• To reduce the prevalence of scabies, skin sores and tinea in five remote Indigenous 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 (ARF) and Rheumatic Heart Disease (RHD).

Indigenous Australians have one of the highest rates of RHD and renal disease in the world. To reduce the prevalence of skin infections the East Arnhem Healthy Skin Project (EAHSP) conducted a comprehensive healthy skin program that included annual mass community scabies treatment days and routine screening and treatment of skin infections.

Our research has found:
  • 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 four-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 six 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 Indigenous children in the Northern Territory (NT) finding an average monthly prevalence of 15.3%.
Chief Investigator:
Project Manager:
Contact information:
Project dates:

The project ran from 2004 - 2007.

  • Rio Tinto Aboriginal Foundation
  • The Ian Potter Foundation
  • Cooperative Research Centre for Aboriginal Health (CRCAH)
  • Australian Government’s Office for Aboriginal and Torres Strait Islander Health.
  • Murdoch Childrens Research Institute
  • Cooperative Research Centre for Aboriginal Health (CRCAH)
  • Northern Territory Government Department of Health and Community Services (NT DHCS)
  • Australasian College of Dermatologists
  • The University of Melbourne.
  1. Clucas, D.B., Carville, K.S., Connors, C., Curries, B,J., Carapetis, J.R., Andrews, R.M. (2008). Disease burden and health-care clinic attendances for young children in remote Aboriginal communities of northern Australia. Bulletin of the World Health Organization, 84(4), 275-281.
  2. Andrews, R.M., Kearns, T., Connors, C., Parker, C., Carville, K., et al. (2009). A Regional Initiative to Reduce Skin Infections amongst Aboriginal Children Living in Remote Communities of the Northern Territory, Australia. PLoS Neglected Tropical Diseases 3(11), e554.
  3. La Vincente, S., Kearns, T., Connors, C., Cameron, S., Carapetis, J., et al. (2009). Community Management of Endemic Scabies in Remote Aboriginal Communities of Northern Australia: Low Treatment Uptake and High Ongoing Acquisition. PLoS Neglected Tropical Diseases 3(5), e444.
  4. Kearns, T., Clucas, D., Connors, C., Currie, B.J., Carapetis, J.R., et al. (2013). Clinic Attendances during the First 12 Months of Life for Aboriginal Children in Five Remote Communities of Northern Australia. PLoS ONE 8(3), e58231.  
  5. East Arnhem Regional Healthy Skin Project: Final Report 2008.