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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 The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners.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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Joseph M, Mushi V, Palilo H, Silvestri V, Kinabo C, Mshana I, Chombo S, Ndaile I, Tarimo D. Prevalence of Sarcoptes scabiei infestation and its associated factors among primary school children: A school-based cross-sectional survey in the Rufiji district, Tanzania. IJID REGIONS 2024; 11:100365. [PMID: 38680841 PMCID: PMC11046246 DOI: 10.1016/j.ijregi.2024.100365] [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: 02/07/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 05/01/2024]
Abstract
Objectives This study aimed to investigate the prevalence of Sarcoptes scabiei infestation and its associated factors among primary school children (PSC) in the Rufiji district. Methods A quantitative school-based cross-sectional study was conducted among 447 PSC in the Rufiji district. The prevalence of scabies among PSC was determined by clinical examination and by microscopic examination of skin samples for the presence of S. scabiei. A structured questionnaire was used to gather data on factors associated with S. scabiei infestation. Descriptive analysis, Fisher's exact, chi-square tests, and logistic regression analysis were used to analyze the data. Results The prevalence of scabies was 2.0%. Of the assessed factors, only physical contact with a person having itchy skin lesions (Adjusted Odds Ratio [AOR]=4.04, 95%CI 4.39-12.50) and infrequency of changing clothes before laundry (AOR=2.99, 95%CI 1.35-4.94) were significantly associated with scabies. The majority of participants demonstrated low levels of knowledge, with half exhibiting poor attitudes and inappropriate healthcare-seeking behaviors. Conclusions There was an ongoing transmission of scabies among PSC in the Rufiji district, with the factors associated with the transmission being physical contact with a person who had an itchy skin lesion and the infrequency of changing clothes before laundry. Therefore, there is a need for regular clinical screening and treatment of positive cases with preventive measures on contact and provision of health education.
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Affiliation(s)
- Mary Joseph
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Vivian Mushi
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Zoology and Wildlife Conservation, College of Natural and Applied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Hoseenu Palilo
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Valeria Silvestri
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Clemence Kinabo
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Irene Mshana
- Central Pathology Laboratory, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Suleiman Chombo
- Department of Biostatistics and Epidemiology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ismail Ndaile
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Donath Tarimo
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Rainer LA, Molefi TL, Kololo SO, Leeme TB, Selemogo M, Molefi M. Prevalence and associated risk factors of scabies and impetigo: A cross-sectional study in Tutume district, Botswana. PLoS Negl Trop Dis 2024; 18:e0011495. [PMID: 38829884 PMCID: PMC11175414 DOI: 10.1371/journal.pntd.0011495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 06/13/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The epidemiology of scabies is poorly understood, particularly in regions with high disease burden. This lack of epidemiological data, especially in sub-Saharan Africa, hampers the control and preventative measures. This study is aimed at estimating the prevalence and associated risk factors of scabies and impetigo in the Nata and Sowa catchment areas of Tutume district. METHODOLOGY A cross-sectional study was conducted in the Tutume District, targeting the settlements of Manxhotae, Malelejwe, Ndutshaa, and Tshwaane. Participants were randomly selected from households in the settlements. Data were collected using questionnaires, and participants were classified as having scabies typical lesions if they met criteria B and or C of International Alliance for the Control of Scabies (IACS) consensus criteria. Statistical significance was set at p<0.05, with a 95% confidence interval for precision. RESULTS A total of 429 participants were enrolled across the four settlements. The overall prevalence of scabies was found to be 18.18% (95%CI 14.8-22.1). The highest prevalence of scabies was in Manxhotae at 27.1% (95%CI 21.2-34.0) and Ndutshaa at 23.4% (95%CI 13.4-37.3). Malelejwe and Tshwaane had lower prevalence of 10.4% (95%CI 6.2-16.8) and 3.4% (95%CI 0.8-12.7), respectively. Only five (5) cases of impetigo were identified. Multivariable logistic regression analysis revealed that younger age of 0-4 years, 5-18 years and a household member with an itch were strongly associated with scabies, with adjusted odds ratios (aOR) of 7.9 (95%CI 2.4-25.6) p-value 0.001, 5.7(95%CI 2.7-11.7), p-value 0.001 and 14.3(95%CI 5.3-38.5) p-value 0.001 respectively. CONCLUSION The prevalence of scabies in the Nata catchment area was noted to be high. The risk factors included younger age, a household member with an itch, and less frequent bathing. Prospective studies are needed to explore household disease transmission dynamics and risk factors specific to the youth.
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Affiliation(s)
- Leungo Audrey Rainer
- Department of Family Medicine & Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Tuduetso Leka Molefi
- Disease Control Division, Community Health Services, Ministry of Health, Gaborone, Botswana
| | - Sidney Otladisa Kololo
- Disease Control Division, Community Health Services, Ministry of Health, Gaborone, Botswana
| | - Tshepo Botho Leeme
- Department of Family Medicine & Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Mpho Selemogo
- Disease Control Division, Community Health Services, Ministry of Health, Gaborone, Botswana
| | - Mooketsi Molefi
- Department of Family Medicine & Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Kottner J, Fastner A, Lintzeri DA, Blume-Peytavi U, Griffiths CEM. Skin health of community-living older people: a scoping review. Arch Dermatol Res 2024; 316:319. [PMID: 38822889 PMCID: PMC11144137 DOI: 10.1007/s00403-024-03059-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/16/2024] [Accepted: 04/26/2024] [Indexed: 06/03/2024]
Abstract
The population of older people is steadily increasing and the majority live at home. Although the home and community are the largest care settings worldwide, most of the evidence on dermatological care relates to secondary and tertiary care. The overall aims were to map the available evidence regarding the epidemiology and burden of the most frequent skin conditions and regarding effects of screening, risk assessment, diagnosis, prevention and treatment of the most frequent skin conditions in older people living in the community. A scoping review was conducted. MEDLINE, Embase and Epistemonikos were systematically searched for clinical practice guidelines, reviews and primary studies, as well as Grey Matters and EASY for grey literature published between January 2010 and March 2023. Records were screened and data of included studies extracted by two reviewers, independently. Results were summarised descriptively. In total, 97 publications were included. The vast majority described prevalence or incidence estimates. Ranges of age groups varied widely and unclear reporting was frequent. Sun-exposure and age-related skin conditions such as actinic keratoses, xerosis cutis, neoplasms and inflammatory diseases were the most frequent dermatoses identified, although melanoma and/or non-melanoma skin cancer were the skin conditions investigated most frequently. Evidence regarding the burden of skin conditions included self-reported skin symptoms and concerns, mortality, burden on the health system, and impact on quality of life. A minority of articles reported effects of screening, risk assessment, diagnosis, prevention and treatment, mainly regarding skin cancer. A high number of skin conditions and diseases affect older people living at home and in the community but evidence about the burden and effective prevention and treatment strategies is weak. Best practices of how to improve dermatological care in older people remain to be determined and there is a particular need for interventional studies to support and to improve skin health at home.
