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Epidemiol Infect. 2018 Jul;146(9):1194-1201. doi: 10.1017/S0950268818001061. Epub 2018 May 8.

Calculation of the age of the first infection for skin sores and scabies in five remote communities in northern Australia.

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School of Mathematics and Statistics,The University of Melbourne,Parkville,Victoria,Australia.
Murdoch Children's Research Institute,The Royal Children's Hospital,Melbourne,Victoria,Australia.
Victorian Infectious Diseases Reference Laboratory Epidemiology Unit,Peter Doherty Institute for Infection and Immunity,The Royal Melbourne Hospital and The University of Melbourne,Melbourne,Victoria,Australia.
Menzies School of Health Research,Charles Darwin University,Darwin,Casuarina,Australia.
Clinical Haematology,The Alfred Hospital and Monash Medical Centre,Melbourne,Victoria,Australia.
Telethon Kids Institute,University of Western Australia and Princess Margaret Hospital for Children,Perth,Western Australia.
National Centre for Epidemiology & Population Health,Australian National University,Canberra,Australia.


Prevalence of skin sores and scabies in remote Australian Aboriginal communities remains unacceptably high, with Group A Streptococcus (GAS) the dominant pathogen. We aim to better understand the drivers of GAS transmission using mathematical models. To estimate the force of infection, we quantified the age of first skin sores and scabies infection by pooling historical data from three studies conducted across five remote Aboriginal communities for children born between 2001 and 2005. We estimated the age of the first infection using the Kaplan-Meier estimator; parametric exponential mixture model; and Cox proportional hazards. For skin sores, the mean age of the first infection was approximately 10 months and the median was 7 months, with some heterogeneity in median observed by the community. For scabies, the mean age of the first infection was approximately 9 months and the median was 8 months, with significant heterogeneity by the community and an enhanced risk for children born between October and December. The young age of the first infection with skin sores and scabies reflects the high disease burden in these communities.


Skin Sores; aboriginal health; age of first infection; northern territory; scabies

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