Anne McNicholas - Academia.edu (original) (raw)

Papers by Anne McNicholas

New Zealand medical …, Jan 1, 2001

To identify screening and diagnostic practices for chlamydia infection in New Zealand. Postal sur... more To identify screening and diagnostic practices for chlamydia infection in New Zealand. Postal survey of doctors and nurses at all sexual health, family planning, youth and student clinics, and randomly selected general practitioners (GPs). Most respondents recognised chlamydia infection as a cause of pelvic inflammatory disease and infertility in females, and epididymitis and non-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Sterile pyuria and arthritis were well recognised only by sexual health doctors. Female doctors were significantly more likely to recognise signs and symptoms than male doctors. GPs were less likely than other respondents to screen for chlamydia infection. Sexual health doctors and nurses were more likely to remove cervical secretions prior to taking endocervical specimens. Contact tracing was regarded as very important by only a quarter of family planning respondents, compared with over 80% of other respondents. While respondents recognised most signs, symptoms, and sequelae of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken incorrectly. Given the long-term health consequences and cost of chlamydia infection sequelae, screening guidelines are urgently required.

The New Zealand medical …, Jan 1, 2001

To identify prescribing and treatment practices for chlamydial infection in New Zealand. Postal s... more To identify prescribing and treatment practices for chlamydial infection in New Zealand. Postal survey to doctors and nurses at all sexual health, family planning, student and youth health centres, and randomly selected general practitioners. There was considerable variation in treatment regimes used for chlamydial infection with few respondents treating in accordance with international guidelines regarding dose, frequency, and duration of treatment. Doxycycline (88.4%) was most commonly used to treat uncomplicated chlamydial infection in non-pregnant patients. Most respondents (70.2%) stipulated doxycycline for longer durations than the seven day regimen international guidelines recommend, with doxycycline 100 mg twice a day for ten days most frequently specified. Among the 259 respondents who would treat pregnant women with erythromycin, 51 different treatment regimens were specified, and 51.7% recorded regimens less than that recommended by international guidelines. When treating a patient presumptively, the majority of respondents tested for chlamydial infection. In contrast to other respondents, sexual health clinic staff rarely provide patients with a prescription for a patient&amp;#39;s partner without seeing the partner. Standardised treatment guidelines are required for patients diagnosed with chlamydial infection. Guidelines should include recommendations for the treatment of partners, and encourage the laboratory confirmation of diagnosis.

The New Zealand medical journal, 2007

During the Phase II clinical trials for a new group B meningococcal vaccine in New Zealand, six s... more During the Phase II clinical trials for a new group B meningococcal vaccine in New Zealand, six study participants (including five children who had been vaccinated with this vaccine) were hospitalised due to acute bronchiolitis. We examined more closely the potential association between bronchiolitis hospitalisation and this vaccine. We used descriptive comparisons, a cohort analysis, and a matched case-control study to examine the potential association of bronchiolitis hospitalisation with the vaccine using New Zealand Health Information Service hospital discharge data and vaccination data from the National Immunisation Register. The distribution of hospitalised bronchiolitis cases throughout New Zealand immediately following the introduction of the vaccine was consistent with historical (pre-vaccine) patterns. Similarly, all point estimates for relative risk (cohort analysis) and odds ratio (case-control study) for assessing the potential association between bronchiolitis hospital...

As part of safety monitoring during a group B meningococcal disease vaccination campaign in New Z... more As part of safety monitoring during a group B meningococcal disease vaccination campaign in New Zealand, we examined the possible excess risk of vaccine-associated simple febrile seizures (SFS). We conducted a cohort analysis using data from active hospital-based surveillance in the South Auckland area and a national immunisation register. Based on analysis of approximately 63,000 doses, we found no statistically significant increase in SFS incidence within 1, 2, 4, or 7 days after vaccination for any/all doses administered to children aged 6 months through 4 years. We concluded that the vaccine is unlikely to induce a heightened risk of SFS.

The New Zealand medical journal, Jan 13, 2009

In response to a devastating group B meningococcal disease epidemic in New Zealand, a case was pr... more In response to a devastating group B meningococcal disease epidemic in New Zealand, a case was prepared for new health funding and a new outer membrane vesicle vaccine, MeNZB, developed. Following clinical trials demonstrating satisfactory immunogenicity and safety profiles a national implementation strategy was prepared. MeNZB was introduced halfway through the 14th year of the epidemic with a campaign targeting children and young people aged under 20 years delivered over 2 years. By its completion in June 2006, the vaccine had been delivered to more than 1 million young people. All of the above steps were achieved within 5 years. This unique endeavour was possible due to a private/public partnership between the New Zealand Ministry of Health and Chiron Vaccines. This paper summarises the outcomes of this campaign including coverage levels achieved, evidence of vaccine effectiveness and safety, and the strategies used to manage key events and risks that emerged during the campaign.