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Affiliation(s)
- Jan Kottner
- Institute of Clinical Nursing Science, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Alexandra Fastner
- Institute of Clinical Nursing Science, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | | | - Ulrike Blume-Peytavi
- Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christopher E M Griffiths
- Department of Dermatology, King's College Hospital, King's College London, London, UK
- Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
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Kim DH, Kim Y, Yun SY, Yu HS, Ko HC, Kim M. Risk factors for scabies in hospital: a systematic review. BMC Infect Dis 2024; 24:353. [PMID: 38575893 PMCID: PMC10993523 DOI: 10.1186/s12879-024-09167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Annually, 175.4 million people are infected with scabies worldwide. Although parasitic infections are important nosocomial infections, they are unrecognized compared to bacterial, fungal, and viral infections. In particular, nonspecific cutaneous manifestations of scabies lead to delayed diagnosis and frequent nosocomial transmission. Hospital-based studies on the risk factors for scabies have yet to be systematically reviewed. METHODS The study followed the PRISMA guidelines and was prospectively registered in PROSPERO (CRD42023363278). Literature searches were conducted in three international (PubMed, Embase, and CINAHL) and four Korean (DBpia, KISS, RISS, and Science ON) databases. We included hospital-based studies with risk estimates calculated with 95% confidence intervals for risk factors for scabies infection. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tools. Two authors independently performed the screening and assessed the quality of the studies. RESULTS A total of 12 studies were included. Personal characteristics were categorized into demographic, economic, residential, and behavioral factors. The identified risk factors were low economic status and unhygienic behavioral practices. Being a patient in a long-term care facility or institution was an important factor. Frequent patient contact and lack of personal protective equipment were identified as risk factors. For clinical characteristics, factors were categorized as personal health and hospital environment. People who had contact with itchy others were at higher risk of developing scabies. Patients with higher severity and those with a large number of catheters are also at increased risk for scabies infection. CONCLUSIONS Factors contributing to scabies in hospitals range from personal to clinical. We emphasize the importance of performing a full skin examination when patients present with scabies symptoms and are transferred from settings such as nursing homes and assisted-living facilities, to reduce the transmission of scabies. In addition, patient education to prevent scabies and infection control systems for healthcare workers, such as wearing personal protective equipment, are needed.
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Affiliation(s)
- Dong-Hee Kim
- College of NursingᆞResearch Institute of Nursing Science, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - Yujin Kim
- College of Nursing, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea.
| | - Sook Young Yun
- College of Nursing, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - Hak Sun Yu
- Department of Parasitology and Tropical Medicine, School of Medicine, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - MinWoo Kim
- Department of Biomedical Convergence Engineering, Pusan National University, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
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Amoako YA, Laryea DO, Agbanyo A, Agbavor B, Oppong MN, Kyem G, Abass KM, van Bentum R, Phillips RO, Stienstra Y. Prevalence and determinants of impetigo in Ghana: a cross-sectional study. BMC Infect Dis 2024; 24:349. [PMID: 38528449 DOI: 10.1186/s12879-024-09242-y] [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: 08/30/2023] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Skin diseases such as impetigo pose a significant public health challenge in low resource settings. Despite this, there is a dearth of epidemiological data on the prevalence of this condition in Ghana. METHODS We conducted a cross sectional study in three settings in Ghana: community members in East Mamprusi district in the North East region, a secondary school in Sekyere East district, and inmates of the Kumasi central prisons both in the Ashanti region. Following a period of training, we performed a standardised skin examination on each participant to assess for scabies and impetigo. We calculated the prevalence of each skin condition and investigated determinants of impetigo. RESULTS/ FINDINGS Of the 1327 participants [males 64.1% and median age 22 (16-29) years], 746 (56.2%) had scabies and 186 (14%) had impetigo which was usually very mild or mild in severity. Most participants with impetigo also had scabies (161/186, 86.6%). Having an itch [RR 6.05 (95% CI 2.53-14.47)], presence of scabies burrows [RR 1.99 (95% CI 1.54-2.59)], clinical scabies [RR 3.15 (2.11-4.72)] or being in preschool [RR 4.56 (1.78-11.67)] increased the risk for impetigo. A combination of the presence of clinical scabies, age, sex and itch most accurately predicted the odds of having impetigo. CONCLUSIONS There is substantial burden of impetigo and scabies in Ghana. There is a need to institute measures to improve detection and control of these common dermatoses as part of Universal Health Coverage package to reduce the scourge of the diseases in this setting.
