NT Health Research and Publications Online

Welcome to NT Health Research and Publications Online, an open access digital repository that showcases the research projects and output of researchers working for the Northern Territory Department of Health (NT Health), while also collecting and preserving publications and multimedia produced in an official capacity, that represent the department. This service is maintained by NT Health Library Services
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4304
Projects
61
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498
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  • Publication
    Journal Article
    Cost-Effectiveness of Clinical Decision Support to Improve CKD Outcomes Among First Nations Australians.
    (2024-11-09)
    Chen, Winnie
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    Howard, Kirsten
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    Gorham, Gillian
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    ; ;
    Adegboye, Oyelola
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    ; ; ;
    Heard, Samuel
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    Talukder, Mohammad Radwanur
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    Baghbanian, Abdolvahab
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    Cass, Alan
    The Northern Territory (NT) is a hotspot for chronic kidney disease (CKD) and has a high incidence of kidney replacement therapy (KRT). The Territory Kidney Care clinical decision support (CDS) tool aims to improve diagnosis and management of CKD in remote NT, particularly among First Nations Australians. We model the cost-effectiveness of the CDS versus usual care.Taking a health care funder perspective, we modeled a cohort of people from remote NT at risk of or with CKD, as of January 1, 2017. A Markov cohort model was developed using 6 years of observed patient-level data (2017-2023), extrapolated to a 15-year time horizon. The CDS tool was modeled to improve CKD diagnosis (scenario 1), improve management (scenario 2), or improve both diagnosis and management (scenario 3).The remote NT cohort consisted of 23,195 people, predominantly (89%) First Nations, with a mean age of 42 years. Scenario 3 (improved diagnosis and management) was most cost-effective at an incremental cost-effectiveness ratio (ICER) of $96,684 per patient avoiding KRT, $30,086 per patient avoiding death. Scenario 1 (improved diagnosis) was less cost-effective, and scenario 2 (improved management) was the least cost-effective. The ICER per quality-adjusted life years (QALYs) gained ranged from $3427 (scenario 3) to $63,486 (scenario 2).Territory Kidney Care is highly cost-effective when it supports early diagnosis of CKD and increases optimal management in diagnosed patients. These results support investing in CDS tools, implemented in strong partnerships, to improve outcomes in settings with a high burden of CKD.
  • Publication
    Journal Article
    Missed Opportunities for Preventing or Diagnosing Acute Rheumatic Fever: A Retrospective Cohort Study of 20 Young Australians Diagnosed With Rheumatic Heart Disease on Screening Echocardiography.
    (2025-02-23)
    Rouhiainen, Oliver
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    Gatti, Jessica
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    Ramadani, Seide
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    Stewart, Jayden
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    Matthews, Melanie
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    A cross-sectional echocardiographic screening study in a remote Aboriginal community in Australia identified hyperendemic levels of rheumatic heart disease (RHD). 20/613 screened were newly diagnosed with RHD, and 18/20 had no known history of acute rheumatic fever (ARF). Our aim was to explore the medical histories of those newly diagnosed with RHD for potential (1) missed opportunities for primary prevention of ARF through management of Group A Streptococcal (Strep A) infection, and (2) missed opportunities for diagnosis of ARF.We assessed community clinic and tertiary hospital medical records of those children with new diagnoses of RHD (n = 20), and collected information regarding previous episodes of possible Strep A infection or its sequelae.All 20 participants had previous documented possible or confirmed Strep A infections, predominantly in the form of impetigo or infected scabies (range 1-17 episodes per participant). At least 15/20 participants had potential Strep A infections where treatment that was documented may not have adequately covered Strep A. 11/20 participants had scabies diagnosed without documented scabies treatment. 2/20 participants had previously diagnosed ARF, however these were diagnosed within the month prior to the community-wide screening for RHD. 2/20 participants had undiagnosed, probable or possible ARF when classified retrospectively from review of their case documentation. 13/20 participants had non-specific presentations with joint complaints that may have represented an ARF episode but with inadequate workup to fulfil diagnostic criteria on retrospective assessment.
  • Publication
    Journal Article
    Use of sodium-glucose cotransporter-2 inhibitors among Aboriginal people with type 2 diabetes in remote Northern Territory: 2012 to 2020.
    Aboriginal people in remote Northern Territory communities experience the highest burden of type 2 diabetes (T2D) globally. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiac and renal outcomes in selected populations. However, safety in this context is unknown. We investigated SGLT2i use and outcomes in remote Aboriginal people with T2D between 2012 and 2020.
  • Publication
    Journal Article
    Clinical characteristics and economic impact of acute hospitalisations due to bronchiectasis exacerbations among adult Indigenous Australians in the Top End Northern Territory.
    This cross-sectional study assessed the clinical and economic costs (Inpatient Activity Database) associated with hospitalisations due to bronchiectasis exacerbations among adult indigenous patients in the Top End, Northern Territory. Twenty case episodes from 15 indigenous patients with a mean age of 51.8 ± 12.7 years were recorded in a 3-month study window. The estimated cost was AUD 400 579.9, with cost per patient AUD 26 705 over 3 months and average cost per admission AUD 20 029. Extrapolating cost data across a 10-year period gave a conservative estimate of AUD 28 million.
  • Publication
    Journal Article
    An outbreak of Salmonella Muenchen gastroenteritis after consuming wild hunted kangaroo, Northern Territory, Australia, 2024.
    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. A probable outbreak case was defined as anyone who was part of a group of people who shared meals on 25-26 August 2024 and subsequently experienced diarrhoea, in the absence of a laboratory test. Of the seven members of the group who shared meals, all became ill (attack rate 100%); three were confirmed cases and four were probable cases. The median age was 32 years (range 23-65 years); six (86%) were male. The median incubation period was 24 hours (range 6-30 hours). The most commonly reported symptoms were diarrhoea (100%, 7/7) and abdominal pain (86%, 6/7). Two cases were admitted to hospital, both for an overnight stay; all recovered. All seven cases consumed the same meal - a single, locally hunted and butchered kangaroo. Contamination likely occurred due to unsafe butchering, storage, transportation and insufficient cooking of the meat. This outbreak highlights the risks of contamination of game meat (in this case kangaroo) with . Those preparing hunted meat should wash hands and knives regularly while butchering an animal to avoid contamination; should store butchered meat below 5 °C to avoid bacterial growth and cook foods thoroughly to kill microbes. We estimate that the cost to society of this outbreak was 9,810 Australian dollars.
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