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Trial registered on ANZCTR
Registration number
ACTRN12609000654257
Ethics application status
Approved
Date submitted
22/06/2009
Date registered
4/08/2009
Date last updated
27/11/2019
Date data sharing statement initially provided
27/11/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Beating scabies and strongyloidiasis in a remote Aboriginal community in the Northern Territory
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Scientific title
A before and after study of scabies and strongyloidiasis prevalence in a remote Aboriginal community following the introduction of an ivermectin mass drug administration (MDA) delivered at months 0 and 12.
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Secondary ID [1]
252984
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Ross Andrews
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
strongyloidiasis
3960
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scabies
4521
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Condition category
Condition code
Infection
4156
4156
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0
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Other infectious diseases
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Public Health
4806
4806
0
0
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Epidemiology
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Skin
4826
4826
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0
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A population census will be conducted at month 0 & 12 to screen the community for scabies and strongyloidiasis followed by a mass drug administration. The following drugs will be given according to weight and pregnancy status regardless of disease status if the eligible drug has not been given in the previoius 7 days to treat scabies or strongyloidiasis.
- weight 15 kg or more and not pregnant, oral ivermectin 200 microgram/kg immediately
- weight 6kg to <15 kg topical 5% permethrin immediately & 200mg (6-10kg) or 400mg (10-<15kg) oral albendazole daily for 3 days
- weight 3.5kg to <6kg topical 5% permethrin immediately
- <3.5kg topical 10% crotamiton daily for 3 days.
Retreatment at 2-3 weeks for those diagnosed with scabies and/or strongyloidiasis will be administered as the same treatment received 2-3 weeks prior.
Scabies
- non-pregnant and 15 kg or greater, oral ivermectin 200micrograms/kg
- pregnant or =3.5 kg and <15 kg, topical 5% permethrin
- <3.5kg, topical 10% crotamiton daily for 3 days
Strongyloidiasis
- Non-pregnant and 15 kg or greater, oral ivermectin 200 microgram/kg immediately
- 6kg to <15 kg, 200mg (6-10kg) or 400mg (>10kg) oral albendazole daily for 3 days
- pregnant females will be treated with oral ivermectin 1 week after delivery with 200 microgram/kg 2-3 weeks apart if not treated by local practitioners previously
- 0 to <6kg discuss with medical supervisor before treatment
At month 6 and 18 participants diagnosed with disease in the previous 6 months will be followed up along with a percentage of negative participants. Only those diagnosed with disease at these 2 time points will receive treatment that will be administered as 2 treatments 2-3 weeks apart.
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Intervention code [1]
3679
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Prevention
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Intervention code [2]
4276
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Treatment: Drugs
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Intervention code [3]
4300
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Early detection / Screening
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Comparator / control treatment
no comparator
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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1. At month 12, demonstrate:
a) a reduction in scabies prevalence from 13% at month 0 to 8% or less. Scabies will be diagnosed clinically and the results of the skin screening performed during the population census at month 0 & 12 will be compared.
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Assessment method [1]
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Timepoint [1]
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Month 0 and 12
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Primary outcome [2]
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1. At month 12, demonstrate:
b) a reduction in strongyloidiasis prevalence from 40% at month 0 to 20% or less. A reduction in prevalence will be assessed at month 0 and 12 by comparing the proportion of positive stool samples for children aged <12 years and the equivacol or positive serology results for those aged 12 years and older. Stool specimens will be examined for larvae by microscopy and culture and IgG antibodies to Strongyloides ratti will be measured in serum samples.
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Assessment method [2]
238183
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Timepoint [2]
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Month 0 and 12
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Secondary outcome [1]
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Epidemiological features of scabies and strongyloidiasis infections in a remote Aboriginal setting including spatial and household clustering will be collected during the population census at months 0 & 12 and the cross sectional survey at months 6 & 18. Demographic data will be collected on all participants at these time points to describe the epidemiological features. The data will be stratified by age, gender, disease status, treatment given and household lot number using Stata 10 and Global Positioning System(GPS) mapping.
