Over a quarter of school-aged children and 12 percent of those aged under one year (infants) in Fiji have skin sores at any given time according to an informing Australian and Fijian research paper recently published in PLoS Neglected Tropical Diseases.
The study also found an alarmingly high rate of scabies in 18 percent of school children and 14 percent of infants highlighting the lack of accurate assessments of these diseases, particularly in tropical developing countries.
“Skin sores and scabies are often thought of as nuisance diseases, but have the potential to cause severe disease and even death if infection becomes complicated,” says Dr Andrew Steer of the University of Melbourne, who conducted the study.
“They are the diseases of those living in poverty. Poor hygiene and living conditions foster these diseases,” he said.
The collaborative team from three Australian institutions (University of Melbourne, Menzies School of Health Research and Queensland Institute of Medical Research), teamed up with the Fiji School of Medicine and the Fiji Ministry of Health to perform a series of studies in 4000 infants and primary school children in Fiji.
The majority of the cases of skin scores in the study were caused by the group A streptococcus (‘strep’) (80 percent in school aged children, and 49 percent in infants), followed by Staphylococcus aureus (‘Staph’).
Although the study was limited to Fiji, the authors consider that similar findings are likely to be found in surrounding Pacific nations including Australia.
“Even higher rates of scabies and sores are found in remote Aboriginal communities in NT,” says Professor Jonathan Carapetis, Director of the Menzies School of Health Research and a senior author on the paper.
“We have made progress on controlling them but rates are still high. We need to look at new ways to deliver scabies treatments and antibiotics for skin sores, which we are doing” he said.”
Previous research in the area also shows that this study has implications for other diseases in areas where scabies is also present.
It has been identified that scabies and associated strep skin infections are linked to Rheumatic Heart Disease and Chronic Kidney Disease as well as severe infections caused by staph and strep bacteria.
Rheumatic Heart Disease is a big killer in Aboriginal and Pacific Islander people in adolescent and young adult years.
“We know that skin infections are often the result of underlying scabies,” Professor Carapetis said.
The cause of Rheumatic Heart Disease is a result of the body’s abnormal reaction to the strep bacteria – in the past thought to be a strep throat infection.
“We hypothesize that Rheumatic Heart Disease could follow a strep bacteria in the skin, developed as a result of scabies,” he said.
“The time has come for more concerted action against childhood skin diseases in Fiji and other tropical developing nations, as well as in Australian Aboriginal communities” noted the authors, and that further research into practicable, effective and sustainable control measures for these diseases is required.