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PloS One 2022Scabies is a major global public health issue that might affect people from all socioeconomic levels. Globally, scabies affects more than 200 million people at any time....
BACKGROUND
Scabies is a major global public health issue that might affect people from all socioeconomic levels. Globally, scabies affects more than 200 million people at any time. It remains one of the commonest skin diseases seen in developing countries including Ethiopia. Therefore, this study aimed to assess the prevalence and determinants of scabies among school-age children in Central Armachiho district, Northwest Ethiopia.
METHODS
A community-based cross-sectional study was conducted from August to September 2020. A multi-stage sampling technique was used to select 850 study populations. Data was checked for its completeness, coded, and entered by using EPI-INFO version 7 and exported to the SPSS version 20 for analysis. A Binary logistic regression model was fitted to identify the determinants of scabies. Crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% CI were used as measurements for the associations. P-values <0.005 were considered significant.
RESULT
Prevalence of scabies among the 850 participants studied was 10.82% (95% CI: 8.7-12.9). Contact history with confirmed scabies patient (AOR = 5.28,95% CI: 2.96-9.44), child not attending school (AOR = 3.08, 95% CI;1.45-6.54), rarely changing clothes (AOR = 2.43,95% CI: 1.27-4.62), sleeping on the floor (AOR = 4.11, 95% CI:1.95-8.67), bed sharing; (AOR = 3.38, 95% CI:2.86-6.15), rarely washing cloth: (AOR = 5.08,95% CI:2.75-9.36), living with internally displaced people; (AOR,95% CI: 3.47 (1.30-9.24) and using only water to wash hands; (AOR = 3.18,95% CI:1.74-5.80) had a statistically significant association with scabies infestation among school-age children.
CONCLUSION
The current study found nearly one out of ten school-age children had scabies. Not attended school, contact history with confirmed scabies patient, not washing cloth, infrequent changing clothes, bedding sharing, sleeping on the floor, living with internally displaced people, and only using water for handwashing practice were the independent predictors for the occurrence of scabies. Health education better to given to the parents or caregivers about the washing of clothing, changing clothes at least once per week, and avoid physical contact with known scabies cases.
Topics: Child; Cross-Sectional Studies; Ethiopia; Humans; Prevalence; Scabies; Water
PubMed: 35700176
DOI: 10.1371/journal.pone.0269918 -
PLoS Neglected Tropical Diseases May 2018Scabies and impetigo are common and important skin conditions which are often neglected in developing countries. Limited data have been published on the prevalence of...
INTRODUCTION
Scabies and impetigo are common and important skin conditions which are often neglected in developing countries. Limited data have been published on the prevalence of scabies and impetigo in Timor-Leste. Sequelae including cellulitis, bacteraemia, nephritis, acute rheumatic fever and rheumatic heart disease contribute significantly to the burden of disease.
METHODS
School students were recruited from schools in Dili (urban) and Ermera (rural) in Timor-Leste for an epidemiological study in October 2016. A standard questionnaire was used to record demographics, anthropometry and skin examination results. Impetigo and scabies were diagnosed based on clinical examination of exposed surfaces, and clinical photographs were reviewed for correlation by an infectious diseases paediatrician. Prevalence of scabies and impetigo were calculated and binary risk factor associations were described using relative risks and 95% confidence intervals. Adjusted odds ratios were calculated using logistic regression multivariate analysis. Continuous variables were analysed for associations using the Mann-Whitney Rank Sum test.
RESULTS
The study enrolled 1396 students; median age 11 years (interquartile range (IQR) 9-15). The prevalence of scabies was 22.4% (95% CI 20.2-24.7%) and active impetigo 9.7% (95% CI 8.3-11.4%); 68.2% of students had evidence of either active or healed impetigo. Students in Ermera were more likely than those in Dili to have scabies (prevalence 32.0% vs 5.2%, aOR 8.1 (95% CI 5.2-12.4), p<0.01). There was no difference in the prevalence of active impetigo between urban and rural sites. More than a third of participants were moderately or severely underweight. Stunting was markedly more common in the rural district of Ermera.
CONCLUSION
Scabies and impetigo are common in Timor-Leste, with very high prevalence of scabies in the rural district of Ermera. Improvements in prevention and treatment are needed, with prioritised activities in the rural areas where prevalence is highest.
Topics: Adolescent; Child; Female; Humans; Impetigo; Logistic Models; Male; Mass Screening; Odds Ratio; Prevalence; Risk Factors; Rural Population; Scabies; Schools; Students; Timor-Leste
PubMed: 29852002
DOI: 10.1371/journal.pntd.0006400 -
Medecine Et Sante Tropicales 2014Scabies is a ubiquitous contagious disease, and its prevalence is growing. Diagnostic difficulties vary according to the patient's age and health. Benzyl benzoate and... (Review)
Review
Scabies is a ubiquitous contagious disease, and its prevalence is growing. Diagnostic difficulties vary according to the patient's age and health. Benzyl benzoate and ivermectin are the reference drugs in France. Decontamination of the patients' bedding, clothing, and environment is essential for successful treatment.
