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Delie AM, Bogale EK, Anagaw TF, Tiruneh MG, Fenta ET, Adal O, Kebede N. Global prevalence and predictors of scabies among prisoners: systematic review and meta-analysis. BMC Public Health 2024; 24:1894. [PMID: 39010037 PMCID: PMC11251225 DOI: 10.1186/s12889-024-19401-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis. RESULTS The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16-19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44-40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77-3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies. CONCLUSION The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.
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Affiliation(s)
- Amare Mebrat Delie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabel Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Ousman Adal
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine Health Sciences, Wollo University, Dessie, Ethiopia
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McRae T, Walker R, Enkel S, Thomas HMM, Jacky J, Sibosado S, Mullane M, Maginnis N, Coffin J, Carapetis JR, Bowen AC. HipHop2SToP a community-led health promotion initiative empowering Aboriginal youth in the Kimberley region of Western Australia: a process evaluation. Front Public Health 2023; 11:1258517. [PMID: 38145075 PMCID: PMC10740280 DOI: 10.3389/fpubh.2023.1258517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/08/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction For millennia, Aboriginal people's ways of knowing, doing and being were shared through art, song, and dance. Colonisation silenced these ways, affecting loss of self-determination for Aboriginal people. Over the past decade in Australia, hip-hop projects have become culturally appropriate approaches for health promotion. When community led, and Aboriginal worldviews centralised, hip-hop workshops are more likely to be effective. In 2020, during the COVID-19 pandemic, a community-led health promotion hip-hop music video, 'HipHop2SToP' was produced involving young people in Dampier Peninsula communities address healthy skin and healthy living practices. Methods We report here a qualitative process evaluation of the HipHop2SToP project. Participants who had been involved in the planning and production of HipHop2SToP were selected using a purposive approach and invited either by email or face-to-face to participate in semi-structured interviews and share their experiences. Semi-structured interviews ranged from 30 to 60 min in duration and were conducted either face-to-face or virtually over MS Teams. Due to personal time constraints, two participants provided written responses to the semi-structured questions. All interviews were audio-recorded with consent and saved as a digital recording in a de-identified format. All audio recordings were transcribed verbatim and uploaded into QSR NVivo v12 along with written responses. Results As a health promotion project, the critical success factors were community-ownership and discovering novel ways to collaborate virtually with remote communities using Microsoft (MS) software. Highlights included observing the young people actively engaged in the project and their catchy lyrics and key messaging for environmental health and skin infections. COVID-19 presented some challenges. Gaps in communication, clarification of stakeholder roles and expectations, and post-production outcomes were also identified as challenges. Conclusion HipHop2SToP validates the need for Aboriginal community led health promotion programs. While creating some challenges COVID-19 also strengthened community ownership and created novel ways of maintaining relationships with remote Aboriginal communities. Future hip-hop projects would benefit from clarity of roles and responsibilities. Strengthening post-production outcomes by including a launch and well-planned, targeted communication and dissemination strategy will ensure the wider translation of important health messages and potential strengthen sustainability.
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Affiliation(s)
- Tracy McRae
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - Roz Walker
- Ngangk Yira Institute For Change, Murdoch University, Perth, WA, Australia
- School of Indigenous Studies, Poche Centre for Indigenous Health Research, University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Stephanie Enkel
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - Hannah M. M. Thomas
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - John Jacky
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Marianne Mullane
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Juli Coffin
- Ngangk Yira Institute For Change, Murdoch University, Perth, WA, Australia
| | - Jonathan R. Carapetis
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Asha C. Bowen
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- University of Notre Dame, Fremantle, WA, Australia
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The Efficacy and Biopharmaceutical Properties of a Fixed-Dose Combination of Disulfiram and Benzyl Benzoate. Int J Mol Sci 2022; 23:ijms231810969. [PMID: 36142878 PMCID: PMC9502479 DOI: 10.3390/ijms231810969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
Scabies and hair lice are parasitic diseases that affect human skin and hair, respectively. The incidence and resistances of these infections are increasing. Tenutex® (disulfiram and benzyl benzoate emulsion) is an alternative to standard insecticides to avoid resistances. The aim of the work is to evaluate the transdermal absorption and the in vitro efficacy against scabies and hair lice after different exposition times. Dermatomed human skin was used to assess the dermal absorption using a validated High Performance Liquid Chromatography (HPLC) method. HEK001 keratinocytes were used to evaluate the cytotoxicity of benzyl benzoate. Only benzyl benzoate was able to cross the skin, but it did not show cytotoxicity at any of the tested concentrations. The product efficacy was tested on Psoroptes ovis after direct contact and after administration on sheep skin explants at different contact times. Permethrin/malathion-resistant strains of Pediculus humanis capitis adults and eggs were directly exposed to Tenutex, and the vitality and hatchability, respectively, were evaluated. The anti-scabies study demonstrated that exposure for 6 or 24 h completely eradicated the parasite. The pediculicidal activity of Tenutex exhibited superior efficacy than standard treatment on resistant lice. The positive results obtained suggest that Tenutex® is a good treatment option, especially in drug resistance situations.
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Navi Z, Najafi F, Paknezhad N, Mousavian G, Bizhani N, Naddaf SR, Mowlavi G. Dermatoparasitoses in Referral Patients to the Laboratory. IRANIAN JOURNAL OF PARASITOLOGY 2022; 17:393-401. [PMID: 36466019 PMCID: PMC9682383 DOI: 10.18502/ijpa.v17i3.10630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dermatoparasitic infestations due to the mites Demodex spp. and Sarcoptes scabie are prevalent dermatological disorders worldwide. METHODS Referral patients from the Departments of Dermatology, Infectious Diseases, and from the psychologists, in some cases, to the laboratory of Medical Helminthology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran were examined and documented for demodicosis and scabies from March 2009 to December 2020. All patients' data were collected and then analyzed statistically by SDATA version 14, using the Chi-square test. RESULTS Out of 494-suspected patients suffering from dermal disorders, 99 patients (20.04%) and 20 cases (4.04%) were found infested with demodicosis and scabies, respectively. Most demodicosis cases belonged to the 46-60 year age group while the infestation rate of scabies was higher in the age group under 5 years (P=<0.0001). Demodicosis was seen more prevalent in women than men, and scabies were higher in men (P =0.15). The cases of demodicosis in fall and scabies in winter and spring were more frequent. Demodicosis picked up in 2015 and 2017 (P=0.03), while the prevalent year for scabies was in 2016 (P=0.77). Both current ectoparasites declined dramatically by Covid-19 pandemic. CONCLUSION Demodicosis and scabies have been found correlated with age, and no statistical association was seen between the gender and seasonal factors. Besides, the obvious decline of demodicosis and scabies infestation rates during the Covid-19 outbreak can mention that social distance and hygiene standards have negative effects on dermatoparasites transmission.
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Affiliation(s)
- Zahra Navi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Najafi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Paknezhad
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Mousavian
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Bizhani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Mowlavi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
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Crusted Scabies, a Neglected Tropical Disease: Case Series and Literature Review. Infect Dis Rep 2022; 14:479-491. [PMID: 35735761 PMCID: PMC9223105 DOI: 10.3390/idr14030051] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
Crusted scabies is a rare form of scabies that presents with more severe symptoms than those of classic scabies. It is characterized by large crusted lesions, extensive scales, thick hyperkeratosis, and contains a large number of highly contagious itch mites. Crusted scabies is more prevalent in immunocompromised, malnourished, and disabled individuals. This disease has been linked to a variety of health problems, including delayed diagnosis, infection risk, and high mortality, mainly from sepsis, and it has the potential to cause an outbreak due to its hyper-infestation, which makes it highly infectious. This article reports three cases of crusted scabies in North Sulawesi, Indonesia. Recent updates and a comprehensive review of the literature on the disease are also included, emphasizing the critical importance of early diagnosis and effective medical management of patients, which are necessary to prevent the complications and spread in communities.
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Gerqari AB, Ferizi M, Halimi S, Begolli I, Begolli M, Gerqari I. Scabies Crustosa in a Patient with Insufficientia Renalis-Case Report. J Arthropod Borne Dis 2021; 15:421-425. [PMID: 36644304 PMCID: PMC9810579 DOI: 10.18502/jad.v15i4.10506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/31/2021] [Indexed: 01/18/2023] Open
Abstract
Background SScabies is caused by the parasite Sarcoptes scabiei. The disease was first described in ancient Greece, while Ferdinand Von Hebra described the stages of development of the arthropodite from the egg to larvae and the adult form of sarcoptosis. The final stage is characterized by the travel of the female parasite and the laying of eggs in stratum corneum and followed by the death of the causer. The main characteristic symptom of scabies is relentless pruritus which is a result of such an infestation inside the skin, as the body reacts to parasites and their excretions, where mites burrow and lay eggs. Methods Here we present the 85-year-old patient with scabies crustosa, latent diabetes and renal insufficiency. Results Persistent pruritus and scabies rash, where large numbers of mites were detected, was left untreated and further progressed into sores due to scratching. Weakened immunity and chronic illness in the patient resulted in a more severe form of the disease which was diagnosed as scabies crustosa. After treatment with a supplemented antiscabiotic regimen, the patient remained symptom free. Conclusion Large population movements, one of the main factors of spread and frequent incidence of scabies, contact with the sick, hygiene means, exchange of wardrobes, sharing bed with the sick, schools, preschools, old-age-care institutions and hospitals, enable spread of the disease. In addition, severe types of scabies that form thick crusts on the skin and present with pruritus as a symptom should be considered in immunocompromised and elderly patients with renal insufficiency where pruritus is also prevalent.