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Affiliation(s)
- Yaw Ampem Amoako
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Komfo Anokye Teaching Hospital, Kumasi, Ghana.
| | | | - Abigail Agbanyo
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernadette Agbavor
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ntiamoah Oppong
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gloria Kyem
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Renee van Bentum
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Sharaf MS. Scabies: Immunopathogenesis and pathological changes. Parasitol Res 2024; 123:149. [PMID: 38433167 PMCID: PMC10909795 DOI: 10.1007/s00436-024-08173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
Scabies is an itchy skin disease caused by the burrowing mite Sarcoptes scabiei. During their lifespan, the female mites invade the stratum corneum and create tunnels, in which they reside, move, feed, deposit fecal pellets, and lay eggs. Recently, scabies was included in the World Health Organization roadmap for neglected tropical diseases 2021-2030. This review attempts to summarize our knowledge about the mite's biology and the disease pathogenesis, pathological changes, and complications. Generally, the host-parasite interaction in scabies is highly complex and involves different mechanisms, some of which are yet largely unknown. Elucidation of the nature of such interaction as well as the underlying mechanisms could allow a better understanding of the mite's biology and the development of novel diagnostic and therapeutic options for scabies control programs. Moreover, identification of the molecular basis of such interaction could unveil novel targets for acaricidal agents and vaccines.
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Affiliation(s)
- Mahmoud S Sharaf
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.
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Hansmann A, Wamba Lékémo G, Fomba C, Kaddoura J, Toure R, Diop A, Ndiaye M, Chosidow O, Marks M, Ly F. Low prevalence of scabies and impetigo in Dakar/Senegal: A cluster-randomised, cross-sectional survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002942. [PMID: 38417092 PMCID: PMC10901544 DOI: 10.1371/journal.pgph.0002942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/25/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Scabies, a parasitic infection caused by Sarcoptes scabiei var. hominis, is a public health problem with significant morbidity worldwide, particularly in low-resource countries. Impetigo, a complication of scabies infection, is a risk factor for sepsis, glomerulonephritis and possibly acute rheumatic fever. Currently, the majority of epidemiological data has been collected in rural populations in the Pacific with limited applicability to urban populations in sub-Saharan Africa, where scabies is also believed to be a problem. To inform future public health programs, more reliable information about the burden of disease is required. METHODOLOGY/PRINCIPAL FINDINGS In July/August 2022, we conducted a cross sectional, cluster-randomised, household survey in Pikine/Dakar using the 'International Association for the Control of Scabies (IACS)' criteria to diagnose scabies and impetigo. All participants underwent a standardised clinical examination by post-graduate dermatology students. For those diagnosed with scabies, an age-adapted 'Dermatology Life Quality Index (DLQI)' questionnaire was filled. We recruited and examined 1697 participants to detect 27 cases of scabies (prevalence: 1.6%, 95% CI 0.8-3.2), mostly in school aged children. Ten participants suffered from impetigo (prevalence: 0.6%, 95% CI 0.3-1.3), 5 of which were dually infected with scabies. Risk factors for scabies infection were young age, male gender and Koranic school attendance. Of those found to have scabies, in 7 out of 22 cases (31.8%) it had a large effect on their lives according to the DLQI questionnaires filled. CONCLUSIONS/SIGNIFICANCE This study adds to the mapping of the burden of scabies across Africa to support public health action. With a low prevalence of scabies that is concentrated amongst poor households and children attending Koranic schools, a focused public health approach targeting Koranic schools and poor households seems to be most appropriate in this community.
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Affiliation(s)
- Andreas Hansmann
- Department of Neonatology and Paediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Genevia Wamba Lékémo
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Chiaka Fomba
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Jade Kaddoura
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ramatoullaye Toure
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Assane Diop
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
| | | | - Olivier Chosidow
- Service de Dermatologie, Henri Mondor Hospital, Université Paris-Est, Créteil, Paris, France
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fatimata Ly
- Service de Dermatologie, Institut d’Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal
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Yirgu R, Middleton J, Fekadu A, Davey G, Bremner S, Jones CI, Cassell JA. No secondary impact of ivermectin mass drug administration for onchocerciasis elimination on the prevalence of scabies in northwestern Ethiopia. Trans R Soc Trop Med Hyg 2024; 118:110-117. [PMID: 37665766 DOI: 10.1093/trstmh/trad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/01/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Mass drug administration (MDA) is among the five major strategies that are currently in use to control, eliminate or eradicate Neglected Tropical Diseases (NTDs). Optimising MDA to control multiple NTDs maximises impact. The objective of this study is to estimate the secondary impact of ivermectin MDA for onchocerciasis on the prevalence of scabies. METHODS This quasi-experimental study was conducted in Ayu Guagusa district, northwestern Ethiopia. Scabies prevalence was estimated in surveys before the MDA, at 6 and 12 months afterwards. The sample size was 1437 people from a panel of 381 randomly selected study households. Multistage sampling was employed in randomly selecting six kebeles (the lowest administrative unit) with respective gotes (small villages) and households. All members of the selected households were invited to participate in the study and participants who were available in all three surveys formed a cohort. RESULTS Scabies prevalence was similar prior to the MDA (13.4%, 95% CI 11.7 to 15.2%) and 6 months after (11.7%, 95% CI 10.1 to 13.2%) but was substantially greater at 12 months (22.1%, 95% CI 20.1 to 24.1%). The 6-month incidence and disappearance rates were 10.8% (95% CI 8.8 to 13.2%) and 82.6% (95% CI 75.0 to 88.6%), respectively. CONCLUSIONS Ivermectin MDA for onchocerciasis was not observed to have a secondary impact on the prevalence of scabies over the follow-up period of 12 months.
