Why Crusted Scabies?
Crusted Scabies is a highly contagious and chronic form of the skin disease, scabies. It develops when a person infected with scabies has a weakened immune system, allowing the scabies mites to breed prolifically.
People with scabies usually have a small number of mites (e.g. 10-15 mites) on their body. Those with Crusted Scabies have an extreme number (e.g. hundreds of thousands of mites).
Considered core transmitters of scabies, people with Crusted Scabies spread scabies to others in their household and community. Undiagnosed and/or poorly managed Crusted Scabies can lead to recurrent infestations in close contacts.
Scabies is known to underlie many skin infections in the Northern Territory, which can lead to serious conditions such as sepsis, Acute Rheumatic Fever, Rheumatic Heart Disease, and chronic kidney disease.
Elimination of Crusted Scabies is the crucial first step in addressing scabies, which is not only endemic across the Northern Territory, but has serious lifelong health implications.
Where we worked
To eliminate Crusted Scabies, we worked in partnership with our First People and local health clinics throughout the Northern Territory. The regions we worked in include Darwin (covering Darwin Urban, Top End West, Top End Central), East Arnhem Land, West Arnhem Land, Katherine and Central (including greater Alice Springs Region and Barkly).
Members of the One Disease team regularly travelled to these regions to work with the local health clinics and conduct education sessions.
One Disease initially believed there to be a similarly high prevalence of scabies and Crusted Scabies in Western Australia and Queensland, as in the Northern Territory. However, our education and detection work did not reveal a burden of Crusted Scabies patients in either of these states.
For the final years of the elimination plan - until the end of 2022, our key focus was on Scabies Free Zones education in the Northern Territory,
which has the largest Crusted Scabies burden.
How we worked
Our overall aim/outcome was to eliminate Crusted Scabies, as a public health concern, from remote Australian Indigenous communities by the end of 2022.
To achieve our aim, building on our past work, we determined the final two goals for our program were:
Promote and advocate for improved processes around Crusted Scabies detection and diagnosis
Prevent the recurrence of Crusted Scabies in clients who have been successfully treated
Our overall strategy was to enhance Crusted Scabies control by combining expertise in disease-specific areas with surveillance, education, capacity building, advocacy and research.
Our work was undertaken in close collaboration with Aboriginal Controlled Community Health Organisations, the Northern Territory Government and disease experts. We were guided by an Advisory Board of experts in our field and funded by the Australian Government Department of Health, donations from individuals and small groups, as well as by philanthropic and corporate partners, who all believe as we do: That no one should die of a preventable disease.