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QIMR Berghofer researchers tackle deadly disease endemic in remote Indigenous communities

Giovanni Torre -

A funding grant will launch a QIMR Berghofer-led mission to eliminate one of the world's most neglected and dangerous tropical diseases, endemic in remote Indigenous communities across Australia.

The multidisciplinary team has been awarded a $5 million Synergy Grant from the National Health and Medical Research Council (NHMRC) to eliminate strongyloidiasis, a little-known and potentially fatal infection caused by the parasitic worm, Strongyloides stercoralis which thrives in communities with poor sanitation.

Project lead and Director of QIMR Berghofer's Population Health Program, Professor Darren Gray, said an effort to control the parasite and eliminate its deadly diseases is "long overdue", and will have a "profound" impact on the health of Indigenous people.

"Strongyloidiasis is the most neglected of the neglected diseases. Despite being preventable and treatable, there is currently no global or national control strategy to manage its identification, prevention and management," he said.

"With an estimated prevalence of up to 60 per cent, Aboriginal communities in northern Australia appear to have one of the highest rates of strongyloidiasis in the world.

"Our project has the potential to eliminate this potentially fatal infection, which has a devastating effect on some of our country's most vulnerable people."

Strongyloidiasis symptoms are highly variable but the infection can lead to life-threatening diseases including sepsis and pneumonia. It is caused by roundworms which enter the body through the skin and invade the lungs and gut. Infestations are linked to faecal contamination and dogs may also play a role in the parasite's life-cycle.

Addressing poor sanitation and hygiene, a lack of clean water, and limited access to health care and health education are crucial to controlling the parasite.

QIMR Berghofer team member and molecular parasitologist Dr Catherine Gordon said strongyloidiasis is "notoriously difficult" to detect.

"If you don't look for this disease, you won't find it. To date, there has been a lack of screening, testing, and education," she said.

"Our project will develop and validate new diagnostics including inexpensive and rapid diagnostic tests which can be conducted and assessed in the field."

With the support of the NHMRC Synergy Grant, QIMR Berghofer's team will seek to determine "the true burden" of the disease in East Arnhem Land and what role animals play in transmission.

The team will pilot an elimination program at two sites, combining treatment, improved sanitation and hygiene, community engagement, education, veterinary management and surveillance.

Professor Gray said in addition to eliminating strongyloidiasis, the program is expected to reduce the impact of other common and preventable infections of poverty including scabies and group A streptococcus, ultimately reducing the burden of Rheumatic Heart Disease.

The project is expected to have far-reaching consequences in the treatment and elimination of a number of serious diseases of poverty in Australia, South-East Asia and beyond, with Professor Gray describing the research as "a game-changer for the control of infectious diseases of poverty globally".

"(It) could ultimately contribute to the breaking of the poverty cycle by improving health and wellbeing and increasing educational attainment and economic output," he said.

The research program brings together a multi-disciplinary team of researchers, practitioners, policy makers, and community, including critical partnerships with Strongyloides Australia, Miwatj Health Aboriginal Service, Animal Management in Rural and Remote Indigenous Communities, East Arnhem Regional Council, NT Health, NT Power and Water and NSW Health Pathology.

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