Location:
Level 6, Seminar Room Wallace Wurth Building UNSW Australia Sydney NSW 2052
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Reception +61 (0)2 9385 0900 recpt@kirby.unsw.edu.au
The Kirby Institute is pleased to present:
Ms Lucia Romani -Public Health Interventions Research Group-The Kirby Institute
"New control initiatives for scabies in highly endemic populations."
Abstract:
Recently added to the World Health Organization list of neglected tropical diseases, scabies is an under-recognised cause of morbidity in many developing countries. It is strongly associated with impetigo which can lead to systemic infection, leading to septicaemia, kidney and heart disease. In our review of global scabies prevalence we found that countries of the Pacific and indigenous populations of Australia have a particularly high burden, with prevalence in children in these areas of up to 50%. In the world’s first and only whole country prevalence study, the national population prevalence of scabies in Fiji was 18.5%. With such a high burden of scabies in many disadvantaged populations, there is a clear need for simple and effective public health measures to control this disease. To strengthen the evidence base for scabies control in highly effected communities, we undertook the first comparative trial of mass drug administration (MDA) for scabies, the SHIFT trial, showing that MDA for the control of scabies and impetigo was safe and highly efficacious, particularly with oral ivermectin as primary agent. To assess the impact of ivermectin MDA on larger populations and assess the safety of mass co-administration, we conducted feasibility trial of joint MDA of ivermectin (for scabies) and azithromycin (for trachoma) in the Solomon Islands, which involved treatment of over 20,000 people. The next logical step in moving towards the elimination of scabies as a global health problem will be conducting a trial in a population of over 100,000 people to assess the impact of ivermectin MDA on the secondary bacterial complications of scabies. The first national plan for scabies control is currently being advocated by the Ethiopian government, in collaboration with our research team, following an outbreak affecting over one million people. This approach would bring scabies control in line with the MDA strategies used for other neglected tropical diseases. However a potential barrier to wider use is the requirement of two doses of treatment for scabies. Further research is needed to determine if MDA with one dose of ivermectin is as effective as MDA with two doses in reducing the prevalence of scabies.
Bio:
Lucia Romaniis a public health researcher and PhD candidate at the Kirby Institute, UNSW. For the past eight years she has been involved in research on the control of scabies in countries of the Pacific region, which have the highest levels recorded in the world. In Fiji she has conducted the first national prevalence survey for scabies and impetigo in the general population, collecting data on over 10,000 people. Lucia has coordinated a trial of mass treatment strategies for scabies control, the SHIFT trial, in collaboration with the Murdoch Children’s Research Institute and Fiji Ministry of Health. Following on her interest in neglected tropical diseases she has recently led a large-scale mass co-administration trial for scabies and trachoma in the Solomon Islands.