Karen Dempsey | Charles Darwin University (original) (raw)

Papers by Karen Dempsey

Bjog: An International Journal Of Obstetrics And Gynaecology, Jan 18, 2016

Population Pregnancies among Northern Territory residents, limited to singleton live births with ... more Population Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37-42 weeks' gestation (n = 78 561). Methods Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. Main outcome measures Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. Results The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34-1.60)]. Conclusions Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers.

Heart, Lung and Circulation, 2020

Diabetes Research and Clinical Practice, 2019

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Clinical Infectious Diseases, 2007

Background. Between November 2003 and January 2004, outbreaks of norovirus in 3 Australian jurisd... more Background. Between November 2003 and January 2004, outbreaks of norovirus in 3 Australian jurisdictions involving 83 cases of illness were associated with imported oyster meat. Methods. Cohort studies were conducted in 2 jurisdictions to identify relative risks of illness for the consumption of oysters. A case series was conducted in the third jurisdiction. Results. The cohort studies conducted in the first 2 jurisdictions identified relative risks of illness of 17 (95% confidence interval, 5-51) and 35 (95% confidence interval, 5-243), respectively, for the consumption of oysters. Multiple strains of norovirus were detected in fecal specimens from 8 of 14 patients and in 1 of the 3 batches of implicated oyster meat using seminested reverse-transcriptase polymerase chain reaction methods. Traceback investigations revealed that all oyster meat was harvested from the same estuary system in Japan within the same month. Conclusions. These outbreaks demonstrate the potential of foodborne disease to spread internationally and the need for national and international collaboration to investigate such outbreaks. Foodborne illness related to norovirus is underestimated because of underreporting of human cases and challenges in laboratory detection of viruses in foods, both of which can delay public health action.

Heart, Lung and Circulation, 2017

ii iii This publication is copyright It may be reproduced in whole or in part for study or traini... more ii iii This publication is copyright It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgment of the source. Reproduction for other purposes requires the written

picture of the nature and extent of injury

Medical Journal of Australia, 2006

Introduction-Methods-Results-GBD groups-GBD categories-Discussion-Competing interests-Author deta... more Introduction-Methods-Results-GBD groups-GBD categories-Discussion-Competing interests-Author details-References

$Research paper thumbnail of Hepatocellular carcinoma in Australia\u27s Northern Territory: high incidence and poor outcome$

Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocell... more Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.Main outcome measures: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors w...

The true incidence of leptospirosis in the Top End of the Northern Territory (NT) is unknown, wit... more The true incidence of leptospirosis in the Top End of the Northern Territory (NT) is unknown, with the reported incidence significantly lower than some other regions of Australia with comparable climatic conditions. The report of a case of leptospirosis in a journalist reporting on crocodile egg harvesting at a fresh water swamp near Darwin, together with 2 other notified cases among crocodile handlers in the 2 preceding years, prompted a serological investigation into the prevalence of previous disease or exposure to the organism among crocodile handlers at a Darwin crocodile park. Serological evidence of exposure was present in 2 of 14 handlers tested. Crocodile handling activities including egg collection are likely to put employees at risk for leptospirosis and rodent control and self-protective measures should be implemented. Background

It may be reproduced in whole or in part for study or training purposes subject to the inclusion ... more It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgment of the source. Reproduction for other purposes requires the written permission of the CEO of the

Background This study was commissioned by the NT Road Safety Task Force to identify factors under... more Background This study was commissioned by the NT Road Safety Task Force to identify factors underpinning the NT’s excessive level of road trauma and quantify their impact on the injury outcomes of Indigenous and non-Indigenous road traffic casualties. It was conducted using a linked dataset of NT public hospital crash-related admission records from the HMD matched to NT Police crash records from the VADB during a nine-year period 1999–2007. Aim This study aimed to provide answers to three research questions:  How useful is a linked dataset as a tool for identifying the relationship between contributing factors and injury outcomes among road traffic casualties?  What is the impact of ethnicity on the relationship between contributing factors and injury outcomes among road traffic casualties?  Which factors have most influence on fatal and ‘high threat to life’ injury outcomes, among Indigenous and non-Indigenous casualties? Literature review The literature review identified that t...