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Affiliation(s)
- Robel Yirgu
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- School of Public Health, Addis Ababa University, Addis Ababa, 9086, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Jo Middleton
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Abebaw Fekadu
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Gail Davey
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- School of Public Health, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Stephen Bremner
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Christopher Iain Jones
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Jackie A Cassell
- NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PX, UK
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
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10
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Cuningham W, Perera S, Coulter S, Wang Z, Tong SYC, Wozniak TM. Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting. Sci Rep 2024; 14:2414. [PMID: 38287025 PMCID: PMC10825221 DOI: 10.1038/s41598-023-50008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/14/2023] [Indexed: 01/31/2024] Open
Abstract
In northern Australia, a region with limited access to healthcare and a substantial population living remotely, antibiotic resistance adds to the complexity of treating infections. Focussing on Escherichia coli urinary tract infections (UTIs) and Staphylococcus aureus skin & soft tissue infections (SSTIs) captured by a northern Australian antibiotic resistance surveillance system, we used logistic regression to investigate predictors of a subsequent resistant isolate during the same infection episode. We also investigated predictors of recurrent infection. Our analysis included 98,651 E. coli isolates and 121,755 S. aureus isolates from 70,851 patients between January 2007 and June 2020. Following an initially susceptible E. coli UTI, subsequent recovery of a cefazolin (8%) or ampicillin (13%) -resistant isolate during the same infection episode was more common than a ceftriaxone-resistant isolate (2%). For an initially susceptible S. aureus SSTI, subsequent recovery of a methicillin-resistant isolate (8%) was more common than a trimethoprim-sulfamethoxazole-resistant isolate (2%). For UTIs and SSTIs, prior infection with a resistant pathogen was a strong predictor of both recurrent infection and resistance in future infection episodes. This multi-centre study demonstrates an association between antibiotic resistance and an increased likelihood of recurrent infection. Particularly in remote areas, a patient's past antibiograms should guide current treatment choices since recurrent infection will most likely be at least as resistant as previous infection episodes. Using population-level surveillance data in this way can also help clinicians decide if they should switch antibiotics for patients with ongoing symptoms, while waiting for diagnostic results.
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Affiliation(s)
- Will Cuningham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, SW17 0RE, UK.
| | | | - Sonali Coulter
- Medication Services Queensland, Prevention Division, Department of Health, Brisbane, QLD, Australia
| | - Zhiqiang Wang
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Steven Y C Tong
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Teresa M Wozniak
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
- Australian e-Health Research Centre CSIRO, Brisbane, QLD, Australia.
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11
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Ricciardo BM, Kessaris HL, Nannup N, Tilbrook D, Farrant B, Michie C, Hansen L, Douglas R, Walton J, Poore A, Whelan A, Barnett TC, Kumarasinghe PS, Carapetis JR, Bowen AC. Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project. Pilot Feasibility Stud 2024; 10:6. [PMID: 38200545 PMCID: PMC10782716 DOI: 10.1186/s40814-023-01428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Indigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association. METHODS This project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0-18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study. RESULTS From 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child's skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review. CONCLUSIONS This co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.
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Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, WA, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia.
- Fiona Stanley Hospital, Murdoch, WA, Australia.
- Perth Children's Hospital, Nedlands, WA, Australia.
| | - Heather-Lynn Kessaris
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Noel Nannup
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Dale Tilbrook
- Telethon Kids Institute, Nedlands, WA, Australia
- Maalingup Aboriginal Gallery, Caversham, WA, Australia
| | - Brad Farrant
- University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Carol Michie
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Lorraine Hansen
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Richelle Douglas
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Jacinta Walton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Ainslie Poore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Alexandra Whelan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Timothy C Barnett
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | | | - Jonathan R Carapetis
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
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12
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Bogino EA, Woldegeorgis BZ, Wondewosen L, Dessu BK, Obsa MS, Hanfore LK, Galtore TE, Kidane W, Kelbore AG. Scabies prevalence and its associated factors among prisoners in southern Ethiopia: An institution-based analytical cross-sectional study. PLoS Negl Trop Dis 2023; 17:e0011826. [PMID: 38134224 PMCID: PMC10773954 DOI: 10.1371/journal.pntd.0011826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 01/08/2024] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Scabies is an ectoparasitic infestation that can easily spread during close human contact and in overcrowded areas such as prisons and public places where sanitation is a problem. Globally, as many as 300 million people are infested with scabies each year. Within Ethiopia, its burden in institutions like prisons is not well-studied. As a consequence, we sought to estimate the prevalence of scabies and also identify factors associated with it among prison inmates in southern Ethiopia. METHODS An institution-based analytical cross-sectional study design was employed. We used, a simple random sampling technique to select 422 prisoners. A pretested-structured questionnaire was used to collect the necessary information. EpiData version 4.2.0.0 and Statistical Packages for Social Science version 25 software were used for data entry and analysis respectively. Both descriptive and inferential statistics were computed. The model fitness was checked using the Hosmer-Lemeshow and omnibus tests. The association between the independent and outcome variables was presented in the form of a table showing the crude odds ratio and adjusted odds ratio (AOR) along with their 95% confidence interval (CI). The level of statistical significance was declared at P.value ≤ 0.05. RESULTS A total of 418 prisoners were interviewed, yielding a 99.1% response rate. The age of the participants ranged from 17 to 60 years. As many as 381 (91.1%) participants were male. The prevalence of scabies was found to be 8.9%. A history of sexual contact in the past two months, before imprisonment (AOR: 9.92 (95% CI 3.07, 32.02), P <0.001), a period of stay less than two months duration in the prison (AOR: 4.54 (95% CI 1.51, 13.54), P = 0.007), poor ventilation (AOR: 3.36 (95% CI 1.07, 10.58), P = 0.038), lack of hygiene soap (AOR: 5.53 (95% CI 1.45, 21.17), P = 0.012), and sharing clothes among each other (AOR: 3.81 (95% CI (1.09, 13.29), P = 0.036) were factors independently associated with a scabies infestation. CONCLUSION In this study, we found the prevalence of scabies was high among prison inmates in Wolaita Zone prison. Furthermore, scabies infestations were associated with a previous history of sexual contact, poorly ventilated rooms, lack of hygiene soaps for washing, and sharing clothes amongst the inmates. Prison administrations should be encouraged to improve sanitary and screening and isolation of prisoners during imprisonment.
