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PLoS Negl Trop Dis. 2015 Oct 30;9(10):e0004151. doi: 10.1371/journal.pntd.0004151. eCollection 2015 Oct.

Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community.

Author information

1
Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
2
James Cook University, Townsville, Australia.
3
Monash University, Melbourne, Australia.
4
QIMR Berghofer Medical Research Institute, Brisbane, Australia.
5
Telethon Kids Institute, University of Western Australia and Princess Margaret Hospital for Children, Perth, Australia.
6
Miwatj Health Aboriginal Corporation, Nhulunbuy, Australia.
7
La Trobe University, Bendigo, Australia.

Abstract

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).

PMID:
26516764
PMCID:
PMC4627839
DOI:
10.1371/journal.pntd.0004151
[Indexed for MEDLINE]
Free PMC Article

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