Projects

Check4Strep

Check4Strep is a co-designed community-based project to demonstrate where the Strep A is and how it’s likely being spread. Obtaining and sharing local data, and developing a local (place-based) response, will be defining features of the study to foster engagement and motivation, and ensure responses are locally relevant.

The centrepiece of Check4Strep is a series of community Strep A engagement days in which the target population will be invited to participate in conversations about Strep A, and get tested for Strep A. The study will collect swab samples for point-of-care testing, and swab and cough samples for culture and Strep A identification at the Menzies laboratory.

Exploring Healthy Living Practice 2: Washing clothes and bedding

STARFISH is looking into the role of Healthy Living Practice 2 ‘Washing clothes and bedding’ to reduce the spread of Strep A and other causes of skin infections. We're achieving this through the following projects:

1. Mapping the growth of rural and remote Aboriginal and Torres Strait community laundries in Australia
2. Exploring barriers and enablers to household washing machine use in remote Aboriginal and Torres Strait Islander communities 
3. Reviewing evidence for the spread of major skin pathogens and ectoparasites via fabrics, and methods for effective laundering 
4. Understanding the presence of Strep A on fabrics 
5. Understanding the standards landscape for laundering in Australia 
6. Guidance for effective HLP2 for i) general health and wellbeing, and ii) to manage skin infections  
7. 'Yarning Quiet Ways About Washing’ 
8.  Health considerations for beds and mattresses

Would you like to talk with us about any of these projects? Please email STARFISHProgram@thekids.org.au or A/Prof Rosemary Wyber (rosemary.wyber@thekids.org.au), Dr Rachel Burgess (rachel.burgess@thekids.org.au) or Dr Kate Summer (kate.summer@thekids.org.au). We also have a monthly ‘drop-in’ meeting where we discuss these projects and other HLP2 considerations. Please email us for more information.

How can communities use their own primary care data to understand the effects of housing on health outcomes?

Functional housing and infrastructure are critical for leading a healthy life. Inadequate housing and living conditions can reduce access to Healthy Living Practices, and increase rates of infectious disease, including Strep A infections. Local clinics are key in managing housing-associated infectious diseases (HAIDs). Understanding how often people need to visit the clinic for HAIDs would be a useful way to monitor the impact of different initiatives that seek to improve housing and living conditions. However, there is currently no agreed list of HAIDs or ways to use clinic data, which makes long-term monitoring and evaluation difficult and dependent on intensive research projects. 

We are seeking to develop a tool to monitor HAIDs using routinely collected primary care (clinic) data. This would enable community-controlled health services to generate, interpret and use their own data, and communicate their stories about housing and health. Our work began with a perspective article followed by a systematic review to develop a list of HAIDs for potential inclusion in the tool. Soon, we will be consulting with key knowledge holders to understand important views on how to best approach this work, followed by a consensus-based decision-making process to refine a shorter list of HAIDs. Alongside this, we are exploring the technical aspects of a HAID tool with primary care community development partners. 

Efficacy of Strep A self-swabbing

The ‘Efficacy of Strep A self-swabbing’ (ESTA) Study aimed to undertake surveillance of those working in a medical research institute to determine the sensitivity of self-collected collected pharyngeal swabs for Strep A among asymptomatic carriers. Results paper coming soon.

Optimising targeted investigations of Strep A transmission and Environmental Health Initiatives (EHIs) assessment: a model-based approach

In this project, we will develop an adaptable framework that will identify the optimal design of Strep A and EHI studies. Our parameter estimations will provide a more nuanced understanding of transmission and so help to identify elements of Strep A transmission pathways that can be targeted by EHIs to disrupt transmission. A Two-Way Learning Panel will meet throughout this project to enable capacity-building, ensure cultural sensitivity, and to maximise the relevance and uptake of findings.

Good living, good health project in remote Northern Territory

Research team
Paul Memmott, Nina Lansbury and Andy Redmond from The University of Queensland

Background research
The design and options for this project are based on the research team’s earlier work on how 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 liveability of yard spaces, and to increase ventilation in the home.

Tennant Creek trial: community centre-based washing machines

Julalikari Council Aboriginal Corporation in Tennant Creek and The University of Queensland will trial community centre-based washing machines in Tennant Creek to evaluate impacts on skin and throat infections of householders by supporting a healthy housing setting.

Project values
This research has been co-developed with values that:

• Trial a household-level initiative/s that seek to reduce skin infections from Strep A bacteria, such as by enabling social distancing, washing of hands, bodies and laundry
• Are wanted by community and are delivered in a way that is acceptable to community
• Leave something useful behind in community that householders value as an appropriate exchange for the time they have invested in engaging with researchers and using the item (such as working washing machines and new beds)
• Link in with/ enhance existing initiatives and have a level of positivity longevity/ sustainability beyond the research timeframe
• Are evaluated before, during and after the initiative. This evaluation could be a mixture of yarns about perceived use and benefit of the initiative, yarns about how often householders have had skin infections, and perhaps permission to access existing health data (in clinic, in hospital, in pathology) for householders.