Australian Paediatric Surveillance Unit (APSU)

Group Leader
Prof Elizabeth Elliott
Director, Australian Paediatric Surveillance Unit
Phone: 02 9845 3382
Email: LouiseB3@chw.edu.au or apsu@chw.edu.au
Website: www.apsu.org.au

Current Research Program

The Australian Paediatric Surveillance Unit (APSU) conducts national active surveillance of rare diseases of childhood, including infectious and vaccine preventable diseases, genetic disorders, childhood injuries and mental health conditions. The study of communicable and vaccine-preventable diseases is supported in part by the Department of Health and Ageing (DoHA) through its communicable diseases program. This report is a summary of surveillance results for communicable and/or vaccine preventable diseases studied through the APSU in 2007.

In 2007, ten communicable or vaccine preventable conditions were studied:

• Acute Flaccid Paralysis (AFP)*
• Acute Intussusception (IS)
• Congenital cytomegalovirus infection
• Congenital rubella infection
• Perinatal exposure to HIV and HIV infection
• Neonatal herpes simplex virus infection
• Hepatitis C Virus infection
• Non-Tuberculous Mycobacterium infection (surveillance to end in 2007)
• Neonatal Group B Streptococcus Infection
• Varicella: neonatal, congenital and severe complications of varicella infection requiring hospitalisation

APSU study protocols are developed with collaborating investigators and/or institutions and the objectives and chief investigators for each study are listed in Table 2. Detailed protocols including case definitions for each disease under surveillance are available at www.apsu.org.au.

The APSU aims to provide epidemiological information that is representative of the Australian population and maximal case ascertainment is a high priority. Despite a representative mailing list (93% of all paediatricians in active clinical practice in Australia participate in monthly surveillance) and high response rates (92.3% for 2007), complete case ascertainment is unlikely. This is particularly relevant in remote communities where children have limited access to pediatricians. However, for most conditions studied by the APSU no national data are available to estimate completeness of ascertainment. APSU encourages the use of complementary data sources where available and reporting by a range of specialists to maximize cases identified. Reported rates for conditions ascertained through the APSU therefore represent a minimum estimate of the incidence of these conditions in the relevant Australian populations.

APSU data contribute significantly to the national surveillance effort, providing valuable information for clinicians, policymakers and the community. The APSU is often the only source of national data that includes clinical and/or laboratory details, and data on both inpatients and outpatients.

Major achievements in last 10 years

• Forty-five studies have been undertaken by the APSU involving almost 350 investigators
• Approximately 300,000 report cards have been sent and 282,000 returned, a 94% response rate
• Approximately 170 original articles have been published in peer reviewed journals and 230 scientific presentations given
• Grants totalling over $3 million have been awarded to the APSU
• Approximately 1277 clinicians report monthly on a population of 4.1 million children aged <15 years
• In collaboration with the National Heart Foundation and the Menzies School of Health Research, Darwin, initiates a study on acute rheumatic fever and explores mechanisms to enhance disease surveillance among Aboriginal and migrant communities
• Joint project to standardise classification of congenital anomalies initiated by APSU and the National Perinatal Statistics Unit

Key publications

Elliott EJ, Watson AJM, Walker-Smith JA, Farthing MJG. Effect of bicarbonate on efficacy of oral rehydration therapy: studies in an experimental model of secretory diarrhea. Gut 1988;29:1052-1057.

Elliott EJ, Watson AJM, Walker-Smith JA, Farthing MJG. Search for the ideal oral rehydration solution: studies in a model of secritory diarrhea. Gut 1991;32:1314-1320.

Elliott EJ, Zhi Li, Bell C, Stiel D, Buret A, Wallace J, Brzuszczak I, O'Loughlin EV. A monoclonal antibody against the CD18 adhesion molecule inhibits colonic structural and ion transport abnormalities caused by Enterohaemorrhagic E.coli 0157:H7 in rabbits. Gastroenterology 1994; 106: 1554-1561.

Elliott EJ, Robins-Browne RM, O'Loughlin EV, Bennett-Wood V, Bourke J, Henning P, Hogg GG, Knight J, Powell H, Redmond D, Contributors to the Australian Paediatric Surveillance Unit. Nationwide study of haemolytic uraemic syndrome: clinical, microbial and epidemiological features. Arch Dis Child, 2001;85:125-131.

