A research team has halved the proportion of potentially deadly skin infections among Indigenous children who took part in their study, which experts hope will “make a big difference for the next generation”.
Almost half of remote-living Indigenous children have skin sores – such as impetigo and scabies – at any one time.
Prof Asha Bowen, a paediatric infectious diseases specialist, said researchers were concerned these high rates of infection were so common in remote communities that they had become normalised.
It means some families don’t seek treatment and some clinicians don’t recognise and diagnose the skin sores, she said.
But untreated skin infections can cause life-threatening illnesses, including rheumatic heart disease, sepsis and kidney disease, all of which Indigenous Australians are disproportionately affected by.
Bowen and her colleagues from the Kids Research Institute Australia, along with researchers from several Aboriginal health organisations, conducted 3,084 skin checks in 777 Indigenous children in the Kimberley region in Western Australia.
It took them four years – “the magnitude of the project was huge,” Bowen said.
Researchers worked closely with community members, schools and local health services to complete skin checks and share culturally appropriate information about treatment and prevention.
At the beginning of their study, 40% of the children had skin sores. By the end of the study this had halved to 20%.
By contrast, 5% of children in metropolitan areas have skin sores, Bowen said. Hospitalisation rates for Aboriginal children due to skin infections are 15 times higher than non-Aboriginal children.
Improved skin checks were the biggest factor in reducing infections, Bowen said, and community feedback was “loud and clear” that skin checks should continue.
But investment in environmental health, including safe housing and regular maintenance, is needed to maintain lower infection rates, the study found. Bowen said maintenance access issues can make behaviours such as hand washing difficult in remote areas, where “it might take three to six months” for someone to come to fix a broken tap.
Researchers also encouraged skin clinics to administer medicine orally, rather than through injection or through a cream, because oral medication was better tolerated and preferred by many patients, improving treatment rates.
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The findings, published on Wednesday in the journals the Lancet Child & Adolescent Health and eClinicalMedicine, highlighted the importance of community involvement in health interventions.
The results of the trial were shared with the study participants and their community before being shared with the journals, in recognition that local involvement was pivotal.
The results informed a recent update to the Kimberley skin guideline and National Healthy Skin Guideline.
The researchers created resources including storybooks translated into local languages and a hip-hop YouTube video that shared healthy skin messages in the children’s own words. An app promoting healthy skin will also be launched.
Bowen hopes that after seeing the study’s findings organisations continue to partner with communities to improve skin health.
Prof Aunty Kerrie Doyle, the associate dean of Indigenous health at the University of Western Sydney, called the study “brilliant” and was hopeful the findings would “make a big difference for the next generation”.
She said skin infections in Indigenous communities were “horrendous” due to overcrowding and inadequate resources, such as water, medicine, clean sheets and washing machines.
Doyle said it was important that greater focus be placed on early intervention and research co-designed with Indigenous communities.