Community-guided and evidence-based strategies to reduce the burden of Group A Streptococcus in Australian Indigenous communities
The overall objective of our study is to provide community-guided and evidence-based recommendations to public health agencies, policy makers, and funders on effective and sustainable interventions to reduce the burden of Group A Streptococcus (Strep A) in Indigenous Australians.
Context: Strep A is a bacterial pathogen responsible for superficial infections of skin and throat, precursors to both invasive and immune-mediated disease sequelae including rheumatic heart disease, and acute post-streptococcal glomerulonephritis (APSGN). Indigenous Australians have some of the highest rates of skin sores (81% of which are caused by Strep A), rheumatic heart disease and APSGN globally. Despite encouraging gains following community-based interventions over the past 20 years, reductions in skin sores have not been sustained. Research into a Strep A vaccine is ongoing and may be a long-term control strategy. However, effective interventions are needed now. This grant will provide funding to facilitate a new collaboration within the framework of an existing NHMRC project grant. It brings together models that have been developed separately by CIs Chisholm and Wu. We will leverage existing funds ($10K from this NHMRC project grant) to support the activities described.
Work to date: (I) As part of CIs Tong and Bowen’s NHMRC project grant, “Optimising interventions to reduce the burden of Group A Streptococcus in Indigenous communities”, CI Chisholm developed a detailed mathematical model of Strep A transmission. (II) CI Wu participated in the development of a static cohort model to explore the value of a Strep A vaccine in Australia. We are seeking to bring these two pieces of work together to extend the final aim of CIs Tong and Bowen’s NHMRC project. These models will provide a unique platform to estimate the likely impact of clinical and social interventions as well as the impact of pipeline Strep A vaccines on reducing the transmission and prevalence of Strep A related disease in Australian Indigenous communities.
The aims of this study are as follows:
Aim1: In consultation with key policy, public health and community partners, to adapt and use our model of Strep A transmission to simulate alternative feasible interventions in Australian Indigenous populations, to define the optimal focus (household, community, region), timing and triggers for treatment strategies for skin sores.
Aim 2: To provide policy makers and funders with an evidence-based blueprint for interventions that are most likely to succeed in Australian Indigenous populations for skin sores.