The New Zealand medical journal, Jan 18, 2008

To describe and investigate epidemic strain serogroup B meningococcal disease in recipients of th... more To describe and investigate epidemic strain serogroup B meningococcal disease in recipients of the meningococcal vaccine, MeNZB. Epidemic strain meningococcal disease cases in vaccine recipients were identified by matching disease notification and laboratory data against the National Immunisation Register. Descriptive analyses were undertaken for disease cases aged under 20 years and vaccine breakthrough cases (epidemic strain meningococcal disease cases with onset 28 or more days after receipt of the third MeNZB dose). Questionnaires were sent to hospital clinicians requesting medical histories and laboratory test results for vaccine breakthrough cases. A committee reviewed this information to assess immune competence in these cases. From the start of the meningococcal B immunisation programme in July 2004 to the end of 2006, 34 vaccine breakthrough cases were identified. No underlying host factors were identified that explained disease occurrence for the 30 cases (88.2%) for whom ...

Vaccine, 2011

New Zealand has experienced a prolonged epidemic of meningococcal B disease since 1991. The epide... more New Zealand has experienced a prolonged epidemic of meningococcal B disease since 1991. The epidemic has waned significantly since its most recent peak in 2001. A strain-specific vaccine, MeNZB, was introduced to control the epidemic in 2004, achieving 81% coverage of people under the age of 20. The vaccine was rolled out in a staged manner allowing the comparison of disease rates in vaccinated and unvaccinated individuals in each year.

The New Zealand medical journal, Jan 12, 2005

To measure the prevalence of urogenital Chlamydia trachomatis infection in a sample of sexually a... more To measure the prevalence of urogenital Chlamydia trachomatis infection in a sample of sexually active female university students, to identify risk factors associated with infection, and to measure the uptake of screening. Female students aged 18-25 years, presenting to a university student health service from March to October 2003, were invited to participate. Information on demographic details and sexual behaviour was collected with a self-completed questionnaire. The students were tested for Chlamydia infection using the Roche Amplicor CT/NG PCR test of first void urine specimens. Chlamydia prevalence was 2.7% (19/715). Infection was associated with previous sexually transmitted infection (STI), non-European ethnicity, and irregular use of condoms. Most participants were not using condoms regularly despite the risk of STI. Screening was technically straightforward and the participation rate was 59.9% (718/1199). New Zealand needs to develop and implement an adequately resourced a...

Vaccine, 2008

New Zealand introduced a tailor-made vaccine (MeNZB) for epidemic control of Group B meningococca... more New Zealand introduced a tailor-made vaccine (MeNZB) for epidemic control of Group B meningococcal disease. The Intensives Vaccine Monitoring Programme (IVMP), which prospectively collected data electronically on a cohort of children receiving vaccinations in sentinel practices across NZ, was developed as part of a national multi-faceted safety strategy. The main aim of the IVMP was to identify the presence of unexpected adverse events occurring with MeNZB vaccination. We describe the methodology and success factors plus consider the limitations encountered in this system which shows potential as a means for post-marketing vaccine and medicine surveillance in the future.

Tissue Antigens, 2005

In this article, we report the identification of a new HLA-A allele found in a DNA sample which w... more In this article, we report the identification of a new HLA-A allele found in a DNA sample which was part of the routine bone marrow donor typing performed in our laboratory. This novel allele officially designated as A*2442 was found in a sample from a female Caucasoid donor (Franken, Bavaria, Germany; lab code 142654) and differs from the closest related allele A*2408 by two nucleotide exchanges. In position 81, the A (A*2408) is changed to 81 C in the novel allele A*2442, resulting in an amino acid substitution at codon 27, glutamine (A*2408) is replaced by histidine ((31)Gln--&amp;amp;amp;gt;(31)His). In position 292, the G (A*2408) is changed to C also resulting in an amino acid replacement, the codon 98 asparagine is mutated to histidine ((98)Asn--&amp;amp;amp;gt;(98)His) in the new A*2442 allele. The second allele was determined to be A*0301. Further typing of this sample is B*1501 B*4001.

454 Qualitative approaches in health research Elizabeth W Plumridge ORIGINAL ARTICLES 456 Transpo... more 454 Qualitative approaches in health research Elizabeth W Plumridge ORIGINAL ARTICLES 456 Transposition of the great arteries: operative outcome in the current era J Armishaw, TL Gentles, AL Calder, PJ Raudkivi, AR Kerr 460 The sexual activity of 654 fourth form Hawkes Bay students Rosy Fenwicke, Gordon Purdie 464 The effect on medical practice of disciplinary complaints: potentially negative for patient care Wayne Cunningham, Susan Dovey 468 Frequency of microdeletions in the azoospermia factor region of the Y-chromosome of New Zealand men Natalie