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Assessment method [1]
8498
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Timepoint [1]
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Month 0, 6, 12 and 18
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Secondary outcome [2]
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a) Scabies/strongyloidiasis treatment failure and acquisition rates assessed at months 6 and 18. The treatment failure and disease acquisition rates will be determined by comparing the faecal/serology results for strongyloidiasis and the skin screening results for scabies from the population census conducted at months 0 and 12 with the cross sectional survey results collected at months 6 and 18. In exploring differences between susceptibles who did and did not acquire scabies/strongyloidiasis over the follow-up period, GEE will be employed given the potential for clustering by household. Simple (univariate) Generalized Estimating Equation (GEE) will be performed for each explanatory variable of interest.
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Assessment method [2]
241552
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Timepoint [2]
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Month 6 and 18
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Secondary outcome [3]
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Proportion of participants reporting any serious adverse events. Reporting of adverse events will be monitored 24-72 hours after administration of oral medications from a questionaire asked prior to administration of medication and compared with answers provided 24-72 hours after administration. The adverse events will be reported as an overall percentage of those who completed the pre and post oral treatment questionaire.
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Assessment method [3]
242486
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Timepoint [3]
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Month 0, 6, 12 and 18
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Eligibility
Key inclusion criteria
All residents in a remote Aboriginal community and the surrounding homelands that have consented to participate
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Minimum age
0
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion from treatment criteria
- Allergy to any of the components of the allocated drug regimen
- Currently on, or has taken ivermectin or completed a 3 day course of albendazole in the previous 7 days
- Has had topical 5% permethrin or completed a 3 day application of 10% crotamiton in the previous 7 days
- Clinical diagnosis of crusted scabies.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/03/2010
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Actual
18/03/2010
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Date of last participant enrolment
Anticipated
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Actual
3/10/2011
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Date of last data collection
Anticipated
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Actual
1/12/2015
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Sample size
Target
2000
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Accrual to date
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Final
1300
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
1804
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0822
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Cooperative Research Centre for Aboriginal Health
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Address [1]
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PO Box 41096
Casuarina, NT 0811
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Country [1]
4143
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Australia
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Funding source category [2]
4144
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Government body
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Name [2]
4144
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Northern Territory Research and Innovation Board
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Address [2]
4144
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GPO Box 3200,
DARWIN NT 0801
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Country [2]
4144
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Australia
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Funding source category [3]
4738
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Other
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Name [3]
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Menzies School of Health Research
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Address [3]
4738
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PO Box 41096
Casuarina, NT 0811
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Country [3]
4738
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Australia
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Funding source category [4]
257954
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Government body
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Name [4]
257954
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National Health and Medical Research Council
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Address [4]
257954
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601 .
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Country [4]
257954
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Australia
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Primary sponsor type
Other
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Name
Menzies School of Health Research
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Address
PO Box 41096
Casuarina, NT, 0811
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
4274
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Address [1]
4274
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Country [1]
4274
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Other collaborator category [1]
626
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University
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Name [1]
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James Cook University
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Address [1]
626
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101 Angus Smith Drive
Townsville QLD 4811
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Country [1]
626
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Australia
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Other collaborator category [2]
627
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University
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Name [2]
627
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Queensalnd Institute of Medical Research
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Address [2]
627
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PO Royal Brisbane Hospital
QLD 4029
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Country [2]
627
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Australia
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Other collaborator category [3]
628
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University
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Name [3]
628
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Charles Sturt Univeristy
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Address [3]
628
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Correspondence Locked Bag 588,
Wagga Wagga,
New South Wales 2678
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Country [3]
628
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
6742
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The Human Research Ethics Committee of NT Department of Health and Families and Menzies School of Health Research
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Ethics committee address [1]
6742
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PO Box 41096 Casuarina, NT, 0811
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Ethics committee country [1]
6742
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Australia
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Date submitted for ethics approval [1]
6742
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25/03/2009
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Approval date [1]
6742
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15/05/2009
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Ethics approval number [1]
6742
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09/34
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Summary
Brief summary
A before and after study of scabies and strongyloidiasis prevalence in a remote Aboriginal community following the introduction of an ivermectin MDA delivered at months 0 and 12. The assessment of prevalence will be through a population census at months 0 and 12 with a cross sectional survey of treatment failure rates and acquisition rates at months 6 and 18. All residents in the remote Aboriginal community are eligible for enrolment. Each household in the community will be visited by the research team to explain the project and obtain informed consent. The population census includes screening for scabies and strongyloidiasis and collection of non-specific disease markers. Participants will then receive ivermectin if they are not pregnant, weight is 15kg or more and they have not been given ivermectin in the previous 7 days. Tretment regimens for those not eligible for ivermectin are: - Pregnant females will receive 5% permethrin cream only -weight >3.5kg and <6kg 5% permethrin only, if diagnosed with strongyloidiasis discuss with medical supervisor - weight >6 kg and <15 kg albendazole 200mg (6-10kg) or 400mg (>10kg)and 5% permethrin. - weight <3.5kg 10% crotamiton only Participants diagnosed with scabies or strongyloidiasis will receive a repeat treatment after 2-3 weeks.