Topics: Global Health; Humans; Scabies
PubMed: 24682642
DOI: 10.1684/mst.2014.0287 -
BMC Infectious Diseases Feb 2019Infestations with scabies mites are a global burden affecting individuals of all ages, classes and ethnicities. As poor sanitation and overcrowding favor the...
BACKGROUND
Infestations with scabies mites are a global burden affecting individuals of all ages, classes and ethnicities. As poor sanitation and overcrowding favor the transmission of this highly contagious disease, epidemic outbreaks are frequently observed among displaced persons and asylum seekers. Due to the growing influx of refugees during the last years, public health authorities in host countries are frequently confronted with the challenge to treat individuals with diagnosed or suspected scabies promptly and effectively to avoid further spreading of the infestation. This study aimed to establish a straightforward and efficient algorithm for rapid screening and treatment of large numbers of patients with confirmed or suspected scabies infestations.
METHODS
Forty-eight individuals (58% males, mean age 22.4 yrs.) from Syria with suspected scabies infestation were allocated to 3 colour-coded groups: (1) no signs or symptoms of infestation, (2) itch only, and (3) itch and typical skin lesions. Patients were treated with a single (group 1) or two doses of oral ivermectin at an interval of 7 days (group 2), or with a combination of 2 doses of ivermectin plus 2 applications of permethrin ointment at an interval of 7 days (group 3). Follow-ups were performed 4 weeks after initial treatments.
RESULTS
All individuals with signs and/or symptoms of infestation had improved skin lesion; in 10/11 (90.9%) lesion had completely resolved. All individuals with initial itch only (n = 32) reported improvement of its intensity or complete resolution. None of the patients of group 1 developed itch or skin lesions. The algorithm was reapplied in 4 individuals (8.3%) after 4 weeks and the outbreak was completely controlled after 8 weeks. Colour-coding ensured fast flow of information between health-care providers at the interfaces of the algorithm.
CONCLUSIONS
Our algorithm proved to be both highly efficient for treatment of large numbers of patients with suspected or diagnosed scabies infestation as well as for prevention of spreading of the disease. Hence, this algorithm is well suited for the management of scabies mass outbreaks.
Topics: Adolescent; Adult; Aged; Algorithms; Animals; Antiparasitic Agents; Disease Outbreaks; Female; Health Personnel; Humans; Infant; Ivermectin; Male; Middle Aged; Permethrin; Refugees; Scabies; Switzerland; Syria
PubMed: 30819115
DOI: 10.1186/s12879-019-3818-5 -
PLoS Neglected Tropical Diseases Jul 2021Crusted scabies is endemic in some remote Aboriginal communities in the Northern Territory (NT) of Australia and carries a high mortality risk. Improvement in active...
BACKGROUND
Crusted scabies is endemic in some remote Aboriginal communities in the Northern Territory (NT) of Australia and carries a high mortality risk. Improvement in active case detection (ACD) for crusted scabies is hampered by a lack of evidence about best practice. We therefore conducted a systematic review of ACD methods for leprosy, a condition with similar ACD requirements, to consider how findings could be informative to crusted scabies detection.
METHODS AND PRINCIPLE FINDINGS
We conducted systematic searches in MEDLINE, CINAHL, Scopus and the Cochrane Database for Systematic Reviews for studies published since 1999 that reported at least one comparison rate (detection or prevalence rate) against which the yield of the ACD method could be assessed. The search yielded 15 eligible studies from 511. Study heterogeneity precluded meta-analysis. Contact tracing and community screening of marginalised ethnic groups yielded the highest new case detection rates. Rapid community screening campaigns, and those using less experienced screening personnel, were associated with lower suspect confirmation rates. There is insufficient data to assess whether ACD campaigns improve treatment outcomes or disease control.
CONCLUSION
This review demonstrates the importance of ACD campaigns in communities facing the highest barriers to healthcare access and within neighbourhoods of index cases. The potential benefit of ACD for crusted scabies is not quantified, however, lessons from leprosy suggest value in follow-up with previously identified cases and their close contacts to support for scabies control and to reduce the likelihood of reinfection in the crusted scabies case. Skilled screening personnel and appropriate community engagement strategies are needed to maximise screening uptake. More research is needed to assess ACD cost effectiveness, impact on disease control, and to explore ACD methods capable of capturing the homeless and highly mobile who may be missed in household centric models.