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Affiliation(s)
- Efa Ambaw Bogino
- Department of Dermatovenereology, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Lantesil Wondewosen
- Department of Dermatovenereology, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | | | | | - Teketel Ermias Galtore
- Department of Midwifery, College of Health Sciences and Medicine, Wachemo University, Durame, Ethiopia
| | - Woldu Kidane
- AMREF Health Africa Ethiopia, Addis Ababa, Ethiopia
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13
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Wiegele S, McKinnon E, van Schaijik B, Enkel S, Noonan K, Bowen AC, Wyber R. The epidemiology of superficial Streptococcal A (impetigo and pharyngitis) infections in Australia: A systematic review. PLoS One 2023; 18:e0288016. [PMID: 38033025 PMCID: PMC10688633 DOI: 10.1371/journal.pone.0288016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 06/09/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Streptoccocal A (Strep A, GAS) infections in Australia are responsible for significant morbidity and mortality through both invasive (iGAS) and post-streptococcal (postGAS) diseases as well as preceding superficial (sGAS) skin and throat infection. The burden of iGAS and postGAS are addressed in some jurisdictions by mandatory notification systems; in contrast, the burden of preceding sGAS has no reporting structure, and is less well defined. This review provides valuable, contemporaneous evidence on the epidemiology of sGAS presentations in Australia, informing preventative health projects such as a Streptococcal A vaccine and standardisation of primary care notification. METHODS AND FINDINGS MEDLINE, Scopus, EMBASE, Web of Science, Global Health, Cochrane, CINAHL databases and the grey literature were searched for studies from an Australian setting relating to the epidemiology of sGAS infections between 1970 and 2020 inclusive. Extracted data were pooled for relevant population and subgroup analysis. From 5157 titles in the databases combined with 186 grey literature reports and following removal of duplicates, 4889 articles underwent preliminary title screening. The abstract of 519 articles were reviewed with 162 articles identified for full text review, and 38 articles identified for inclusion. The majority of data was collected for impetigo in Aboriginal and Torres Strait Islander populations, remote communities, and in the Northern Territory, Australia. A paucity of data was noted for Aboriginal and Torres Strait Islander people living in urban centres or with pharyngitis. Prevalence estimates have not significantly changed over time. Community estimates of impetigo point prevalence ranged from 5.5-66.1%, with a pooled prevalence of 27.9% [95% CI: 20.0-36.5%]. All studies excepting one included >80% Aboriginal and Torres Strait Islander people and all excepting two were in remote or very remote settings. Observed prevalence of impetigo as diagnosed in healthcare encounters was lower, with a pooled estimate of 10.6% [95% CI: 3.1-21.8%], and a range of 0.1-50.0%. Community prevalence estimates for pharyngitis ranged from 0.2-39.4%, with a pooled estimate of 12.5% [95% CI: 3.5-25.9%], higher than the prevalence of pharyngitis in healthcare encounters; ranging from 1.0-5.0%, and a pooled estimate of 2.0% [95% CI: 1.3-2.8%]. The review was limited by heterogeneity in study design and lack of comparator studies for some populations. CONCLUSIONS Superficial Streptococcal A infections contribute to an inequitable burden of disease in Australia and persists despite public health interventions. The burden in community studies is generally higher than in health-services settings, suggesting under-recognition, possible normalisation and missed opportunities for treatment to prevent postGAS. The available, reported epidemiology is heterogeneous. Standardised nation-wide notification for sGAS disease surveillance must be considered in combination with the development of a Communicable Diseases Network of Australia (CDNA) Series of National Guideline (SoNG), to accurately define and address disease burden across populations in Australia. TRIAL REGISTRATION This review is registered with PROSPERO. Registration number: CRD42019140440.
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Affiliation(s)
- Sophie Wiegele
- Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | | | - Bede van Schaijik
- University of Western Australia, Perth, Western Australia, Australia
| | - Stephanie Enkel
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | | | - Asha C. Bowen
- Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Rosemary Wyber
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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14
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Ayele A, Adane M, Adane B, Berihun G, Gebrehiwot M, Woretaw L, Berhanu L, Atanaw G, Feleke H, Moges M, Tegegne E, Azanaw J, Malede A. Living in a large family and low daily water consumption substantially expose for human scabies in rural Ethiopia: a matched analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:134. [PMID: 38017554 PMCID: PMC10685524 DOI: 10.1186/s41043-023-00471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/03/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Scabies has been added to the neglected tropical diseases portfolio for large-scale disease control action since 2017 and is part of the WHO roadmap for NTDs 2021-2030, targeted at ending the neglect to achieve the sustainable development goals. Previous studies have not fitted matched analysis to identify predictors of scabies infestation in Ethiopia. Information is also scarce about predictors of scabies infestation in this area. Therefore, this study aimed to identify predictors of scabies infestation in rural Aneded District, northwest Ethiopia. METHODS A community-based matched case-control study involving 183 cases and 549 controls was undertaken from March 1 to May 31, 2021, in rural Aneded District. A two-stage sampling technique with a house-to-house census for the screening of scabies cases was employed. A structured questionnaire with questions on sociodemographics, behavior, water supply, sanitation, and hygiene, and delivery of scabies-specific interventions was used. Pretesting, training of data collectors and supervisors, and supervision were applied to keep the data quality. A multivariable conditional logistic regression model was fitted to identify predictors of scabies. RESULTS Unmarried individuals or those in separated families (adjusted matched odds ratio (AmOR = 2.71; 95% CI 1.30-5.65); those unable to read and write or in illiterate families (AmOR = 5.10; 95% CI 1.81-14.36); those in large families (AmOR = 6.67; 95% CI 2.83-15.73); households that had longer travel times for water collection (AmOR = 2.27; 95% CI 1.08-4.76); those that had low daily water consumption (AmOR = 6.69; 95% CI 2.91-15.37); households that disposed of solid wastes in open fields (AmOR = 5.60; 95% CI 2.53-12.40); and households that did not receive scabies-specific interventions (AmOR = 2.98; 95% CI 1.39-6.39) had increased odds of scabies. CONCLUSIONS Being unmarried, illiteracy, large family, long travel time for water collection, low daily water consumption, open dumping of solid wastes, and inaccessibility of scabies-specific interventions are predictors of scabies. This information is instrumental for redesigning improved scabies-specific interventions that consider educational status, marital status, family size, water collection time, daily water consumption, solid waste disposal, and equity and optimization in delivering existing interventions in rural Ethiopia.