Falls are a major source of preventable morbidity and mortality particularly for older people. Mo... more Falls are a major source of preventable morbidity and mortality particularly for older people. Most jurisdictions have well established coordinated, multi-faceted falls prevention strategies. The NT does not. This study analysed NT hospitalisation data for falls occurring in the community over the 10 years 1999-2008. Data is presented on number and rates of falls hospitalisations, type of injury, length of stay, types of fall, activity being undertaken and place of the fall, contribution of alcohol and cost of inpatient care. The rate of falls hospitalisation and their costs increased steadily during the study period. Rates of falls hospitalisation in the NT for both Indigenous and non-Indigenous people are consistently higher than in the rest of Australia. There are important variations within the NT. For Indigenous people hospitalisation rates are higher among young adults and middle aged people but lower in people aged over 64 years compared to non-Indigenous people. Central Aust...

In Australia, disease registers for acute rheumatic fever (ARF) and rheumatic heart disease (RHD)... more In Australia, disease registers for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were previously established to facilitate disease surveillance and control, yet little is known about the extent of case-ascertainment. We compared ARF/RHD case ascertainment based on Australian ARF/RHD register records with administrative hospital data from the Northern Territory (NT), South Australia (SA), Queensland (QLD) and Western Australia (WA) for cases 3–59 years of age. Agreement across data sources was compared for persons with an ARF episode or first-ever RHD diagnosis. ARF/RHD registers from the different jurisdictions were missing 26% of Indigenous hospitalised ARF/RHD cases overall (ranging 17–40% by jurisdiction) and 10% of non-Indigenous hospitalised ARF/RHD cases (3–28%). The proportion of hospitalised RHD cases (36%) was half the proportion of hospitalised ARF cases (70%) notified to the ARF/RHD registers. The registers were found to capture few RHD cases in metropoli...

International Journal of Environmental Research and Public Health, 2020

Journal of the American Heart Association

Background In 2018, the World Health Organization prioritized control of acute rheumatic fever (A... more Background In 2018, the World Health Organization prioritized control of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), including disease surveillance. We developed strategies for estimating contemporary ARF/RHD incidence and prevalence in Australia (2015–2017) by age group, sex, and region for Indigenous and non‐Indigenous Australians based on innovative, direct methods. Methods and Results This population‐based study used linked administrative data from 5 Australian jurisdictions. A cohort of ARF (age <45 years) and RHD cases (<55 years) were sourced from jurisdictional ARF/RHD registers, surgical registries, and inpatient data. We developed robust methods for epidemiologic case ascertainment for ARF/RHD. We calculated age‐specific and age‐standardized incidence and prevalence. Age‐standardized rate and prevalence ratios compared disease burden between demographic subgroups. Of 1425 ARF episodes, 72.1% were first‐ever, 88.8% in Indigenous people and 78.6% wer...

Communicable Diseases Intelligence

The Northern Territory (NT) Centre for Disease Control (CDC) undertook contact tracing of all not... more The Northern Territory (NT) Centre for Disease Control (CDC) undertook contact tracing of all notified cases of coronavirus disease 2019 (COVID-19) within the Territory. There were 28 cases of COVID-19 notified in the NT between 1 March and 30 April 2020. In total 527 people were identified as close contacts over the same period; 493 were successfully contacted; 445 were located in the NT and were subsequently quarantined and monitored for disease symptoms daily for 14 days after contact with a confirmed COVID-19 case. Of these 445 close contacts, 4 tested positive for COVID-19 after developing symptoms; 2/46 contacts who were cruise ship passengers (4.3%, 95% CI 0.5–14.8%) and 2/51 household contacts (3.9%, 95% CI 0.5–13.5%). None of the 326 aircraft passengers or 4 healthcare workers who were being monitored in the NT as close contacts became cases.