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Affiliation(s)
- Antigona Begolli Gerqari
- Dermatology Clinic, University Clinical Center of Kosovo,Corresponding author: Dr Antigona Begolli Gerqari, E-mail:
| | - Mybera Ferizi
- Dermatology Clinic, University Clinical Center of Kosovo
| | - Sadije Halimi
- Dermatology Clinic, University Clinical Center of Kosovo
| | | | | | - Idriz Gerqari
- Nuclear Medicine Department, University Clinical Center of Kosovo
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Gramp P, Gramp D. Scabies in remote Aboriginal and Torres Strait Islander populations in Australia: A narrative review. PLoS Negl Trop Dis 2021; 15:e0009751. [PMID: 34591843 PMCID: PMC8483324 DOI: 10.1371/journal.pntd.0009751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Scabies has recently gained international attention, with the World Health Organization (WHO) recognizing it as a neglected tropical disease. The International Alliance for the Control of Scabies recently formed as a partnership of more than 15 different countries, with an aim to lead a consistent and collaborative approach to preventing and controlling scabies globally. Scabies is most prevalent in low-resource and low socioeconomic areas that experience overcrowding and has a particularly high prevalence in children, with an estimated 5% to 10% in endemic countries. Scabies is widespread in remote Aboriginal and Torres Strait Islander communities in Australia with the prevalence of scabies in Aboriginal and Torres Strait Islander children in remote communities estimated to be as high as 33%, making it the region with the third highest prevalence in the world. This population group also have very high rates of secondary complications of scabies such as impetigo, poststreptococcal glomerulonephritis (PSGN), and rheumatic heart disease (RHD). This article is a narrative review of scabies in remote Aboriginal and Torres Strait Islander populations in Australia, including clinical manifestations of disease and current treatment options and guidelines. We discuss traditional approaches to prevention and control as well as suggestions for future interventions including revising Australian treatment guidelines to widen the use of oral ivermectin in high-risk groups or as a first-line treatment.
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Affiliation(s)
- Prudence Gramp
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Dallas Gramp
- Gold Coast University Hospital, Southport, Queensland, Australia
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Ghosh P, Tesfaye W, Manandhar A, Calma T, Bushell M, Oguoma VM, Kosari S, McMillan F, Peterson G, Thomas J. Mass drug administration campaigns for scabies and impetigo: protocol for a systematic review and meta-analysis. BMJ Paediatr Open 2021; 5:e001132. [PMID: 34263086 PMCID: PMC8245437 DOI: 10.1136/bmjpo-2021-001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Scabies is recognised as a neglected tropical disease, disproportionately affecting the most vulnerable populations around the world. Impetigo often occurs secondarily to scabies. Several studies have explored mass drug administration (MDA) programmes, with some showing positive outcomes-but a systematic evaluation of such studies is yet to be reported. The main aim of this systematic review is to generate comprehensive evidence on the effect and feasibility of MDA programmes in reducing the burden of scabies and impetigo. Methods and analysis A systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Electronic databases to be searched will include CINAHL EBSCOhost, Medline Ovid, ProQuest, Science Direct, PubMed and SCOPUS. In addition, grey literature will be explored via the Australian Institute of Health and Welfare, Australian Indigenous HealthInfoNet, Informit, OaIster database and WHO. No language restrictions will be applied. All treatment studies following an MDA protocol, including randomised/quasi-controlled trials, and prospective before-after interventional studies, will be considered. The main outcome is the change in prevalence of scabies and impetigo The Cochrane collaboration risk of bias assessment tool will be used for assessing the methodological quality of studies. A random-effect restricted maximum likelihood meta-analysis will be performed to generate pooled effect (OR) using STATA V.16. Appropriate statistical tests will be carried out to quantify heterogeneity between studies and publication bias. Ethics and dissemination Ethical approval is not required since data will be extracted from published works. The findings will be communicated to the scientific community through a peer-reviewed journal publication. This systematic review will present an evidence on the effect of MDA interventions on scabies and impetigo, which is instrumental to obtain a clear understanding of the treatments widely used in these programmes. PROSPERO registration number CRD42020169544.
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Affiliation(s)
- Pousali Ghosh
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Wubshet Tesfaye
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Avilasha Manandhar
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Thomas Calma
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Mary Bushell
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Victor M Oguoma
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Sam Kosari
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Faye McMillan
- School of Public Health and Community Medicine, The University of New South Wales, Kensington, New South Wales, Australia
| | - Greg Peterson
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Jackson Thomas
- Health, University of Canberra, Canberra, Australian Capital Territory, Australia
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Alharthi AS, Alsofyani MA, Alharthi WK, Alsalmi SA, Altalhi AS, Alswat KA. Assessment of Knowledge and Fear of Scabies in a Saudi Population. J Multidiscip Healthc 2021; 14:1361-1371. [PMID: 34135594 PMCID: PMC8197587 DOI: 10.2147/jmdh.s308236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives Scabies is a common contagious parasitic dermatological illness. In 2017, WHO recognized scabies as a neglected tropical disease. The aim of the present research was to assess the level of knowledge and fear of scabies among the Saudi population. Methods This is a cross-sectional online study conducted in the western region of Saudi Arabia from January to September 2019. We used a validated, 12-questions questionnaire to assess the scabies knowledge and the Fear of Scabies Scale-10 (FSS-10) to determine the level of fear toward scabies. Results A total of 3778 respondents were included with majorities of them being female and between the age of 15-30 years. About 93.3% of the respondents were considered to have good level of knowledge towards scabies and those were more likely to be females, live in an urban area, have heard about scabies in the past, younger in age, achieved higher educational level, and work for the medical and general education sector (all P <0.001). The total possible scores ranging from 10 (less fear) to 40 (greater fear). The mean total FSS-10 score was 33 ± 4.46 with 58.3% of them were considered to have greater fear and those were more likely to be female, younger in age, educated with higher educational degree, work for the general education sector and medical and, but less likely to be unemployed (all P <0.001). Partial correlation adjusting for potential confounders showed significant positive correlation between FSS-10 score and the scabies knowledge score (r = 0.152, P <0.001). Conclusion Despite the good level of scabies knowledge, the level of fear towards scabies is high. Further educational programs recommended decreasing the negative effect of scabies on the community and the individuals' quality of life.
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Affiliation(s)
- Ahmad S Alharthi
- Department of Otorhinolaryngology - Head and Neck Surgery, Taif University, Taif, Saudi Arabia
| | | | | | | | | | - Khaled A Alswat
- Department of Medicine, School of Medicine, Taif University, Taif, Saudi Arabia
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Aina DA, Jobarteh R, Alawadhi A, Phelps R, Silverberg N. A case of neutrophilic superficial eccrine ductitis. JAAD Case Rep 2021; 11:69-71. [PMID: 33898685 PMCID: PMC8060513 DOI: 10.1016/j.jdcr.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Deborah A Aina
- Saba University School of Medicine, The Bottom, Saba, Caribbean, Netherlands
| | - Ruth Jobarteh
- Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Ameen Alawadhi
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Robert Phelps
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Nanette Silverberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
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Weill A, Bernigaud C, Mokni M, Gil S, Elefant E, Chosidow O. Scabies-infested pregnant women: A critical therapeutic challenge. PLoS Negl Trop Dis 2021; 15:e0008929. [PMID: 33411710 PMCID: PMC7790223 DOI: 10.1371/journal.pntd.0008929] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Amandine Weill
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Université Paris-Est, Créteil, France
- Groupe de recherche Dynamyc, EA7380, Faculté de Santé de Créteil, École nationale vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
- Fondation PremUp, Paris, France
- * E-mail: (AW); (CB)
| | - Charlotte Bernigaud
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Université Paris-Est, Créteil, France
- Groupe de recherche Dynamyc, EA7380, Faculté de Santé de Créteil, École nationale vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
- * E-mail: (AW); (CB)
| | - Mourad Mokni
- Service de Dermatologie, Hôpital La Rabta, Faculté de Médecine, Université al Manar 2, Laboratoire de Recherche Infection et Santé Publique LR18SP01, Tunis, Tunisie
| | - Sophie Gil
- Fondation PremUp, Paris, France
- Université de Paris, INSERM, UMR-S 1139, 3PHM, Paris, France
| | - Elisabeth Elefant
- Centre de Référence sur les Agents Tératogènes (CRAT), Hôpital Armand Trousseau, AP-HP, Sorbonne Université, Paris, France
| | - Olivier Chosidow
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Université Paris-Est, Créteil, France
- Groupe de recherche Dynamyc, EA7380, Faculté de Santé de Créteil, École nationale vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
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Goodarzi H, Wu TT, Wang J, Teng JM. Neonatal Dermatology: The Normal, the Common, and the Serious. Neoreviews 2021; 22:e40-e51. [PMID: 33386313 DOI: 10.1542/neo.22-1-e40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The objective of this review is to help practitioners of neonatal and pediatric medicine become more familiar with diagnosing and managing neonatal skin conditions. This article will discuss normal neonatal skin care and benign and common rashes, as well as some of the serious dermatologic conditions that require specialists for further evaluation and/or treatment.
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Affiliation(s)
- Heidi Goodarzi
- Department of Dermatology, Stanford University, Palo Alto, CA
| | - Tiffany T Wu
- Department of Dermatology, Stanford University, Palo Alto, CA
| | - Jami Wang
- Department of Dermatology, Stanford University, Palo Alto, CA
| | - Joyce M Teng
- Department of Dermatology, Stanford University, Palo Alto, CA
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Kwak R, Kamal K, Charrow A, Khalifian S. Mass migration and climate change: Dermatologic manifestations. Int J Womens Dermatol 2021; 7:98-106. [PMID: 33537399 PMCID: PMC7838242 DOI: 10.1016/j.ijwd.2020.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022] Open
Abstract
Major changes in climate resulting in mass migrations have unique dermatologic implications for global vulnerable populations. Dermatologic manifestations commonly accompany the infectious and communicable diseases that proliferate in the settings of confinement, crowding, and limited sanitation associated with mass migration. Ectoparasitic infestations abound in refugee camps, and poor nutrition, hygiene, and compromised immunity put refugees at an increased risk for more dangerous infectious diseases carried by these ectoparasites. Climate change also profoundly affects the worldwide distribution of various vector-borne illnesses, thereby leading to the emergence of various communicable diseases in previously nonendemic areas. Natural disasters not only disrupt important lifesaving treatments, but also challenge various infectious disease control measures that are critical in preventing rapid transmission of highly infectious diseases. This article reviews the infectious diseases commonly found in these scenarios and provides an in-depth discussion of important implications for the dermatologist.
