Skin Disease Control In Remote Aboriginal Children: Translating Evidence Into Practice With A Cluster Randomised, Stepped Wedge Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,818,581.00
Summary
At any one time, almost one in two children living in remote Indigenous Australian communities have skin sores and one in three have scabies . Despite this high burden, skin infections are under-recognised. Increasing community and health care provider knowledge and access to the best available treatments will be evaluated with the goal of halving the burden of skin infection over five years and implementing the strategies, resources and knowledge to sustain this.
Cluster Randomised Trial Comparing One Versus Two Doses Of Ivermectin For Mass Drug Administration To Control Scabies
Funder
National Health and Medical Research Council
Funding Amount
$540,512.00
Summary
Scabies is a common skin disease in developing countries, in particular in the Pacific region. In the Western Province of Solomon Islands, one in two children suffer from the infestation, and 20% of the population. We know that mass drug administration with two doses of oral ivermectin is effective to reduce the burden of scabies in the community. We now propose a study to determine whether one single dose is as effective. This would have major public health benefits.
The Efficacy Of Mass Drug Administration Strategies To Control Scabies In A Highly Endemic Population.
Funder
National Health and Medical Research Council
Funding Amount
$705,396.00
Summary
Globally there are an estimated 300 million scabies cases annually. Many Pacific countries, including Fiji, have among the highest rates in the world. This island based study in Fiji will compare the short and long term efficacy of two mass treatment protocols using oral ivermectin or topical permethrin against conventional treatment. This study will be the first population-wide treatment trial for scabies that compares new interventions to standard of care treatment.
Does Mass Drug Administration For Scabies Result In Control Of Serious Bacterial Complications? A Proof Of Concept Towards Global Elimination.
Funder
National Health and Medical Research Council
Funding Amount
$883,760.00
Summary
Scabies is common skin disease in developing countries, in particular in the Pacific region. In Fiji, one in two children suffer from the infestation, which affects over 20% of the population. A recent study conducted in Fiji on 2000 people showed that mass drug administration (MDA) with oral ivermectin is a safe and effective way to reduce the burden of scabies in the community. We will expand the MDA program to 100,000 people, the largest study of MDA ivermectin for scabies ever undertaken.
Optimising Intervention Strategies To Reduce The Burden Of Group A Streptococcus In Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$856,896.00
Summary
Skin sores are highly prevalent in remote Australian Indigenous communities and can lead to invasive infections and rheumatic heart disease. We will develop mathematical models to understand the transmission of skin sores, allowing us to define the optimal extent (household, community, region), timing and triggers for interventions to interrupt transmission. This will guide public health policy in reducing the prevalence of skin sores and scabies, and their accompanying disease burden.
Prevention Of Group A Streptococcal Disease In The Developing World: Investigating Innovative Control Strategies For Rheumatic Heart Disease And Impetigo
Funder
National Health and Medical Research Council
Funding Amount
$178,614.00
Summary
Group A streptococcal diseases, including rheumatic heart disease and impetigo, are major causes of illness globally, mostly in developing countries. This proposal is a comprehensive investigation into new ways of curbing these diseases, including using ultrasound screening for rheumatic heart disease, community wide treatment for impetigo and laboratory testing for new vaccines. The studies will be done in Fiji and will be relevant for other developing countries and for Indigenous Australians.
Evidence-driven Strategies To Reduce The Burden Of Infections Among Indigenous Children
Funder
National Health and Medical Research Council
Funding Amount
$267,859.00
Summary
Dr Asha Bowen will be building the evidence to reduce the burden of infectious diseases in Australia's Indigenous children during her early career fellowship. This will include a randomised controlled trial on the treatment of acute gastroenteritis in the Northern Territory and developing new strategies to reduce the burden of skin infections in children living in remote communities.
A Novel Paradigm For Immunity And Vaccine Development Against Group A Streptococcus
Funder
National Health and Medical Research Council
Funding Amount
$491,229.00
Summary
Serious disease caused by the group A streptococcus (GAS) is responsible for more than 500,000 deaths per year. With no effective control strategies available, a vaccine is urgently needed. One vaccine shows great promise, but there are concerns it may not cover all GAS strains. Our project aims to show that the vaccine may in fact have very broad coverage because of cross-protection between strains using natural immunity model, and may lead to a new paradigm in understanding of GAS immunity.
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
Antigens, Allergens And Immune Responses In Normal And Crusted Scabies
Funder
National Health and Medical Research Council
Funding Amount
$302,036.00
Summary
Scabies (itch mite), a parasitic skin infestation of the mite Sarcoptes scabiei, is a major problem among most children in many Aboriginal communities in Australia, often accompanied by streptococcal infections which cause serious diseases. Our world-first molecular studies utilised variable microsatellite markers to demonstrate that scabies mites on people are genetically distinct from those on dogs. This has important implications in control programs in Aboriginal communities. In our current N ....Scabies (itch mite), a parasitic skin infestation of the mite Sarcoptes scabiei, is a major problem among most children in many Aboriginal communities in Australia, often accompanied by streptococcal infections which cause serious diseases. Our world-first molecular studies utilised variable microsatellite markers to demonstrate that scabies mites on people are genetically distinct from those on dogs. This has important implications in control programs in Aboriginal communities. In our current NHMRC program we have cloned scabies antigens, with the aim of understanding more about immunity, which normally limits infestation from developing to the extreme levels seen in the debilitating disease crusted scabies. Our hypothesis is that crusted scabies is the consequence of an immune deficit in these patients. The first such cloned antigen is the equivalent of a known asthma-inducing allergen from a closely related housedust mite. We seek support to continue this successful program and to extend it to search for candidate vaccine antigens.The development of a vaccine would be a step of major importance in prevention. Recent reports estimate up to 300 million scabies cases worldwide, commonly associated with overcrowding and poverty. We are the first laboratory worldwide to have successfully initiated molecular studies on scabies. We have formed close collaborations with the only laboratory with an animal model (Arlian, USA), and the best group working on epidemiology and control of human scabies (Taplin, USA) and co-published with these groups. It is imperative that our NHMRC support be continued and increased to a level compatible with the importance, potential and achievements so far of this unique program.Read moreRead less