Healthy Skin Workshop A/Prof Asha Bowen Head, Skin Health, Telethon Kids Institute [email protected] International Meeting on Indigenous Child Health, 22 – 24 March 2019
Healthy Skin Workshop
A/Prof Asha BowenHead, Skin Health, Telethon Kids Institute
International Meeting on Indigenous Child Health, 22 – 24 March 2019
Faculty/Presenter Disclosure
• In the past 12 months, Dr Asha Bowen has no relevant financial relationships with the manufacturer(s) of commercial services discussed in this CME activity
• I do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.
• All of the photos used are consented for use in presentations and online. Where possible, the communities represented want to present images of Healthy Skin. We have attempted throughout to frame all images in a positive light to reflect this important strengths based approach to achieving healthy skin.
Learning Objectives
1. Identify different types of skin infections including scabies, skin sores and crusted scabies
2. Understand the importance of community consultation and strategies to partner in research that is important for improving Indigenous health outcomes
3. Understand the integration of health promotion and environmental health into programs for skin infection control
Adapted from Engelman et al PLoS NTD 2013
Australian Aboriginal Children are:
• World Leaders for impetigo prevalence (median 45%)1,3
• Top 5 for scabies prevalence (median 10 – 25%)1,2,3
1Bowen et al PLOS One 2015; 2Romani et al Lancet Inf Dis 2014; 3May et al MJA 2016
Systematic Review Reference
SR commissioned by Kimberley Aboriginal Health Planning Forum to inform skin treatment in the context of a region-wide APSGN outbreak affecting >130 children (~2% of Aboriginal childhood population)
National Healthy Skin Guideline
Mr Glenn Pearson, Head Aboriginal Programs, Telethon Kids Institute, Dr Asha Bowen and National Indigenous Health Minister, Mr Ken Wyatt launching the Guideline 2 May 2018
www.telethonkids.org.au/skin-guidelines
• Free to download, print, share, use & train health care workers
• Endorsed by 18 Aus organisations• >2500 views • >850 downloads• >200 quiz completions
75.00
80.00
85.00
90.00
95.00
100.00
105.00
Treatment success Clinical success Sore resolution
Day 7 results
BPG SXT3 SXT5 SXT
0
5
10
15
20
25
30
35
40
45
Baseline 12 months Baseline 12 months
Scabies Impetigo
Pre
vale
nce
(%
)
Standard Permethrin Ivermectin
94% reduction
67% reduction
• Moisturise dry, cracked skin
• Cover skin sores from dirt or
being scratched
• Apply Bush Medicines
• Bathe/wash children every day
• Clean hands with soap & water
• Wash towels, clothes & bedding &
dry in the sun
• If skin is not improving after
a day or two, speak to your
health clinic
CareClean
CheckHome
• Make an Environmental
Health referral to help
check house
10. Maintaining Healthy Skin
Acknowledgements
Jonathan Carapetis, Vicky O’Donnell, Bec Smith, Ray Christophers, Roz Walker, Juli Coffin, Julie Marsh, Andrew Steer, Steven Tong, David Atkinson, Glenn Pearson, Kristen White, Tom Snelling, David Hendrickx, Clancy Read, Frieda McLoughlin, Marianne Mullane, Rachael Donovan, Tim Barnett, Bec Pavlos, Jeff Cannon, Hannah Mann, Monica Frain, Rahaney Poelina, Tracy McRae, John Jacky, Janine McNamara, Dylan Barth,
+ all teams throughout Kimberley
“Gotta keep it strong”https://www.youtube.com/watch?v=bhLU5Qnf0n8
Changes in Practice Slide (1)
• Skin infections are under-recognised and under-appreciated.
• Commit to training health care workers about the importance of skin infection recognition and treatment.
Changes in Practice Slide (2)
• Skin infections are common, are a visual diagnosis and may present in combination with other illnesses.
• Commit to recognition using visual handbooks to guide health care workers.
Changes in Practice Slide (3)
• Skin infections should be recognised and treated early to reduce transmission to other children and family members
Changes in Practice Slide (4)
• Consider opportunities to prevent further skin infections e.g. education on hand and body washing, clothes washing, checking children regularly for skin infections, maintenance to achieve functional health hygiene in homes
www.telethonkids.org.au/[email protected] @ashabowen