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12 Nov 2020

Preventing skin infections would solve other major health problems in remote communities

This week is NAIDOC Week - a celebration across Australia celebrating the history, culture and achievements of Aboriginal and Torres Strait Islander peoples.

The Doherty Institute would like to recognise the celebration by highlighting some of the important work we are doing in Indigenous health.

Skin infections have major long-term impacts on health in remote Indigenous communities across Australia. Doherty Institute researchers are working with communities and using a range of research approaches to reduce the risk of skin infections and decrease the use of antibiotics.

Between 40 and 50 per cent of school-aged children in some remote communities have a skin sore at any one time, and three-quarters of adults visit a clinic with a skin infection at least once each year.

“Skin sores can lead to complications of rheumatic heart disease, a long-term chronic condition linked to premature mortality and the need for open heart surgery,” says Royal Melbourne Hospital Clinician Researcher at the Doherty Institute, Associate Professor Steven Tong.

Skin infections also increase the use of antibiotics and this creates antimicrobial resistance that feeds back to exacerbate problems related to treatment of infections.

“Kids are going to clinic every two weeks in the first year of life and having up to six courses of antibiotics in that first year,” says Associate Professor Tong.

“So there was a high rate of antibiotic use and a lot of it seemed to be driven by skin infections. Preventing these infections so that antibiotics aren’t needed is a real priority,” Associate Professor Tong and University of Melbourne Professor Jodie McVernon, in collaboration with the Menzies School of Health Research in Darwin, are currently combing through historical data with the aim of forming a more complete picture of the issue.

“When we combine all that with new data we’re collecting about social relationships between families and households in remote communities, we can generate a much richer story about the way infections are transmitted,” explains Professor McVernon.

“This understanding helps us to think with communities about types of interventions that might be more effective at preventing repeated infections.”

The researchers are hoping to quantify some of the transmission events to create meaningful advocacy and drive holistic models of change within communities.

The project has created new opportunities for collaborations including with One Disease, a not-for-profit organisation that aims to eliminate crusted scabies. Crusted scabies is a severe and highly contagious form of scabies present in some remote Indigenous communities across Australia.

“We’re working with One Disease to quantify the contribution of crusted scabies to the overall risk of infection in households and communities. We’ll use this information to inform future discussions around two main areas – mass drug administration and a vaccine for Group A Streptococcus – and how they might best be used as part of a suite of interventions,” says Professor McVernon.

“There are a number of different vaccines at various points along the pipeline. We’re working with others to understand how immunity from vaccines differs from natural immunity after infection, and how good natural immunity is at preventing repeat infections. Having that data and analysis will hopefully inform design and use of such vaccines.”

This article was first published in the Celebrating five years of the Doherty Institute Impact Report.

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