The East Arnhem Healthy Skin Project (EAHSP) aimed to reduce the prevalence of scabies, skin sores and tinea in five remote Aboriginal communities, as these conditions are endemic in children aged <15 years. Skin infections are most commonly due to Group A streptococcal bacteria and are associated with outbreaks of acute post streptococcal glomerulonephritis (kidney disease) and acute rheumatic fever and rheumatic heart disease. Indeed, Indigenous Australians have one of the highest rates of rheumatic heart disease and renal disease in the world. To reduce the prevalence of skin infections the EAHSP conducted a comprehensive healthy skin program that included annual mass community scabies treatment days and routine screening and treatment of skin infections.

The key findings from this project are:

• The chart audit component of the study identified a previously undocumented burden of scabies and skin sores starting within the first few months of life. As a result community workers have become more involved with screening and education in the baby clinics as well as continuing the work in the community.
• Skin sore prevalence reduced substantially over the three-year study period from 46.1% in the first 18 months to 27.6% in the last 18 months. The reduction in skin sores was evident for all age groups but remains unacceptably high.
• Scabies prevalence remained constant over the three-year study period at 13.5%. Additional work undertaken with CRCAH support showed low levels of treatment uptake were a contributing factor to ongoing scabies transmission and suggest that this was probably also the case during annual mass community scabies treatment days.
• In households where there was a person with scabies, almost 10% of susceptible individuals acquired scabies during a 4-week follow-up period. There were very low levels of treatment uptake reported among household contacts (44%), but those individuals who did not acquire scabies were almost 6 times more likely to belong to a household where everyone in the house had used the scabies treatment cream.
• The study was the first to monitor tinea prevalence over time in Aboriginal children in the NT finding an average monthly prevalence of 15.3%.

Resources from this project you may find useful:

• Healthy Skin Story
• Recognising and Treating Skin Conditions
• CRCAH Website