A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia

A. Miller, E. L. Young, V. Tye, R. Cody, M. Muscat, V. Saunders, M. L. Smith, J. A. Judd, R. Speare

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven 'treat-and-test' mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004(-)2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the 'treat-and-test' intervention was 16.6% [95% confidence interval 14.2(-)19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities.
    LanguageEnglish
    Article number48
    Pages1-11
    Number of pages11
    JournalTropical Medicine and Infectious Disease
    Volume3
    Issue number2
    DOIs
    StatePublished - 4 May 2018

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    Strongyloides
    Queensland
    Strongyloides stercoralis
    Strongyloidiasis
    Serology
    Community Health Services
    Ivermectin
    Health Promotion
    Pharmaceutical Preparations
    Environmental Health
    Communicable Diseases

    Cite this

    Miller, A., Young, E. L., Tye, V., Cody, R., Muscat, M., Saunders, V., ... Speare, R. (2018). A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia. Tropical Medicine and Infectious Disease, 3(2), 1-11. [48]. DOI: 10.3390/tropicalmed3020048
    Miller, A. ; Young, E. L. ; Tye, V. ; Cody, R. ; Muscat, M. ; Saunders, V. ; Smith, M. L. ; Judd, J. A. ; Speare, R./ A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia. In: Tropical Medicine and Infectious Disease. 2018 ; Vol. 3, No. 2. pp. 1-11
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    title = "A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia",
    abstract = "This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven 'treat-and-test' mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12{\%} faecal examination, 30{\%} serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004(-)2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the 'treat-and-test' intervention was 16.6{\%} [95{\%} confidence interval 14.2(-)19.3]. The cure rate after two doses of ivermectin was 79.8{\%}, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities.",
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    author = "A. Miller and Young, {E. L.} and V. Tye and R. Cody and M. Muscat and V. Saunders and Smith, {M. L.} and Judd, {J. A.} and R. Speare",
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    Miller, A, Young, EL, Tye, V, Cody, R, Muscat, M, Saunders, V, Smith, ML, Judd, JA & Speare, R 2018, 'A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia' Tropical Medicine and Infectious Disease, vol. 3, no. 2, 48, pp. 1-11. DOI: 10.3390/tropicalmed3020048

    A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia. / Miller, A.; Young, E. L.; Tye, V.; Cody, R.; Muscat, M.; Saunders, V.; Smith, M. L.; Judd, J. A.; Speare, R.

    In: Tropical Medicine and Infectious Disease, Vol. 3, No. 2, 48, 04.05.2018, p. 1-11.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Young,E. L.

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    AU - Saunders,V.

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    AB - This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven 'treat-and-test' mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004(-)2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the 'treat-and-test' intervention was 16.6% [95% confidence interval 14.2(-)19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities.

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    Miller A, Young EL, Tye V, Cody R, Muscat M, Saunders V et al. A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia. Tropical Medicine and Infectious Disease. 2018 May 4;3(2):1-11. 48. Available from, DOI: 10.3390/tropicalmed3020048