Project to eliminate parasitic disease in remote communities

A QIMR Berghofer-led project aims to eliminate strongyloidiasis, a little-known and potentially fatal infection that thrives in communities with poor sanitation.

The multidisciplinary project team was recently awarded a $5 million Synergy Grant from the National Health and Medical Research Council (NHMRC).

Professor Darren Gray, project lead and Director of QIMR Berghofer’s Population Health Program, said an effort to control the parasitic worm Strongyloides stercoralis and eliminate its deadly diseases is long overdue and will have a profound impact on the health of Indigenous Australians.

“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,” Gray said.

Australian First Nations communities have one of the highest rates of strongyloidiasis in the world, said Flinders University environmental health expert Professor Kirstin Ross in a new Royal Society article.

“This disease is transmitted when plumbing or other environmental health hardware components are failing,” said Ross, who is also part of the NHMRC project.

With an estimated prevalence of up to 60%, Aboriginal communities in northern Australia appear to have one of the highest rates of strongyloidiasis in the world, according to Gray.

“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,” Gray said.

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.

Dr Catherine Gordon, a member of the QIMR Berghofer team and molecular parasitologist, 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.

“Our project will develop and validate new diagnostics including inexpensive and rapid diagnostic tests which can be conducted and assessed in the field,” Gordon said.

With the support of the NHMRC Synergy Grant, QIMR Berghofer’s cross-functional 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.

Gray said in addition to eliminating strongyloidiasis, this 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.

“This research is a game changer for the control of infectious diseases of poverty globally and could ultimately contribute to the breaking of the poverty cycle by improving health and wellbeing and increasing educational attainment and economic output,” Gray said.

This research program brings together a multidisciplinary team of researchers, practitioners, policymakers and community, including 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.

Image credit: iStock.com/jarun011