temperature Chain’ Many of the risk factors for adult NCD (CTC), use of quality checklists to improve arise and are potentially modifiable services, integration of other services during adolescence. Adolescents with immunisation, and/or innovative experience a significant burden of approaches to community engagement. preventable NCD (e.g. mental disorder), with many of these diseases having These all aim to improve equitable implications for their current and longer coverage with good quality vaccines. term health and wellbeing. In countries Diseases and age-groups targeted range such as Indonesia there are limited data from hepatitis B, especially prevention of measuring the range of NCD risk factors perinatal transmission through birth-dose and outcomes in adolescents, posing vaccination, routine vaccines in the first a significant barrier to effective policy. year of life, to human papilloma vaccine Burnet Institute, in collaboration with the given to school age children. Settings of Australia Indonesia Centre is undertaking interest include Papua New Guinea (PNG), a study that aims to fill these data gaps. Myanmar, and other settings in Africa or Asia. The aim of the project is to describe the burden and determinants of mental The project aims to support the collation disorder and substance use (key NCD and analysis of evidence from outcomes) and metabolic risks amongst resource-constrained settings to Indonesian adolescents so as to inform support global strategies for innovative preventive interventions. immunisation programs and to generate evidence from specific settings in Africa, The project is underway and is Asia or the Pacific to guide local policy or mixed-methods in design. Potential procedures. opportunities include the analysis of qualitative data around attitudes and This work applies implementation perceived opportunities for intervention, research tools to improved service or qualitative data analysis focused on delivery, as well as tools for measuring burden. policy-relevant evidence review (including literature reviews). The findings will be used for manuscripts and policy briefs. Research activities can include, review of country-level data and publications to inform WHO technical advisory groups and/or systematic literature review, and/or design of survey instruments and other data collection tools for new implementation research. For more information: burnet.edu.au/education_and_training [email protected]
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