
Nusrat HomairaUNSW Sydney | UNSW · Discipline of Paediatrics, School of Women's and Children's Health
Nusrat Homaira
MBBS, MPH, PhD
About
134
Publications
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Introduction
Additional affiliations
April 2013 - April 2016
January 2007 - January 2013
Publications
Publications (134)
One Health is increasingly recognized for its value in addressing emerging infectious disease threats. In Bangladesh, the integration of One Health approaches into outbreak investigation and response can be traced back to the advent of outbreaks of Nipah and avian influenza viruses. Through accounts from epidemiological, anthropological, ecological...
Background
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRIs) associated hospitalisations in children. It is unclear if hospitalized RSV-ALRI differs in clinically from other viral ALRIs. We aimed to compare the disease impact of hospitalised RSV with other viral ALRI in children under 2 years.
Met...
Introduction:
Personalised Asthma Action Plans (AAPs) are a cornerstone of paediatric asthma management. We aimed to assess parental knowledge and perceptions of the use of AAPs in managing their child's asthma.
Methods:
In 2023 we conducted a cross-sectional survey to assess knowledge and perceptions of AAPs in parents/caregivers of children ag...
The prevalence of low birth weight (LBW) is an important indicator of child health and wellbeing. However, in many countries, decisions regarding care and treatment are often based on mothers’ perceptions of their children’s birth size due to a lack of objective birth weight data. Additionally, birth weight data that is self-reported or recorded of...
Background:
Asthma is the most common chronic respiratory illness among children in Australia. While childhood asthma prevalence varies by region, little is known about variations at the small geographic area level. Identifying small geographic area variations in asthma is critical for highlighting hotspots for targeted interventions. This study a...
Background
Asthma is the leading source of unscheduled hospitalisation in Australian children, with a high burden placed upon children, their parents/families, and the healthcare system. In Australia, there are widening disparities in paediatric asthma care including inequitable access to comprehensive ongoing and planned asthma care for children....
Background
Antimicrobial resistance (AMR) is a major global public health crisis and around the last decade, newspapers were one of the main sources of public dissemination of information for so. This study highlights how Bangladeshi mainstream newspapers represented AMR-related news and how they created the narrative of AMR in Bangladesh.
Methods...
Background
Antimicrobial resistance (AMR) is a major global public health crisis and around the last decade, newspapers were one of the main sources of public dissemination of information for so. This study highlights how Bangladeshi mainstream newspapers represented AMR-related news and how they created the narrative of AMR in Bangladesh.
Methods...
Background
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRIs) in children aged <2 years. Currently, there are limited data on risk factors for very severe RSV-ALRI requiring intensive care unit (ICU) admission.
Methods
We conducted a case-control study of children aged <2 years admitted with RSV-AL...
Background
Acute lower respiratory infection (ALRI) caused by respiratory viruses is among the most common causes of hospitalization and mortality in children. We aimed to identify risk factors for poor outcomes in children <5 years old hospitalized with ALRI caused by respiratory syncytial virus (RSV), influenza and severe acute respiratory syndro...
Objective:
This scoping review investigated the existing literature and identified the evidence gaps related to diagnosis and management in children aged 2-18 years presenting to hospitals with a co-diagnosis of asthma and community-acquired pneumonia.
Data sources:
We designed a scoping review following Arksey and O'Malley's scoping review fram...
Purpose
Earlier coronavirus-19 (COVID-19) pandemic reports did not implicate increased disease burden in asthmatics while subsequent findings have been inconsistent. To date, the impact of COVID-19 on childhood asthma remains undetermined and is further complicated with ongoing emergence of new variants. This study aimed to investigate association...
Background:
Uniformity and compliance with clinical practice guidelines (CPGs) for use of palivizumab in preventing severe RSV infection in Australian high-risk infants remain unclear.
Methods:
An online survey was conducted across the Australian and New Zealand Neonatal Network (ANZNN) to determine clinical practices around palivizumab. A liter...
Background:
According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on...
Introduction
The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine an...
Background
We aimed to assess the direct protective effect of 13 valent pneumococcal conjugate vaccine (13vPCV) against invasive pneumococcal pneumonia (IPP; including pneumonia and empyema) in children using a nation-wide case-control study across 11 paediatric tertiary hospitals in Australia.
Methods
Children < 18 years old admitted with pneumon...
Although national and international guidelines have strongly discouraged use of antibiotics to treat COVID-19 patients with mild or moderate symptoms, antibiotics are frequently being used. This study aimed to determine antibiotics-prescribing practices among Bangladeshi physicians in treating COVID-19 patients. We conducted a cross-sectional surve...
Background: Uniformity and compliance with clinical practice guidelines (CPGs) for use of palivizumab in preventing severe RSV infection in Australian high-risk infants remain unclear. Methods: An online survey was conducted across the Australian and New Zealand Neonatal Network (ANZNN) to determine clinical practices around palivizumab. A literatu...
