Research on vaccines to prevent otitis media in First Nations children has been named in the NHMRC’s latest top 10 best research projects.
The work, led by Darwin scientist Professor Amanda Leach AM, head of the Ear Health Research Program at Menzies School of Health Research, was honoured in the National Health and Medical Research Council’s newly released 10 of the Best – Fifteenth Edition.
The NHMRC-funded project VOICES: Vaccines to prevent Otitis media In Children Entering School included two randomised controlled trials of novel schedules that mixed licenced pneumococcal vaccines. Results were published in The Lancet.
The project also involved Leach leading a team that developed updated national guidelines for prevention and treatment of otitis media including antibiotic use.
As an early career researcher on the Tiwi Islands, Leach was shocked by what she saw and has since dedicated her life to making a difference to the hearing outcomes of First Nations children.
“Half the children were wearing hearing aids”
“On my first trip to the Tiwi Islands, I saw that half the school children were wearing hearing aids,” Leech said in the NHMRC publication. “It was a phenomenal and distressing thing to see.”
She went on to discover that two types of bacteria, pneumococcus and non-typeable H. influenzae (NTHi) caused otitis media or ‘glue ear’. The report said this had “changed the fundamental understanding of the cause of ear disease and hearing loss, and how to prevent it.”
Leach, director of the NHMRC’s Centre for Research Excellence in ear and hearing health for Aboriginal and Torres Strait Islander children, said pneumococcal conjugate vaccines (PCVs) could prevent most ear infections. But different formulations, PHiD-CV10 and PCV13, had not been evaluated in head-to-head or combination schedules.
“I think this was one of the very first projects globally to combine different vaccines into a schedule,” she said in the NHMRC publication.
A media release in 2022 when results were published in The Lancet said new and important findings included that one vaccine was much better than the other when given to babies as early as one month old, and infant and booster dose combinations of both offered cost savings and flexibility.
“The current vaccines available are effective against many targeted strains and we found less otitis media caused by these strains. However, the study also showed an increase in otitis media caused by non-targeted strains,” Leach said in the media release.
“There was also no effect on the extremely persistent and stubborn bacteria called NTHi, which causes most otitis media. We know that vaccines work but there are simply too many ear and nose bugs out there, and we don’t yet have vaccines for all of them.
“This in no way closes the gate on vaccination for otitis media. Expanded vaccines are being developed and some will soon be available.”
The $1,317,169 grant was allocated to Leach’s research team including Professor Kim Mulholland, Professor Mathuram Santosham, Professor Peter Morris, Dr Jemima Beissbarth, Ms Nicole Wilson and Ms Beth Arrowsmith.
World’s highest rate of burst ear drums
The report said Aboriginal and/or Torres Strait Islander children have the highest reported rate of otitis media and burst ear drums in the world and nearly all living in remote areas have ear problems that start within weeks of birth. For many, otitis media leads to hearing loss and devastating learning and life outcomes.
The current median age for hearing aid fitting in First Nations children is about five years, with delays of up to three years due to requirements for diagnostics and referrals and limited availability of specialists, it added.
New funds for potassium delivery, listening brain markers, online support
Meanwhile, three more ear health projects have received NHMRC funding in the latest round. They are:
- A project aiming to develop a sensor for inner ear potassium that would control drug delivery into the inner ear via an implantable device. Curtin University hearing and balance researcher, lecturer and neuroscientist, Dr Daniel Brown, has received $584,941 for the Meniere’s disease research.
He said symptoms arose due to excessive fluid in the membranous labyrinth of the inner ear, which could rupture, causing a sudden increase in potassium ions in the fluid that surrounds the sensitive inner ear hair cells.
- Dr Vijayalakshmi Easwar from National Acoustic Laboratories has received $1,151,714 to investigate neuromarkers of intervention success in children with hearing loss.
“Despite exceptional clinical care for infants with hearing loss, their language abilities are not commensurate with their age and cognition,” Easwar said. “Ensuring and enabling optimal listening through hearing aids as soon as they are fit (around one to two months of age) is critical.
“To facilitate such a proactive approach, we will identify novel brain markers of successful listening and develop clinical tests that can help optimise listening experience from the time hearing aids are provided in infancy.”
- The HearHealth novel online support service empowering consumers with hearing loss. The three-year project led by Professor Bamini Gopinath from Macquarie University Hearing has received $660,737, will be co-designed with Deafness Forum Australia and Google, and include other partners Curtin University, University of Sydney and University of Wollongong.
Gopinath said it would provide access to credible, consumer-friendly educational materials and resources, facilitate improved perspective of hearing health needs and hearing loss risk factors, and promote behaviour change via online self-assessment and tailored care plans.
