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Scabies and risk of skin sores in remote Australian Aboriginal communities: a self-controlled case series study.

Affiliation(s)

(Aung, Cuningham, McVernon, Campbell) Victorian Infectious Disease Reference Laboratory, The Royal Melbourne Hospital and The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
(Cuningham, Andrews, Kearns, Tong) Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
(Hwang, McVernon, Simpson) Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
(Andrews) National Centre for Epidemiology & Population Health, Australian National University, ACT, Australia
(Carapetis) Telethon Kids Institute, University of Western Australia and Perth Children's Hospital, Perth, WA, Australia
(Clucas) Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
(McVernon, Campbell) Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, Australia
(Tong) Victorian Infectious Diseases Service, The Royal Melbourne Hospital and The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia

Year

2018

Citation

PLoS Neglected Tropical Diseases. Vol.12(7), 2018.

Journal

PLoS Neglected Tropical Diseases

Conference name

Conference location

Grant information

No: 1104975 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
No: 1117140 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
No: 1145033 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
The authors acknowledge the following organisations as research partners: our partners in this work: Northern Territory Remote Health, Aboriginal Medical Services Alliance Northern Territory, Northern Territory Centre for Disease Control, One Disease and Miwatj Health, NHMRC HOT NORTH initiative, and the Lowitja Institute and the Cooperative Research Centre for Aboriginal Health who lent significant support to the EAHSP.

Abstract

Background: Skin sores caused by Group A streptococcus (GAS) infection are a major public health problem in remote Aboriginal communities. Skin sores are often associated with scabies, which is evident in scabies intervention programs where a significant reduction of skin sores is seen after focusing solely on scabies control. Our study quantifies the strength of association between skin sores and scabies among Aboriginal children from the East Arnhem region in the Northern Territory. Methods and Results: Pre-existing datasets from three published studies, which were conducted as part of the East Arnhem Healthy Skin Project (EAHSP), were analysed. Aboriginal children were followed from birth up to 4.5 years of age. Self-controlled case series design was used to determine the risks, within individuals, of developing skin sores when infected with scabies versus when there was no scabies infection. Participants were 11.9 times more likely to develop skin sores when infected with scabies compared with times when no scabies infection was evident (Incidence Rate Ratio (IRR) 11.9; 95% CI 10.3-13.7; p<0.001), and this was similar across the five Aboriginal communities. Children had lower risk of developing skin sores at age <=1 year compared to at age >1 year (IRR 0.8; 95% CI 0.7-0.9). Conclusion(s): The association between scabies and skin sores is highly significant and indicates a causal relationship. The public health importance of scabies in northern Australia is underappreciated and a concerted approach is required to recognise and eliminate scabies as an important precursor of skin sores.Copyright © 2018 Aung et al. http://creativecommons.org/licenses/by/4.0/.

PubMed ID

30044780 [https://www.ncbi.nlm.nih.gov/pubmed/?term=30044780]

Type

Article

Study type

Case series or case report

Subjects

Rural and remote health
Infectious diseases

Keywords