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Trial registered on ANZCTR
Registration number
ACTRN12607000476437
Ethics application status
Approved
Date submitted
23/08/2007
Date registered
21/09/2007
Date last updated
20/06/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Empyema in Children.
To obtain an accurate assessment of the disease burden among children with parapneumonic effusions and empyema associated with S.pneumoniae. There is potential to affect the national vaccination program if the project highlights that there is a large proportion of types of Streptococcus causing disease in children not covered by the current vaccine.
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Scientific title
Prospective Study of Enhanced National Surveillance for Pneumococcal Empyema Thoracis in Children in Australia and New Zealand
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Empyema
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Streptococcus pneumoniae
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Condition category
Condition code
Infection
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Studies of infection and infectious agents
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Respiratory
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
To obtain an accurate assessment of the disease burden among children with parapneumonic effusions and empyema associated with S.pneumoniae, the aim is to enrol children with parapneumonic effusions or empyema over a twenty four month period from all children presenting to paediatric hospitals throughout Australia and to Auckland, New Zealand. Clinical data on demographics, vaccination status, presentation, management and outcome will be obtained. Pleural effusions and empyema fluid specimens will be cultured, and analysis will be performed to describe the distribution of hospitalized children with culture-positive and culture-negative parapneumonic effusions and empyema. Children with culture-negative pneumococcal polymerase chain reaction (PCR)-positive effusions and empyema will be described by month of discharge, age, sex, underlying medical conditions as well as signs and symptoms of pneumonia. Pleural fluid will be tested for the presence of S.pneumoniae deoxyribonucleic acid (DNA) and, if positive, further tested to identify the pneumococcal serotype.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
N/A
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Control group
Active
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Outcomes
Primary outcome [1]
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Identify the bacterial causes of empyema, including description and distribution of strains causing pneumococcal empyema
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Assessment method [1]
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Timepoint [1]
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At the completion of the observational study (24 months)
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Secondary outcome [1]
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To determine incidence and prevelance of empyema, describing epidemiology, clinical features and current management
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Assessment method [1]
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Timepoint [1]
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At the completion of the observational study (24 months)
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Eligibility
Key inclusion criteria
Children whose clinical condition necessitates drainage of pleural fluid secondary to pneumonia, and who present with the classical features of empyema; fever, cough, raised white cell count, raised C-reactive protein (CRP) and fluid present on ultrasound.
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Minimum age
0
Years
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Maximum age
16
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Those over the age of 16yrs old, and those who do not present to a paediatric hospital
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
27/04/2007
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Actual
27/04/2007
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Date of last participant enrolment
Anticipated
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Actual
12/03/2009
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Date of last data collection
Anticipated
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Actual
12/03/2009
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Sample size
Target
200
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Accrual to date
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Final
173
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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GlaxoSmith Kline Biologicals
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Address [1]
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Rixensart
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Country [1]
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Belgium
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Primary sponsor type
Individual
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Name
A/Prof Adam Jaffe (Principle Investigator)
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Address
Sydney Children's Hospital
High Street, Randwick 2031
NSW
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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.
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Address [1]
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.
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney and Illawarra Area Health Service HREC - Northern Sector
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Ethics committee address [1]
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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01/01/2007
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Approval date [1]
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27/02/2007
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Ethics approval number [1]
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EC00134
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Summary
Brief summary
Empyema is the accumulation of infective fluid around the lung and occurs in about 1 percent of pneumonias in children. The bacterium Streptococcus pneumoniae is a leading cause of empyema. There has been a national vaccination program in Australia for the past 5 years which covers 7 types of Streptococcus. There is evidence in other countries that a type called Serotype 1 is emerging and this is not covered by the vaccine in this country. There is also evidence that following the introduction of the vaccine in other countries there has been a rise in the number of empyemas in children. The aim of this project is to accurately assess the types of Streptococcus causing empyemas in children in Australia using molecular techniques which can increase our identification of the bacteria causing empyema greater than our current standard techniques. The significance of the project is that it has the potential to affect the national vaccination program. If the project highlights that there is a large proportion of types of Streptococcus causing disease in children not covered by the current vaccine, then it may influence the Department of Health and Ageing in changing to another vaccine with a broader coverage. In addition, it is not known how best to manage children with empyemas and we will get data from different sites on how they are treating these children. We aim to develop a position paper for the Australian Paediatric Respiratory Group on managing children with this disease in Australia.
