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Trial registered on ANZCTR
Registration number
ACTRN12613001089729
Ethics application status
Approved
Date submitted
2/09/2013
Date registered
30/09/2013
Date last updated
30/09/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
A school-based health education package for prevention of soil-transmitted helminth infections in China
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Scientific title
Chinese schoolchildren cartoon-based health education package versus a health education poster for the prevention of soil-transmitted helminth infections
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Secondary ID [1]
283027
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Soil-transmitted helminths: Trichuris, Ascaris, Hookworm
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Condition category
Condition code
Public Health
290218
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0
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Epidemiology
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Public Health
290219
290219
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0
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Health promotion/education
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Infection
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will be a video-based health education package comprised of: 1) health education cartoon: narrative 12min cartoon video; content: story about a boy who gets infected with Soil-transmitted Helminths (STH) because of unhygienic behaviour. Key messages: a) symptoms of the disease. b) where and how can children get infected. c) how can disease be prevented. 2) A take-home pamphlet with key messages; 3) Classroom discussions; and 4) Drawing and essay competitions for key message reinforcement.
The cartoon will be shown twice in October 2013 followed by distribution of the pamphlet and classroom discussions; and then shown twice in February/March 2014 followed by classroom discussions and the drawing and essay competitions. This will take place in the intervention schools.
Two rounds of Albendazole chemotherapy will be administered following the baseline survey in October 2013 in all study schools. Albendazole will also be administered to those found positive at the two follow-up surveys in June 2014 and June 2015 respectively.
The Albendazole regimen will follow standard World Health Organization (WHO) guidelines (a single oral dose of 400mg).
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Intervention code [1]
287748
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Prevention
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Intervention code [2]
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Treatment: Drugs
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Comparator / control treatment
Traditional health education material: textbook-based general hygiene education and wall-posters in schools. Frequency of textbook based teaching: twice per semester, school-year 3-6, total of one year intervention. Wall-poster: permanent during intervention.
Albendazole treatment at baseline and of positives at follow-up: same as for intervention group
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Control group
Active
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Outcomes
Primary outcome [1]
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Soil-transmitted helminth infection rate will be assessed by follow-up parasitological stool tests using Kato-Katz thick smear to count the parasite eggs per species. Molecular diagnostics will also be undertaken.
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Assessment method [1]
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Timepoint [1]
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Soil-transmitted helminth infection rates will be assessed at baseline (October 2013) and then at each follow-up (June 2014 and June 2015).
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Primary outcome [2]
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Child's knowledge on infection risk of soil-transmitted helminth will be assessed with baseline and follow-up questionnaires.
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Assessment method [2]
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Timepoint [2]
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Knowledge will be assessed at baseline (October 2013) and at follow-up (June 2014 and June 2015).
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Secondary outcome [1]
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Change in infection risk behaviour will be assessed with standardised behaviour observations by the investigatory team at baseline and at follow-up.
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Assessment method [1]
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Timepoint [1]
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Behaviour will be assessed at baseline (October 2013) and at follow-up (June 2014 and June 2015).
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Secondary outcome [2]
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Measures of STH associated morbidity (anaemia, stunted growth, academic performance). These will be measured by Haemoglobin levels, height and weight, school attendance and academic grades; at baseline and follow-up.
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Assessment method [2]
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Timepoint [2]
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Morbidity measures will be assessed at baseline (October 2013) and at follow-up (June 2014 and June 2015).
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Eligibility
Key inclusion criteria
Grade 4 pupil of study school
Pupil at school for duration of study
Informed consent obtained
Age 9-11 years
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Minimum age
9
Years
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Maximum age
11
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
No informed consent
Outside of specified age range
Pupil will not be present for duration of study
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All 4th grade students in the selected study schools, from whom's informed consent was received, will be enrolled for the study. Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple Randomisation: Random number generation will be used in MS Excel to randomise schools into control or intervention groups
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We estimated a design effect of 1.1 based on our previous study. Sample size calculations were then undertaken for an individually randomized trial and multiplied by the design effect. Assuming an STH incidence of 18% (typical of communities with 50% prevalence) and an intervention efficacy of 33%; the study will have 80% power with a sample size of 20 intervention clusters (40 in total) and 44 students per cluster at the end of the trial following a predicted annual 10% loss to follow-up (total N = 1760).