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Trial website
http://www.menzies.edu.au/page/Research/Projects/Skin/Scabies_and_worms/
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Trial related presentations / publications
http://www.menzies.edu.au/page/Research/Indigenous_Health/Skin/Scabies/ Cross-Cultural, Aboriginal Language, Discovery Education for Health Literacy and Informed Consent in a Remote Aboriginal Community in the Northern Territory, Australia. Shield JM, Kearns TM, Gar?gulkpuy J, Walpulay L Gundjirryirr R Bundhala L, Djarpanbuluwuy V, Andrews RM, Judd J. Trop Med Infect Dis. 2018 Jan 29;3(1). pii: E15. doi: 10.3390/tropicalmed3010015. Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community. Kearns TM, Currie BJ, Cheng AC, McCarthy J, Carapetis JR, Holt DC, Page W, Shield J, Gundjirryirr R, Mulholland E, Ward L, Andrews RM. PLoS Negl Trop Dis. 2017 May 15;11(5):e0005607. doi: 10.1371/journal.pntd.0005607. eCollection 2017 May. Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. Kearns TM, Speare R, Cheng AC, McCarthy J, Carapetis JR, Holt DC, Currie BJ, Page W, Shield J, Gundjirryirr R, Bundhala L, Mulholland E, Chatfield M, Andrews RM. PLoS Negl Trop Dis. 2015 Oct 30;9(10):e0004151. doi: 10.1371/journal.pntd.0004151. eCollection 2015 Oct. Soil-Transmitted Helminths in Children in a Remote Aboriginal Community in the Northern Territory: Hookworm is Rare but Strongyloides stercoralis and Trichuris trichiura Persist. Holt DC, Shield J, Harris TM, Mounsey KE, Aland K, McCarthy JS, Currie BJ, Kearns TM. Trop Med Infect Dis. 2017 Oct 4;2(4). pii: E51. doi: 10.3390/tropicalmed2040051.
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Public notes
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Contacts
Principal investigator
Name
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Ms Therese Kearns
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Address
29117
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PO Box 41096
Casuarina, 0811
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Country
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Australia
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Phone
29117
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+61 407 190 675
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Fax
29117
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Email
29117
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[email protected]
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Contact person for public queries
Name
12274
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Therese Kearns
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Address
12274
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PO Box 41096
Casuarina, NT, 0811
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Country
12274
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Australia
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Phone
12274
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+61 407 190 675
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Fax
12274
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+61 8 8927 5187
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Email
12274
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[email protected]
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Contact person for scientific queries
Name
3202
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Therese Kearns
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Address
3202
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PO Box 41096
Casuarina, NT, 0811
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Country
3202
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Australia
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Phone
3202
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+61 8 8922 8196
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Fax
3202
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+61 8 8927 5187
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Email
3202
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community.
2015
https://dx.doi.org/10.1371/journal.pntd.0004151
Embase
Strongyloides stercoralis seropositivity is not associated with increased symptoms in a remote Aboriginal community.
2021
https://dx.doi.org/10.1111/imj.14884
N.B. These documents automatically identified may not have been verified by the study sponsor.
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