Program goal
To reduce the prevalence of scabies and skin sores in Indigenous
communities, and reduce the impact of associated chronic diseases,
including rheumatic fever and renal disease.
Program overview
In some communities, up to 70% of Aboriginal children have scabies
and/or skin sores. The CRC for Aboriginal Health has supported a
long-term program of work, which, with community-based education
and health promotion activity, has been able to reduce scabies from
30% to as little as 5% in the short term, with associated dramatic
reductions in skin sore severity and prevalence. If skin infections
of this sort can be controlled, other diseases linked to
scabies—such as rheumatic heart disease and renal
disease—may also be reduced.
The CRC for Aboriginal Health takes a holistic approach to
health. We know that medical treatments alone are unlikely to
provide solutions in Aboriginal health. Poverty, lack of
infrastructure such as water and housing, and the strength and
wellness of communities as a whole are equally important. The work
of the CRC for Aboriginal Health focuses on comprehensive primary
healthcare and primary prevention, but also includes biomedical
research to understand more about how scabies and skin sores can be
treated and controlled. We know that to achieve sustainable change,
we must also support capacity development at the community level,
as well as among the workforce and in the research world.
For more detail on the framework of the Program background,
outcomes and operation, go to the Healthy Skin Program Statement [pdf] or the Healthy Skin Program Summary [pdf].
Research priorities
The research in this
program builds on more than a decade of clinical, biomedical and
public health activities. Healthy Skin was identified as a priority
in convocation discussions and research proposal assessments.
The Program is made up of seven research projects, ranging from
bio-medical and clinical research to action research aimed at
reducing the prevalence of scabies, skin sores and tinea through a
combination of community treatment days, routine screening at
health clinics and home visits. The 'Filling the Gaps' and the
'East Arnhem Regional Health Skin' projects were both 3-year
projects, directly funded by the CRC for Aboriginal Health:
East
Arnhem Healthy Skin project
The East Arnhem
Healthy Skin project was completed in August 2007. This project
aimed to reduce the prevalence of scabies, skin sores and tinea in
five East Arnhem communities in the Northern Territory's Top End.
Through a combination of community treatment days, and routine
screening at health clinics and home visits, the skin sore burden
among children in these communities almost halved - down from 46%
to 28% of the children seen.
As part of the project, 11 community health workers graduated
successfully with credit, towards a primary health care
qualification. These community workers educated and screened
children for scabies, skin sores and tinea and referred those with
skin infections to the clinic for treatment.
Filling
the Gaps project
Filling the Gaps was a 3-year project largely focused around
bio-medical and clinical research, which aimed to address several
significant knowledge gaps that are potential barriers to the
effectiveness and sustainability of community-based healthy skin
interventions. The project addressed the following four themes:
(1) Scabies resistance and the immunology of infection
(2) Determinants of persistent/recurrent scabies
(3) Treatment of skin sores and the role of antibiotic
resistance
(4) Epidemiology of GAS isolates in East Arnhem and Queensland.
Major outputs of the project to date are the publication of
peer-reviewed journal articles and presentations at national and
international conferences.
Research transfer/knowledge exchange
With the completion of seven projects, a strong body of work with
clear and key messages has emerged from the Healthy Skin Program.
Over the past couple of years considerable effort has been put into
ensuring that lessons learnt from these projects are used to guide
changes in practice and/or inform the development of policy to
improve the health status of Aboriginal and Torres Strait Islander
people.
For up-to-date information on the treatment of skin conditions,
please refer to the CARPA Standard Treatment Manual.
Publications
To order the above Flipchart, Final report of the East Arnhem
Healthy Skin project, or Policy Brief, please email
admin@lowitja.org.au or phone the
CRC for Aboriginal Health on 08 8943 5000.
- Andrews RM, McCarthy J, Carapetis JR and Currie BJ. Skin
disorders including pyoderman, scabies and tinea infections. Ped
Clin North America, 2009. In press.
More information is available on the following
individual project pages:
Page last updated 09.10.2009
