Clinical Associate Professor Deborah Lehmann

Clinical predictors of hypoxic pneumonia in children from the Eastern Highlands Province, Papua New Guinea: secondary analysis of two prospective observational studies

Pneumonia is the leading cause of death in young children globally and is prevalent in the Papua New Guinea highlands. We investigated clinical predictors of hypoxic pneumonia to inform local treatment guidelines in this resource-limited setting.

Otitis media at 6-monthly assessments of Australian First Nations children between ages 12–36 months: Findings from two randomised controlled trials of combined pneumococcal conjugate vaccines

In remote communities of northern Australia, First Nations children with hearing loss are disproportionately at risk of poor school readiness and performance compared to their peers with no hearing loss. The aim of this trial is to prevent early childhood persisting otitis media (OM), associated hearing loss and developmental delay.

Ear and hearing outcomes in Aboriginal infants living in an urban Australian area: the Djaalinj Waakinj birth cohort study

Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area. Aboriginal infants enrolled in the Djaalinj Waakinj prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected.

Pneumococcal carriage, serotype distribution, and antimicrobial susceptibility in Papua New Guinean children vaccinated with PCV10 or PCV13 in a head-to-head trial

Children in Papua New Guinea (PNG) are at high risk of pneumococcal infections. We investigated pneumococcal carriage rates, serotype distribution, and antimicrobial susceptibility in PNG children after vaccination with 10-valent or 13-valent pneumococcal conjugate vaccines (PCV10; PCV13).

Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study

Australian Aboriginal and/or Torres Strait Islander children in rural/remote areas suffer high rates of persistent otitis media (OM) from early infancy. We aimed to determine the proportion of Aboriginal infants living in an urban area who have OM and investigate associated risk factors.

Emergence of a multidrug-resistant and virulent Streptococcus pneumoniae lineage mediates serotype replacement after PCV13: an international whole-genome sequencing study

Serotype 24F is one of the emerging pneumococcal serotypes after the introduction of pneumococcal conjugate vaccine (PCV). We aimed to identify lineages driving the increase of serotype 24F in France and place these findings into a global context.

Immunogenicity, otitis media, hearing impairment, and nasopharyngeal carriage 6-months after 13-valent or ten-valent booster pneumococcal conjugate vaccines, stratified by mixed priming schedules: PREVIX_COMBO and PREVIX_BOOST randomised controlled trials

Australian First Nations children are at very high risk of early, recurrent, and persistent bacterial otitis media and respiratory tract infection. With the PREVIX randomised controlled trials, we aimed to evaluate the immunogenicity of novel pneumococcal conjugate vaccine (PCV) schedules.

Distinct Streptococcus pneumoniae cause invasive disease in Papua New Guinea

Streptococcus pneumoniae is a key contributor to childhood morbidity and mortality in Papua New Guinea (PNG). For the first time, whole genome sequencing of 174 isolates has enabled detailed characterisation of diverse S. pneumoniae causing invasive disease in young children in PNG, 1989-2014.

High prevalence of hearing loss in urban Aboriginal infants: the Djaalinj Waakinj cohort study

Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study

Pneumonia is a leading cause of childhood mortality with Streptococcus pneumoniae a major contributor. Pneumococcal conjugate vaccines (PCVs) have been introduced into immunisation programs in many low- to middle-income countries yet there is a paucity of data evaluating the effectiveness in these settings. We assess the effectiveness of 13-valent PCV against hypoxic pneumonia, hospitalisation and other clinical endpoints in children <5 years living in Eastern Highlands Province, Papua New Guinea).

International links between Streptococcus pneumoniae vaccine serotype 4 sequence type (ST) 801 in Northern European shipyard outbreaks of invasive pneumococcal disease

Pneumococcal disease outbreaks of vaccine preventable serotype 4 sequence type (ST)801 in shipyards have been reported in several countries. We aimed to use genomics to establish any international links between them.

Children with secondary care episodes for otitis media have poor literacy and numeracy outcomes: A data linkage study

We examined the association between otitis media and educational attainment in a retrospective population cohort of Western Australian children who participated in the Grade 3 National Assessment Program—Literacy and Numeracy in 2012.

Differences in Pneumococcal and Haemophilus influenzae Natural Antibody Development in Papua New Guinean Children in the First Year of Life

Development of vaccines to prevent disease and death from Streptococcus pneumoniae, and nontypeable Haemophilus influenzae (NTHi), the main pathogens that cause otitis media, pneumonia, meningitis and sepsis, are a global priority.

