Biomedical subjects

Paul W Roche

Publications and source records attributed to Paul W Roche.

7 recordsLinked to original sources

PubMed2006

Australia's notifiable diseases status, 2004, annual report of the National Notifiable Diseases Surveillance System.

In 2004, 60 diseases and conditions were nationally notifiable in Australia. States and Territories reported a total of 110,929 cases of communicable diseases to the National Notifiable Diseases Surveillance System (NNDSS): an increase of 4 per cent on the number of notifications in 2003. In 2004, the most frequently notified diseases were sexually transmissible infections (46,762 cases; 42% of total notifications), gastrointestinal diseases (25,247 cases; 23% of total notifications) and bloodborne diseases (19,191 cases; 17% of total notifications). There were 13,206 notifications of vaccine preventable diseases, 6,000 notifications of vectorborne diseases, 1,799 notifications of other bacterial infections (includes, legionellosis, leprosy, meningococcal infections and tuberculosis) and 877 notifications of zoonotic diseases.

Adolescent↗

PubMed2006

Annual report of the National Influenza Surveillance Scheme, 2005.

Surveillance of influenza in Australia is based on laboratory isolation of influenza viruses, sentinel general-practitioner reports of influenza-like illness, and absenteeism data from a major national employer. In 2005, 4,575 cases of laboratory-confirmed influenza-like illness were reported, which was 115 per cent higher than in 2004. The influenza season started in the first week of June, with peak activity in early August, a month earlier than in 2004. Influenza A was the predominant type notified (73%), while influenza B activity continued to increase compared to previous years. During 2005, the influenza notification rate amongst persons aged over 65 years (22 cases per 100,000 population) was 70 per cent higher than the mean rate of the last four years. One thousand one hundred and seventy-four influenza isolates from Australia were antigenically analysed: 689 were A(H3N2), 210 were A(H1N1) strains and 275 were influenza B viruses. Continued antigenic drift was seen with the A(H3N2) viruses from the previous reference strains with approximately one quarter of isolates being distinguishable from A/Wellington/1/2004-like viruses and more closely matched to A/California/7/2004-like viruses.

Australia↗

PubMed2006

Invasive pneumococcal disease in Australia, 2004.

There were 2,375 cases of invasive pneumococcal disease (IPD) notified to the National Notifiable Diseases Surveillance System in Australia in 2004; a notification rate of 11.8 cases per 100,000 population. The rate varied between states and territories and by geographical region with the highest rates in the Northern Territory. Invasive pneumococcal disease was reported most frequently in children aged less than 5 years (55.4 cases per 100,000 population). Enhanced surveillance for IPD was carried out in all states and territories, in 2004, providing additional data on 2,023 (85%) cases. The overall rate of IPD in Indigenous Australians was 3.2 times the rate in non-Indigenous Australians. There were 154 deaths attributed to IPD resulting in an overall case fatality rate of 7.6 per cent. Rates of IPD in the Indigenous and non-Indigenous under 2-year-old population were similar in 2004 (91.5 and 93.6 cases per 100,000 population, respectively) following a targeted introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV) in mid-2001 for Indigenous infants and children. Serotypes of isolates were identified from 80 per cent of all notified cases, with 72 per cent of isolates belonging to serotypes represented in the 7vPCV and 91 per cent in the 23-valent polysaccharide pneumococcal vaccine (23vPPV). Comparison of serotypes in the 7vPCV target population showed that the rate of IPD due to 7vPCV serotypes decreased by 74 per cent between 2001-02 and 2003-04. Of 216 isolates with reduced penicillin susceptibility, 83 per cent belonged to pneumococcal serotypes in the 7vPCV and 95 per cent in the 23vPPV.

Adolescent↗

PubMed2006

Tuberculosis notifications in Australia, 2004.

The National Notifiable Disease Surveillance System received 1,076 tuberculosis (TB) notifications in 2004, of which 1,043 were new cases and 33 were relapses. The incidence of TB in Australia has remained at a stable rate since 1985 and was 5.4 cases per 100,000 population in 2004. The high-incidence groups remain people born overseas and Indigenous Australians at 21.7 and 8.1 cases per 100,000 population, respectively. By contrast, the incidence of TB in the non-Indigenous Australian-born population was 1.0 cases per 100,000 population. Comparison of the 2004 TB notification data against the performance indicators set by National Tuberculosis Advisory Committee highlights that enhanced TB control measures should be considered among these high-risk groups.