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Affiliation(s)
- Ruby Kwak
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Kanika Kamal
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Alexandra Charrow
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Saami Khalifian
- Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, CA, United States
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14
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Korhonen PK, Gasser RB, Ma G, Wang T, Stroehlein AJ, Young ND, Ang CS, Fernando DD, Lu HC, Taylor S, Reynolds SL, Mofiz E, Najaraj SH, Gowda H, Madugundu A, Renuse S, Holt D, Pandey A, Papenfuss AT, Fischer K. High-quality nuclear genome for Sarcoptes scabiei-A critical resource for a neglected parasite. PLoS Negl Trop Dis 2020; 14:e0008720. [PMID: 33001992 PMCID: PMC7591027 DOI: 10.1371/journal.pntd.0008720] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/27/2020] [Accepted: 08/17/2020] [Indexed: 12/16/2022] Open
Abstract
The parasitic mite Sarcoptes scabiei is an economically highly significant parasite of the skin of humans and animals worldwide. In humans, this mite causes a neglected tropical disease (NTD), called scabies. This disease results in major morbidity, disability, stigma and poverty globally and is often associated with secondary bacterial infections. Currently, anti-scabies treatments are not sufficiently effective, resistance to them is emerging and no vaccine is available. Here, we report the first high-quality genome and transcriptomic data for S. scabiei. The genome is 56.6 Mb in size, has a a repeat content of 10.6% and codes for 9,174 proteins. We explored key molecules involved in development, reproduction, host-parasite interactions, immunity and disease. The enhanced 'omic data sets for S. scabiei represent comprehensive and critical resources for genetic, functional genomic, metabolomic, phylogenetic, ecological and/or epidemiological investigations, and will underpin the design and development of new treatments, vaccines and/or diagnostic tests.
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Affiliation(s)
- Pasi K. Korhonen
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Robin B. Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Guangxu Ma
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tao Wang
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Andreas J. Stroehlein
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil D. Young
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Ching-Seng Ang
- Bio21 Mass Spectrometry and Proteomics Facility, The University of Melbourne, Melbourne, Victoria, Australia
| | - Deepani D. Fernando
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Hieng C. Lu
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Sara Taylor
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Simone L. Reynolds
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ehtesham Mofiz
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Shivashankar H. Najaraj
- Faculty of Health, School—Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Harsha Gowda
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Anil Madugundu
- Institute of Bioinformatics, Bangalore, India
- Center for Individualized Medicine and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America
- Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | | | - Deborah Holt
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- College of Health and Human Sciences, Charles Darwin University, Darwin, Australia
| | - Akhilesh Pandey
- Center for Individualized Medicine and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America
| | - Anthony T. Papenfuss
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Katja Fischer
- Cell and Molecular Biology Department, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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15
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Lake SJ, Phelan SL, Engelman D, Sokana O, Nasi T, Boara D, Gorae C, Schuster T, Grobler AC, Osti MH, Andrews R, Marks M, Whitfeld MJ, Romani L, Kaldor J, Steer A. Protocol for a cluster-randomised non-inferiority trial of one versus two doses of ivermectin for the control of scabies using a mass drug administration strategy (the RISE study). BMJ Open 2020; 10:e037305. [PMID: 32868360 PMCID: PMC7462236 DOI: 10.1136/bmjopen-2020-037305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Scabies is a significant contributor to global morbidity, affecting approximately 200 million people at any time. Scabies is endemic in many resource-limited tropical settings. Bacterial skin infection (impetigo) frequently complicates scabies infestation in these settings. Community-wide ivermectin-based mass drug administration (MDA) is an effective control strategy for scabies in island settings, with a single round of MDA reducing population prevalence by around 90%. However, current two-dose regimens present a number of barriers to programmatic MDA implementation. We designed the Regimens of Ivermectin for Scabies Elimination (RISE) trial to investigate whether one-dose MDA may be as effective as two-dose MDA in controlling scabies in high-prevalence settings. METHODS AND ANALYSIS RISE is a cluster-randomised non-inferiority trial. The study will be conducted in 20 isolated villages in Western Province of Solomon Islands where population prevalence of scabies is approximately 20%. Villages will be randomly allocated to receive either one dose or two doses of ivermectin-based MDA in a 1:1 ratio. The primary objective of the study is to determine if ivermectin-based MDA with one dose is as effective as MDA with two doses in reducing the prevalence of scabies after 12 months. Secondary objectives include the effect of ivermectin-based MDA on impetigo prevalence after 12 and 24 months, the prevalence of scabies at 24 months after the intervention, the impact on presentation to health facilities with scabies and impetigo, and the safety of one-dose and two-dose MDA. ETHICS AND DISSEMINATION This trial has been approved by the ethics review committees of the Solomon Islands and the Royal Children's Hospital, Australia. Results will be disseminated in peer-reviewed publications and in meetings with the Solomon Islands Ministry of Health and Medical Services and participating communities. TRIAL REGISTRATION DETAILS Australian New Zealand Clinical Trials Registry: ACTRN12618001086257. Date registered: 28 June 2018.
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Affiliation(s)
- Susanna J Lake
- Tropical Disease Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sophie L Phelan
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Daniel Engelman
- Tropical Disease Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Oliver Sokana
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Titus Nasi
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Dickson Boara
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Christina Gorae
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Tibor Schuster
- Clinical Epidemiology and Biostatistics Unit, McGill University, Montreal, Quebec, Canada
| | - Anneke C Grobler
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Millicent H Osti
- Tropical Disease Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ross Andrews
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michael Marks
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases, London, UK
| | - Margot J Whitfeld
- Department of Dermatology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Lucia Romani
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Steer
- Tropical Disease Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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16
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Jastaniah MWA, Zimmo ZFK, Bakallah MWS, Hantoush MSS, Abdal-Aziz M. Clinical presentation and risk factors of increased scabies cases in the Western region of Saudi Arabia in 2016-2018. Saudi Med J 2020; 40:820-827. [PMID: 31423520 PMCID: PMC6718851 DOI: 10.15537/smj.2019.8.24360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To describe the clinical characteristics of scabies in the Makkah province and analyze risk factors associated with the outbreak. Methods: A cross-sectional study was conducted between June 2016 and June 2018 by collecting the data of patients reported to have infestations at King Abdulaziz Medical City, Makkah, Saudi Arabia. A comparative analysis was conducted of patients reported before and during the outbreak of scabies. Results: Of the 352 patients identified, the range of cases was 0-24 cases per month before the months of the outbreak (March to April 2018). However, the actual number of cases reported increased 2.8 times the expected maximum in April 2018. Saudi nationals were 2.5 times more affected than non-Saudi nationals during the outbreak period compared to before the outbreak (95%CI: 1.02, 6.05, p=0.045). Symptoms involving upper arms, axillae (53.7% versus 68.7%, p=0.048), and torso (50% versus 66.4%, p=0.033) were significantly under-represented among outbreak patients. The presence of additional comorbidities was reported more frequently in patients diagnosed with scabies before versus during the outbreak months (25.8% versus 8.2%, p=0.014). Permethrin prescriptions increased (75.6% versus 41%), crotamiton prescriptions decreased (13.5% versus 48%), and the hospitalization was lower (3.8% versus 13.5%) during the outbreak. Conclusion: The clinical presentation and risk factors of scabies change significantly with scabies outbreaks, and consequently so do the lines of treatment in Saudi Arabia. The present study highlights the importance of adopting strategies related to community infection control and prevention.
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Affiliation(s)
- Mohammed Wasil A Jastaniah
- Department of Infection Prevention and Control, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia. E-mail.
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17
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Gopinath H, Karthikeyan K. Genital scabies: Haven of an unwelcome guest. Indian J Sex Transm Dis AIDS 2020; 41:10-16. [PMID: 33062975 PMCID: PMC7529175 DOI: 10.4103/ijstd.ijstd_69_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/10/2018] [Accepted: 12/30/2019] [Indexed: 11/04/2022] Open
Abstract
The itch mite Sarcoptes scabiei var. hominis has been a menace to humanity for ages. Diagnosing scabies can be a challenge in view of the varied presentations of the disease. The male genitalia are an important area of predilection of the mite. Examination of this often overlooked area is essential as it may reveal both characteristic and atypical manifestations of scabies. Genital involvement also attains special relevance in view of the possible sexual transmission of the mite. In addition to the morbidity caused by itching, patients may have to deal with myths, stigma, and embarrassment.
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Affiliation(s)
- Hima Gopinath
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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18
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Abstract
Scabies, an ectoparasitic infestation of the skin by the mite Sarcoptes scabiei, is a clinical problem of particular significance in the elderly population because of unique vulnerability factors. Such factors include reduced mobility, residency in grouped living facilities, and difficulty with implementation of certain treatments. There is also risk of transmission to nearby caretakers and cohabitants. Furthermore, the diagnosis of scabies can be difficult, as this condition can closely resemble other dermatologic diseases. Complicating the diagnosis in this group is the variety of medical settings in which these patients are evaluated, some of which may not be equipped to follow diagnostic guidelines. The diagnosis itself can be complex because of varying clinical presentation and mite burden. Finally, the transmissibility of scabies, especially in grouped living arrangements, makes prompt and proper treatment of this condition paramount. All of these factors present a unique challenge for the clinician treating elderly patients. This article aims to describe the susceptibility factors, clinical presentation, diagnosis, and management considerations specific to elderly adults with scabies.
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Affiliation(s)
- Jodi Raffi
- Department of Dermatology, University of California San Francisco, Divisadero St. 1701, San Francisco, CA, 94110, USA
- School of Medicine, University of California Irvine, 1001 Health Sciences Road, Irvine, CA, 92617, USA
| | - Raagini Suresh
- Department of Dermatology, University of California San Francisco, Divisadero St. 1701, San Francisco, CA, 94110, USA
| | - Daniel C Butler
- Department of Dermatology, University of California San Francisco, Divisadero St. 1701, San Francisco, CA, 94110, USA.
