Strongyloidiasis and Health Promotion: a neglected area of Health Promotion Action

1. Methods: We conducted a review of the current literature on Strongyloides and Health Promotion. We searched OvidSp, Scopus, and Web of Science using MESh terms and text words strongyloid* and health promotion; strongyloid and health education; strongyloid* and public health; strongyloid* and Australia. We applied the action areas of the Health Promotion Framework for Action3 to map current action in strongyloidiasisin Australia. The Framework operates from an individual (downstream) to a population focus (upstream) approach. Introduction: Infection with the parasitic, small intestinal nematode Strongyloidesstercoralis is endemic in many rural and remote Indigenous communities in Australia. In northern Australia prevalences of >25% are common1.. Strongyloidiasisis clinically important because of the unique ability of the parasite to reproduce and persist within an individual for decades with the potential for those with chronic infection to develop severe disseminated disease and die2. Strongyloides does not exist in the non-Indigenous population of Australia, except for travellers , refugees, or the military. There appeared to be limited information about the health promotion strategies for the management and prevention of strongyloidiasis2. Preliminary results/progress: There is little published evidence about public health and health promotion approaches to the control and prevention of strongyloidiasis in Australia. Applying the Framework for Health Promotion Action highlighted that evidence was needed in all action areas of the Framework. Using this framework has also assisted in mapping current strategies in each of these areas to highlight the gaps in health promotion and prevention interventions for strongyloidiasis. Strongyloidiasis and Health Promotion: a neglected area of Health Promotion Action Conclusions: Strongyloidesat a high prevalence (>25%) in any community is a marker of poverty and an issue of human rights in Australia, a wealthy country. Multiple interventions including better health promotion and prevention strategies will assist in addressing this disease that does not exist in the mainstream Australian population. Appropriate screening, early intervention and treatment and improved infrastructure will also assist in reducing this neglected issue. Framework for Health Promotion Action Downstream Upstream Community and Health Development Engagement Community Action Advocacy Disease Prevention Primary Secondary Tertiary Communication Strategies Health Information Behaviour Change Campaigns Health Education and Empowerment Knowledge Understanding Skill development Infrastructure and Systems Change Policy Legislation Organisational Change Dr.JenniJudd, Professor Adrian Miller & Professor Rick Speare Primary Care Approaches Lifestyle/behaviouristApproaches Socio-ecological approaches Source: Murphy and Keleher, 2003 Key Message: The comprehensive application of the Health Promotion Framework for action highlights gaps and priorities for addressing strongyloidiasis in Australian Indigenous communities. . Map of region where strongyloidiasis is endemic in Indigenous communities. 7th National Workshop on Strongyloidiasis, Freemantle, 20-21 Mar 2012 3 References: 1. Adams M, Page W and Speare R, Strongyloidiasis: an issue in Aboriginal Communities, Rural and Remote Health 3(online), 2003. Available from: http://rrh.deakin.edu.au 2. Johnston FH, Morris PS, Speare R, McCarthy J, Currie B, Ewald D, Page W, and Dempsey W, Strongyloidiasis: A Review of the evidence for Australian Practitioners, Aust. J.Rural Health (2005) 13, 247-254. 3. Murphy B, and Keleher H, Framework for Health Promotion Action: A Discussion Paper for Course Development, School of Health and Social Development, Deakin University, Melbourne. 4. Shield JM, Page W. Effective diagnostic tests and anthelmintic treatment for Strongyloidesstercoralis make community control feasible. PNG Med J 2008;51(3/4):105-119.