The Kirby Institute’s Dr Lucia Romani and Professor John Kaldor are part of a highly collaborative team of researchers who have been working in Fiji and the Solomon Islands on projects to eliminate scabies. The projects adopt the method of mass drug administration, which involves treating an entire population for scabies once, regardless of whether or not individuals carry the parasite. The studies showed that by treating the entire population, scabies infection reduced by up to 90%, providing the evidence base for future elimination projects.
Australian researchers have been awarded AU$10 million to lead a global program to wipe out scabies – the human parasite linked to severe skin infections, blood poisoning, kidney failure and heart disease.
The funds come from the Macquarie Group’s 50th anniversary philanthropic commitment to address social need. Murdoch Children’s Research Institute (MCRI) will use the funds to establish the first World Scabies Elimination Program.
Professor Andrew Steer says the tiny mite Sarcoptes scabiei affects hundreds of millions of people, but research led by MCRI and its partners has proven that it is possible to have a massive impact through treatment of whole populations.
“Right now in Fiji, the research team is working with the Fiji Ministry of Health to treat 140,000 people for scabies, but with this funding we aim to treat 1.5 million people – the entire populations of Fiji and the Solomon Islands,” Professor Steer says.
Fiji and the Solomon Islands are among the world’s most affected countries, and will also be pilot countries for the World Scabies Elimination Program. In addition to supporting program delivery, members of the research team will evaluate the program’s acceptability, cost and effectiveness on a country-wide scale.
“Scabies infection rates are high in many Pacific nations, parts of South America and Africa, and in Australian indigenous communities, where up to 50% of children may have scabies,” Professor Steer says.
“Scabies is a disease of over-crowding, and people in low-income, crowded, and tropical environments with inadequate access to health services are most prone to infestation. Children are particularly vulnerable to scabies.”
Globally, there are an estimated 455 million cases of scabies every year, and around 200 million people are affected at any time.
Professor Steer says that the constant scratching caused by the mites opens up the skin, leading to the skin infection impetigo.
“If harmful bacteria enters the wound, this can result in rheumatic heart disease and chronic kidney disease, even in children,” he says.
“Our research has shown that the most effective way to wipe out scabies is to treat whole communities. We have found that the oral drug ivermectin is a highly effective community-based treatment – ivermectin has been used to treat over 1 billion people for other parasitic infections and is known to be very safe.”
“With the support of the $10 million from Macquarie Group, we will offer it to everyone in the community, regardless of whether they have been diagnosed with scabies. The only exceptions are pregnant women and children under five, who will be given an alternative skin-cream treatment.”
Research by MCRI, conducted in partnership with the Kirby Institute at UNSW Sydney and the health ministries of Fiji and the Solomon Islands, has proven that the number of people with scabies in a community can be reduced by more than 90% with a single mass treatment of ivermectin.
Professor John Kaldor from the Kirby Institute described ivermectin as one of the most effective public health interventions we have.
Professor Kaldor said the funds will enable MCRI, the Kirby Institute and its partners to launch the World Scabies Elimination Program, working closely with other researchers in Australia and internationally, health ministries and the World Health Organization.
For the World Scabies Elimination Program, MCRI and partners will begin work to:
- Map the global populations affected by scabies
- Establish affordable and reliable access to effective treatments
- Scale-up mass drug administration strategies in highly-affected countries
- Support affected communities and health workers to introduce elimination programs.
“We are increasingly understanding the multiple harms that scabies causes to individuals and communities. People miss school and work and are stigmatized because of this disease, and effects flows on to national economies,” Professor Kaldor says.
Professor Steer said the researchers were greatly appreciative and thankful for the support of the Macquarie Group.
“These funds will make a huge difference to the lives of people infected with scabies,” Professor Steer says.
Chair of the Macquarie Group Foundation, Mary Reemst, congratulated MCRI and its partners. “The World Scabies Elimination Program has tools at the ready to eliminate a highly-contagious, debilitating disease,” Ms Reemst said. “With a bold approach to tackling a global health problem, the Murdoch Children's Research Institute and its partners promise to positively impact quality of life for millions of people.”
Available for interview:
- Professor Andrew Steer, Murdoch Children’s Research Institute, Research Director of Infection and Immunity
- Professor John Kaldor, Kirby Institute, UNSW Sudney, Head of Public Health Interventions Research Group
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