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19
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Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality. Epidemiol Infect 2019; 147:e250. [PMID: 31496448 PMCID: PMC6805746 DOI: 10.1017/s0950268819001249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
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20
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May PJ, Tong SYC, Steer AC, Currie BJ, Andrews RM, Carapetis JR, Bowen AC. Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health 2019; 24:280-293. [PMID: 30582783 PMCID: PMC6850630 DOI: 10.1111/tmi.13198] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We conducted a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource‐limited settings where skin infections are endemic. The aim is to inform strategies, guidelines and research to improve skin health in populations that are inequitably affected by infections of the skin and the downstream consequences of these. The systematic review is reported according to the PRISMA statement. From 1759 titles identified, 81 full text studies were reviewed and key findings outlined for impetigo, scabies, crusted scabies and tinea. Improvements in primary care and public health management of skin infections will have broad and lasting impacts on overall quality of life including reductions in morbidity and mortality from sepsis, skeletal infections, kidney and heart disease.
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Affiliation(s)
- Philippa J May
- Northern Territory Centre for Disease Control, Casuarina, Australia
| | - Steven Y C Tong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Parkville, Australia.,Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Andrew C Steer
- Royal Children's Hospital, Parkville, Australia.,Murdoch Children's Research Institute, University of Melbourne, Parkville, Australia
| | - Bart J Currie
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,Royal Darwin Hospital, Casuarina, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Jonathan R Carapetis
- Perth Children's Hospital, Nedlands, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, University of Western Australia, Nedlands, Australia.,School of Medicine, University of Western Australia, Nedlands, Australia
| | - Asha C Bowen
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.,Perth Children's Hospital, Nedlands, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, University of Western Australia, Nedlands, Australia.,School of Medicine, University of Western Australia, Nedlands, Australia.,University of Notre Dame Australia, Fremantle, Australia
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21
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Ong CY, Vasanwala FF. Infected with Scabies Again? Focus in Management in Long-Term Care Facilities. Diseases 2018; 7:diseases7010003. [PMID: 30597979 PMCID: PMC6473425 DOI: 10.3390/diseases7010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/11/2018] [Accepted: 12/22/2018] [Indexed: 12/01/2022] Open
Abstract
Scabies is a significant public health condition in long-term care facilities, plaguing even developed countries. Although treatments are available, eradication and control of scabies cases still remain a challenge due to delays in diagnosis and difficulties in maintaining preventive and surveillance measures. Prompt treatment of patients and their contacts that are affected, along with concomitant education of health staff and family members, are paramount. Environmental disinfestation is also a concern.
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Affiliation(s)
- Chong Yau Ong
- Department of Family Medicine, Division of Medicine, Sengkang General Hospital, Singapore 544886, Singapore.
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 544886, Singapore.
| | - Farhad Fakhrudin Vasanwala
- Department of Family Medicine, Division of Medicine, Sengkang General Hospital, Singapore 544886, Singapore.
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 544886, Singapore.
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22
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Martin D, Wiegand R, Goodhew B, Lammie P, Mkocha H, Kasubi M. Impact of Ivermectin Mass Drug Administration for Lymphatic Filariasis on Scabies in Eight Villages in Kongwa District, Tanzania. Am J Trop Med Hyg 2018; 99:937-939. [PMID: 30062986 PMCID: PMC6159570 DOI: 10.4269/ajtmh.18-0018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/20/2018] [Indexed: 11/29/2022] Open
Abstract
Scabies was recently added to the World Health Organization list of neglected tropical diseases. The ability to treat scabies with oral ivermectin makes a mass drug administration (MDA) campaign a feasible option for scabies control. Ivermectin MDA in communities endemic for lymphatic filariasis (LF) or onchocerciasis may already be having an impact on scabies. We examined the effect of ivermectin MDA for LF on scabies prevalence over 4 years in eight Tanzanian villages. At baseline, 4.4% (95% confidence interval [CI]: 3.7-5.4) of individuals tested positive for scabies, decreasing to 0.84% (95% CI: 0.51-1.4) after one round of ivermectin MDA but increased in Year 3 (2.5% [95% CI: 1.9-3.3]) and Year 4 (2.9% [95% CI: 2.2-3.8]). Most scabies cases were seen in children younger than 15 years. The data suggest that single-dose ivermectin MDA may not be effective in attaining long-term decreases when scabies prevalence is less than 5%.
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Affiliation(s)
- Diana Martin
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brook Goodhew
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patrick Lammie
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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23
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Impact of ivermectin administered for scabies treatment on the prevalence of head lice in Atoifi, Solomon Islands. PLoS Negl Trop Dis 2018; 12:e0006825. [PMID: 30252856 PMCID: PMC6173439 DOI: 10.1371/journal.pntd.0006825] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/05/2018] [Accepted: 09/07/2018] [Indexed: 11/17/2022] Open
Abstract
Background Scabies and head lice are ubiquitous ectoparasitic infestations that are common across the Pacific Islands. Ivermectin is an effective treatment for both conditions, although the doses used vary. At a community level, mass drug administration (MDA) with ivermectin is an effective strategy to decrease prevalence of scabies. To what extent MDA with ivermectin will also reduce prevalence of head lice is unknown. Methodology Head lice prevalence was assessed before and after MDA with oral ivermectin (at a dose of 200 micrograms per kilogram of body weight) administered on day 1 and day 8. The primary outcome was the change in prevalence of head louse infestation at two weeks compared to baseline. Longer term efficacy was assessed three months after MDA. Results 118 participants were enrolled. Baseline prevalence of active head louse infestation was 25.4% (95% CI 18.4–34.0). At two-week follow-up, prevalence was 2.5% (95% CI 0.9–7.2), a relative reduction of 89.1% (95% CI 72.7–91.4%, p<0.001). At three-month follow-up, prevalence was 7.5% (95% CI 2.7–12.3), a relative reduction of 70.6% (95% CI 72.7%-91.4%, p <0.001). Head louse infestation was associated with younger age (age ≤10 years: prevalence 46.7%; adjusted odds ratio compared to adults of 7.2, 95%CI 2.0–25.9) and with having at least one other member of the household with active head louse infestation (adjusted odds ratio 4.3, 95%CI 1.7–11.1). Conclusions Head louse infestation is common in the Solomon Islands. This proof of principle study shows that oral ivermectin at a dose of 200 micrograms per kilogram can reduce the burden of active head louse infestation, offering an additional collateral benefit of MDA with ivermectin for scabies control. Trial registration ClinicalTrials.gov NCT03236168. Head lice and scabies are both caused by ectoparasites and lead to itchy skin conditions that are associated with secondary bacterial infections and social stigma. Both are common in developing countries. In the Solomon Islands, mass treatment of communities using ivermectin (at dose of 200 micrograms per kilogram) has been shown to be an effective strategy in reducing scabies prevalence. This study shows that the same dose of ivermectin and the same regime of mass drug administration is also effective at reducing the burden of head louse infestation, offering an additional benefit to community wide treatment.
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24
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Dietrich A, Joshi K, Sayed C. Infestations in the Geriatric Patient. CURRENT GERIATRICS REPORTS 2018. [DOI: 10.1007/s13670-018-0255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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25
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Efficacy and Pharmacokinetics Evaluation of a Single Oral Dose of Afoxolaner against Sarcoptes scabiei in the Porcine Scabies Model for Human Infestation. Antimicrob Agents Chemother 2018; 62:AAC.02334-17. [PMID: 29914951 DOI: 10.1128/aac.02334-17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 06/07/2018] [Indexed: 11/20/2022] Open
Abstract
Scabies is a major and potentially growing public health problem worldwide with an unmet need for acaricidal agents with greater efficacy and improved pharmacological properties for its treatment. The objective of the present study was to assess the efficacy and describe the pharmacokinetics profile of a novel acaricide, afoxolaner (AFX), in a relevant experimental porcine model. Twelve pigs were experimentally infested and either treated with 2.5 mg/kg single dose oral AFX (n = 4) or 0.2 mg/kg, two doses 8 days apart, oral ivermectin ([IVM] n = 4) or not treated for scabies (n = 4). The response to treatment was assessed by the reduction of mite counts in skin scrapings as well as clinical and pruritus scores over time. Plasma and skin pharmacokinetics profiles for both AFX and IVM were evaluated. AFX efficacy was 100% at days 8 and 14 posttreatment and remained unchanged until the study end (day 45). IVM efficacy was 86% and 97% on days 8 and 14, respectively, with a few mites recovered at the study end. Clinical and pruritus scores decreased in both treated groups and remained constant in the control group. Plasma mean residence times (MRT) were 7.1 ± 2.4 and 1.1 ± 0.2 days for AFX and IVM, respectively. Skin MRT values were 16.2 ± 16.9 and 2.7 ± 0.5 days for AFX and IVM, respectively. Overall, a single oral dose of AFX was efficacious for the treatment of scabies in experimentally infested pigs and showed remarkably long MRTs in plasma and, notably, in the skin.
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Abstract
CONTEXT: Infections are common in contact sports. This review aims to describe the epidemiology, presenting signs and symptoms, treatment guidelines, and regulations for several common infections seen in contact sport athletes. The conditions discussed include bacterial skin infections, herpes simplex virus, molluscum contagiosum, common warts, tinea, scabies, head lice, conjunctivitis, human immunodeficiency virus, hepatitis C virus, and vaccine-preventable illnesses. EVIDENCE ACQUISITION: Searches were performed across PubMed and MEDLINE research databases. In addition, general internet search engine results and reviews of reference lists of relevant papers were used to identify additional sources of evidence. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: The most common infections seen in contact sport athletes include bacterial skin infections, herpes simplex virus, molluscum contagiosum, common warts, tinea, scabies, head lice, conjunctivitis, and vaccine-preventable illnesses. Other infections, including human immunodeficiency virus and hepatitis C, are uncommon but potentially life threatening. CONCLUSION: Infections are common in contact sport athletes. The provider who cares for these athletes should be aware of the most common infections and their appropriate management. Early diagnosis and appropriate clinical management are important for treating the infected athlete, minimizing risk of transmission, minimizing time lost from competition, and preventing large outbreaks.