Introduction
Frequent asthma attacks in children result in unscheduled hospital presentations. Patient centered care coordination can reduce asthma hospital presentations. In 2016, The Sydney Children's Hospitals Network launched the Asthma Follow up Integrated Care Initiative with the aim to reduce pediatric asthma emergency department (ED) presen...
Public health measures to mitigate the COVID-19 pandemic have altered health care for chronic conditions. The impact of the COVID-19 pandemic on paediatric asthma, the most common chronic respiratory cause of childhood hospitalisation, in Australia, remains unknown. In a multicentre study, we examined the impact of three waves of COVID-19 on paedia...
Aim:
This study aims to identify the hospitalised morbidity associated with three common chronic health conditions among young people using a population-based matched cohort.
Methods:
A population-level matched case-comparison retrospective cohort study of young people aged ≤18 years hospitalised with asthma, type 1 diabetes (T1D) or epilepsy du...
Background
Whilst very limited studies have demonstrated a correlation between the COVID-19 pandemic and depressive symptoms amongst Bangladeshi medical students, the prevalence and associated factors of depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9) remains widely unknown.
Objective
The study aimed to investigate the...
BACKGROUND AND OBJECTIVES
COVID-19 public health measures have altered respiratory syncytial virus (RSV) epidemiology, resulting in an unseasonal summer epidemic in Australia in 2020. We aimed to determine if the shifted RSV epidemic was more severe compared with previous years or if age-specific changes were associated with the resurgence.
METHOD...
Background
Baseline assessment of standard precaution relating to infection prevention and control (IPC) preparedness to fight health crisis within healthcare facilities at different levels and its associated factors in Bangladesh remains unknown.
Methods
We analyzed the nationally representative Bangladesh health facility survey (BHFS) data condu...
Respiratory syncytial virus (RSV) is the leading cause of ALRI hospitalisations in Aboriginal infants specifically those aged<6 months. Maternally derived RSV antibody (Ab) can protect against severe RSV disease in infancy. However, the efficiency of transplacental transfer of maternal anti‐RSV Ab remains unknown in Aboriginal infants. We character...
Fever in children under five years of age is a common and predominantly self-limiting sign of illness. However, in low- and middle-income countries, antibiotics are frequently used in febrile children, although these children may not benefit from antibiotics. In this study, we explored the prevalence of, and factors associated with, antibiotic use...
Background
Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized.
Methods
The RSV Global Onlin...
Background
There is inconclusive evidence of the effect of asthma on the academic performance of young people. This study aims to compare scholastic performance and high school completion of young people hospitalised with asthma compared to matched peers not hospitalised with asthma.
Method
A population-based matched case-comparison cohort study o...
Purpose
To evaluate potential variation in care management pathways following hospital discharge for children with asthma in New South Wales, Australia.
Methods
A cross-sectional web-based survey was conducted in emergency departments (EDs) and paediatric units of public hospitals with more than five paediatric beds within New South Wales, Austral...
Background
Human parainfluenza virus (hPIV) is a common virus in childhood acute lower respiratory infections (ALRI). However, no estimates have been made to quantify the global burden of hPIV in childhood ALRI. We aimed to estimate the global and regional hPIV-associated and hPIV-attributable ALRI incidence, hospital admissions, and mortality for...
Introduction
Rumors and conspiracy theories, can contribute to vaccine hesitancy. Monitoring online data related to COVID-19 vaccine candidates can track vaccine misinformation in real-time and assist in negating its impact. This study aimed to examine COVID-19 vaccine rumors and conspiracy theories circulating on online platforms, understand their...
Introduction: Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown.
Methods: We analysed nationally representative, population-bas...
Introduction
Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia.
Methods
This was a randomised, double blinded, placebo-controlled clinical trial in c...
Objective:
We conducted a systematic review and meta-analysis to determine the effectiveness of comprehensive community-based interventions with ≥ 2 components in improving asthma outcomes in children.
Methods:
A systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Co...
Background
Oseltamivir is recommended in the treatment of influenza illness in high‐risk populations, including those with chronic heart and lung diseases.
Objectives
We conducted a systematic review and meta‐analysis to determine the rate of use and effectiveness of oseltamivir in these groups of patients.
Methods
The protocol for the systematic...
Background
Empyema is a serious complication of pneumonia frequently caused by Streptococcus pneumoniae (SP). We assessed the impact of the 13-valent pneumococcal conjugate vaccine (13vPCV) on childhood pneumonia and empyema after inclusion in the Australian National Immunisation Program.
Methods
For bacterial pneumonia and empyema hospitalisation...
Infective pleural effusions and necrotizing pneumonia are uncommon severe complications of community-acquired pneumonia in childhood. They are caused mainly by Streptococcus pneumoniae and Staphylococcus aureus. The choice of antibiotic therapy is dependent on local clinical guidelines. In addition, chest drainage with or without fibrinolytics is u...
Introduction
Emerging evidence suggests young children are at greater risk of COVID-19 infection than initially predicted. However, a comprehensive understanding of epidemiology of COVID-19 infection in young children under five years, the most at-risk age-group for respiratory infection, remain unclear. We conducted a systematic review and meta-an...
