- To determine if mass drug administration is an effective public health measure to reduce the prevalence of scabies (skin mite) and strongyloides (intestinal worm).
- Conduct a population census at month 0 and 12 to collect data on scabies and strongyloides status
- Implement a community-wide MDA with ivermectin at month 0 and 12
- Conduct a cross sectional survey at month six with participants who were positive for scabies and/or strongyloides at month 0 to determine treatment failure rates. This will be repeated at month 18 for those positive at month 12
- Screen a percentage of negative people at month six and 18 to determine acquisition rates.
Over 1300 people participated in the mass drug administration project from 2010-2012. Scabies prevalence fluctuated over the two years, reducing from 4% to 2% in the first year and from 9% to 4% in the second year. Strongyloides prevalence reduced from 21% to 5% in the first year and from 6% to 3% in the second year.
A particularly exciting aspect of the project was the training of local community workers in a newly developed, nationally accredited program, Certificate II in Child Health Research. Twelve graduates of the training program were employed on the project to work with a multidisciplinary team that included: pharmacy students, parasitologists, epidemiologists, registered nurses, health workers and medical practitioners.
Implications for policy and practice:
The MDA was an acceptable public health approach to the community and showed a significant and sustained reduction in the seroprevalence of Strongyloides. Scabies prevalence was able to be reduced after each MDA but a sustained reduction was not maintained due to an outbreak believed to be linked to a suspected crusted scabies case.
Our research has found:
We have presented data at national and international conferences highlighting the acceptability of mass drug administration.
- Professor Ross Andrews
- Therese Kearns
The project ran from 2010 to 2012.
- National Health and Medical Research Council (NHMRC).
The Menzies School of Health Research is hoping the drug Ivermectin will rid the Echo Island community, east of Darwin, of scabies and the strongyloides worm.