Population Health Metrics, 2013

Background: A continuously operating survey can yield advantages in survey management, field oper... more Background: A continuously operating survey can yield advantages in survey management, field operations, and the provision of timely information for policymakers and researchers. We describe the key features of the sample design of the New Zealand (NZ) Health Survey, which has been conducted on a continuous basis since mid-2011, and compare to a number of other national population health surveys. Methods: A number of strategies to improve the NZ Health Survey are described: implementation of a targeted dual-frame sample design for better Māori, Pacific, and Asian statistics; movement from periodic to continuous operation; use of core questions with rotating topic modules to improve flexibility in survey content; and opportunities for ongoing improvements and efficiencies, including linkage to administrative datasets. Results and discussion: The use of disproportionate area sampling and a dual frame design resulted in reductions of approximately 19%, 26%, and 4% to variances of Māori, Pacific and Asian statistics respectively, but at the cost of a 17% increase to all-ethnicity variances. These were broadly in line with the survey's priorities. Respondents provided a high degree of cooperation in the first year, with an adult response rate of 79% and consent rates for data linkage above 90%. Conclusions: A combination of strategies tailored to local conditions gives the best results for national health surveys. In the NZ context, data from the NZ Census of Population and Dwellings and the Electoral Roll can be used to improve the sample design. A continuously operating survey provides both administrative and statistical advantages.

International Journal of Epidemiology, 2009

In July 2004 a strain-specific vaccine was introduced to combat an epidemic of group B meningococ... more In July 2004 a strain-specific vaccine was introduced to combat an epidemic of group B meningococcal disease in New Zealand. We estimated the effectiveness of this vaccine in pre-school-aged children. We conducted a cohort analysis of all children in New Zealand who were aged 6 months to &amp;amp;amp;amp;amp;lt;5 years at the time the vaccine became available for that age group in their area. We defined cases as children who were diagnosed with laboratory-confirmed epidemic strain meningococcal disease. We calculated person-days-at-risk using data from the National Immunization Register and population estimates from Statistics New Zealand. We estimated vaccine effectiveness as 1--relative risk. Compared with unvaccinated children, fully vaccinated children were five to six times less likely to contract epidemic strain meningococcal disease in the 24 months after they became eligible to receive a full vaccination series, corresponding to an estimated vaccine effectiveness of 80.0% (95% confidence interval: 52.5-91.6) for children aged 6 months to &amp;amp;amp;amp;amp;lt;5 years and 84.8% (95% confidence interval: 59.4-94.3) for children aged 6 months to &amp;amp;amp;amp;amp;lt;3 years. With over 3 million doses administered to individuals aged under 20 years throughout New Zealand, combined evidence from the Phase I and II clinical trials, the descriptive epidemiology of meningococcal disease, and this study provide evidence supporting the effectiveness of this vaccine in the 2 years following vaccination.

Human Immunology, 1996

As part or the AnthropologyComponent, the distributionofHLA-B35 alleles (B*3501 to 351:.'1) was s... more As part or the AnthropologyComponent, the distributionofHLA-B35 alleles (B*3501 to 351:.'1) was studied in 16 differentpopulalionsbygroup specific amplification and SSQP hybridization. The results were as follows: Population: 3501 3502 )503 3504 3505 3506 3508 3509 35'" French(65*) 3'

Australian and New Zealand Journal of Public Health, 2001

To determine the extent to which clinic-based sexually transmitted infection (STI) surveillance u... more To determine the extent to which clinic-based sexually transmitted infection (STI) surveillance underrepresents the number of laboratory-confirmed cases of Chlamydia trachomatis and Neisseria gonorrhoeae in the Waikato and Bay of Plenty regions of New Zealand; and to estimate incidence rates for these two infections. Data on C. trachomatis and N. gonorrhoeae were collected from diagnostic laboratories in the study regions for the year 2000, and compared with routine clinic-based STI surveillance data. Most laboratory-confirmed C. trachomatis (65.5%) and N. gonorrhoeae (55.7%) infections were diagnosed by healthcare providers outside the clinic-based STI surveillance system. The estimated incidence rate for C. trachomatis was 501 per 100,000, and 50 per 100,000 for N. gonorrhoeae. Laboratory surveillance of C. trachomatis and N. gonorrhoeae provides a more complete picture of disease burden. Given the high infection rates reported, developing a national strategy for the management of STIs should be a public health priority in New Zealand.

Human Vaccines & Immunotherapeutics, 2013

The utility of wild-type outer membrane vesicle (wtOMV) vaccines against serogroup B (MenB) menin... more The utility of wild-type outer membrane vesicle (wtOMV) vaccines against serogroup B (MenB) meningococcal disease has been explored since the 1970s. Public health interventions in Cuba, Norway and New Zealand have demonstrated that these protein-based vaccines can prevent MenB disease. Data from large clinical studies and retrospective statistical analyses in New Zealand give effectiveness estimates of at least 70%. A consistent pattern of moderately reactogenic and safe vaccines has been seen with the use of approximately 60 million doses of three different wtOMV vaccine formulations. The key limitation of conventional wtOMV vaccines is their lack of broad protective activity against the large diversity of MenB strains circulating globally. The public health intervention in New Zealand (between 2004-2008) when MeNZB was used to control a clonal MenB epidemic, provided a number of new insights regarding international and public-private collaboration, vaccine safety surveillance, vaccine effectiveness estimates and communication to the public. The experience with wtOMV vaccines also provide important information for the next generation of MenB vaccines designed to give more comprehensive protection against multiple strains.