Topics: Australia; Humans; Leprosy; Scabies
PubMed: 34297724
DOI: 10.1371/journal.pntd.0009577 -
PLoS Medicine Nov 2021Scabies is a neglected tropical disease hyperendemic to many low- and middle-income countries. Scabies can be successfully controlled using mass drug administration... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Scabies is a neglected tropical disease hyperendemic to many low- and middle-income countries. Scabies can be successfully controlled using mass drug administration (MDA) using 2 doses of ivermectin-based treatment. If effective, a strategy of 1-dose ivermectin-based MDA would have substantial advantages for implementing MDA for scabies at large scale.
METHODS AND FINDINGS
We did a cluster randomised, noninferiority, open-label, 3-group unblinded study comparing the effectiveness of control strategies on community prevalence of scabies at 12 months. All residents from 35 villages on 2 Fijian islands were eligible to participate. Villages were randomised 1:1:1 to 2-dose ivermectin-based MDA (IVM-2), 1-dose ivermectin-based MDA (IVM-1), or screen and treat with topical permethrin 5% for individuals with scabies and their household contacts (SAT). All groups also received diethylcarbamazine and albendazole for lymphatic filariasis control. For IVM-2 and IVM-1, oral ivermectin was dosed at 200 μg/kg and when contraindicated substituted with permethrin. We designated a noninferiority margin of 5%. We enrolled 3,812 participants at baseline (July to November 2017) from the 35 villages with median village size of 108 (range 18 to 298). Age and sex of participants were representative of the population with 51.6% male and median age of 25 years (interquartile range 10 to 47). We enrolled 3,898 at 12 months (July to November 2018). At baseline, scabies prevalence was similar in all groups: IVM-2: 11.7% (95% confidence interval (CI) 8.5 to 16.0); IVM-1: 15.2% (95% CI 9.4 to 23.8); SAT: 13.6% (95% CI 7.9 to 22.4). At 12 months, scabies decreased substantially in all groups: IVM-2: 1.3% (95% CI 0.6 to 2.5); IVM-1: 2.7% (95% CI 1.1 to 6.5); SAT: 1.1% (95% CI 0.6 to 2.0). The risk difference in scabies prevalence at 12 months between the IVM-1 and IVM-2 groups was 1.2% (95% CI -0.2 to 2.7, p = 0.10). Limitations of the study included the method of scabies diagnosis by nonexperts, a lower baseline prevalence than anticipated, and the addition of diethylcarbamazine and albendazole to scabies treatment.
CONCLUSIONS
All 3 strategies substantially reduced prevalence. One-dose was noninferior to 2-dose ivermectin-based MDA, as was a screen and treat approach, for community control of scabies. Further trials comparing these approaches in varied settings are warranted to inform global scabies control strategies.
TRIAL REGISTRATION
Clinitrials.gov NCT03177993 and ANZCTR N12617000738325.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dose-Response Relationship, Drug; Female; Fiji; Geography; Humans; Impetigo; Infant; Ivermectin; Male; Middle Aged; Residence Characteristics; Risk Factors; Scabies; Young Adult
PubMed: 34758017
DOI: 10.1371/journal.pmed.1003849 -
Epidemiology and Infection Aug 2016Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations.... (Review)
Review
Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations. In this paper, we describe key findings from a retrospective review of scabies outbreaks reported in the literature over the past 30 years. We undertook this review to gain insights into the impact of institutional outbreaks, the burden in terms of attack rates, economic costs, treatment trends, the types of index cases and outbreak progression. We found 84 reports over 30 years, with outbreaks most frequently reported in aged care facilities (n = 40) and hospitals (n = 33). On average, scabies outbreaks persisted for 3 months, and the median attack rate was 38%. While 1% lindane was once the most commonly employed acaricide, 5% permethrin and oral ivermectin are increasingly used. Crusted scabies represented the index case for 83% of outbreaks, and scabies was misdiagnosed in 43% outbreaks. The frequency of reported scabies outbreaks has not declined consistently over time suggesting the disease is still highly problematic. We contend that more research and practice emphasis must be paid to improve diagnostic methods, surveillance and control, health staff education and management of crusted scabies to prevent the development of scabies outbreaks in institutional settings.
Topics: Disease Outbreaks; Health Facilities; Humans; Scabies
PubMed: 27019288
DOI: 10.1017/S0950268816000443 -
Clinical Infectious Diseases : An... Sep 2022Scabies is a neglected tropical disease of the skin that can lead to impetigo, serious secondary bacterial infections and immune-mediated diseases. Mass drug... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Scabies is a neglected tropical disease of the skin that can lead to impetigo, serious secondary bacterial infections and immune-mediated diseases. Mass drug administration (MDA) has been reported in several studies to reduce the prevalence of scabies and impetigo. We aimed to assess the efficacy of MDA for scabies on scabies and impetigo.