Statistical analyses
A hierarchical generalised linear model with school as a random effect will be used for formal analyses of infection and knowledge, and carried out using SAS software (SAS Institute, Cary, NC). Models will be fitted using Generalised Estimating Equations (GEE) and a log-binomial distribution used to estimate relative risks and therefore intervention efficacy against infection. Analyses of changes in knowledge and behaviour scores will use a log-normal distribution, and a time-intervention interaction to estimate differential change over time. Potential confounders such as age and sex will be incorporated. Spearman correlation coefficients will be used to estimate correlations among behaviour, knowledge, and incidence.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
21/10/2013
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
2000
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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China
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State/province [1]
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Yunnan
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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United Bank of Switzerland (UBS) Optimus Foundation
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Address [2]
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UBS Optimus Foundation
Management
Augustinerhof 1
P.O. Box
CH-8098 Zurich
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Country [2]
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Switzerland
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Primary sponsor type
Individual
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Name
Darren Gray
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Address
University of Queensland, School of Population Health, Herston Road, Brisbane, QLD 4006, Australia
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Donald McManus
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Address [1]
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Molecular Parasitology Laboratory QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD 4006, Australia
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Franziska Bieri
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Address [2]
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University of Queensland, School of Population Health, Herston Road, Brisbane, QLD 4006, Australia
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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QIMR Berghofer Medical Research Institute Human Ethics Committee
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Ethics committee address [1]
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300 Herston Road Herston QLD 4006 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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16/04/2013
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Ethics approval number [1]
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P1271
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Ethics committee name [2]
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University of Queensland Medical Research Ethics Committee
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Ethics committee address [2]
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The University of Queensland Brisbane QLD 4072 Australia
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
289741
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Approval date [2]
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13/05/2013
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Ethics approval number [2]
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2103000116
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Summary
Brief summary
Our central thesis is that a video-based health educational package, developed by our group, targeting schoolchildren, can influence their behaviour in a way conducive to the prevention of parasitic worm infections, thereby playing a pivotal role in the sustainable control and prevention of Neglected Tropical Diseases (NTDs) globally. An extensive school-based field trial targeting Han Chinese schoolchildren undertaken by our multidisciplinary team in Hunan province, China established proof of principle that our video-based health educational package widens student knowledge and changes behaviour, resulting in fewer STH infections. To evaluate the potential for up-scaling of our video-based health educational package as a universal school-focused educational tool forming part of multi-component sustainable integrated NTD control programs, we wish to assess the generalisability of our findings in different geographical areas with a high force of infection (high prevalence) and different ethnic groups. This will provide an evidence base for translation of the package into public health policy and practice in the Asian region and beyond. We will test the hypothesis that: A video-based health educational package (for use in schools) targeting STH increases student knowledge of the worms, their transmission, symptoms, treatment and prevention, and changes hygiene behaviour, thus preventing infections in children in diverse ethnic and endemic settings. We will test this hypothesis with the following specific aim: To determine if the video-based health educational package (for use in schools) is effective in preventing STH infection in schoolchildren in Yunnan (a province with a high force of infection and diverse ethnicities)
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Darren Gray
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Address
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University of Queensland, School of Population Health, Herston Rd, Herston, Brisbane, QLD 4006
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Country
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Australia
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Phone
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+61 7 33464651
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Franziska Bieri
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Address
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University of Queensland, School of Population Health, Herston Rd, Herston, Brisbane, QLD 4006
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Country
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Australia
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Phone
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+61 424455618
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Franziska Bieri
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Address
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University of Queensland, School of Population Health, Herston Rd, Herston, Brisbane, QLD 4006
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Country
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Australia
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Phone
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+61 424455618
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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