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Affiliation(s)
- Andrew R. Peterson
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Emma Nash
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa
| | - B.J. Anderson
- University of Minnesota, Minneapolis, Minnesota
- Boynton Health Service, Minneapolis, Minnesota
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Fernando DD, Reynolds SL, Zakrzewski M, Mofiz E, Papenfuss AT, Holt D, Fischer K. Phylogenetic relationships, stage-specific expression and localisation of a unique family of inactive cysteine proteases in Sarcoptes scabiei. Parasit Vectors 2018; 11:301. [PMID: 29769145 PMCID: PMC5956821 DOI: 10.1186/s13071-018-2862-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/23/2018] [Indexed: 11/17/2022] Open
Abstract
Background Scabies is worldwide one of the most common, yet neglected, parasitic skin infections, affecting a wide range of mammals including humans. Limited treatment options and evidence of emerging mite resistance against the currently used drugs drive our research to explore new therapeutic candidates. Previously, we discovered a multicopy family of genes encoding cysteine proteases with their catalytic sites inactivated by mutation (SMIPP-Cs). This protein family is unique in parasitic scabies mites and is absent in related non-burrowing mites. We postulated that the SMIPP-Cs have evolved as an adaptation to the parasitic lifestyle of the scabies mite. To formulate testable hypotheses for their functions and to propose possible strategies for translational research we investigated whether the SMIPP-Cs are common to all scabies mite varieties and where within the mite body as well as when throughout the parasitic life-cycle they are expressed. Results SMIPP-C sequences from human, pig and dog mites were analysed bioinformatically and the phylogenetic relationships between the SMIPP-C multi-copy gene families of human, pig and dog mites were established. Results suggest that amplification of the SMIPP-C genes occurred in a common ancestor and individual genes evolved independently in the different mite varieties. Recombinant human mite SMIPP-C proteins were produced and used for murine polyclonal antibody production. Immunohistology on skin sections from human patients localised the SMIPP-Cs in the mite gut and in mite faeces within in the epidermal skin burrows. SMIPP-C transcription into mRNA in different life stages was assessed in human and pig mites by reverse transcription followed by droplet digital PCR (ddPCR). High transcription levels of SMIPP-C genes were detected in the adult female life stage in comparison to all other life stages. Conclusions The fact that the SMIPP-Cs are unique to three Sarcoptes varieties, present in all burrowing life stages and highly expressed in the digestive system of the infective adult female life stage may highlight an essential role in parasitism. As they are excreted from the gut in scybala they presumably are able to interact or interfere with host proteins present in the epidermis. Electronic supplementary material The online version of this article (10.1186/s13071-018-2862-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deepani D Fernando
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane, QLD, 4006, Australia.,School of Veterinary Sciences, University of Queensland, Gatton, QLD, 4343, Australia.,Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simone L Reynolds
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane, QLD, 4006, Australia
| | - Martha Zakrzewski
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane, QLD, 4006, Australia
| | - Ehtesham Mofiz
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Anthony T Papenfuss
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, 3052, Australia.,Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, 3000, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Deborah Holt
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Katja Fischer
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane, QLD, 4006, Australia.
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Wilkins AL, Steer AC, Cranswick N, Gwee A. Question 1: Is it safe to use ivermectin in children less than five years of age and weighing less than 15 kg? Arch Dis Child 2018; 103:514-519. [PMID: 29463522 DOI: 10.1136/archdischild-2017-314505] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/11/2018] [Accepted: 01/15/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Amanda L Wilkins
- Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Andrew C Steer
- Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Noel Cranswick
- Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Amanda Gwee
- Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Abstract
BACKGROUND Scabies is an intensely itchy parasitic infection of the skin. It occurs worldwide, but is particularly problematic in areas of poor sanitation, overcrowding, and social disruption. In recent years, permethrin and ivermectin have become the most relevant treatment options for scabies. OBJECTIVES To assess the efficacy and safety of topical permethrin and topical or systemic ivermectin for scabies in people of all ages. SEARCH METHODS We searched the following databases up to 25 April 2017: the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, and IndMED. We searched the World Health Organization International Clinical Trials Registry Platform, the ISRCTN registry, CenterWatch Clinical Trials Listing, ClinicalTrials.gov, TrialsCentral, and the UK Department of Health National Research Register for ongoing trials. We also searched multiple sources for grey literature and checked reference lists of included studies for additional trials. SELECTION CRITERIA We included randomized controlled trials that compared permethrin or ivermectin against each other for people with scabies of all ages and either sex. DATA COLLECTION AND ANALYSIS Two review authors independently screened the identified records, extracted data, and assessed the risk of bias for the included trials.The primary outcome was complete clearance of scabies. Secondary outcomes were number of participants re-treated, number of participants with at least one adverse event, and number of participants withdrawn from study due to an adverse event.We summarized dichotomous outcomes using risk ratios (RR) with 95% confidence intervals (CI). If it was not possible to calculate the point estimate, we described the data qualitatively. Where appropriate, we calculated combined effect estimates using a random-effects model and assessed heterogeneity. We calculated numbers needed to treat for an additional beneficial outcome when we found a difference.We assessed the certainty of the evidence using the GRADE approach. We used the control rate average to provide illustrative clearance rates in the comparison groups. MAIN RESULTS Fifteen studies (1896 participants) comparing topical permethrin, systemic ivermectin, or topical ivermectin met the inclusion criteria. Overall, the risk of bias in the included trials was moderate: reporting in many studies was poor. Nearly all studies were conducted in South Asia or North Africa, where the disease is more common, and is associated with poverty.EfficacyOral ivermectin (at a standard dose of 200 μg/kg) may lead to slightly lower rates of complete clearance after one week compared to permethrin 5% cream. Using the average clearance rate of 65% in the trials with permethrin, the illustrative clearance with ivermectin is 43% (RR 0.65, 95% CI 0.54 to 0.78; 613 participants, 6 studies; low-certainty evidence). However, by week two there may be little or no difference (illustrative clearance of permethrin 74% compared to ivermectin 68%; RR 0.91, 95% CI 0.76 to 1.08; 459 participants, 5 studies; low-certainty evidence). Treatments with one to three doses of ivermectin or one to three applications of permethrin may lead to little or no difference in rates of complete clearance after four weeks' follow-up (illustrative cures with 1 to 3 applications of permethrin 93% and with 1 to 3 doses of ivermectin 86%; RR 0.92, 95% CI 0.82 to 1.03; 581 participants, 5 studies; low-certainty evidence).After one week of treatment with oral ivermectin at a standard dose of 200 μg/kg or one application of permethrin 5% lotion, there is probably little or no difference in complete clearance rates (illustrative cure rates: permethrin 73%, ivermectin 68%; RR 0.93, 95% CI 0.74 to 1.17; 120 participants, 1 study; moderate-certainty evidence). After two weeks of treatment, one dose of systemic ivermectin compared to one application of permethrin lotion may lead to similar complete clearance rates (extrapolated cure rates: 67% in both groups; RR 1.00, 95% CI 0.78 to 1.29; 120 participants, 1 study; low-certainty evidence).There is probably little or no difference in rates of complete clearance between systemic ivermectin at standard dose and topical ivermectin 1% lotion four weeks after initiation of treatment (illustrative cure rates: oral ivermectin 97%, ivermectin lotion 96%; RR 0.99, 95% CI 0.95 to 1.03; 272 participants, 2 studies; moderate-certainty evidence). Likewise, after four weeks, ivermectin lotion probably leads to little or no difference in rates of complete clearance when compared to permethrin cream (extrapolated cure rates: permethrin cream 94%, ivermectin lotion 96%; RR 1.02, 95% CI 0.96 to 1.08; 210 participants, 1 study; moderate-certainty evidence), and there is little or no difference among systemic ivermectin in different doses (extrapolated cure rates: 2 doses 90%, 1 dose 87%; RR 0.97, 95% CI 0.83 to 1.14; 80 participants, 1 study; high-certainty evidence).SafetyReporting of adverse events in the included studies was suboptimal. No withdrawals due to adverse events occurred in either the systemic ivermectin or the permethrin group (moderate-certainty evidence). Two weeks after treatment initiation, there is probably little or no difference in the proportion of participants treated with systemic ivermectin or permethrin cream who experienced at least one adverse event (55 participants, 1 study; moderate-certainty evidence). After four weeks, ivermectin may lead to a slightly larger proportion of participants with at least one adverse event (extrapolated rates: permethrin 4%, ivermectin 5%; RR 1.30, 95% CI 0.35 to 4.83; 502 participants, 4 studies; low-certainty evidence).Adverse events in participants treated with topical ivermectin were rare and of mild intensity and comparable to those with systemic ivermectin. For this comparison, it is uncertain whether there is any difference in the number of participants with at least one adverse event (very low-certainty evidence). No withdrawals due to adverse events occurred (62 participants, 1 study; moderate-certainty evidence).It is uncertain whether topical ivermectin or permethrin differ in the number of participants with at least one adverse event (very low-certainty evidence). We found no studies comparing systemic ivermectin in different doses that assessed safety outcomes. AUTHORS' CONCLUSIONS We found that for the most part, there was no difference detected in the efficacy of permethrin compared to systemic or topical ivermectin. Overall, few and mild adverse events were reported. Our confidence in the effect estimates was mostly low to moderate. Poor reporting is a major limitation.
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Affiliation(s)
- Stefanie Rosumeck
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDivision of Evidence Based Medicine, Department of Dermatology, Venerology and AllergologyCharitéplatz 1BerlinBerlinGermany10117
| | - Alexander Nast
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDivision of Evidence Based Medicine, Department of Dermatology, Venerology and AllergologyCharitéplatz 1BerlinBerlinGermany10117
| | - Corinna Dressler
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDivision of Evidence Based Medicine, Department of Dermatology, Venerology and AllergologyCharitéplatz 1BerlinBerlinGermany10117
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Dean P, Geraghty SR, Real FJ. Case 4: Diffuse Rash in a 2-month-old Girl. Pediatr Rev 2018; 39:214-215. [PMID: 29610432 DOI: 10.1542/pir.2017-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Sheela R Geraghty
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Francis J Real
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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31
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Yeoh DK, Anderson A, Cleland G, Bowen AC. Are scabies and impetigo "normalised"? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections. PLoS Negl Trop Dis 2017; 11:e0005726. [PMID: 28671945 PMCID: PMC5510902 DOI: 10.1371/journal.pntd.0005726] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/14/2017] [Accepted: 06/19/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Complications of scabies and impetigo such as glomerulonephritis and invasive bacterial infection in Australian Aboriginal children remain significant problems and the overall global burden of disease attributable to these skin infections remains high despite the availability of effective treatment. We hypothesised that one factor contributing to this high burden is that skin infection is under-recognised and hence under-treated, in settings where prevalence is high. METHODS We conducted a prospective, cross-sectional study to assess the burden of scabies, impetigo, tinea and pediculosis in children admitted to two regional Australian hospitals from October 2015 to January 2016. A retrospective chart review of patients admitted in November 2014 (mid-point of the prospective data collection in the preceding year) was performed. Prevalence of documented skin infection was compared in the prospective and retrospective population to assess clinician recognition and treatment of skin infections. RESULTS 158 patients with median age 3.6 years, 74% Aboriginal, were prospectively recruited. 77 patient records were retrospectively reviewed. Scabies (8.2% vs 0.0%, OR N/A, p = 0.006) and impetigo (49.4% vs 19.5%, OR 4.0 (95% confidence interval [CI 2.1-7.7) were more prevalent in the prospective analysis. Skin examination was only documented in 45.5% of cases in the retrospective review. Patients in the prospective analysis were more likely to be prescribed specific treatment for skin infection compared with those in the retrospective review (31.6% vs 5.2%, OR 8.5 (95% CI 2.9-24.4). CONCLUSIONS Scabies and impetigo infections are under-recognised and hence under-treated by clinicians. Improving the recognition and treatment of skin infections by clinicians is a priority to reduce the high burden of skin infection and subsequent sequelae in paediatric populations where scabies and impetigo are endemic.