METHODS
We conducted a systematic review and meta-analysis of reports on the impact of MDA on scabies and impetigo. We included randomized control trials and observational evaluations reported from January 1970 to April 2021 and involving human participants. We searched PubMed, Ovid Medline, Embase, and Cochrane. We considered MDA as treatment intended for the whole population, regardless of individual infection status or symptoms. The main outcome assessed was the change in scabies and impetigo prevalence following MDA. This review is registered with PROSPERO (CRD42020169839).
RESULTS
We identified 1110 records, of which 11 met inclusion criteria for the review and 9 were deemed suitable for meta-analysis for scabies and 4 for impetigo. Most studies were in small populations. There was a high degree of heterogeneity between studies (I2 value 96.19%). The overall relative reduction of the impact of MDA on scabies prevalence was 79%. The effect size was comparable for MDA based on ivermectin and permethrin. MDA for scabies also led to a reduction in impetigo prevalence with a relative reduction of 66%.
CONCLUSIONS
MDA for scabies is highly effective in reducing the prevalence of scabies and impetigo. Further research is needed to determine the durability of impact, and the effectiveness of MDA regimens in larger populations.
Topics: Humans; Impetigo; Ivermectin; Mass Drug Administration; Neglected Diseases; Permethrin; Scabies
PubMed: 35088849
DOI: 10.1093/cid/ciac042 -
PLoS Neglected Tropical Diseases Aug 2022Scabies was added to the WHO NTD portfolio in 2017 and targets for the control of scabies were included in the 2021-2030 WHO NTD roadmap. A major component of scabies...
BACKGROUND
Scabies was added to the WHO NTD portfolio in 2017 and targets for the control of scabies were included in the 2021-2030 WHO NTD roadmap. A major component of scabies control efforts a strategy based on mass drug administration (MDA) with ivermectin. Currently diagnosis of scabies relies on clinical examination with a limited role for diagnostic testing. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases, a working group was assembled and tasked with agreeing on priority use cases for and developing target product profiles (TPPs) for new diagnostics tools for scabies.
METHODOLOGY AND PRINCIPAL FINDINGS
The working group convened three times and established two use cases: establishing if the 10% threshold for mass drug administration had been reached and if the 2% threshold for stopping mass drug administration has been achieved. One subgroup assessed the current diagnostic landscape for scabies and a second subgroup determined the test requirements for both use cases. Draft TPPs were sent out for input from stakeholders and experts. Both TPPs considered the following parameters: product use, design, performance, configuration, cost, access and equity. The group considered the use of the tests as a single step process or as part of a two step process following initial clinical examination. When used a single step test (the ideal scenario) for starting MDA a new diagnostic required a sensitivity of ≥92% and a specificity of ≥98%. When used a single step test (the ideal scenario) for stopping MDA a new diagnostic required a sensitivity of ≥80% and a specificity of ≥99%.
CONCLUSIONS
The TPPs developed will provide test developers with guidance to ensure that novel diagnostic tests meet identified public health needs.
Topics: Humans; Ivermectin; Mass Drug Administration; Neglected Diseases; Scabies
PubMed: 36040928
DOI: 10.1371/journal.pntd.0010556 -
Danish Medical Journal Aug 2023Patients with scabies are often misdiagnosed before being attended by a dermatologist. The aim of this study was to use a smartphone app to screen individuals from the...
INTRODUCTION
Patients with scabies are often misdiagnosed before being attended by a dermatologist. The aim of this study was to use a smartphone app to screen individuals from the general population with scabies symptoms.
METHODS
Subjects who suspected that they had scabies were recruited online and downloaded a app tailored for this study. A questionnaire on symptoms was completed and photos of the skin were uploaded from within the app. Two physicians, a board-certified dermatologist and a resident dermatologist, evaluated the requests by categorising the scabies risk of each case, and categorisation triggered an auto-generated response describing the level of scabies and letting the participant know whether to contact a general practitioner or not.
RESULTS
Within 15 days of advertisement, 228 requests were sent (71% women); mean age 24 years (standard deviation: ± 10.0). Itch was experienced by 90% (n = 208) and rash by 76% (n = 174). The rash was distributed bilaterally in 79% (n = 138). The areas of rash localisation were: arms (63%), hands (56%), legs (55%), abdomen (52%), inner thigh (45%), chest (26%), genitals (24%), head and neck (17%) and axilla (16%). 5% of all cases evaluated by either the senior or junior physician were evaluated as having a high risk of scabies.
CONCLUSION
In a very short time, the app received a high number of requests from individuals worrying about scabies; 5% of the incoming requests were categorised as carrying a high risk of having scabies. Mobile apps are a helpful tool to screen for scabies in primary care settings.
FUNDING
Omhu A/S.
TRIAL REGISTRATION
Not relevant.
Topics: Humans; Female; Young Adult; Adult; Male; Scabies; Mobile Applications; Skin; Exanthema; Axilla
PubMed: 37622645
DOI: No ID Found