Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community.
BACKGROUND:Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal...
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doaj-75f8f03dc3524bda83aa2f5de86ca22b2020-11-25T01:45:07ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352015-10-01910e000415110.1371/journal.pntd.0004151Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community.Thérèse M KearnsRichard SpeareAllen C ChengJames McCarthyJonathan R CarapetisDeborah C HoltBart J CurrieWendy PageJennifer ShieldRoslyn GundjirryirrLeanne BundhalaEddie MulhollandMark ChatfieldRoss M AndrewsBACKGROUND:Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. METHODS:Utilizing a before and after study design, we measured scabies prevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined disease acquisition and treatment failures. Scabies infestations were diagnosed clinically with additional laboratory investigations for crusted scabies. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 2-3 weeks if scabies was diagnosed, others followed a standard alternative algorithm. PRINCIPAL FINDINGS:We saw >1000 participants at each population census. Scabies prevalence fell from 4% at baseline to 1% at month 6. Prevalence rose to 9% at month 12 amongst the baseline cohort in association with an identified exposure to a presumptive crusted scabies case with a higher prevalence of 14% amongst new entries to the cohort. At month 18, scabies prevalence fell to 2%. Scabies acquisitions six months after each MDA were 1% and 2% whilst treatment failures were 6% and 5% respectively. CONCLUSION:Scabies prevalence reduced in the six months after each MDA with a low risk of acquisition (1-2%). However, in a setting where living conditions are conducive to high scabies transmissibility, exposure to presumptive crusted scabies and population mobility, a sustained reduction in prevalence was not achieved. CLINICAL TRIAL REGISTRATION:Australian New Zealand Clinical Trial Register (ACTRN-12609000654257).http://europepmc.org/articles/PMC4627839?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thérèse M Kearns Richard Speare Allen C Cheng James McCarthy Jonathan R Carapetis Deborah C Holt Bart J Currie Wendy Page Jennifer Shield Roslyn Gundjirryirr Leanne Bundhala Eddie Mulholland Mark Chatfield Ross M Andrews |
spellingShingle |
Thérèse M Kearns Richard Speare Allen C Cheng James McCarthy Jonathan R Carapetis Deborah C Holt Bart J Currie Wendy Page Jennifer Shield Roslyn Gundjirryirr Leanne Bundhala Eddie Mulholland Mark Chatfield Ross M Andrews Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. PLoS Neglected Tropical Diseases |
author_facet |
Thérèse M Kearns Richard Speare Allen C Cheng James McCarthy Jonathan R Carapetis Deborah C Holt Bart J Currie Wendy Page Jennifer Shield Roslyn Gundjirryirr Leanne Bundhala Eddie Mulholland Mark Chatfield Ross M Andrews |
author_sort |
Thérèse M Kearns |
title |
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. |
title_short |
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. |
title_full |
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. |
title_fullStr |
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. |
title_full_unstemmed |
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. |
title_sort |
impact of an ivermectin mass drug administration on scabies prevalence in a remote australian aboriginal community. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2015-10-01 |
description |
BACKGROUND:Scabies is endemic in many Aboriginal and Torres Strait Islander communities, with 69% of infants infected in the first year of life. We report the outcomes against scabies of two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. METHODS:Utilizing a before and after study design, we measured scabies prevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined disease acquisition and treatment failures. Scabies infestations were diagnosed clinically with additional laboratory investigations for crusted scabies. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 2-3 weeks if scabies was diagnosed, others followed a standard alternative algorithm. PRINCIPAL FINDINGS:We saw >1000 participants at each population census. Scabies prevalence fell from 4% at baseline to 1% at month 6. Prevalence rose to 9% at month 12 amongst the baseline cohort in association with an identified exposure to a presumptive crusted scabies case with a higher prevalence of 14% amongst new entries to the cohort. At month 18, scabies prevalence fell to 2%. Scabies acquisitions six months after each MDA were 1% and 2% whilst treatment failures were 6% and 5% respectively. CONCLUSION:Scabies prevalence reduced in the six months after each MDA with a low risk of acquisition (1-2%). However, in a setting where living conditions are conducive to high scabies transmissibility, exposure to presumptive crusted scabies and population mobility, a sustained reduction in prevalence was not achieved. CLINICAL TRIAL REGISTRATION:Australian New Zealand Clinical Trial Register (ACTRN-12609000654257). |
url |
http://europepmc.org/articles/PMC4627839?pdf=render |
work_keys_str_mv |
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