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Affiliation(s)
- Daniel K. Yeoh
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia
- Paediatric Services, Western Australia Country Health Service Kimberley Region, Broome, Western Australia
- * E-mail:
| | - Aleisha Anderson
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia
- Paediatric Services, Western Australia Country Health Service Kimberley Region, Broome, Western Australia
- Paediatric Services, Hedland Health Campus, Port Hedland, Western Australia
| | - Gavin Cleland
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia
- Paediatric Services, Western Australia Country Health Service Kimberley Region, Broome, Western Australia
| | - Asha C. Bowen
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory
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32
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Salavastru CM, Chosidow O, Boffa MJ, Janier M, Tiplica GS. European guideline for the management of scabies. J Eur Acad Dermatol Venereol 2017. [PMID: 28639722 DOI: 10.1111/jdv.14351] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Scabies is caused by Sarcoptes scabiei var. hominis. The disease can be sexually transmitted. Patients' main complaint is nocturnal itch. Disseminated, excoriated, erythematous papules are usually seen on the anterior trunk and limbs. Crusted scabies occurs in immunocompromised hosts and may be associated with reduced or absent pruritus. Recommended treatments are permethrin 5% cream, oral ivermectin and benzyl benzoate 25% lotion. Alternative treatments are malathion 0.5% aqueous lotion, ivermectin 1% lotion and sulphur 6-33% cream, ointment or lotion. Crusted scabies therapy requires a topical scabicide and oral ivermectin. Mass treatment of large populations with endemic disease can be performed with a single dose of ivermectin (200 micrograms/kg of bodyweight). Partner management needs a look-back period of 2 months. Screening for other STI is recommended. Patients and close contacts should avoid sexual contact until completion of treatment and should strictly observe personal hygiene rules when living in crowded spaces. Written information should be provided to suspected cases.
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Affiliation(s)
- C M Salavastru
- Department of Dermato-Pediatry, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - O Chosidow
- Department of Dermatology, Hôpital Henri Mondor AP-HP, Créteil, France
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - M Janier
- STD Clinic, Hôpital Saint-Louis AP-HP, and Head of Dermatology Department, Hôpital Saint-Joseph, Paris, France
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Ferreira AA, Esteves A, Mahia Y, Rosmaninho A, Silva A. An Itchy Problem: A Clinical Case of Crusted Scabies. Eur J Case Rep Intern Med 2017; 4:000591. [PMID: 30755943 PMCID: PMC6346783 DOI: 10.12890/2017_000591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 11/29/2022] Open
Abstract
Scabies is an infestation of the skin by the mite Sarcoptes scabiei. A more severe form called crusted or Norwegian scabies may occur in immunosuppressed patients and the elderly. Crusted scabies mostly differs from normal scabies by the exuberance of its lesions, body distribution and high contagiousness, and requires different and more prolonged treatment. Early recognition of the lesions and isolation precautions are crucial for disease control and prevention of transmission. The authors describe a clinical case of crusted scabies with pruritus and exuberant cutaneous lesions.
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Affiliation(s)
| | - Alexandra Esteves
- Serviço de Medicina 1, Unidade Local de Saúde do Alto Minho, EPE, Portugal
| | - Yolanda Mahia
- Serviço de Anatomia Patológica, Unidade Local de Saúde do Alto Minho, EPE, Portugal
| | | | - Augusta Silva
- Serviço de Medicina 1, Unidade Local de Saúde do Alto Minho, EPE, Portugal
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Mila-Kierzenkowska C, Woźniak A, Krzyżyńska-Malinowska E, Kałużna L, Wesołowski R, Poćwiardowski W, Owcarz M. Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Ointment in Treatment of Scabies. J Arthropod Borne Dis 2017; 11:1-9. [PMID: 29018829 PMCID: PMC5629290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 09/13/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to compare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment. METHODS Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals. RESULTS At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001) and sulfur group (P< 0.001). At the end of two-week interval, the cure rate at permethrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001). At 4-week follow up the applied treatment was effective in all studied individuals. CONCLUSION The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.
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Affiliation(s)
| | - Alina Woźniak
- The Chair of Medical Biology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Lucyna Kałużna
- Department of Cosmetology and Aesthetic Dermatology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Roland Wesołowski
- The Chair of Medical Biology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Wojciech Poćwiardowski
- Institute of Food Technology, Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences, Bydgoszcz, Poland
| | - Marcin Owcarz
- Ludwik Rydygier Voivodship Polyclinical Hospital, Toruń, Poland
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Fang F, Candy K, Melloul E, Bernigaud C, Chai L, Darmon C, Durand R, Botterel F, Chosidow O, Izri A, Huang W, Guillot J. In vitro activity of ten essential oils against Sarcoptes scabiei. Parasit Vectors 2016; 9:594. [PMID: 27876081 PMCID: PMC5120413 DOI: 10.1186/s13071-016-1889-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/15/2016] [Indexed: 01/01/2023] Open
Abstract
Background The development of alternative approaches in ectoparasite management is currently required. Essential oils have been demonstrated to exhibit fumigant and topical toxicity to a number of arthropods. The aim of the present study was to assess the potential efficacy of ten essential oils against Sarcoptes scabiei. Methods The major chemical components of the oils were identified by GC-MS analysis. Contact and fumigation bioassays were performed on Sarcoptes mites collected from experimentally infected pigs. For contact bioassays, essential oils were diluted with paraffin to get concentrations at 10, 5, and even 1% for the most efficient ones. The mites were inspected under a stereomicroscope 10, 20, 30, 40, 50, 60, 90, 120, 150, and 180min after contact. For fumigation bioassay, a filter paper was treated with 100 μL of the pure essential oil. The mites were inspected under a stereomicroscope for the first 5min, and then every 5min until 1h. Results Using contact bioassays, 1% clove and palmarosa oil killed all the mites within 20 and 50min, respectively. The oils efficacy order was: clove > palmarosa > geranium > tea tree > lavender > manuka > bitter orange > eucalyptus > Japanese cedar. In fumigation bioassays, the efficacy order was: tea tree > clove > eucalyptus > lavender > palmarosa > geranium > Japanese cedar > bitter orange > manuka. In both bioassays, cade oil showed no activity. Conclusion Essential oils, especially tea tree, clove, palmarosa, and eucalyptus oils, are potential complementary or alternative products to treat S. scabiei infections in humans or animals, as well as to control the mites in the environment. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1889-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fang Fang
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China.,Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France
| | - Kerdalidec Candy
- Parasitology-Mycology Department, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Elise Melloul
- Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France
| | - Charlotte Bernigaud
- Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France.,Dermatology Department, AP-HP, Henri Mondor Hospital, UPEC, Créteil, France
| | - Ling Chai
- Guangxi Key Laboratory of Traditional Chinese Medicine Quality Standards, Guangxi Institute of Traditional Medical and Pharmaceutical Sciences, Nanning, China
| | - Céline Darmon
- Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France
| | - Rémy Durand
- Parasitology-Mycology Department, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Françoise Botterel
- Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France
| | - Olivier Chosidow
- Dermatology Department, AP-HP, Henri Mondor Hospital, UPEC, Créteil, France
| | - Arezki Izri
- Parasitology-Mycology Department, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Weiyi Huang
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Jacques Guillot
- Research group Dynamyc, EA 7380 EnvA, UPEC, UPE, Maisons-Alfort & Créteil, France.
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Bernigaud C, Fang F, Fischer K, Lespine A, Aho LS, Dreau D, Kelly A, Sutra JF, Moreau F, Lilin T, Botterel F, Guillot J, Chosidow O. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model. PLoS Negl Trop Dis 2016; 10:e0005030. [PMID: 27732588 PMCID: PMC5061321 DOI: 10.1371/journal.pntd.0005030] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/09/2016] [Indexed: 11/08/2022] Open
Abstract
Background Scabies is one of the commonest dermatological conditions globally; however it is a largely underexplored and truly neglected infectious disease. Foremost, improvement in the management of this public health burden is imperative. Current treatments with topical agents and/or oral ivermectin (IVM) are insufficient and drug resistance is emerging. Moxidectin (MOX), with more advantageous pharmacological profiles may be a promising alternative. Methodology/Principal Findings Using a porcine scabies model, 12 pigs were randomly assigned to receive orally either MOX (0.3 mg/kg once), IVM (0.2 mg/kg twice) or no treatment. We evaluated treatment efficacies by assessing mite count, clinical lesions, pruritus and ELISA-determined anti-S. scabiei IgG antibodies reductions. Plasma and skin pharmacokinetic profiles were determined. At day 14 post-treatment, all four MOX-treated but only two IVM-treated pigs were mite-free. MOX efficacy was 100% and remained unchanged until study-end (D47), compared to 62% (range 26–100%) for IVM, with one IVM-treated pig remaining infected until D47. Clinical scabies lesions, pruritus and anti-S. scabiei IgG antibodies had completely disappeared in all MOX-treated but only 75% of IVM-treated pigs. MOX persisted ~9 times longer than IVM in plasma and skin, thereby covering the mite’s entire life cycle and enabling long-lasting efficacy. Conclusions/Significance Our data demonstrate that oral single-dose MOX was more effective than two consecutive IVM-doses, supporting MOX as potential therapeutic approach for scabies. Scabies caused by the Sarcoptes scabiei mite affects many people worldwide and has been recently recognized by the WHO as a truly neglected tropical disease. Currently available treatments are insufficient to overcome this insidious disease and its co-morbidities for example impetigo, rheumatic heart disease and post-streptococcal glomerulonephritis. Treatment management is a major issue, as problems with compliance as well as mite resistance to current drugs are reported. Data have accumulated indicating that moxidectin could be a genuine new candidate drug for sustainable scabies control. To provide proof of concept, we utilized an experimental scabies pig model that closely resembles the human route of scabies infection. We demonstrated that a single moxidectin dose, when compared with the currently recommended two-doses ivermectin treatment routine, achieved a better and faster acaricidal efficacy. Importantly, the skin half-life of moxidectin is longer, potentially covering the entire mite life cycle. Our baseline data demonstrate in principle the potential and feasibility of moxidectin treatment for scabies, thereby enabling the move into larger high-powered efficacy and dose ranging studies in human populations. Moxidectin could indeed play a game-changing role in scabies control and has the potential to accelerate the steps towards elimination of this insidious disease.
