Skin infections and infestations in Aboriginal communities in northern Australia

Authors

  • Bart J Currie,

    1. Tropical Medicine and International Health Unit, Menzies School of Health Research and Royal Darwin Hospital Clinical School, Flinders University, Casuarina, Northern Territory, Australia
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  • Jonathan R Carapetis

    1. Tropical Medicine and International Health Unit, Menzies School of Health Research and Royal Darwin Hospital Clinical School, Flinders University, Casuarina, Northern Territory, Australia
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  • BJ Currie, FRACP. JR Carapetis, FRACP.

  • This paper was presented, in part, at the Annual Scientific Meeting of the Royal Australasian College of Physicians in Perth, April 1999.

  • Manuscripts for this section should be submitted to Dr W Weightman.

Correspondence: AssociateProfessor Bart Currie, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia. Email: bart@menzies.edu.au

SUMMARY

The most important skin infections in Aboriginal communities in central and northern Australia are scabies and streptococcal pyoderma. Scabies is endemic in many remote Aboriginal communities, with prevalences in children up to 50%. The cycles of scabies transmission underlie much of the pyoderma. Up to 70% of children have skin sores, with group A streptococcus (GAS) the major pathogen. Group A streptococcus is responsible for the continuing outbreaks of post-streptococcal glomerulonephritis and acute rheumatic fever (ARF). The cycles of scabies transmission in dogs and humans do not appear to significantly overlap. Guidelines have been developed for community control of scabies and skin sores and successful community initiated coordinated programmes have occurred. The anthropophilic dermatophyte Trichophyton rubrum is ubiquitous in many communities, again reflecting living conditions. Other skin infections related to the tropical environment include melioidosis, nocardiosis, Chromobacterium violaceum and chromoblastomycosis. Sustainable and long-term improvements in scabies, skin sores and GAS-related disease and tinea require fundamental changes that address social and economic inequities and, in particular, living conditions and overcrowding.

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