Adolescent↗

PubMed2005

Annual report of the National Influenza Surveillance Scheme, 2004.

The National Influenza Surveillance Scheme includes data on influenza-like illness from sentinel general practitioner practices, laboratory reports of influenza from National Notifiable Diseases Surveillance Scheme and absenteeism data from a national employer. In 2004, 2,116 cases of laboratory-confirmed influenza-like illness were reported, which was 41 per cent lower than the previous year. Peak activity was recorded in September, a month later than in 2003. Influenza A was again predominant while influenza B had an increased activity compared to the previous season. Four hundred and fifty-four isolates were antigenically analysed: 342 were A (H3N2 strain), 4 were A(H1N1 strain) strains and 108 were influenza B viruses. Further antigenic drift was seen in the A(H3N2) subtype with approximately one third of all isolates antigenically distinguishable from the A/Fujian/411/2002 reference strain. Vaccination coverage indicated that 79 per cent of Australians aged over 65 years received the 2004 influenza vaccine.

Australia↗

PubMed2005

Evaluation of the Australian Gonococcal Surveillance Programme.

The Australian Gonococcal Surveillance Programme (AGSP) is a laboratory network that monitors the susceptibility of gonococcal isolates to antibiotics used in the treatment of infection. This report evaluates and reports on the simplicity, flexibility, sensitivity, representativeness, timeliness and acceptability of the AGSP. The World Health Organization's (WHO) Questionnaire for Assessment of Antimicrobial Resistance (AMR) National Networks was used in undertaking this evaluation and we report on the questionnaire's usefulness. The evaluation revealed that the AGSP was structurally simple, acceptable, timely and that the data were actively used by the stakeholders. However, the flexibility, representativeness and sensitivity of the AGSP are challenged by the increasing use of molecular based methods to diagnose gonococcal infections, as this is reducing the number of isolates available for testing. Despite this challenge, the AGSP has been able to identify differences in the antimicrobial susceptibility of gonococcal strains circulating in metropolitan and regional communities and the data generated are used to devise or modify standard treatment regimens for gonorrhoea. The functioning of the system can be improved by better availability of data through a dedicated website. Ideally, linkage of AGSP data to notification data would ensure that the AGSP is sensitive to and representative of the changes in gonococcal resistance amongst various sub-populations, although it will increase system complexity. The WHO questionnaire was found to be useful in undertaking the evaluation of the AGSP as it was simple and well-structured. However, the questionnaire needs to be expanded to include benchmarks that guide the assessment process.

Australia↗

PubMed2002

The paper grip test for screening on intrinsic muscle paralysis in the foot of leprosy patients.

Plantar intrinsic foot muscles provide structure to the foot during walking and thus regulate mechanical foot sole stresses. When paralyzed, for instance in leprosy patients with neuropathy of the distal part of the tibial nerve, there is a high prevalence of plantar ulceration and deformities, especially when muscle weakness goes together with loss of foot sole sensibility. These patients should get immediate care involving education, special footwear and reconstructive surgery before further foot impairment and deformity becomes manifest. Thus far, in leprosy patients little attention is paid to screening of plantar intrinsic muscles activity. This can be done with a new simple and non-invasive method, the Paper Grip Test (PGT). There are two variants for detecting intrinsic muscle weakness of the foot, PGT1 for the great toe and PGT2 for the combined lesser toes. In this study, 517 leprosy patients and 170 healthy volunteers were investigated with the PGT. Sensibility of the foot sole was tested by means of a 10 gram monofilament. Specificity to the PGT1 is found to be about 95.3% which is considered good for physical diagnostic tests. PGT2 is less specific than PGT1. Individual muscle power and understanding of the patient seems to influence the outcome of the test to a certain extent. Sensitivity can only be calculated when the diagnosis is confirmed by electromyography. Especially patients with anesthetic feet, females, older patients and patients with PN-, BB- or LL-types of leprosy appeared to have a higher prevalence of intrinsic foot muscle weakness. All results were analyzed by means of the bivariate Pearson correlation-analysis and proved to be statistically significant (p = < 0.05). It is concluded that the PGT1, more than the PGT2, is a useful screening test on the function of plantar intrinsic foot muscles in leprosy patients in hospitals and during fieldwork in developing countries.

Adult↗