Principles Relevant to Health Research among Indigenous Communities

Research within Indigenous communities has been criticised for lacking community engagement, for being exploitative, and for poorly explaining the processes of research. To address these concerns, and to ensure ‘best practice’, Jamieson, et al. (2012) recently published a summary of principles outlined by the NHMRC (2003) in “one short, accessible document”. Here we expand on Jamieson et al.’s paper, which while commendable, lacks emphasis on the contribution that communities themselves can make to the research process and how culturally appropriate engagement, can allow this contribution to be assured, specifically with respect to engagement with remote communities. Engagement started before the research proposal is put forward, and continued after the research is completed, has integrity. We emphasise the value of narratives, of understanding cultural and customary behaviours and leadership, the importance of cultural legitimacy, and of the need for time, not just to allow for delays, but to ensure genuine participatory engagement from all members of the community. We also challenge researchers to consider the outcomes of their research, on the basis that increasing clinical evidence does not always result in better outcomes for the community involved

Human strongyloidiasis: identifying knowledge gaps, with emphasis on environmental control

Michael J Taylor, Tara A Garrard, Francis J O'Donahoo, Kirstin E Ross Health and Environment, School of the Environment, Flinders University, Adelaide, SA, Australia Abstract: Strongyloides is a human parasitic nematode that is poorly understood outside a clinical context. This article identifies gaps within the literature, with particular emphasis on gaps that are hindering environmental control of Strongyloides. The prevalence and distribution of Strongyloides is unclear. An estimate of 100–370 million people infected worldwide has been proposed; however, inaccuracy of diagnosis, unreliability of prevalence mapping, and the fact that strongyloidiasis remains a neglected disease suggest that the higher figure of more than 300 million cases is likely to be a more accurate estimate. The complexity of Strongyloides life cycle means that laboratory cultures cannot be maintained outside of a host. This currently limits the range of laboratory-based research, which is vital to controlling Strongyloides through environmental alteration or treatment. Successful clinical treatment with antihelminthic drugs has meant that controlling Strongyloides through environmental control, rather than clinical intervention, has been largely overlooked. These control measures may encompass alteration of the soil environment through physical means, such as desiccation or removal of nutrients, or through chemical or biological agents. Repeated antihelminthic treatment of individuals with recurrent strongyloidiasis has not been observed to result in the selection of resistant strains; however, this has not been explicitly demonstrated, and relying on such assumptions in the long-term may prove to be shortsighted. It is ultimately naive to assume that continued administration of antihelminthics will be without any negative long-term effects. In Australia, strongyloidiasis primarily affects Indigenous communities, including communities from arid central Australia. This suggests that the range of Strongyloides extends beyond the reported tropical/subtropical boundary. Localized conditions that might result in this extended boundary include accumulation of moisture within housing because of malfunctioning health hardware inside and outside the house and the presence of dog fecal matter inside or outside housing areas. Keywords: Strongyloides stercoralis, strongyloidiasis, environmental control, parasitology, nematod

Strongyloidiasis in Oceania

Strongyloidiasis is a potentially fatal disease caused by species of Strongyloides (Nematoda). In Oceania, two species infect humans: S. stercoralis and S. kellyi. S. stercoralis is widespread throughout Oceania and causes serious disease in any age group. S. kellyi is localised to Papua New Guinea and causes serious disease in infants. Infective larvae enter the body through the skin and migrate through the tissues. Adult females live in the mucosa of the proximal small intestine. The life cycle of S. stercoralis includes autoinfection, unusual in parasitic worms, whereby some of the offspring of the parasitic adults become infective in the lower intestine and complete the life cycle in the same person. This ensures that the infection persists, and the population of the worms can increase out of control, usually when the person is immunodefi cient or immunosuppressed. The worms can be eliminated by oral ivermectin, and the person is probably cured if their serology is negative 6 months after treatment. This chapter contains details of the life cycles, transmission, clinical manifestations, diagnostic tests and how to interpret them, most effective treatment options, how to ensure that treatment has been effective and what to consider when developing effective prevention and control strategies

The National Strongyloides Working Group in Australia 10 workshops on: Commendations and recommendations

Strongyloidiasis, caused by the intestinal helminth Strongyloides stercoralis, is commonly found in developing nations in tropical and subtropical regions.1 Strongyloidiasis was omitted by the World Health Organization (WHO) as one of the Soil Transmitted Helminths in their Neglected Tropical Diseases Roadmap and can therefore be considered one of the most neglected tropical diseases.2,3 Despite its reputation as a disease of developing countries, strongyloidiasis remains an important disease in Australia, particularly for Aboriginal and Torres Strait Islanders, and those living in remote communities

The National Strongyloides Working Group in Australia 10 workshops on: Commendations and recommendations

Judd, JA ORCiD: 0000-0001-8441-5008Strongyloidiasis, caused by the intestinal helminth Strongyloides stercoralis, is commonly found in developing nations in tropical and subtropical regions.1 Strongyloidiasis was omitted by the World Health Organization (WHO) as one of the Soil Transmitted Helminths in their Neglected Tropical Diseases Roadmap and can therefore be considered one of the most neglected tropical diseases.2,3 Despite its reputation as a disease of developing countries, strongyloidiasis remains an important disease in Australia, particularly for Aboriginal and Torres Strait Islanders, and those living in remote communities

Recent developments in criminal justice social work in Australia and India: critically analysing this emerging area of practice

The psychosocial issues posed by offenders, victims of crime and their respective families who have come into contact with the criminal justice system continue to escalate in quality and quantity around the world. As a result of this, the involvement of social workers in such criminal justice issues in developing (India) and developed (Australia) countries has expanded from mere supervisory enforcement to matters relating to the provision of welfare and the design as well as administering of rehabilitative treatment. This paper will therefore critically analyse the recent developments in this sector, initially tracing the history of criminal justice social work practice in both countries, examining their current practices, uncovering its influences and delineating the challenges faced by such practitioners. The paper will thereafter offer a range of possible measures that can be employed to facilitate the viability of criminal justice social work in these countries