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Affiliation(s)
- Charlotte Bernigaud
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- APHP, Hôpital Henri-Mondor, Department of Dermatology, UPEC, Créteil, France
- * E-mail:
| | - Fang Fang
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- Department of Parasitology, College of Animal Science and Technology, University of Guangxi, Nanning, China
| | - Katja Fischer
- Infections Diseases Department, Scabies Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Anne Lespine
- Toxalim, INRA, INP-ENVT, INP-EI-Purpan, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Ludwig Serge Aho
- Epidemiology and Infection Control Unit, University Hospital of Dijon, Dijon, France
| | | | - Andrew Kelly
- Department of Agriculture, Fisheries and Forestry, Queensland Animal Science Precinct, University of Queensland, Gatton Campus, Queensland, Australia
| | - Jean-François Sutra
- Toxalim, INRA, INP-ENVT, INP-EI-Purpan, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Francis Moreau
- Centre de Recherche BioMédicale (CRBM), EnvA, UPE, Maisons-Alfort, France
| | - Thomas Lilin
- Centre de Recherche BioMédicale (CRBM), EnvA, UPE, Maisons-Alfort, France
| | - Françoise Botterel
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- APHP, Hôpital Henri-Mondor, Parasitology and Mycology, Department of Microbiology, DHU VIC, UPEC, Créteil, France
| | - Jacques Guillot
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- Department of Parasitology and Mycology, Biopôle d'Alfort, Ecole nationale vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - Olivier Chosidow
- APHP, Hôpital Henri-Mondor, Department of Dermatology, UPEC, Créteil, France
- EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques) and INSERM, CIC 1430, UPE, Créteil, France
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May P, Bowen A, Tong S, Steer A, Prince S, Andrews R, Currie B, Carapetis J. Protocol for the systematic review of the prevention, treatment and public health management of impetigo, scabies and fungal skin infections in resource-limited settings. Syst Rev 2016; 5:162. [PMID: 27659511 PMCID: PMC5034664 DOI: 10.1186/s13643-016-0335-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/09/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Impetigo, scabies, and fungal skin infections disproportionately affect populations in resource-limited settings. Evidence for standard treatment of skin infections predominantly stem from hospital-based studies in high-income countries. The evidence for treatment in resource-limited settings is less clear, as studies in these populations may lack randomisation and control groups for cultural, ethical or economic reasons. Likewise, a synthesis of the evidence for public health control within endemic populations is also lacking. We propose a systematic review of the evidence for the prevention, treatment and public health management of skin infections in resource-limited settings, to inform the development of guidelines for the standardised and streamlined clinical and public health management of skin infections in endemic populations. METHODS The protocol has been designed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. All trial designs and analytical observational study designs will be eligible for inclusion. A systematic search of the peer-reviewed literature will include PubMed, Excertpa Medica and Global Health. Grey literature databases will also be systematically searched, and clinical trials registries scanned for future relevant studies. The primary outcome of interest will be the clinical cure or decrease in prevalence of impetigo, scabies, crusted scabies, tinea capitis, tinea corporis or tinea unguium. Two independent reviewers will perform eligibility assessment and data extraction using standardised electronic forms. Risk of bias assessment will be undertaken by two independent reviewers according to the Cochrane Risk of Bias tool. Data will be tabulated and narratively synthesised. We expect there will be insufficient data to conduct meta-analysis. The final body of evidence will be reported against the Grades of Recommendation, Assessment, Development and Evaluation grading system. DISCUSSION The evidence derived from the systematic review will be used to inform the development of guidelines for the management of skin infections in resource-limited settings. The evidence derived will be intended for use by clinicians, public health practitioners and policy makers in the treatment of skin infections and the development of skin infection control programmes. The review will identify any gaps in the current evidence to provide direction for future research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015029453.
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Affiliation(s)
- Philippa May
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872 Australia
| | - Asha Bowen
- Telethon Kids Institute, University of Western Australia, West Perth, Australia
| | - Steven Tong
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Andrew Steer
- Murdoch Children’s Research Institute, University of Melbourne, Parkville, Australia
| | | | - Ross Andrews
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Bart Currie
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Jonathan Carapetis
- Telethon Kids Institute, University of Western Australia, West Perth, Australia
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Yeoh DK, Bowen AC, Carapetis JR. Impetigo and scabies - Disease burden and modern treatment strategies. J Infect 2016; 72 Suppl:S61-7. [PMID: 27180311 DOI: 10.1016/j.jinf.2016.04.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Impetigo and scabies both present different challenges in resource-limited compared with industrialised settings. Severe complications of these skin infections are common in resource-limited settings, where the burden of disease is highest. The microbiology, risk factors for disease, diagnostic approaches and availability and suitability of therapies also vary according to setting. Taking this into account we aim to summarise recent data on the epidemiology of impetigo and scabies and describe the current evidence around approaches to individual and community based treatment.
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Affiliation(s)
- Daniel K Yeoh
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
| | - Asha C Bowen
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
| | - Jonathan R Carapetis
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
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Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward. Epidemiol Infect 2016; 144:2462-71. [PMID: 27019288 DOI: 10.1017/s0950268816000443] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
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.
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Mounsey KE, Bernigaud C, Chosidow O, McCarthy JS. Prospects for Moxidectin as a New Oral Treatment for Human Scabies. PLoS Negl Trop Dis 2016; 10:e0004389. [PMID: 26985995 PMCID: PMC4795782 DOI: 10.1371/journal.pntd.0004389] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kate E. Mounsey
- Inflammation & Healing Research Cluster, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, Queensland, Australia
- Infectious Diseases & Immunology Division, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- * E-mail:
| | | | - Olivier Chosidow
- Dermatology Department, Henri Mondor Hospital, AP-HP, UPEC, Créteil, France
- Université Paris-est Créteil Val de Marne, Créteil, France
| | - James S. McCarthy
- Infectious Diseases & Immunology Division, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Medicine, University of Queensland, Herston, Queensland, Australia
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Thomas J, Carson CF, Peterson GM, Walton SF, Hammer KA, Naunton M, Davey RC, Spelman T, Dettwiller P, Kyle G, Cooper GM, Baby KE. Therapeutic Potential of Tea Tree Oil for Scabies. Am J Trop Med Hyg 2016; 94:258-266. [PMID: 26787146 PMCID: PMC4751955 DOI: 10.4269/ajtmh.14-0515] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 05/08/2015] [Indexed: 11/20/2022] Open
Abstract
Globally, scabies affects more than 130 million people at any time. In the developed world, outbreaks in health institutions and vulnerable communities result in a significant economic burden. A review of the literature demonstrates the emergence of resistance toward classical scabicidal treatments and the lack of effectiveness of currently available scabicides in reducing the inflammatory skin reactions and pyodermal progression that occurs in predisposed patient cohorts. Tea tree oil (TTO) has demonstrated promising acaricidal effects against scabies mites in vitro and has also been successfully used as an adjuvant topical medication for the treatment of crusted scabies, including cases that did not respond to standard treatments. Emerging acaricide resistance threatens the future usefulness of currently used gold standard treatments (oral ivermectin and topical permethrin) for scabies. The imminent development of new chemical entities is doubtful. The cumulative acaricidal, antibacterial, antipruritic, anti-inflammatory, and wound healing effects of TTO may have the potential to successfully reduce the burden of scabies infection and the associated bacterial complications. This review summarizes current knowledge on the use of TTO for the treatment of scabies. On the strength of existing data for TTO, larger scale, randomized controlled clinical trials are warranted.
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Affiliation(s)
- Jackson Thomas
- University of Canberra, Faculty of Health, Bruce, Canberra, Australia; Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Queensland, Australia; School of Medicine and Pharmacology, The University of Western Australia and Translational Renal Research Group, Harry Perkins Institute of Medical Research, Nedlands, Western Australia; Burnet Institute, Melbourne, Victoria, Australia; School of Medicine, Flinders University, Katherine, Northern Territory, Australia; Private Practice, Charnwood, Canberra, Australia
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Thomas J, Peterson GM, Walton SF, Carson CF, Naunton M, Baby KE. Scabies: an ancient global disease with a need for new therapies. BMC Infect Dis 2015; 15:250. [PMID: 26123073 PMCID: PMC4487193 DOI: 10.1186/s12879-015-0983-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 06/10/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Scabies is an ancient disease (documented as far back as 2500 years ago). It affects about 300 million people annually worldwide, and the prevalence is as high as about 60% in Indigenous and Torres Strait Islander children in Australia. This is more than six times the rate seen in the rest of the developed world. Scabies is frequently complicated by bacterial infection leading to the development of skin sores and other more serious consequences such as septicaemia and chronic heart and kidney diseases. This causes a substantial social and economic burden especially in resource poor communities around the world. DISCUSSION Very few treatment options are currently available for the management of scabies infection. In this manuscript we briefly discuss the clinical consequences of scabies and the problems found (studies conducted in Australia) with the currently used topical and oral treatments. Current scabies treatment options are fairly ineffective in preventing treatment relapse, inflammatory skin reactions and associated bacterial skin infections. None have ovicidal, antibacterial, anti-inflammatory and/or anti-pruritic properties. Treatments which are currently available for scabies can be problematic with adverse effects and perhaps of greater concern the risk of treatment failure. The development of new chemical entities is doubtful in the near future. Though there may be potential for immunological control, the development of a vaccine or other immunotherapy modalities may be decades away. The emergence of resistance among scabies mites to classical scabicides and ineffectiveness of current treatments (in reducing inflammatory skin reactions and secondary bacterial infections associated with scabies), raise serious concerns regarding current therapy. Treatment adherence difficulties, and safety and efficacy uncertainties in the young and elderly, all signal the need to identify new treatments for scabies.
