Ivermectin mass drug administration program to treat endemic scabies and strongyloidiasis in a remote aboriginal community in northern Australia

Kearns, T., Andrews, R., Speare, R., Cheng, A., McCarthy, J., Carapetis, J., Holt, D., Mulholland, E., Currie, B., Page, W., McDonnell, J., and Shield, J. (2011) Ivermectin mass drug administration program to treat endemic scabies and strongyloidiasis in a remote aboriginal community in northern Australia. In: Tropical Medicine and International Health, pp. 198-199. From: 7th European Congress on Tropical Medicine and International Health, 3-6 October 2011, Barcelona, Spain.

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Abstract

Background: In many Aboriginal communities in northern Australia 70% of children are clinically diagnosed with scabies before they reach 1 year of age and a high percentage of adults and children in the same communities are sero-positive for Strongyloides stercoralis. As both parasitic infections can be treated with ivermectin and mass drug administration (MDA) programs are recommended when helminth infections are £20% and scabies >5%, we hypothesised that an ivermectin MDA would reduce the endemic prevalence of these two infections.

Methods: A population census for prevalence and MDA was conducted at months 0 and 12 to be followed by cross sectional surveys for disease acquisition and treatment failures at months 6 and 18. Scabies was diagnosed clinically and strongyloidiasis by faecal microscopy and/or agar plate culture or by serology. Participants were administered a stat dose of 200 lg/kg ivermectin unless pregnant or their weight was <15 kg. All participants received one dose of ivermectin and those diagnosed with scabies and/or strongyloidiasis were given a 2nd dose after 2–3 weeks.

Results: There were 1011 (81%) participants enrolled from 127 (80%) houses and 7 (78%) surrounding homelands. Scabies prevalence reduced from 4% at month 0 to a point estimate of 1.8% at month 6 and strongyloidiasis from 21% to 6% over the same period. At month 6, disease acquisition of scabies was 1% and strongyloidiasis 3%, with treatment failures of 11% and 16% respectively. The 2nd population census and MDA#2 is currently underway and preliminary results will be presented at the congress.

Conclusion: These results are preliminary data from a study in progress however early indications for the success of the study are encouraging. A rigorously evaluated MDA has potential global ramifications for changing public health policy for the control of endemic scabies and strongyloidiasis.

Item ID: 21367
Item Type: Conference Item (Poster)
Additional Information:

Tropical Medicine & International Health. Special Issue: Abstracts of the 7th European Congress on Tropical Medicine and International Health. 3-6 October 2011 Barcelona, Spain. Volume 16, Issue Supplement s1, pages 198-199, October 2011

ISSN: 1365-3156
Date Deposited: 11 Apr 2012 01:24
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 100%
Citation Count from Web of Science Web of Science 2
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