Objective
To develop and validate a prediction risk score for identification of children at risk of developing life-threatening asthma (LTA).
Methods
Our study utilized existing medical records and retrospective analysis to develop and validate a risk score. The study population included children aged 2-17 years, admitted with a primary diagnosis...
Background
Human metapneumovirus is a common virus associated with acute lower respiratory infections (ALRIs) in children. No global burden estimates are available for ALRIs associated with human metapneumovirus in children, and no licensed vaccines or drugs exist for human metapneumovirus infections. We aimed to estimate the age-stratified human m...
The UN Secretary General Antonio Guterres has described the Rohingya community of Myanmar as one of the most discriminated ethnic minorities in the world [1]. In August 2017, an escalation in the violence that is referred to as ethnic cleansing forced >600,000 Rohingyas to seek refuge in neighbouring Cox’s Bazar District of Bangladesh from their ho...
The Australian Asthma Handbook does not recommend use of fixed dose combination (FDC) controller medicines for asthma in children aged ≤5 years. FDCs are only recommended in children and adolescents (aged 6–18 years) not responding to initial inhaled corticosteroid (ICS) therapy. Using Pharmaceutical Benefits Scheme dispensing claims from 2013–2018...
Background:
Infections caused by antibiotic resistant pathogens are increasing, with antibiotic overuse a key contributing factor.
Objective:
The CareTrack Kids (CTK) team assessed the care of children in Australia aged 0-15 years in 2012 and 2013 to determine the proportion of care in line with clinical practice guidelines (CPGs) for 17 common...
Background:
Cystic fibrosis (CF) is a multisystem disease and the importance of growth and nutrition has been well established, given its implications for lung function and overall survival. It has been established that intestinal dysbiosis (i.e. microbial imbalance) and inflammation is present in people with CF. Probiotics are commercially availa...
Introduction: Asthma is the most common chronic illness of childhood. Frequent asthma attacks may result in unscheduled hospital presentations. Unscheduled hospital presentations are a marker of poorly controlled asthma - a significant burden to the health systems and families. Following hospital presentation, the New South Wales (NSW) clinical pra...
BACKGROUND:
Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (<5 years) and older people (≥65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and program...
Objective:
In a population-based cohort study, we determined the association between the age at first severe respiratory syncytial virus (RSV) disease and subsequent asthma.
Methods:
Incidence rates and rate ratios of the first asthma-associated hospitalization after 2 years of age in children hospitalized for RSV disease at <3 months, 3 to <6 m...
Background and objective:
We conducted a comprehensive assessment of guideline adherence in paediatric asthma care, including inpatient and ambulatory services, in Australia.
Methods:
National and international clinical practice guidelines (CPG) relating to asthma in children were searched and 39 medical record audit indicator questions were dev...
Objective
To estimate rates of respiratory syncytial virus (RSV)‐associated hospitalisation across the age spectrum, and to identify groups at particular risk of serious RSV‐associated disease.
Design, setting and participants
Retrospective review of National Hospital Morbidity Database data for all RSV‐associated hospitalisations in Australia, 20...
Background
Bronchiolitis is the most common cause of respiratory hospitalisation in children aged <2 years. Clinical practice guidelines (CPGs) suggest only supportive management of bronchiolitis. However, the availability of CPGs do not guarantee that they are used appropriately and marked variation in the clinical management exists. We conducted...
Objective: To investigate the effectiveness of technology enabled learning in improving asthma first aid knowledge and self-confidence in providing asthma first aid to children in staff within a school setting. Study Design: A prospective randomized parallel study using a pre and post test design was conducted across Metropolitan schools of New Sou...
Background
Data on burden of severe influenza in children with a range of chronic lung diseases (CLDs) remain limited.
Method
We performed a cohort study to estimate burden of influenza‐associated hospitalization in children with CLDs using population‐based linked data. The cohort comprised all children in New South Wales, Australia, born between...
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy and safety of probiotics for improving health outcomes in children and adults with CF.
Background:
Seasonal influenza-associated mortality estimates help identify the burden of disease and assess the value of public health interventions such as annual influenza immunization. Vital registration is limited in Bangladesh making it difficult to estimate seasonal influenza mortality.
Objectives:
Our study aimed to estimate seasonal inf...
Objective
To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.
Settings
The study was conducted in New South Wales (NSW), Australia.
Participants
The study comprised all children born in NSW between 2000 and 2010 with com...
Background:
Preterm birth and developmental vulnerability are more common in Australian Aboriginal compared with non-Aboriginal children. We quantified how gestational age relates to developmental vulnerability in both populations.
Methods:
Perinatal datasets were linked to the Australian Early Development Census (AEDC), which collects data on f...
Background:
In March 2011, a multidisciplinary team investigated 2 human cases of highly pathogenic avian influenza A(H5N1) virus infection, detected through population-based active surveillance for influenza in Bangladesh, to assess transmission and contain further spread.
Methods:
We collected clinical and exposure history of the case patients...
Background We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developi...