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Affiliation(s)
- Agernesh Ayele
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Balew Adane
- Department of Environmental Health, Debre Markos University, Debre Markos, Ethiopia
| | - Gete Berihun
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Lebasie Woretaw
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Leykun Berhanu
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Getu Atanaw
- Department of Obstetrics and Gynecology, University of Gondar, Gondar, Ethiopia
| | - Hailemariam Feleke
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| | - Mekonnen Moges
- Department of Environmental Health, Debre Markos University, Debre Markos, Ethiopia
| | - Eniyew Tegegne
- Department of Environmental Health, Debre Markos University, Debre Markos, Ethiopia
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Malede
- Department of Environmental Health, Wollo University, Dessie, Ethiopia.
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia.
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15
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Sharaf MS, Othman AA, Abdel-Ghaffar AE, Ali DM, Eid MM. Crusted scabies in a rabbit model: a severe skin disease or more? Parasit Vectors 2023; 16:413. [PMID: 37964301 PMCID: PMC10647032 DOI: 10.1186/s13071-023-05995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Around 200-300 million people are estimated to be affected by scabies annually worldwide. However, the mechanisms by which this disease may affect the general condition of the host are not entirely clear. The aim of the present study was to evaluate the systemic changes that may accompany crusted scabies in both treated and non-treated experimental animals. METHODS Male New Zealand rabbits were infected with Sarcoptes scabiei var. cuniculi and divided into the following three groups: control, ivermectin-treated, and fluralaner-treated. Several methods were used to evaluate the systemic changes, including histopathological examination of the liver, kidney, heart, and spleen, as well as the measurement of serum biochemical parameters and immunological parameters. RESULTS Several definite structural and functional changes at the systemic level were revealed, as evidenced by the observed histopathological changes in the tissue sections of internal organs and the highly significant increases in markers of systemic inflammation, serum procalcitonin, and oxidative stress markers. Abnormalities in the liver and renal function results, as well as in the serum lipid profile, were also noted. Additionally, a disorganized immune response was noted, evidenced by a mixed type 1 and type 2 helper T cell response. Although there was notable clinical and parasitological cure in the ivermectin-treated group, the histopathological, biochemical, and immunological markers indicated incomplete resolution. In contrast, the fluralaner-treated group exhibited a nearly complete resolution of changes in these parameters. CONCLUSIONS We conclude that crusted scabies is a systemic syndrome that can affect several organs besides the skin. Inflammation, oxidative stress, and possibly bacterial infections, are all implicated as underlying mechanisms of tissue damage due to the disease. We recommend that fluralaner, a promising scabicidal agent, should be studied for possible human use, and especially for control programs.
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Affiliation(s)
| | - Ahmad Ali Othman
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Dareen Mohamed Ali
- Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Mahmoud Eid
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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16
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Richardson NA, Cassell JA, Head MG, Lanza S, Schaefer C, Walker SL, Middleton J. Scabies outbreak management in refugee/migrant camps in Europe 2014-2017: a retrospective qualitative interview study of healthcare staff experiences and perspectives. BMJ Open 2023; 13:e075103. [PMID: 37940153 PMCID: PMC10632829 DOI: 10.1136/bmjopen-2023-075103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES Provide insights into the experiences and perspectives of healthcare staff who treated scabies or managed outbreaks in formal and informal refugee/migrant camps in Europe 2014-2017. DESIGN Retrospective qualitative study using semistructured telephone interviews and framework analysis. Recruitment was done primarily through online networks of healthcare staff involved in medical care in refugee/migrant settings. SETTING Formal and informal refugee/migrant camps in Europe 2014-2017. PARTICIPANTS Twelve participants (four doctors, four nurses, three allied health workers, one medical student) who had worked in camps (six in informal camps, nine in formal ones) across 15 locations within seven European countries (Greece, Serbia, Macedonia, Turkey, France, the Netherlands, Belgium). RESULTS Participants reported that in camps they had worked, scabies diagnosis was primarily clinical (without dermatoscopy), and treatment and outbreak management varied highly. Seven stated scabicides were provided, while five reported that only symptomatic management was offered. They described camps as difficult places to work, with poor living standards for residents. Key perceived barriers to scabies control were (1) lack of water, sanitation and hygiene, specifically: absent/limited showers (difficult to wash off topical scabicides), and inability to wash clothes and bedding (may have increased transmission/reinfestation); (2) social factors: language, stigma, treatment non-compliance and mobility (interfering with contact tracing and follow-up treatments); (3) healthcare factors: scabicide shortages and diversity, lack of examination privacy and staff inexperience; (4) organisational factors: overcrowding, ineffective interorganisational coordination, and lack of support and maltreatment by state authorities (eg, not providing basic facilities, obstruction of self-care by camp residents and non-governmental organisation (NGO) aid). CONCLUSIONS We recommend development of accessible scabies guidelines for camps, use of consensus diagnostic criteria and oral ivermectin mass treatments. In addition, as much of the work described was by small, volunteer-staffed NGOs, we in the wider healthcare community should reflect how to better support such initiatives and those they serve.
