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Trop. Med. Infect. Dis. 2018, 3(2), 48; https://doi.org/10.3390/tropicalmed3020048

A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia

1
Ellengowan Drive, Charles Darwin University, Darwin 0909, Northern Territory, Australia
2
Woorabinda Multi-Purpose Health Service, Queensland Health, 1 Munns Drive, Woorabinda, QLD 4713, Australia
3
Aboriginal and Torres Strait Islander Health, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
4
Australian Research Alliance for Children and Youth (ARACY), Griffith Criminology Institute, Brisbane, QLD 4001, Australia
5
School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC V1Y 1V7, Canada
6
School of Health Medicine and Applied Sciences, Centre of Indigenous Health Equity Research, Central Queensland University, Bundaberg, QLD 4670, Australia
7
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
Deceased.
*
Author to whom correspondence should be addressed.
Received: 15 March 2018 / Revised: 17 April 2018 / Accepted: 27 April 2018 / Published: 4 May 2018
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Abstract

This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven ‘treat-and-test’ mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004–2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the ‘treat-and-test’ intervention was 16.6% [95% confidence interval 14.2–19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities. View Full-Text
Keywords: Strongyloides stercoralis; aboriginal; indigenous; soil-transmitted helminths; mass drug administration Strongyloides stercoralis; aboriginal; indigenous; soil-transmitted helminths; mass drug administration
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Miller, A.; Young, E.L.; Tye, V.; Cody, R.; Muscat, M.; Saunders, V.; Smith, M.L.; Judd, J.A.; Speare, R. A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia. Trop. Med. Infect. Dis. 2018, 3, 48.

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