Eliminating Crusted Scabies: The One Disease Experience in Remote NT Communities

Ms Michelle Dowden1, Ms Meg Scolyer1, Ms Irene OMeara1, Ms Hannah Woerle1

1One Disease, Darwin, NT, Australia


Aboriginal communities in the Northern Territory, Australia, have some of the highest reported rates of scabies in the world. Secondary skin infections associated with scabies can lead to ongoing heart and kidney complications.
In 2014, scabies was added to the World Health Organisation’s list of Neglected Tropical Diseases (NTDs); and in 2017, the scabies classification was elevated from Category B to Category A in the NTD profile. Scabies is the only WHO Category A NTD that does not yet have a roadmap for Elimination.

What is happening:
To date, the not-for-profit One Disease is the only organisation with an informed, planned approach for addressing Crusted Scabies in the Northern Territory; and is leading the way in developing a framework for Elimination. One Disease aims to Eliminate Crusted Scabies from the NT by 2019, and across Australia by 2022.
Preliminary work in readiness for Elimination of Crusted Scabies has seen One Disease focus on two key aims: Improve detection and diagnosis of Crusted Scabies; and prevent recurrence of Crusted Scabies episodes requiring hospital.
Utilising a quality improvement framework, One Disease alongside local health services, is reshaping health systems, to better facilitate coordinated care for people with Crusted Scabies. One Disease are enabling systems change at multiple levels – family, community health centre, and hospital.

Providing leadership for improvements in detection, diagnosis, treatment, and management of Crusted Scabies, has seen a more coordinated approach for controlling Crusted Scabies – the first step in Elimination of this debilitating, yet entirely preventable disease.


Meg is an RN, with post grad experience and qualifications in community development and health promotion. Meg’s role at One Disease involves working in partnership with local communities in West Arnhem Land, to develop locally owned strategies for improving management of Crusted Scabies. A core element of this work is providing support and education to individuals, families, remote clinicians, and hospital staff; but also includes advocacy; care coordination; screening and active case finding; building the capacity of local people to manage scabies; development of care management plans for clinical information systems; updating clinical guidelines; and practice based research.