Abstract In low-resource settings such as Melanesia, gestational diabetes often goes undiagnosed due to many factors, including the unsuitability of current tests. Ideally a gestational diabetes test for low-resource settings should meet criteria related to acceptability, test performance and operational characteristics, with minimal impositions on individual patients or the wider health system. None of the six tests recommended in country-specific gestational diabetes guidelines in Melanesia (2-hour oral glucose tolerance test, glucose challenge test, fasting plasma glucose, random plasma glucose, 2-hour postprandial glucose and glycated haemoglobin) meet criteria related to these attributes. Additionally, each Melanesian country has different, complex algorithms that use multiple tests in different combinations. With a high and increasing burden of diabetes mellitus (and therefore assumed gestational diabetes), Melanesian health practitioners and policymakers should be aware of the limitations of recommended tests for gestational diabetes and be open to alternative technologies that may be more appropriate.

Objective: To investigate levels of awareness of dengue among the inhabitants of Queensland (QLD), a dengue-prevalent state in the north east of Australia. Methods: A computer-assisted telephone interviewing survey was conducted in mid 2014. A total of 1. 223 randomly selected respondents (≥ 18 years) across QLD completed a structured questionnaire covering all aspects of dengue. Results: 97.55% had heard of dengue and participated further. Among them, 54.70% had travelled overseas (48.11% to dengue-risk countries) in the last five years. A total of 94.47% said transmission is by mosquito bite. In addition, 84.83% knew of current transmission of dengue in QLD, while 80.97% knew the focus is Far North and North QLD. Furthermore, 2.35% and 8.97% had experienced an infection in their life or that of their immediate family/partner, respectively. 85.03% identified correctly at least one means of prevention. A total of 69.72% advised to use insect repellent, wear covered clothing and avoid visiting mosquito-prone areas while 20.93% advised fumigation and clearing water containers around residences. There was a significant difference (P < 0.05) between residents of South East QLD and the rest of QLD regarding knowledge of prevention. However, such awareness was not affected significantly by overseas travel (P > 0.05). Conclusions: Although many people throughout QLD have heard of dengue, about 15% appear unaware of local transmission, its symptoms and of methods to reduce risk of infection. A lack of knowledge regarding prevention of mosquito breeding is evident in South East QLD, where dengue is not currently reported. The study suggests that future dengue awareness campaigns should target communities in both endemic and potentially endemic areas throughout Queensland.

Recent experience with pandemic influenza A(H1N1)pdm09 highlighted the importance of global surveillance for severe respiratory disease to support pandemic preparedness and seasonal influenza control. Improved surveillance in the southern hemisphere is needed to provide critical data on influenza epidemiology, disease burden, circulating strains and effectiveness of influenza prevention and control measures. Hospital-based surveillance for severe acute respiratory infection (SARI) cases was established in New Zealand on 30 April 2012. The aims were to measure incidence, prevalence, risk factors, clinical spectrum and outcomes for SARI and associated influenza and other respiratory pathogen cases as well as to understand influenza contribution to patients not meeting SARI case definition.All inpatients with suspected respiratory infections who were admitted overnight to the study hospitals were screened daily. If a patient met the World Health Organization’s SARI case definition, a respiratory specimen was tested for influenza and other respiratory pathogens. A case report form captured demographics, history of presenting illness, co-morbidities, disease course and outcome and risk factors. These data were supplemented from electronic clinical records and other linked data sources.Hospital-based SARI surveillance has been implemented and is fully functioning in New Zealand. Active, prospective, continuous, hospital-based SARI surveillance is useful in supporting pandemic preparedness for emerging influenza A(H7N9) virus infections and seasonal influenza prevention and control.

Many azoospermic men do not possess mature spermatozoa at the time of surgical sperm extraction. This study is a systematic review and meta-analysis evaluating outcomes following round spermatid injection (ROSI), a technique which utilizes immature precursors of spermatozoa for fertilization. An electronic search was performed to identify relevant articles published through October 2018. Human cohort studies in English involving male patients who had round spermatids identified and used for fertilization with human oocytes were included. Fertilization rate, pregnancy rate, and resultant delivery rate were assessed following ROSI. Meta-analysis outcomes were analyzed using a random-effects model. Data were extracted from 22 studies involving 1099 couples and 4218 embryo transfers. The fertilization rate after ROSI was 38.7% (95% confidence interval [CI]: 31.5%-46.3%), while the pregnancy rate was 3.7% (95% CI: 3.2%-4.4%). The resultant delivery rate was low, with 4.3% of embryo transfers resulting in a delivery (95% CI: 2.3%-7.7%). The pregnancy rate per couple was 13.4% (95% CI: 6.8%-19.1%) and the resultant delivery rate per couple was 8.1% (95% CI: 6.1%-14.4%). ROSI has resulted in clinical pregnancies and live births, but success rates are considerably lower than those achieved with mature spermatozoa. While this technique may be a feasible alternative for men with azoospermia who decline other options, couples should be aware that the odds of a successful delivery are greatly diminished and the prognosis is relatively poor.