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Applied epidemiology in communicable diseases, immunisation, and environmental health in Tasmania




Dyke, Hayley

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This thesis describes four major projects and other course requirements completed for the degree of Master of Philosophy in Applied Epidemiology (MAE) during field placements in 2021 and 2022. In 2021 I was placed in the Communicable Diseases Prevention Unit (CDPU) in the Tasmanian Department of Health, and completed three major projects. I was closely involved in the development, design, and implementation of a local passive surveillance system for adverse events following immunisation (AEFI), launched in the context of the beginning of the SARS-CoV-2 (COVID-19) mass vaccination campaign in Tasmania in March 2021. I then evaluated the performance of this AEFI surveillance system in November 2021, and made recommendations to improve the surveillance system for its continued use beyond the COVID-19 pandemic. I analysed gonococcal infection notification data received by the CDPU between 2010 and 2021, as in-depth analysis and reporting had not been performed for some time as regular business had been interrupted by the COVID-19 pandemic. I made some recommendations for improved gonococcal infection surveillance in Tasmania, and for consideration of future targeted public health messaging. Finally, I led an outbreak investigation for a cluster of cases of foodborne gastroenteritis at a catered workshop in a hotel venue in the north-east of Tasmania. I performed a cohort study, and while a pathogen and vehicle were not determined with certainty, a number of important public health actions occurred as a result of the investigation. In 2022 I was placed in the Environmental Health team at the Menzies Institute for Medical Research, University of Tasmania. The focus of this team is predominantly on air quality, and this experience provided an interesting insight into environmental epidemiology. I completed my epidemiological study during this placement. This was an evaluation of the association between key air pollutants, particulate matter less than 2.5 micrometres in diameter (PM2.5) and nitrogen dioxide (NO2), and educational outcomes in school-aged children in Australia. I used school-level National Assessment Program - Literacy and Numeracy (NAPLAN) scores as the outcome, and performed multivariable linear regressions to evaluate associations. We found that PM2.5 was associated with poorer scores, which supports emerging evidence that air quality negatively impacts on educational outcomes. Educational attainment is an important social determinant of health, and we have planned further studies to be conducted as a result of these findings. Teaching, epidemiological, and other public health activities undertaken during my field placements are described in the final chapter.






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