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. 2024 Sep 23;21(9):1262.
doi: 10.3390/ijerph21091262.

Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia

Nina Lansbury  1 , Paul C Memmott  1 , Rosemary Wyber  2   3 , Clarissa Burgen  4 , Samuel K Barnes  1 , Jessica Daw  3 , Jeffrey Cannon  3 , Asha C Bowen  3   5 , Rachel Burgess  3 , Patricia N Frank  4 , Andrew M Redmond  1   6
Affiliations

Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia

Nina Lansbury et al. Int J Environ Res Public Health. .

Abstract

Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.

Keywords: Indigenous health; environmental health; group A Streptococcus (Strep A); housing; impetigo; rheumatic heart disease.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cost estimates (upfront and ongoing) of each of the environmental health initiatives for a model remote Indigenous community in Northern Territory, Australia.
See this image and copyright information in PMC

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