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Affiliation(s)
- Naomi A Richardson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | - Jackie A Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | - Michael G Head
- Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Stefania Lanza
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | | | - Stephen L Walker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jo Middleton
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
- NIHR Global Health Research Unit on Neglected Tropical Diseases, and NIHR Applied Research Collaboration Kent, Surrey and Sussex, Brighton and Sussex Medical School, Falmer, UK
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17
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Armitage EP, Keeley AJ, de Crombrugghe G, Senghore E, Camara FE, Jammeh M, Bittaye A, Ceesay H, Ceesay I, Samateh B, Manneh M, Sesay AK, Kampmann B, Kucharski A, de Silva TI, Marks M. Streptococcus pyogenes carriage acquisition, persistence and transmission dynamics within households in The Gambia (SpyCATS): protocol for a longitudinal household cohort study. Wellcome Open Res 2023; 8:41. [PMID: 37954923 PMCID: PMC10638483 DOI: 10.12688/wellcomeopenres.18716.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/14/2023] Open
Abstract
Background Streptococcus pyogenes (StrepA) causes a significant burden of disease globally from superficial infections to invasive disease. It is responsible for over 500,000 deaths each year, predominantly in low- and middle-income countries (LMIC). Superficial StrepA infections of the skin and pharynx can lead to rheumatic heart disease, the largest cause of StrepA-related deaths in LMIC. StrepA can also asymptomatically colonise normal skin and the pharynx (carriage), potentially increasing infection risk. Streptococcus dysgalactiae subsp. equisimilis (SDSE) carriage is also common in LMIC and may interact with StrepA. This study aims to investigate StrepA and SDSE carriage and infection epidemiology, transmission dynamics and naturally acquired immunity within households in The Gambia. Methods A longitudinal household observational cohort study will be conducted over one year. 45 households will be recruited from the urban area of Sukuta, The Gambia, resulting in approximately 450 participants. Households will be visited monthly, and available participants will undergo oropharyngeal and normal skin swabbing. Incident cases of pharyngitis and pyoderma will be captured via active case reporting, with swabs taken from disease sites. Swabs will be cultured for the presence of group A, C and G beta-haemolytic streptococci. Isolates will undergo whole genome sequencing. At each visit, clinical, socio-demographic and social mixing data will be collected. Blood serum will be collected at baseline and final visit. Oral fluid and dried blood spot samples will be collected at each visit. Mucosal and serum anti-StrepA antibody responses will be measured. Outcome This study will report StrepA and SDSE clinical epidemiology, risk factors, transmission dynamics, and serological responses to carriage and infection. Detailed social mixing behaviour will be combined with phylogenetic relatedness to model the extent of transmission occurring withing and between households. The study will provide data to help meet global strategic StrepA research goals.
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Affiliation(s)
- Edwin P. Armitage
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Alex J. Keeley
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Gabrielle de Crombrugghe
- Molecular Bacteriology Laboratory, Faculty of Medicine, Free University of Brussels, Brussels, Belgium
| | - Elina Senghore
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Fatoumatta E. Camara
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Musukoi Jammeh
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Amat Bittaye
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Haddy Ceesay
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Isatou Ceesay
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Bunja Samateh
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Muhammed Manneh
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Abdul Karim Sesay
- Genomics Strategic Core Platform, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Adam Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thushan I. de Silva
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- The Florey Institute and Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, S10 2TN, UK
| | - Michael Marks
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Hospital for Tropical Diseases, University College London Hospital, London, NW1 2BU, UK
| | - MRCG StrepA Study Group
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- Molecular Bacteriology Laboratory, Faculty of Medicine, Free University of Brussels, Brussels, Belgium
- Genomics Strategic Core Platform, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- The Florey Institute and Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, S10 2TN, UK
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Hospital for Tropical Diseases, University College London Hospital, London, NW1 2BU, UK
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Melese F, Malede A, Sisay T, Geremew A, Gebrehiwot M, Woretaw L, Atanaw G, Azanaw J, Melese M, Feleke H. Cloth sharing with a scabies case considerably explains human scabies among children in a low socioeconomic rural community of Ethiopia. Trop Med Health 2023; 51:52. [PMID: 37710350 PMCID: PMC10502969 DOI: 10.1186/s41182-023-00544-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND In 2020, scabies were integrated into the WHO roadmap for neglected tropical diseases, aimed at ending the negligence to realize the SDGs. Ethiopia has also introduced scabies as a notifiable disease in drought-prone localities since 2015. Many of the previous studies employed study designs that might be subject to bias. Moreover, there is no scientific evidence about scabies in this area. Hence, this study aimed to determine the prevalence and associated factors of scabies among children aged below 15 years in rural Ethiopia. METHODS A community-based cross-sectional study was carried out among 942 children in rural kebeles of Lay Gayent District from March through May 15, 2021. A two-stage sampling technique was applied. Data on sociodemographics, housing, water supply and sanitation, children's personal hygiene, and caregivers' knowledge about scabies were collected by a structured questionnaire. Data quality was maintained through pretesting, training of data collectors and supervisors, and supervision. An adjusted binary logistic regression was modelled to identify factors associated with scabies. The Hosmer-Lemeshow goodness-of-fit test was run to check the model fitness. RESULTS The prevalence of scabies was 21.5% (95% CI 19.0-24.3). Maternal illiteracy (adjusted odds ratio (AOR) = 1.61; 95% CI 1.07-2.43); low household wealth (AOR = 2.04; 95% CI 1.25-3.33); unimproved water source (AOR = 1.58; 95% CI 1.05-2.40); not cleaning a house daily (AOR = 2.43; 95% CI 1.63-3.62); not trimming nails (AOR = 2.21; 95% CI 1.50-3.25); cloth sharing with a scabies case (AOR = 11.77; 95% CI 6.94-19.97); and low caregiver knowledge about scabies (AOR = 2.44; 95% CI 1.64-3.63) were factors associated with scabies. CONCLUSIONS Scabies remains a significant public health issue among children aged below 15 years in the district. Maternal illiteracy, low household wealth, unimproved water source, not cleaning a house daily, not trimming nails, cloth sharing with a scabies case, and low caregiver knowledge about scabies were factors associated with scabies. Community-wide interventions with prime emphasis on improving maternal education and caregivers' knowledge about scabies, upgrading household wealth, ensuring a safe water supply, providing healthy housing, and ensuring adequate personal hygiene are warranted.
