AbstractAim: To report on the effectiveness of mass drug administration (MDA) in reducing the prevalence of scabies and strongyloidiasis in a remote Australian Aboriginal community.
Method: A population census and MDA was conducted at month 0 and 12 to screen participants for scabies and strongyloidiasis and administer medications. Scabies was diagnosed clinically, strongyloidiasis serologically or from coprological examination. Participants were administered a stat dose of 200 μg/kg ivermectin unless their weight was <15 kg or were pregnant. Participants diagnosed with scabies and/or strongyloidiasis received a 2nd treatment 2-3 weeks after the first medication was administered. Two cross sectional surveys were conducted six months after the MDAs to determine treatment failures, disease acquisition and an estimation of disease prevalence.
Results: At the population census and MDA at month 0, 1012 (80%) participants were screened. Scabies prevalence was 4% and strongyloidiasis was 21%. At month 12, 1060 participants were screened, 702 that had been seen previously and 358 new entries. The prevalence of scabies increased to 9% from an outbreak associated with a crusted scabies participant whilst strongyloidiasis prevalence decreased to 6%.
At the cross sectional surveys at month 6 and 18 the treatment failures remained constant at 6% and 7% for scabies and increased slightly but not significantly from 17% to 23% for strongyloidiasis. Scabies acquisition increased but not significantly from 3% to 5% and decreased from 4% to 1% for strongyloidiasis. Scabies prevalence decreased significantly at both cross sectional surveys from 4% (month 0) to 1% (month 6) and 9% (month 12) to 2% (month 18). Strongyloidiasis prevalence decreased significantly from 21% (month 0) to 6% (month 6) which was sustained for the duration of the project.
Conclusion: Scabies and strongyloidiasis are neglected tropical conditions that are endemic in remote Aboriginal communities in Australia. MDA did have some success as a public health measure in reducing the prevalence of both parasitic infections.
|Date of Award||Dec 2013|
|Supervisor||Ross Andrews (Supervisor) & Allen Cheng (Supervisor)|