Beating scabies and strongyloidiasis in a remote Aboriginal community in the Northern Territory
A before and after study of scabies and strongyloidiasis prevalence in a remote Aboriginal community following the introduction of an ivermectin mass drug administration (MDA) delivered at months 0 and 12.
Menzies School of Health Research
2,000 participants
Mar 18, 2010
Interventional
Conditions
Summary
A before and after study of scabies and strongyloidiasis prevalence in a remote Aboriginal community following the introduction of an ivermectin MDA delivered at months 0 and 12. The assessment of prevalence will be through a population census at months 0 and 12 with a cross sectional survey of treatment failure rates and acquisition rates at months 6 and 18. All residents in the remote Aboriginal community are eligible for enrolment. Each household in the community will be visited by the research team to explain the project and obtain informed consent. The population census includes screening for scabies and strongyloidiasis and collection of non-specific disease markers. Participants will then receive ivermectin if they are not pregnant, weight is 15kg or more and they have not been given ivermectin in the previous 7 days. Tretment regimens for those not eligible for ivermectin are: - Pregnant females will receive 5% permethrin cream only -weight >3.5kg and <6kg 5% permethrin only, if diagnosed with strongyloidiasis discuss with medical supervisor - weight >6 kg and <15 kg albendazole 200mg (6-10kg) or 400mg (>10kg)and 5% permethrin. - weight <3.5kg 10% crotamiton only Participants diagnosed with scabies or strongyloidiasis will receive a repeat treatment after 2-3 weeks.
Eligibility
Inclusion Criteria1
- All residents in a remote Aboriginal community and the surrounding homelands that have consented to participate
Exclusion Criteria5
- Exclusion from treatment criteria
- Allergy to any of the components of the allocated drug regimen
- Currently on, or has taken ivermectin or completed a 3 day course of albendazole in the previous 7 days
- Has had topical 5% permethrin or completed a 3 day application of 10% crotamiton in the previous 7 days
- Clinical diagnosis of crusted scabies.
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Interventions
A population census will be conducted at month 0 & 12 to screen the community for scabies and strongyloidiasis followed by a mass drug administration. The following drugs will be given according to weight and pregnancy status regardless of disease status if the eligible drug has not been given in the previoius 7 days to treat scabies or strongyloidiasis. - weight 15 kg or more and not pregnant, oral ivermectin 200 microgram/kg immediately - weight 6kg to <15 kg topical 5% permethrin immediately & 200mg (6-10kg) or 400mg (10-<15kg) oral albendazole daily for 3 days - weight 3.5kg to <6kg topical 5% permethrin immediately - <3.5kg topical 10% crotamiton daily for 3 days. Retreatment at 2-3 weeks for those diagnosed with scabies and/or strongyloidiasis will be administered as the same treatment received 2-3 weeks prior. Scabies - non-pregnant and 15 kg or greater, oral ivermectin 200micrograms/kg - pregnant or =3.5 kg and <15 kg, topical 5% permethrin - <3.5kg, topical 10% crotamiton daily for 3 days Strongyloidiasis - Non-pregnant and 15 kg or greater, oral ivermectin 200 microgram/kg immediately - 6kg to <15 kg, 200mg (6-10kg) or 400mg (>10kg) oral albendazole daily for 3 days - pregnant females will be treated with oral ivermectin 1 week after delivery with 200 microgram/kg 2-3 weeks apart if not treated by local practitioners previously - 0 to <6kg discuss with medical supervisor before treatment At month 6 and 18 participants diagnosed with disease in the previous 6 months will be followed up along with a percentage of negative participants. Only those diagnosed with disease at these 2 time points will receive treatment that will be administered as 2 treatments 2-3 weeks apart.
Locations(1)
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ACTRN12609000654257