The SToP Trial: See, Treat and Prevent Impetigo and Scabies

McLoughlin F1, Bowen AC1 -4, Carapetis JR1-4, Tong SYC3,5, Coffin J6, Steer A7, Walker R1,4, Marsh J1,4, Christophers R8, O’Donnell V9, Smith B10.

1Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute,  2Princess Margaret Hospital for Children, 3Menzies School of Health Research, 4University of Western Australia, 5Doherty Institute, 6Notre Dame University, 7Murdoch Childrens Research Institute, 8Nirrumbuk Aboriginal Corporation, 9Kimberley Aboriginal Medical Services, 10Western Australia Country Health Services, Kimberley



In remote Australian Aboriginal communities, skin infections (scabies and impetigo) are common. At any one time, 45% (IQR 34-49%) of children have impetigo and 5 – 35% have scabies.


Materials and Methods:

The SToP Trial is a cluster randomised trial (stepped-wedge design) that evaluates an intervention program intended to enhance sustainable skin health practices. Under Aboriginal leadership, it will be rolled out in four Kimberley community clusters, commencing early 2018. Three components will be evaluated: a) “See”ing skin infections through development of training resources/packages within a community dermatology model through school-based surveillance of the primary outcome; b) “Treat”ing skin infections using the latest evidence implemented using the Structured Administration and Supply Arrangements ‘standing orders’ namely co-trimoxazole 3 days BD for impetigo, ivermectin on days 0 and 8 for scabies cases and their contacts and holistic care including treatment of those identified with crusted scabies; and c) “Prevent”ing skin infections through embedded, culturally informed and developed health promotion and environmental health activities.


Outcome and Conclusions:

The primary outcome is to reduce the burden of impetigo in school aged Aboriginal children (5-9 years) by 50%. School-aged children have a high disease burden and are identifiable. This outcome is likely to reflect a reduction in skin infections across all ages.