The preventable burden of Strep A infections in remote Indigenous communities

Samuel Barnes, University of Queensland, QLD

For Aboriginal and Torres Strait Islander peoples – hereon respectfully referred to as Indigenous - living on Country is crucial for connection to culture and community. It is also important for self-determination, facilitating choice in life, participation in decisions and control of social and cultural development. However, the perpetuation of colonisation has meant that the strengths that come from living on Country may be outweighed by poorer health outcomes given prejudiced policy adversely affects these communities.

Strep A infections, also referred to as Group A Streptococcus, and their downstream consequences are one such example of an infection sustained in high rates among remote living Indigenous communities despite their reduction in prevalence elsewhere in the nation. While Strep A infections of the skin and throat (impetigo and pharyngitis) can be controlled by penicillin, untreated superficial infections can progress to a series of acute and chronic immune-mediated diseases. Most notably are acute rheumatic fever (ARF) leading to rheumatic heart disease (RHD) and acute post-streptococcal glomerulonephritis (APSGN) leading to chronic kidney disease (CKD). Given the preventable nature of diseases and the specific role of social determinants in Strep A infection and progression, these conditions are acknowledged as diseases of poverty.

Specifically, primordial causes of Strep A infection are known to be correlated to several social determinants of health, particularly those in the home environment. There are several examples of prevention strategies to halt Strep A transmission – for example, publicly accessible laundromats in Barunga (Northern Territory) have been associated with a widespread reduction of impetigo and scabies, and Indigenous environmental health officers who are critical in the support of Healthy Living Practices in Indigenous communities. Further, health promotion campaigns targeting personal hygiene and household cleanliness have successfully reduced rates of trachoma with flow-on effects for other infections diseases; Strep A included. However, there is a need for a greater understanding as to which programs and interventions yield the greatest success.

As part of the STopping Acute Rheumatic Fever Infections to Strengthen Health (STARFISH) grant funded by the NHMRC and commencing in late 2022, we propose examining physical infrastructure and resource influences, otherwise known as health hardware, as well as crowding, while making a strong case for in-home trials to understand the complexities of Strep A transmission prior to establishing exploratory scientific research.

Understanding Animal Management Needs in Far North QLD

Helen Bigmore and Bonny Cumming, AMRRIC and Samuel Hudson, Kowanyama Aboriginal Shire Council, NT

AMRRIC is partnering with Indigenous Local Government Authorities (LGA) in Far North QLD to undertake Animal Management Needs Assessments. These assessments involve AMRRIC staff working alongside local Animal Control or Environmental Health Officers to undertake a community-wide dog and cat census, interview key local staff and evaluate the facilities and equipment available to support each LGA’s animal management program. Information collected through each needs assessment is reported back to each participating LGA, as well as collated into an advocacy report.

Ensuring your promotional materials have the greatest impact on the people you service

Isaac Buckle and Camelia Juboy, Shire of Derby West Kimberley, WA

Creating health promotional materials that are suitable for your communities and clients can be challenging at best. How do you ensure from the get go that what you’re creating will have a long lasting impact? Through this poster, we’ll be breaking down two health initiatives which have been a core part of the Shire of Derby West Kimberley’s (Shire) Aboriginal Environmental Health program. We’ll explore our ‘Live Deadly’ health campaign as well as the Environmental Health Referral program; which is being implemented by other environmental health workers across the state.

Our ‘Live Deadly’ Health campaign, officially launched in 2019, was created to combat a gap in health promotion materials aimed at adults and young families. Its aim was to increase the level of health literacy within this target audience. We found that there is one main component to ensuring that your health messages are not only well received, but also eye catching; with a long lasting legacy in increasing environmental health awareness. That main component is consulting and including your local community members every step of the way. We’ll explore the challenges in using locals as your models, as well as using appropriate language to break down your health messages into digestible sections. We’ll also be looking at what the future has in stall, with the launch of our Gibb River Road edition.

The next program we will break down is the Shire’s Environmental Health Clinical referral program. Originally implemented in 2014, it hoped to cover the gap created in sending sick patients back to an unsuitable environment. Over the past 8 years, we’ve been able to create a reliable method in initiating environmental health referrals, as well as creating meaningful promotional materials. We will present on the many tools and aids we have developed and what we are hoping to produce in the future; to create greater ownership and pride for better health outcomes.

Overall, the poster presentation will aim to breakdown what obstacles may arise in creating community specific health promotion materials. We will present where to begin, what has worked for us and how we are still reviewing and improving our programs. The overall aim of the poster will demonstrate how community consultation is the foundation to any great product, and how trust and familiarity work hand in hand to arrive there.

