Abstract
This thesis portfolio spans my interrelated work across two scales, that of parasites (specifically acarines, i.e. mites and ticks) and planetary health (a field aiming to safeguard both human health and its underpinning natural systems). Chapter 1 is a supporting statement contextualising, summarising, and appraising my submitted publications and their contribution. This is followed by two chapters of publications written by me whilst working at Brighton and Sussex Medical School.Chapter 2 concerns two medical acarology topics: scabies (Sarcoptes scabiei infestation) and disease hazard from ticks (particularly re Ixodes ricinus and Haemaphysalis punctata). Scabies outbreaks are a public health burden in semi-closed institutions. Included is a report of a prospective study of care home outbreaks, a communication piece challenging the oft-stated link with hygiene, another advocating for improved treatment availability, and a book chapter describing epidemiology in institutions (e.g. health and care settings, refugee camps, prisons) and providing management recommendations. This is followed by an article on tick hazard in the South Downs National Park, a high-risk area for Lyme disease. I report a Park-wide hazard assessment and suggest planetary health based actions to decrease hazard without negatively affecting ecosystems. Chapter 3 primarily concerns SURFACES, my planetary health project in Papua New Guinea (PNG) with a partial focus on skin diseases (e.g. scabies, tinea imbricata). Logging companies threaten PNGs rainforests. Clans own most land and can act as a force for conservation. However, to those without health provision, company offers of roads and income can decrease remoteness from medical services, making desire for health a driver for deforestation and erosion of health-related ecosystem services. To help avoid this trade-off, I developed a novel health needs assessment methodology, led a team to conduct it, and used its data to win funds to establish primary care for medically neglected communities, enabling expansion of an indigenous-led conservation area. Included is a protocol paper and toolkit, the assessment’s results paper, an article outlining the project’s rationale and ethical considerations, and a short piece on implications of scabies mass drug administrations in Oceania. Appendices: (A) first pages of additional co-authored papers to contextualise my submitted work; (B) co-author statements verifying my contributions to the publications in chapters 2 and 3.
| Date of Award | Feb 2025 |
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| Original language | English |
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| Supervisor | Carrie Llewellyn (Supervisor) |