The burden of bacterial skin infection, scabies and atopic dermatitis among urban-living Indigenous children in high-income countries: a protocol for a systematic review

Abstract

Background Bacterial skin infections and scabies disproportionately affect children in resource-poor countries as well as underprivileged children in high-income countries. Atopic dermatitis is a common childhood dermatosis that predisposes to bacterial skin infection. In Australia, at any one time, almost half of all Aboriginal and Torres Strait Islander children living remotely will have impetigo, and up to one-third will also have scabies. Yet, there is a gap in knowledge of the skin infection burden for urban-living Australian Aboriginal and Torres Strait Islander children, as well as atopic dermatitis which may be a contributing factor. The objective of this study is to provide a global background on the burden of these disorders in Indigenous urban-living children in high-income countries. These countries share a similar history of colonisation, dispossession and subsequent ongoing negative impacts on Indigenous people. Methods This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols statement. Observational studies reporting incidence and/or prevalence data on bacterial skin infection, scabies and/or atopic dermatitis in urban-living Indigenous children in high-income countries will be included. Literature searches will be conducted in several international electronic databases (from 1990 onwards), including MEDLINE, Embase, EmCare, Web of Science and PubMed. Reference lists and citation records of all included articles will be scanned for additional relevant manuscripts. Two investigators will independently perform eligibility assessment of titles, abstract and full-text manuscripts, following which both investigators will independently extract data. Where there is disagreement, the senior author will determine eligibility. The methodological quality of selected studies will be appraised using an appropriate tool. Data will be tabulated and narratively synthesised. We expect there will be insufficient data to perform meta-analysis. Discussion This study will identify and evaluate epidemiological data on bacterial skin infection, scabies and atopic dermatitis in urban-living Indigenous children in high-income countries. Where available, the clinical features, risk factors, comorbidities and complications of these common childhood skin disorders will be described. The evidence will highlight the burden of disease in this population, to contribute to global burden of disease estimates and identify gaps in the current literature to provide direction for future research. Systematic review registration PROSPERO CRD42021277288

Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project

“…Recently, a systematic review has synthesised the available global literature on skin health in urban-living Indigenous children in high-income countries that share a history of colonisation, displacement and subsequent ongoing health inequities. 19,44 Our results are comparable to the ndings, and add further knowledge to the burden of these skin diseases, whilst scoping out a methodology for future studies.…”

The burden of atopic dermatitis and bacterial skin infections among urban‐living Indigenous children and young people in high‐income countries: A systematic review

“…We have reported according to the PRISMA 2020 statement and checklist 13 . The systematic review protocol is published online, with only two notable amendments to the original information: (1) Exclusion of scabies from the systematic review due to a paucity of published literature; and (2) Extension of the age of CYP from ≤18 to <20 years to better reflect the published literature (Systematic review registration: PROSPERO registration number: CRD42021277288) 14 …”

The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

“…Global statistics from 2015 show that more than 162 million children in low- and middle-income countries have impetigo, with the median prevalence being the highest in children in warm and humid Oceania (29.7%); further, half of the children living in remote Aboriginal communities in northern Australia and Torres Strait Islanders develop impetigo (44.5%) ( 41 ). The median prevalence of impetigo in children from marginalized communities in high-income countries has been reported to be as high as 19.4% ( 42 ). During July–August 2018, there was an increase in the incidence of impetigo in Dutch children for unknown reasons ( 43 ).…”