Protecting our community together- a local united response

Isaac Buckle and Camelia Juboy, Shire of Derby West Kimberley, WA

In early 2020 when globally agencies responded to emerging COVID 19, the Shire as no different. This presentation aims to share the challenges, the wins and some of the new ideas and adaption to service the team put in place for a local response to a global issue. Being a regional community collaborating with local agencies has been key to provide an effective response

Compassionate Community Animal Care and Control

Kaylene Doust, Roper Gulf Regional council, NT

Roper Gulf Regional Council is committed to improving animal health, welfare and control within our region. RGRC wants to avoid situations where socioeconomic circumstances of animal owners and the subsequent inability to afford veterinary services, results in poorer human and animal health outcomes and traumatic forced mass culling of unwanted or sick animals.
The strengths of our program are:
Relationships – Building trust between the vet team and Roper Gulf communities
Consistency – Three visits per year in RGRC communities and extended twice yearly visits to Borroloola/Robinson River including desexings
Respect – Owner consent to treatment
Door to door conversations, information sessions and school based education
Employment/ training opportunities for local peoples. 

Researching how to reduce the incidence of Strep A infections

Stephanie Enkel, Dr Hannah Thomas, Dr Nina Lansbury, Prof Jonathan Carapetis and Assoc Prof Asha Brown, Telethon Kids Institute, WA

Australia is a pet-loving nation; companion animals are a big part of our lives and our families. This applies equally to Aboriginal communities, where pets can play even more significant roles as guardians and as companions. However, challenges to the health and welfare of pets can parallel those in human populations in remote Aboriginal communities and access to – and uptake of – veterinary services can be limited. Pet dogs and cats in remote and disadvantaged Aboriginal communities experience a higher incidence of infectious disease and misadventure, overpopulation is frequently a problem and mortality rates are high. In addition, features of Aboriginal community housing can present challenges to responsible pet ownership. Inadequate gates and fencing, in particular, often lead to pets roaming and can result in a high incidence of nuisance behaviours and compromised community safety.

Our research builds on the approach of organisations such as AMRRIC (Animal Management in Rural and Remote Indigenous Communities) in working collaboratively with Aboriginal communities to deliver culturally sensitive companion animal health programs that aim to achieve sustainable improvements in animal welfare and in community well-being. This study aims to evaluate an RSPCA Indigenous Community Companion Animal Health Program (ICCAHP) by quantifying the effects of the program on dog and cat population dynamics and pet health. The study also aims to better understand the relationships of Aboriginal pet owners with their pets in remote NSW and determine if community housing in NSW is effective in supporting responsible pet ownership. The study is being conducted in association with RSPCA ICCAHPs funded by NSW Health, Aboriginal Environmental Health Unit in Aboriginal communities across NSW. Pet owners participating in ICCAHPs were invited to complete a questionnaire about their pets and their experience with the ICCAHP.

This presentation will outline preliminary findings of our research which demonstrate that companion animal health programs can have significant positive impacts on companion animal populations with important implications for animal health and welfare. The findings also highlight the important positive role of companion animals in Aboriginal communities and highlight the potential of companion animal health programs for strengthening relationships with communities.

Companion Animal Education in Remote Communitiesn

Michelle Hayes, AMRRIC, NT

AMRRIC is a One Health organisation focused on collaborating with Aboriginal and Torres Strait Islander communities to provide animal-education that focuses on improving the health outcomes of people, animals, and the environment. Education includes parasitic management, dog health needs, hygiene programs, implications of cats in communities, and a dog/animal tracking and health needs program. These programs occur in many remote communities across Australia and aim to deliver materials that are engaging, culturally appropriate, relevant, and meaningful to remote community audiences.

AMRRIC’s One Health Approach: Research, Training and Education and Product Availability

Jessica Hoopes, Katrina Doody and Michael Spry, AMRRIC, NT

The importance of One Health approaches that acknowledge the links between humans, animals and the environment are becoming increasingly recognised. Animal Management in Rural and Remote Indigenous Communities (AMRRIC) works to improve the lives of Aboriginal and Torres Strait Islander people, their companion animals and their shared community. Focusing on the value of One Health initiatives, AMRRIC is expanding its activities in the areas of most need, including One Health research, training and educational programs and improving local availability of animal health programs.

Environmental health, climate change and remote communities.

Nina Lansbury, Paul Memmott, Andrew M Redmond, University of Queensland, Patrick (Pepy) Jakkamarra Simpson and Patricia Nururla Frank, Anyinginyi Health Aboriginal Corporation, NT

Climate change raises risks to the health of First Nations Peoples in remotely-located communities. These include extreme weather events and heat, drinking water contamination, and to food supply chains and residential mobility.
This presentation provides examples and options from Central Australia (Barkly region) and the Torres Strait Islands.
Supporting remote Indigenous communities to minimise the health risks from climate change is essential to Closing the Gap in Indigenous equity.
Environmental Health Workers (EHWs) based in remote communities have a key role to play..

Milpa’s Six Steps to Stop Germs: A unified approach to preventable childhood infections

Nick Wilson, Indigenous Eye Health - The University of Melbourne, VIC

Good hygiene practices and access to health hardware can prevent a range of childhood infections including otitis media, respiratory infections, skin infections, trachoma, tooth and gum disease and COVID 19. 'Milpa's Six Steps to Stop Germs' are a set of unified hygiene health promotion resources that help to prevent trachoma and other childhood infections.