Lack of effectiveness of 13-valent pneumococcal conjugate vaccination against pneumococcal carriage density in Papua New Guinean infants

Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity.

PCV10 elicits Protein D IgG responses in Papua New Guinean children but has no impact on NTHi carriage in the first two years of life

Nasopharyngeal colonisation with nontypeable Haemophilus influenzae (NTHi) is associated with development of infections including pneumonia and otitis media. The 10-valent pneumococcal conjugate vaccine (PCV10) uses NTHi Protein D (PD) as a carrier. Papua New Guinean children have exceptionally early and dense NTHi carriage, and high rates of NTHi-associated disease.

An observational study of the reactogenicity and immunogenicity of 13-valent pneumococcal conjugate vaccine in women of childbearing age in Papua New Guinea

Maternal immunization with pneumococcal conjugate vaccine (PCV) may protect young infants in high-risk settings against the high risk of pneumococcal infections in early life. The aim of this study was to determine the safety and immunogenicity of 13-valent PCV (PCV13) in healthy women of childbearing age in PNG.

Djaalinj Waakinj (listening talking): Rationale, cultural governance, methods, population characteristics–an urban Aboriginal birth cohort study of otitis media

The majority of Australian Aboriginal and Torres Strait Islander (hereafter referred to as “Aboriginal”) people live in urban centres. Otitis media (OM) occurs at a younger age, prevalence is higher and hearing loss and other serious complications are more common in Aboriginal than non-Aboriginal children. Despite this, data on the burden of OM and hearing loss in urban Aboriginal children are limited.

Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: summary of recommendations

The 2001 Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Islander populations were revised in 2010. This 2020 update by the Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children used for the first time the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Pneumococcal conjugate vaccine primes mucosal immune responses to pneumococcal polysaccharide vaccine booster in Papua New Guinean children

Invasive pneumococcal disease remains a major cause of hospitalization and death in Papua New Guinean (PNG) children. We assessed mucosal IgA and IgG responses in PNG infants vaccinated with pneumococcal conjugate vaccine (PCV) followed by a pneumococcal polysaccharide vaccine (PPV) booster.

10-Valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine versus 13-valent pneumococcal conjugate vaccine (PCV13) as a booster dose

18 months of age infants receiving 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine will have higher antibody levels

The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies

Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems

Safety and immunogenicity of pneumococcal conjugate vaccines in a high-risk population: a randomised controlled trial of PCV in Papua New Guinean infants

Infant vaccination with 3 doses of PCV10 or PCV13 is safe and immunogenic in a highly endemic setting

Australian Aboriginal children have higher hospitalization rates for otitis media but lower surgical procedures than non-Aboriginal children

Aboriginal children and children from lower socio-economic backgrounds were over-represented with OM-related hospitalizations but had fewer TTIs

A collaborative yarn on qualitative health research with Aboriginal communities

In this paper, we seek to provide guidance for researchers who are new to undertaking research with Aboriginal and Torres Strait Islander communities

Immunogenicity and Immune Memory after a Pneumococcal Polysaccharide Vaccine Booster in a High-Risk Population Primed with Pneumococcal Conjugate Vaccine

PPV is immunogenic in 9-month-old children at high risk of pneumococcal infections and does not affect the capacity to produce protective immune responses

Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012)

Given the beneficial effect of infant rotavirus vaccination efforts should be taken to optimize rotavirus vaccine coverage in those at highest risk

Moraxella catarrhalis Restriction-Modification Systems Are Associated with Phylogenetic Lineage and Disease

We observed an association between Type III DNA methyltransferase presence and Otitis Media-associated middle ear isolates

Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries

We will investigate the relationship between PCV coverage and VT carriage among undervaccinated children in Asia and the Pacific

The Impact of Pneumococcal Vaccination on Bacterial and Viral Pneumonia in Western Australian Children: Record Linkage Cohort Study of 469589 Births, 1996-2012

We assessed the impact of PCV on all-cause and pathogen-specific pneumonia hospitalizations in Western Australian (WA) children aged 16 years.

Rationale and methods of a randomized controlled trial of immunogenicity, safety and impact on carriage of pneumococcal conjugate and polysaccharide vaccines in infants in Papua New Guinea

Vaccination trials in high endemicity areas are needed to provide evidence and guidance on idea strategies to protect children in these areas against infections

Pneumococcal responses are similar in Papua New Guinean children aged 3-5 years vaccinated in infancy with pneumococcal polysaccharide vaccine with or without prior pneumococcal conjugate vaccine, or without pneumococcal vaccination

We studied in a non-randomized follow-up trial the persistence of pneumococcal immunity in children, 3-5 years of age, in community controls of a similar age.