McDonald AM, Li Y, Cruickshank M, Elliott EJ, Kaldor J, Ziegler JB. Use of interventions for reducing mother-to-child transmission of HIV in Australia. Med J Aust. 2001;174:449-52

Elliott EJ, McIntyre P, Ridley G, Morris A, Massie J, McEniery J, Knight G, Contributors to the Australian Paediatric Surveillance Unit. A national study of infants hospitalised with pertussis in the acellular vaccine era. Pediatr Infect Dis J. 2004, 23:246-252.

Morris A, Elliott EJ, D'Souza RM, Antony J, Kennett M, Longbottom H. Acute flaccid paralysis in Australian children. J Paediatr Child Health. 2003;39:22-6.

Elliott EJ, Payne J, Bower C. Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: a survey of paediatricins' knowledge, attitudes and practice. J Paediatr Child Health. 2006; 42:698-703.

Grenier D, Elliott EJ, Zurynski Y et al. Beyond counting numbers: Public health impacts of national paediatric surveillance units studies. Arch Dis Child. 2006; Epub ahead of print Dec 11.

Thomas DE, Elliott EJ, Baur L. Low glycaemic index, or low glycaemic load diets for overweight and obesity (Protocol). The Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No. CD005105.

Research Staff

• Dr Yvonne Zurynski BAppSc, MAppSc, PhD - Assistant Director
• Karen Pattinson - Office Coordinator
• Ingrid Charters - Administrative Officer
• Nicole McKay B Sc, BAppSc (HIM) - Data Manager
• Deepika Mahajan M Sc (Hons.) PhD - Research Fellow
• Elizabeth Peadon MBBS MPH FRACP - Research Officer
• Suwen He
• Sarah Srikanthan
• Nicola Benwell MBBS, PhD, BSc (Neuroscience)

Research support (2005-2008)

Description (all named investigators on any proposal or grant on which a participant is involved, Project title, source of support, scheme and round) 2006 ($'000) 2007 ($'000) 2008 ($'000) 2009 ($'000) University of Sydney International Development Grant, Dien Bien Phu Maternal and Child Health Project, Vietnam. PI Elliott E. 2006. $30,000       Department of Health and Ageing. Australian Paediatric Surveillance Unit 2000-2006, $680,000 $80,000 $80,000 $80,000   Faculty of Medicine University of Sydney 2005-9, Australian Paediatric Surveillance Unit $60,000 $60,000 $60,000 $60,000 Nutricia Australasia. Centre for Evidence Based Paediatrics, Gastroenterology and Nutrition. PIs: Elliott E. 2000-2006 $300,000 $60,000       NHMRC Enabling Grant; ID 402784; 2006-10;. Elliott EJ (CIA), Bower C, Kaldor J, Booy R, Sullivan E. Australian Paediatric Surveillance Unit: A collaborative network for child health research. $1million $200,000 $200,000 $200,000 $200,000 Healthway WA, 2006-8, Bower C, Elliott E (CIB), Henly N, Payne J, O'Leary C, D'Antoine, Bartu. Alcohol in pregnancy: health promotion for health professionals. $350,000 $116,666 $116,666 $116,666   NHMRC Practitioner Fellowship. Elliott EJ. ID 457084 - 2007-11. $339,450 $67,890 $67,890 $67,890 $67,890 University of Sydney International Development Fund. Elliott EJ, Jeffery H, Morris J. Improving maternal and child health in Vietnam. 2006-7. $15,000 $15,000     United Nations Population Fund. Jeffery H, Elliott EJ, Morris J, Hill D. 2007   $15,000     NHMRC Early start to life. Roberts, CL, O'Connell DL, Bell JC, Elliott E, Morris JM, Criag ME. A population-based longitudinal cohort study of size at birth and childhood morbidity and mortality. Requested $497,500 over 3 years.     $187,500 $155,000 Healthway WA, D'Anoitne H, Henley N, Payne J, Elliott E, Bower C, Bartu A. Alcohol and pregnancy: women's knowledge, attitudes and practices. 2007-8   $8,985 $8,985   Healthway WA, Payne J, Bower C, Elliott E, Henley N,O'Leary C, D'Anoitne H, Bartu A. Alcohol and pregnancy: Aboriginal women's knowledge, attitudes and practices. 2007-8     $8,985 $8,985

Opportunities for Students

Postgraduate Research available at the University of Sydney.