A Doctors Dream - A Story of Hope from the Top End

About Crusted Scabies

A neglected and misunderstood disease

scabies 1Crusted scabies is a severe, highly infectious and debilitating form of scabies. It occurs when an individual’s immune system is not able to control scabies reproduction, resulting in millions of mites covering the body. The disease is life threatening due to complications from severe skin infections. At-risk people  in remote communities succumb to lifelong disease and this has significant impact on their psychosocial health and quality of life.

Case reports from remote communities in the 1940 s published in the Medical Journal of Australia (MJA) describe the significant suffering, disfigurement and scorn suffered by patients with the condition. More than 60 years on, the suffering and stigma continues.scabies 2

Family members develop recurrent scabies, skin sores and complications, children suffer weight-loss, have needed sedation to sleep and have been excluded from school. In adults it results in significant disruption to employment and personal relationships. Patients suffer their illness and shame for decades. Being highly infectious, managing it is the first step towards controlling scabies as a public health issue in remote communities.

 

 

 Simple Scabies and skin sores – a disease borne of disadvantage

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Scabies is a parasitic mite that lives and lays eggs in the upper layer of skin. In some remote communities, scabies affects 7 out of every 10 children before their first birthday. Scabies causes a severe itch that often leads to damage to the skin and secondary infection. The skin sores resulting from scabies have been associated with chronic kidney and rheumatic heart disease.

 

Crusted scabies in remote Australia, a new way forward: lessons and outcomes from the East Arnhem Scabies Control Program

MJA Article Dr Buddhi Lokuge By Buddhi Lokuge et. al, MJA 200 (11) • 16 June 2014 Results published in the Medical Journal of Australia show days spent in hospital for crusted scabies down by 80% and spread of scabies to immediate household contacts down by 75%, in families supported by this model of care.

For clinicians managing crusted scabies: Treatment guidelines and manual

“A new model of care to support families to overcome a debilitating disease”. A model adopted by remote clinic guidelines (CARPA 6th edition)