News in Science

Top End program reduces skin infections

A community-based treatment program in Northern Australia has successfully reduced the number of Aboriginal children with skin infections, according to a new study.

The finding, published in the latest edition of PLoS Neglected Tropical Diseases, demonstrates that education programs involving local people can have a significant impact on reducing disease in remote communities.

Epidemiologist Dr Ross Andrews of Charles Darwin University in Darwin says seven out of ten Aboriginal children contract a skin infection before their first birthday.

He says skin infections can lead to more severe medical conditions such as blood poisoning, kidney and heart disease.

According to Andrews, environmental conditions are the main cause of skin infections such as skin sores and scabies.

Scabies is caused by a parasite that burrows into the skin where they lay their eggs.

"[It] is essentially a disease of poverty and overcrowding," he says.

Andrews says they can only live in human skin and therefore "need close contact to get from one human to another."

Apart from the itchiness of the bite, the site can also become an entry point for infections such as staph, he says.

"We've shown that scabies have a role in about 50 to 70% of skin sores."

Community study

Andrews says the community-based program involved annual treatment days for children with scabies and skin sores. Local workers were also trained to conduct house to house visits to educate people about skin hygiene.

In three years, Andrews says, the program checked more than 2000 children in several remote communities in East Arnhemland in the Northern Territory.

"Initially 46% of the kids had skin sores," he says, but the end of the program the number of children with skin sores had reduced by 14%.

Andrews admits there is still a long way to go to reduce skin infections in remote communities.

At present only a fifth of children that need treatment are receiving it, he says.

"We also didn't see any impact in the [number of children] with scabies. We think most people take the [treatment] cream, but they don't use it."

Treatment options

He says convincing people to use the cream is the next challenge, but they're also researching alternative treatment options.

"In one of the communities we are looking at a tablet [treatment]," which according to Andrews has been very successful in African communities.

Andrews says the overall burden of skin infections in the communities involved in the study has decreased, but the study has yet to establish whether the reduction in skin infections can lead to a decrease in heart disease and kidney disease.

That requires longer term studies, he says.

Andrews says despite the poor living conditions and overcrowding in these remote communities the program did "make some in roads."

"It's small [programs] working locally that we think has been a real driver here".