Program goal
The goal is 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
major priorities identified are:
East
Arnhem Healthy Skin project
The East Arnhem
Healthy Skin project is based in the Yolngu communities of North
East Arnhem Land. It aims to develop a coordinated large-scale
community-based program to control scabies and skin infections at a
regional level. Local community workers from each of these
communities are employed to work in their local clinics, through
local schools and alongside the Healthy Skin team to screen
children’s skin for scabies and skin sores, to treat these
conditions and to provide education to families.
Filling
the Gaps project
The project aims to address several significant knowledge gaps that
are potential barriers to the effectiveness and sustainability of
community-based interventions. These knowledge gaps form four
themes to the Filling the Gap project:
- scabies resistance and the immunology of infection;
- determinants of persistent/recurrent scabies;
- treatment of skin sores and the role of antibiotic
resistance;
- epidemiology of group A streptococcal isolates in East Arnhem
and Queensland Indigenous communities.
Research transfer
A primary focus of the Healthy Skin program is research transfer,
where research findings are disseminated and translated to
Aboriginal communities, healthcare service providers, health
professionals and policy/guideline makers. In order for the
outcomes of the Healthy Skin program to be sustainable, this
information needs to be delivered in a user-friendly manner to
those who can make use of it. A number of strategies are used and
include:
- regular updates of the CARPA Manual, to update the
existing clinical and antibiotic guidelines for the treatment and
management of scabies and skin sores;
- a Vocational Education Training Certificate II level curriculum
in Healthy Skin, which has been developed and is currently being
delivered to all community workers throughout North East Arnhem
Land.
A research transfer plan involving all of the projects within
the Healthy Skin program is currently being developed and will take
into account the combined findings from laboratory and
community-based projects to address social determinant issues such
as access to water, appropriate health hardware, nutrition, health
promotion and waste disposal.
All projects
In addition to the above projects, a range of other program
activity is occurring in the Healthy Skin program. Information
about some of these other activities can be found on this page. For
a full list of current Healthy Skin projects go to Research
projects.
