Evaluating the effectiveness and sustainability of a primary healthcare strategy to reduce the prevalence of strongyloidiasis in endemically infected Indigenous communities in Northern Australia
Page, Wendy A., Blair, David, Dempsey, Karen, Biggs, Beverley Ann, and Judd, Jenni A. (2025) Evaluating the effectiveness and sustainability of a primary healthcare strategy to reduce the prevalence of strongyloidiasis in endemically infected Indigenous communities in Northern Australia. PLoS Neglected Tropical Diseases, 19 (5). e0013136.
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Abstract
Background Strongyloidiasis is endemic in many remote Indigenous communities in Australia. Early diagnosis, treatment, and follow-up of chronic strongyloidiasis can prevent life-threatening clinical complications and decrease transmission in these endemic communities. The aim of this paper is to evaluate the effectiveness and sustainability of a primary healthcare strategy designed to measure and reduce the prevalence of strongyloidiasis in four remote communities in northeast Arnhem Land. Methodology The primary healthcare strategy was a prospective, longitudinal, health-systems intervention designed to integrate serological testing for chronic strongyloidiasis into the Indigenous preventive adult health assessment utilising the electronic health-record systems in four Aboriginal health services. Positive cases were recalled for treatment, and opportunistic follow-up serology after six months. Results were tracked using Strongyloides reports generated by the electronic health-record system. This paper describes the changes in prevalence, effectiveness of treatment, and reinfection during the implementation phase, 2012–2016. An improved Strongyloides electronic report was developed to evaluate the effectiveness and sustainability of the intervention to the end of 2020. Principal Findings During the entire period 2012–2020, 84% (2390/2843) of the resident adults in the four communities were tested for strongyloidiasis at least once. Prevalence was reduced from 44% (1056/2390) ever-positive to 10% (232/2390) positive on their last test. Of positive, treated cases with a follow-up serology test, the last test was negative in 85% (824/967) of individuals. Point prevalence continued to decrease in each community four years after the end of the implementation phase. Conclusions The results provided practice-based evidence of a significant decrease in the prevalence of strongyloidiasis attributable to the strategy which could be replicated in other health services utilising electronic health-record systems. The final evaluation demonstrated the sustainability and ongoing benefits for endemically infected com-munities, and the key role that health services can play in strongyloidiasis prevention and control programs.
| Item ID: | 88107 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1935-2735 |
| Copyright Information: | © 2025 Page 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. |
| Date Deposited: | 24 Mar 2026 01:29 |
| FoR Codes: | 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450402 Aboriginal and Torres Strait Islander biomedical and clinical sciences @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3207 Medical microbiology > 320704 Medical parasitology @ 50% |
| SEO Codes: | 21 INDIGENOUS > 2103 Aboriginal and Torres Strait Islander health > 210303 Aboriginal and Torres Strait Islander health system performance @ 100% |
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