{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:13:28Z","timestamp":1782375208801,"version":"3.54.5"},"reference-count":73,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australia\u2019s National Health and Medical Research Council (NHMRC)","award":["GNT2010716"],"award-info":[{"award-number":["GNT2010716"]}]},{"name":"Australia\u2019s National Health and Medical Research Council (NHMRC)","award":["GNT2025252"],"award-info":[{"award-number":["GNT2025252"]}]},{"name":"Australia\u2019s National Health and Medical Research Council (NHMRC)","award":["GNT1175509"],"award-info":[{"award-number":["GNT1175509"]}]},{"name":"NHMRC Investigator Grant","award":["GNT2010716"],"award-info":[{"award-number":["GNT2010716"]}]},{"name":"NHMRC Investigator Grant","award":["GNT2025252"],"award-info":[{"award-number":["GNT2025252"]}]},{"name":"NHMRC Investigator Grant","award":["GNT1175509"],"award-info":[{"award-number":["GNT1175509"]}]},{"name":"PhD scholarship from the University of Queensland","award":["GNT2010716"],"award-info":[{"award-number":["GNT2010716"]}]},{"name":"PhD scholarship from the University of Queensland","award":["GNT2025252"],"award-info":[{"award-number":["GNT2025252"]}]},{"name":"PhD scholarship from the University of Queensland","award":["GNT1175509"],"award-info":[{"award-number":["GNT1175509"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.<\/jats:p>","DOI":"10.3390\/ijerph21091262","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T03:49:46Z","timestamp":1727149786000},"page":"1262","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5410-6332","authenticated-orcid":false,"given":"Nina","family":"Lansbury","sequence":"first","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Memmott","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3904-9269","authenticated-orcid":false,"given":"Rosemary","family":"Wyber","sequence":"additional","affiliation":[{"name":"Yardhura Walani, National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT 0200, Australia"},{"name":"The Kids Research Institute, Perth, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Burgen","sequence":"additional","affiliation":[{"name":"Barkly Region Community, Tennant Creek, NT 0860, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel K.","family":"Barnes","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-2640","authenticated-orcid":false,"given":"Jessica","family":"Daw","sequence":"additional","affiliation":[{"name":"The Kids Research Institute, Perth, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Cannon","sequence":"additional","affiliation":[{"name":"The Kids Research Institute, Perth, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha C.","family":"Bowen","sequence":"additional","affiliation":[{"name":"The Kids Research Institute, Perth, WA 6009, Australia"},{"name":"Perth Children\u2019s Hospital, Perth, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Burgess","sequence":"additional","affiliation":[{"name":"The Kids Research Institute, Perth, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia N.","family":"Frank","sequence":"additional","affiliation":[{"name":"Barkly Region Community, Tennant Creek, NT 0860, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Redmond","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia"},{"name":"Royal Brisbane and Women\u2019s Hospital, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ali, S., Foster, T., and Hall, N. 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