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Trial website
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Trial related presentations / publications
Presentations Strachan RE, Gilbert GL, Cornelius A et al. Pleural Fluid Nucleic Acid Testing Enhances Pneumococcal Surveillance in Children.Respirology 201115(1):A80 Poster Presentation at Thoracic Society of Australia and New Zealand, Annual Scientific Meeting, Perth, 2011; 16 (Suppl. 1), 37-86 Strachan RE, Gilbert G, Martin A et al. Identification of the Bacterial Causes of Childhood Empyema in Australia by Enhanced Molecular Surveillance. American Journal of Respiratory and Critical Care Medicine 2010; Vol 181:A43277 Poster presentation at American Thoracic Society, New Orleans 2010 Strachan RE, Gilbert GL, Martin A et al. Results of the enhanced pneumococcal surveillance in children with empyema in Australia. Respirology 2010;15(1):A80 Poster Presentation at Thoracic Society of Australia and New Zealand, Annual Scientific Meeting, Brisbane, 2010 Strachan R, Jaffé A. Assessment of the burden of paediatric empyema in Australia. Respirology 2009;14:Suppl 1. A19 Oral presentation at Thoracic Society of Australia and New Zealand Annual Scientific Meeting, Darwin, Australia 2009 Strachan R, Gilbert L, Martin A et al. Enhanced pneumococcal surveillance in children with empyema in Australia. Respirology 2009;14:Suppl 1. A83 Poster presentation at Thoracic Society of Australia and New Zealand Annual Scientific Meeting, Darwin, Australia 2009 Strachan R, Gilbert L, Martin A, et al (on behalf of the Australasian Research Network in Empyema (ARNiE)). Identifying the bacterial causes of childhood empyema in Australia. Poster presentation at 13th International Conference for Infectious Diseases, Kuala Lumpar, Malaysia June 2008 Publications Jaffé A, Strachan RE, Williams KJ. Consent in paediatric research: an evaluation of the guidance provided in the 2007 NHMRC National statement on ethical conduct in human research. Medical Journal of Australia 2008; 189: 347-348 [Letter] Strachan RE, Jaffe A. Assessment of the burden of paediatric empyema in Australia. Journal of Paediatrics & Child Health 2009; 45:431-436 Strachan RE, Cornelius A, Gilbert G et al. A bedside assay to detect Streptococcus pneumoniae in children with empyema. Pediatric Pulmonology 2010; 46 (2): 179-183 Strachan RE, Jaffe A. Recommendations for managing paediatric empyema thoracis Medical Journal of Australia 2011; 195 (2): 95 Strachan RE, Cornelius A, Gilbert G et al. Bacterial Causes of Emypema in Children, Australia, 2007-2009. Emerg Infect Dis 2011; 17 (10): 1839-1845 Strachan RE, Cornelius A, Gilbert G et al. Pleural fluid nucleic acid testing enhances Pneumococcal surveillance in children. Respirology 2012; 17(1): 114-119 Strachan RE, Snelling TL, Jaffe A. Increased paediatric hospitalizations for empyema in Australia after introduction of the 7-valent pneumococcal conjugate vaccine. WHO Bulletin 2013; 91 (3): 167-173
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Roxanne Strachan
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Address
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Sydney Chidlren's Hospital
High Street, Randwick 2031
NSW
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Country
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Australia
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Phone
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+61 2 93820639
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Fax
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+61 2 93820860
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Email
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[email protected]
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Contact person for scientific queries
Name
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A/Prof Adam Jaffe
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Address
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Sydney Chidlren's Hospital
High Street, Randwick 2031
NSW
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Country
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Australia
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Phone
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+61 2 93821111
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Bacterial Causes of Empyema in Children, Australia, 2007–2009 - Volume 17, Number 10—October 2011 - Emerging Infectious Diseases journal - CDC
2011
https://doi.org/10.3201/eid1710.101825
N.B. These documents automatically identified may not have been verified by the study sponsor.
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