Predictors of pneumococcal carriage and the effect of the 13-valent pneumococcal conjugate vaccination the Western Australian Aboriginal population

The PCV7 was introduced to prevent IPD in WA Aboriginal people in 2001 to a lesser extent in older people.

Rhinovirus C is associated with wheezing and rhinovirus A is associated with pneumonia in hospitalized children in Morocco

We aimed to describe the distribution of RV species and associations between RV species and clinical features in children hospitalized with clinically severe pneumonia in Morocco

Cord blood Streptococcus pneumoniae-specific cellular immune responses predict early pneumococcal carriage in high-risk infants in Papua New Guinea

We aimed to explore whether newborns in high-risk areas have pre-existing pneumococcal-specific cellular immune responses that effects early acquisition.

Childhood pneumonia and meningitis in the Eastern Highlands Province, Papua New Guinea in the era of conjugate vaccines: study methods and challenges

Recruitment of large numbers of pediatric pneumonia and meningitis cases and community controls in a third-world setting presents unique challenges

Limited impact of neonatal or early infant schedules of 7-valent pneumococcal conjugate vaccination

Early 7vPCV schedules have limited impact on pneumococcal vaccine type carriage in PNG

The PneuCarriage Project: A Multi-Centre Comparative Study to Identify the Best Serotyping Methods for Examining Pneumococcal Carriage

The PneuCarriage project, a large, international multi-centre study for the identification of the best pneumococcal serotyping methods for carriage studies

Aboriginal and non-Aboriginal children in Western Australia carry different serotypes of pneumococci with different antimicrobial susceptibility profiles

Differences in pneumococcal serotypes, genotypes, and antimicrobial susceptibility between Aboriginal and non-Aboriginal children living in the same area

Rhinovirus species and clinical features in children hospitalised with pneumonia from Mozambique

The prevalence of human rhinovirus (RV) species in children hospitalised with pneumonia in Manhiça, Mozambique

Geographic consistency in dominant, non-typeable Haemophilus influenzae genotypes colonising four distinct Australian paediatric groups: a cohort study

Identified dominant PCR-ribotypes common to geographically disparate Australian paediatric populations

A longitudinal study of natural antibody development to pneumococcal surface protein A families 1 and 2 in Papua New Guinean Highland children: a cohort study

Pneumococcal surface protein A is immunogenic and natural anti-PspA immune responses are acquired through exposure and develop with age

Respiratory viruses in young South African children with acute lower respiratory infections and interactions with HIV

RV-A and RV-C are endemic in South African children and HIV infection may be protective against RSV and bronchiolitis.

A systematic review of the evidence that swimming pools improve health and wellbeing in remote Aboriginal communities in Australia

The benefits that swimming pools may bring to to ear and eye health in remote Aboriginal communities remains unresolved

Evaluation of impact of 23 valent pneumococcal polysaccharide vaccine following 7 valent pneumococcal

The impact of the 23vPPV booster on IPD incidence among Australian Indigenous children is unclear from regional reports of small case numbers.

Streptococcus pneumoniae and Haemophilus influenzae in paediatric meningitis patients at Goroka General Hospital

This research presents serotype, antimicrobial susceptibility and outcome data from paediatric meningitis patients prior to introduction of Haemophilus...

Risk factors and comorbidities for invasive pneumococcal disease in Western Australian Aboriginal and non-Aboriginal people

Australian Aboriginal people have among the highest rates of invasive pneumococcal disease (IPD) worldwide. This paper investigates clinical diagnosis, risk...

Morbidity due to acute lower respiratory infection in children with birth defects: A total population-based linked data study

Children with birth defects experience higher rates of hospitalisation for ALRIs before age 2 years than children with no birth defects.

Diversity of Nontypeable Haemophilus influenzae strains colonizing Australian Aboriginal and non-Aboriginal children

Nontypeable Haemophilus influenzae (NTHI) strains are responsible for respiratory-related infections which cause a significant burden of disease in...

High Nasopharyngeal Carriage of Non-Vaccine Serotypes in Western Australian Aboriginal People Following 10 Years of Pneumococcal Conjugate Vaccination

Invasive pneumococcal disease (IPD) continues to occur at high rates among Australian Aboriginal people.