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Affiliation(s)
- Jackson Thomas
- Faculty of Health, University of Canberra, Bruce, 2601, ACT, Australia.
| | - Greg M Peterson
- Faculty of Health, University of Tasmania, Hobart, 7005, TAS, Australia.
| | - Shelley F Walton
- Faculty of Science; Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, 4558, QLD, Australia.
| | - Christine F Carson
- School of Medicine and Pharmacology (M503), The University of Western Australia, Nedlands, 6009, WA, Australia.
- Translational Renal Research Group, Harry Perkins Institute of Medical Research, Nedlands, 6009, WA, Australia.
| | - Mark Naunton
- Faculty of Health, University of Canberra, Bruce, 2601, ACT, Australia.
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Bader MS, Brooks AA, Srigley JA. Postexposure management of healthcare personnel to infectious diseases. Hosp Pract (1995) 2015; 43:107-27. [PMID: 25728206 PMCID: PMC7103705 DOI: 10.1080/21548331.2015.1018091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/09/2015] [Indexed: 11/16/2022]
Abstract
Healthcare personnel (HCP) are at risk of exposure to various pathogens through their daily tasks and may serve as a reservoir for ongoing disease transmission in the healthcare setting. Management of HCP exposed to infectious agents can be disruptive to patient care, time-consuming, and costly. Exposure of HCP to an infectious source should be considered an urgent medical concern to ensure timely management and administration of postexposure prophylaxis, if available and indicated. Infection control and occupational health departments should be notified for management of exposed HCP, identification of all contacts of the index case, and application of immediate infection control measures for the index case and exposed HCP, if indicated. This article reviews the main principles of postexposure management of HCP to infectious diseases, in general, and to certain common infections, in particular, categorized by their route of transmission, in addition to primary prevention of these infections.
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Affiliation(s)
- Mazen S. Bader
- Department of Medicine, Hamilton Health sciences, Juravinski hospital and Cancer Centre, Hamilton, Ontario, Canada
| | - Annie A. Brooks
- Department of Pharmacy, Hamilton Health Sciences, Juravinski hospital and Cancer Centre, Hamilton, Ontario, Canada
| | - Jocelyn A. Srigley
- Department of Medicine, Infection Prevention and Control, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Abstract
Scabies infection is antediluvian and ubiquitous both in developing and developed countries, yet often neglected. Scabies has a predilection to infect vulnerable subsets of population in crowding conditions, typically applicable to residents in the nursing home. The mite incites a unique immunological response from human hosts. Scabies does not manifest as a singular skin condition and may present atypically in older adults, the majority of nursing home residents, where delay has deleterious consequences. Further, pruritus or itching, the hallmark of scabies infection, is a common complaint from a variety of causes among older adults. Hence, the diagnosis is often delayed or missed. There are several pharmacological treatment options; long-term care practitioners need to understand the characteristics of each agent before selection. Even more relevant is the importance of nonpharmacological aspects of management, crucial in the success of averting spread or outbreaks in long-term care settings.
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Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England. Epidemiol Infect 2014; 143:1542-51. [PMID: 25195595 DOI: 10.1017/s0950268814002143] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks.
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Abstract
Scabies and bedbugs are two emerging ectoparasitic infections reported in crowded areas, including hospitals. Skin involvement is the main presenting initial manifestation for both infections, and the diagnosis is yet challenging for both. Topical permethrin is considered the first-line therapy for scabies except for crusted scabies which is mainly treated with oral ivermectin. To the contrary, treatment of bedbugs is mainly symptomatic. Avoiding close contact, early diagnosis and treatment of infected persons as well as decontamination of the involved environment play an essential role in controlling outbreaks in healthcare settings.
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Affiliation(s)
- Maroun Sfeir
- Department of Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA,
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Taman A, Azab M. Present-day anthelmintics and perspectives on future new targets. Parasitol Res 2014; 113:2425-33. [PMID: 24894082 DOI: 10.1007/s00436-014-3969-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 05/25/2014] [Indexed: 12/29/2022]
Abstract
In absence of vaccines for the majority of helminths, chemotherapy is still the mainstay for controlling human helminthiases. However, a limited number of drugs are available in the market to combat parasitic helminths in human. Besides, the development and spread of drug resistance have declined the use of most currently available anthelmintics. Clearly, availability of new anthelmintic agents will be essential in the next few years. More research into the mechanisms of drug actions and their targets are eminent for the discovery and development of novel anthelmintic agents. Recent drug discovery techniques mostly rely on mechanism-based screening of compounds on heterologously expressed targets in bacterial, mammalian or yeast cells. Although this is usually a successful approach, it is money- and time-consuming; meanwhile, pharmaceutical companies prefer the tested target that is chosen based on basic research. The nervous system is the site of action of several chemotherapeutics including pesticides and antinematode drugs; accordingly, the nervous system continues to be a promising target. Recent advances in exploring helminths' nervous system, neurotransmitters and receptors have paved the way for the development of potential agents targeting the nervous system and its components.
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Affiliation(s)
- Amira Taman
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt,
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49
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FitzGerald D, Grainger RJ, Reid A. Interventions for preventing the spread of infestation in close contacts of people with scabies. Cochrane Database Syst Rev 2014; 2014:CD009943. [PMID: 24566946 PMCID: PMC10819104 DOI: 10.1002/14651858.cd009943.pub2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Scabies, caused by Sarcoptes scabiei variety hominis or the human itch mite, is a common parasitic infection. While anyone can become infected, it causes significant morbidity in immunocompromised hosts and it spreads easily between human hosts where there is overcrowding or poor sanitation. The most common symptom reported is itch which is worse at night. As the symptoms are attributed to an allergic reaction to the mite, symptoms usually develop between four to six weeks after primary infection. Therefore, people may be infected for some time prior to developing symptoms. During this time, while asymptomatic, they may spread infection to others they are in close contact with. Consequently, it is usually recommended that when an index case is being treated, others who have been in close contact with the index case should also be provided with treatment. OBJECTIVES To assess the effects of prophylactic interventions for contacts of people with scabies to prevent infestation in the contacts. SEARCH METHODS We searched electronic databases (Cochrane Occupational Safety and Health Review Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE (Ovid), Pubmed, EMBASE, LILACS, CINAHL, OpenGrey and WHO ICTRP) up to November 2013. SELECTION CRITERIA Randomised controlled trials (RCTs) or cluster RCTs which compared prophylactic interventions which were given to contacts of index cases with scabies infestation. Interventions could be compared to each other, or to placebo or to no treatment. Both drug treatments and non-drug treatments were acceptable. DATA COLLECTION AND ANALYSIS Two authors intended to extract dichotomous data (developed infection or did not develop infection) for the effects of interventions and report this as risk ratios with 95% confidence intervals. We intended to report any adverse outcomes similarly. MAIN RESULTS We did not include any trials in this review. Out of 29 potentially-relevant studies, we excluded 16 RCTs as the data for the contacts were either not reported or were reported only in combination with the outcomes for the index cases. We excluded a further 11 studies as they were not RCTs. We also excluded one study as not all subjects were examined at baseline and follow-up, and another as it was a case study. AUTHORS' CONCLUSIONS The effects of providing prophylactic treatments for contacts of people with scabies to prevent infestation are unknown. We need well-designed RCTs of the use of prophylactic measures to prevent the transmission of scabies conducted with people who had the opportunity for prolonged skin contact with an index case, such as family members, healthcare workers or residential care personnel, within the previous six weeks.
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Affiliation(s)
| | - Rachel J Grainger
- Tallaght Hospital, a teaching hospital of Trinity College DublinMicrobiology DepartmentTallaghtDublin 24Ireland
| | - Alex Reid
- Tallaght Hospital, a teaching hospital of Trinity College DublinOccupational Health DepartmentDublinIreland24
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Abstract
CONTEXT Cutaneous infections are common in wrestlers. Although many are simply a nuisance in the everyday population, they can be problematic to wrestlers because such infections may result in disqualification from practice or competition. Prompt diagnosis and treatment are therefore important. EVIDENCE ACQUISITION Medline and PubMed databases, the Cochrane Database of Systematic Reviews, and UpToDate were searched through 2012 with the following keywords in various combinations: skin infections, cutaneous infections, wrestlers, athletes, methicillin-resistant Staphylococcus aureus, skin and soft tissue infections, tinea corporis, tinea capitis, herpes simplex, varicella zoster, molluscum contagiosum, verruca vulgaris, warts, scabies, and pediculosis. Relevant articles found in the primary search, and selected references from those articles were reviewed for pertinent clinical information. RESULTS The most commonly reported cutaneous infections in wrestlers are herpes simplex virus infections (herpes gladiatorum), bacterial skin and soft tissue infections, and dermatophyte infections (tinea gladiatorum). The clinical appearance of these infections can be different in wrestlers than in the community at large. CONCLUSION For most cutaneous infections, diagnosis and management options in wrestlers are similar to those in the community at large. With atypical presentations, testing methods are recommended to confirm the diagnosis of herpes gladiatorum and tinea gladiatorum. There is evidence to support the use of prophylactic medications to prevent recurrence of herpes simplex virus and reduce the incidence of dermatophyte infections in wrestlers.
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Affiliation(s)
| | - Kevin deWeber
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
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