Impact of an ivermectin mass drug administration on scabies prevalence in a remote Australian Aboriginal community

Kearns, Thérèse M., Speare, Richard, Cheng, Allen C., McCarthy, James, Carapetis, Jonathan R., Holt, Deborah C., Currie, Bart J., Page, Wendy, Shield, Jennifer, Gundjirryirr, Roslyn, Bundhala, Leanne, Mulholland, Eddie, Chatfield, Mark, and Andrews, Ross M. (2015) Impact of an ivermectin mass drug administration on scabies prevalence in a remote Australian Aboriginal community. PLoS Neglected Tropical Diseases, 9 (10). e0004151. pp. 1-13.

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Abstract

Background: Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community.

Methods: Utilizing a before and after study design, we measured scabies prevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined disease acquisition and treatment failures. Scabies infestations were diagnosed clinically with additional laboratory investigations for crusted scabies. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 2–3 weeks if scabies was diagnosed, others followed a standard alternative algorithm.

Principal Findings: We saw >1000 participants at each population census. Scabies prevalence fell from 4% at baseline to 1% at month 6. Prevalence rose to 9% at month 12 amongst the baseline cohort in association with an identified exposure to a presumptive crusted scabies case with a higher prevalence of 14% amongst new entries to the cohort. At month 18, scabies prevalence fell to 2%. Scabies acquisitions six months after each MDA were 1% and 2% whilst treatment failures were 6% and 5% respectively.

Conclusion: Scabies prevalence reduced in the six months after each MDA with a low risk of acquisition 1–2%). However, in a setting where living conditions are conducive to high scabies transmissibility,exposure to presumptive crusted scabies and population mobility, a sustained reduction in prevalence was not achieved.

Item ID: 42099
Item Type: Article (Research - C1)
ISSN: 1935-2735
Keywords: scabies, mass drug administration, ivermectin, Galiwin'ku, Australian Aborigines, incidence
Additional Information:

© 2015 Kearns et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Funders: National Health and Medical Research Council of Australia (NHMRC), Cooperative Research Centre for Aboriginal Health (CRCAH), Northern Territory Research Innovation Board (NTRIB)
Projects and Grants: NHMRC GTN0605804, CRCAH HS331, NT RIB6-2008
Date Deposited: 17 Mar 2016 00:00
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 10%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 50%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
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