Diverging Trends in Gastroenteritis Hospitalizations during Two Decades in Western Australian Aboriginal and Non-Aboriginal Children

Our findings highlight the need to consider age, ethnicity, seasonality and climate when evaluating rotavirus vaccine programs.

How Accurate Are International Classification of Diseases-10 Diagnosis Codes in Detecting Influenza and Pertussis Hospitalizations in Children?

Influenza diagnosis codes had high specificity (98.6%) and modest positive predictive value (PPV; 84.1%) and sensitivity (86.1%) for a laboratory-confirmed...

Safety and Immunogenicity of Neonatal Pneumococcal Conjugate Vaccination in Papua New Guinean Children: A Randomised Controlled Trial

We conducted an open randomized controlled trial in Papua New Guinea to compare safety, immunogenicity and priming for memory of 7-valent PCV (PCV7) given in...

Association between early bacterial carriage and otitis media in Aboriginal and non-Aboriginal children

Streptococcus pneumoniae (Pnc), nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat) are the most important bacterial pathogens...

Can linked emergency department data help assess the out-of-hospital burden of acute lower respiratory infections

There is a lack of data on the out-of-hospital burden of acute lower respiratory infections (ALRI) in developed countries.

Prevalence of and risk factors for human rhinovirus infection in healthy aboriginal and non-aboriginal western australian children

Human rhinovirus (HRV) species C (HRV-C) have been associated with frequent and severe acute lower respiratory infections and asthma in hospitalized children.

Respiratory viral pathogens associated with lower respiratory tract disease among young children

Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG).

Reduction in disparity for pneumonia hospitalisations between Australian indigenous and non-Indigenous children

In the 1990s pneumonia hospitalisation rates in Western Australia (WA) were 13 times higher in Indigenous children than in non-Indigenous children...

Hospitalisation for bronchiolitis in infants is more common after elective caesarean delivery

The authors previously reported an increased risk of hospitalisation for acute lower respiratory infection up to age 2 years in children delivered by...

Effect of early carriage of streptococcus pneumoniae on the development of pneumococcal protein-specific cellular immune responses in infancy

The aim of this study was to examine the relationship between nasopharyngeal pneumococcal colonization in early life and the development of T cell responses.

Use of data linkage to investigate the aetiology of acute lower respiratory infection hospitalisations in children

The aim was to document the aetiology of acute lower respiratory infection (ALRI) hospitalisations in Western Australian children

Hospitalisation for bronchiolitis in infants is more common after elective caesarean delivery

The authors previously reported an increased risk of hospitalisation for acute lower respiratory infection up to age 2 years in children delivered by...

Pneumococcal conjugate vaccination at birth in a high-risk setting: No evidence for neonatal T-cell tolerance

Concerns about the risk of inducing immune deviation-associated "neonatal tolerance" as described in mice have restricted the widespread adoption...

Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related

We investigated predictors of nasopharyngeal carriage in Australian Aboriginal and non-Aboriginal children.

Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related bacteria

Streptococcus pneumoniae, Moraxella catarrhalis, and nontypeable Haemophilus influenzae is associated with otitis media

A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children

Acute lower respiratory infections (ALRI) are a major cause of hospitalisation in young children

Are you listening? The inaugural OMOZ Workshop - towards a better understanding of otitis media

Are you listening? The inaugural OMOZ Workshop - towards a better understanding of otitis media

The changing epidemiology of invasive pneumococcal disease

We investigated trends in invasive pneumococcal disease (IPD) in Western Australia (WA).

The interaction between respiratory viruses and pathogenic bacteria

Data on asymptomatic identification rates of respiratory viruses are limited, particularly in Indigenous populations, who suffer a high burden of OM.

Antimicrobial susceptibility of Moraxella catarrhalis isolated from children in Kalgoorlie-Boulder

To investigate antimicrobial susceptibility of Moraxella catarrhalis isolated from a cohort of children being followed in a study of the natural history of OM

Diverging trends for lower respiratory infections in non-Aboriginal and Aboriginal children

To investigate temporal trends in admission rates for acute lower respiratory infections (ALRI) in a total population birth cohort of non-Aboriginal and...

Infection is the major component of the disease burden in Aboriginal and non-Aboriginal Australian children: a population-based study

Infection accounts for the majority of pediatric mortality and morbidity in developing countries, but there are limited data on the infectious diseases...