Publications by authors named "Anthony D K Draper"

Background: Serosurveillance can be used to assess population immunity to vaccine-preventable diseases (VPDs). This study aimed to determine seroprevalence of four VPDs across Timor-Leste and identify immunity gaps.

Methods: A population-representative three-stage cluster random sample of census-enumerated households were visited between October 2021 and February 2023.

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An outbreak of salmonellosis occurred in August 2024 after consuming wild hunted kangaroo in a remote area of the Northern Territory (NT), Australia. We conducted an outbreak investigation via telephone and face-to-face interviews, using a standardised questionnaire that recorded symptoms and exposures to foods and activities prior to onset of symptoms. A confirmed outbreak case was defined as anyone with laboratory confirmed Muenchen infection who was part of a group of people who shared meals on 25-26 August 2024.

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Article Synopsis
  • - The Northern Territory (NT) of Australia has the highest alcohol consumption and injury rates, leading to a study on alcohol-related injury (ARI) hospitalisations from 2007 to 2022 to assess the relationship between alcohol and injuries, and the impact of alcohol policies.
  • - Findings revealed that 22.6% of all injury hospitalisations were linked to alcohol, with assaults being the primary cause (46%), and a significant decline in ARI hospitalisations was noted in Central Australia after implementing alcohol policies in 2017-2018.
  • - The study emphasizes the effectiveness of these alcohol policies in reducing ARI hospitalisations in Central Australia, suggesting the need for sustained efforts to combat alcohol-related harm.
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The bacterium Vibrio parahaemolyticus is ubiquitous in tropical and temperate waters throughout the world and causes infections in humans resulting from water exposure and from ingestion of contaminated raw or undercooked seafood, such as oysters. We describe a nationwide outbreak of enteric infections caused by Vibrio parahaemolyticus in Australia during September 2021-January 2022. A total of 268 persons were linked with the outbreak, 97% of whom reported consuming Australia-grown oysters.

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Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste.

Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients.

Results: In 2020, 291/394 (73.

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Timor-Leste is a mountainous, half-island nation with a population of 1.3 million, which shares a land border with Indonesia and is 550 km from Darwin, Australia. Since independence in 2002, Timor-Leste has achieved significant development; however, high levels of poverty remain.

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Dengue virus (DENV) infection causes 390 million infections per year and 40,000 deaths globally. It is endemic in many countries in Asia, Africa, the Americas, the Caribbean, and Oceania. Dengue is endemic in Timor-Leste year-round, but peak transmission occurs during the rainy season.

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In low-to-middle-income countries (LMICs), enteric pathogens contribute to child malnutrition, affecting nutrient absorption, inducing inflammation, and causing diarrhoea. This is a substantial problem in LMICs due to high disease burden, poor sanitation and nutritional status, and the cyclical nature of pathogen infection and malnutrition. This relationship remains understudied in Timor-Leste.

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The response to the COVID-19 pandemic in Timor-Leste offers lessons that may be useful for incorporating into future responses to infectious disease outbreaks in similar resource-limited settings. In this paper, we identify nine key areas for learning from Timor-Leste's experience of the COVID-19 pandemic: (1) the importance of prior preparation for health emergencies, (2) the establishment of effective leadership and governance structures, (3) the protective impact of early border restrictions, (4) the rapid expansion of diagnostic laboratory capacity, (5) the impact of effective health communications in supporting the vaccine roll-out, (6) the opportunity to build capacity for clinical care, (7) the use of public health interventions that were found to have limited public health impact, (8) the broader effects of the pandemic and the public health response and (9) translation of lessons from COVID-19 to other public health priorities.

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Introduction: The World Health Organisation recommends that healthcare workers (HCWs) are immune to measles and rubella, and those at risk of exposure are offered the hepatitis B vaccine. No formal programme for occupational assessment and provision of vaccinations to HCWs currently exists in Timor-Leste.

Methods: A cross-sectional study was undertaken to determine the seroprevalence of hepatitis B, measles and rubella among HCWs in Dili, Timor-Leste.

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Introduction: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection.

Methods And Analysis: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age.

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Background: Early detection of rheumatic heart disease (RHD) through echocardiographic screening can facilitate early access to effective treatment, which reduces the risk for progression. Accurate, feasible approaches to echocardiographic screening that can be incorporated into routine health services are needed. The authors hypothesized that offsite expert review could improve the diagnostic accuracy of nonexpert-obtained echocardiographic images.

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Timor-Leste is a small nation of 1.3 million people which shares a land border with Indonesia and is 550 km from Darwin, Australia. It is one of the poorest nations in Asia.

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Background: Lack of access to diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can limit disease surveillance in remote areas. Serological surveillance can indicate the true extent and distribution of infections in such settings.

Methods: This study monitored SARS-CoV-2 seroprevalence in residual serum samples salvaged from laboratories at five healthcare facilities across Timor-Leste from March to October 2021.

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Background: Echocardiographic screening can detect asymptomatic cases of rheumatic heart disease (RHD), facilitating access to treatment. Barriers to implementation of echocardiographic screening include the requirement for expensive equipment and expert practitioners. We aimed to evaluate the diagnostic accuracy of an abbreviated echocardiographic screening protocol (single parasternal-long-axis view with a sweep of the heart) performed by briefly trained, nonexpert practitioners using handheld ultrasound devices.

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Aim: To describe the epidemiology of invasive Salmonella disease in children in the Northern Territory, Australia.

Methods: Design: A retrospective review of invasive salmonellosis cases identified by pathology records and the Northern Territory Notifiable Disease Surveillance System. Case definitions: Those aged 18 years or under, with Salmonella cultured from a usually sterile site, collected in the Northern Territory between 1 July 2005 and 30 June 2015.

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Abstract: Strict physical distancing measures and border controls have been introduced in the Northern Territory (NT), and across Australia, to reduce the spread of coronavirus disease 2019 (COVID-19). These measures have been associated with reduced incidence of other respiratory illnesses such as influenza. It is currently unclear what effect these measures have on non-respiratory communicable diseases.

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An outbreak of Salmonella Muenchen gastroenteritis occurred in a remote coastal Aboriginal community in the Northern Territory (NT) of Australia. There were 22 people sick (attack rate 55%); 7 had laboratory confirmed S. Muenchen infection; 2 required medical evacuation and admission to the intensive care unit (ICU).

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Introduction: Scabies and impetigo are common and important skin conditions which are often neglected in developing countries. Limited data have been published on the prevalence of scabies and impetigo in Timor-Leste. Sequelae including cellulitis, bacteraemia, nephritis, acute rheumatic fever and rheumatic heart disease contribute significantly to the burden of disease.

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