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Affiliation(s)
- Fekadie Melese
- Hospital Quality Unit and Public Health Emergency Management Office, Nefas Mewcha Primary Hospital, Nefas Mewcha, Ethiopia
| | - Asmamaw Malede
- Department of Environmental Health, Wollo University, Dessie, Ethiopia.
| | - Tadesse Sisay
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Abraham Geremew
- Department of Environmental Health, Haramaya University, Harar, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Lebasie Woretaw
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Getu Atanaw
- Department of Obstetrics and Gynecology, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| | - Mihret Melese
- Department of Medical Physiology, University of Gondar, Gondar, Ethiopia
| | - Hailemariam Feleke
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
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Micallef D, Boffa MJ. Worldwide prevalence of scabies: Some knowns but still many unknowns. J Eur Acad Dermatol Venereol 2023; 37:1687-1688. [PMID: 37622220 DOI: 10.1111/jdv.19292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/26/2023]
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Schneider S, Wu J, Tizek L, Ziehfreund S, Zink A. Prevalence of scabies worldwide-An updated systematic literature review in 2022. J Eur Acad Dermatol Venereol 2023; 37:1749-1757. [PMID: 37147907 DOI: 10.1111/jdv.19167] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
Scabies is a World Health Organization-defined neglected tropical disease, with continuously rising incidence worldwide in recent years. The aim of this study was to provide an update of the worldwide prevalence and new treatment approaches of scabies in population-based settings. MEDLINE (PubMed), Embase and LILACS databases were reviewed for English and German language population-based studies from October 2014 to March 2022. Two authors independently screened the records for eligibility, extracted all data and one critically appraised the quality of the studies and risk of bias. Systematic review registration: PROSPERO CRD42021247140. Overall, 1273 records were identified through database searching, of which 43 studies were included for the systematic review. Most of the studies (n = 31) examined the scabies prevalence in medium or low human development index countries. The highest prevalence of scabies reported in the general population (children and adults) was recorded in five randomly selected communities in Ghana (71.0%), whereas the highest scabies prevalence in studies, which only examined children (76.9%), was recorded in an Indonesian boarding school. The lowest prevalence was recorded in Uganda (0.18%). The systematic review highlights the prevalence of scabies worldwide, showing that scabies is still a serious, increasing disease that occurs globally and is clustered in developing countries. More transparent data on scabies prevalence are needed to identify risk factors to find new prevention measures.
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Affiliation(s)
- S Schneider
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - J Wu
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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21
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He R, Zhang Q, Xu L, Guo M, Gu X, Xie Y, Xu J, Shen Z. Characterization of a novel galectin in Sarcoptes scabiei and its role in regulating macrophage functions. Front Microbiol 2023; 14:1251475. [PMID: 37692380 PMCID: PMC10484005 DOI: 10.3389/fmicb.2023.1251475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023] Open
Abstract
Sarcoptes scabiei (S. scabiei) endangers human and other mammalian health. There has been limited research into S. scabiei pathogenic mechanisms and the immunological interaction between S. scabiei and hosts. Galectins have critical roles in biological processes such as cell adhesion, signal transduction, and immune response mediation. Galectins of S. scabiei (SsGalectins) were cloned, expressed, and identified, and their transcriptional levels in S. scabiei were measured at various developmental stages. Fluorescent tissue localization was performed on SsGalectins of S. scabiei and scabies skin. A mouse AD model was constructed to evaluate the effect of rSsGalectins on skin pathogenic changes. Quantitative polymerase chain reaction and enzyme-linked immunoassay were used to identify macrophage polarization-related components and investigate the immunoregulatory effect of rSsGalectins on mouse macrophages. The results demonstrated that the S. scabiei infection causes macrophage infiltration in the scabies skin. The rSsGalectins displayed strong reactogenicity, and distinct genes of the SsGalectins were differently expressed in different developmental stages of S. scabiei. Fluorescence tissue localization revealed that the SsGalectins were mainly in the mouthparts, intestines, and body surface. Additionally, S. scabiei could secrete SsGalectins into the infected skin, proving that SsGalectins were excretion and secretion proteins of S. scabiei. In the mouse atopic dermatitis model, cutaneous macrophage infiltration and inflammation increase after rSsGalectins injection. Simultaneously, when rSsGalectins acted on bone marrow-derived macrophages, M1 macrophage-related polarization factors IL-1β, IL-6, and inducible nitric oxide synthase all increased, demonstrating that rSsGalectins can induce M1 polarization and produce pro-inflammatory cytokines. In conclusion, the SsGalectins are involved in the pathogenic process of S. scabiei by regulating the polarization of host macrophages to the M1 type when S. scabiei invade the host and promoting the incidence and development of the host's inflammatory response. This study offers fresh light on the pathogenic process of scabies mites, investigates the immunological interaction mechanism between S. scabiei and the host, and offers new insights into S. scabiei prevention and therapy.
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Affiliation(s)
- Ran He
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Qian Zhang
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Luyang Xu
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Maochuan Guo
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Xiaobin Gu
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Yue Xie
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Jing Xu
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Zhaoli Shen
- College of Science, Sichuan Agricultural University, Ya'an, China
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Tellioglu N, Chisholm RH, Campbell PT, Collinson S, Timothy J, Kollie K, Zayzay S, Devine A, McVernon J, Marks M, Geard N. Modelling mass drug administration strategies for reducing scabies burden in Monrovia, Liberia. Epidemiol Infect 2023; 151:e153. [PMID: 37593956 PMCID: PMC10548539 DOI: 10.1017/s0950268823001310] [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: 01/13/2023] [Revised: 05/29/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
Scabies is a parasitic infestation with high global burden. Mass drug administrations (MDAs) are recommended for communities with a scabies prevalence of >10%. Quantitative analyses are needed to demonstrate the likely effectiveness of MDA recommendations. In this study, we developed an agent-based model of scabies transmission calibrated to demographic and epidemiological data from Monrovia. We used this model to compare the effectiveness of MDA scenarios for achieving scabies elimination and reducing scabies burden, as measured by time until recrudescence following delivery of an MDA and disability-adjusted-life-years (DALYs) averted. Our model showed that three rounds of MDA delivered at six-month intervals and reaching 80% of the population could reduce prevalence below 2% for three years following the final round, before recrudescence. When MDAs were followed by increased treatment uptake, prevalence was maintained below 2% indefinitely. Increasing the number of and coverage of MDA rounds increased the probability of achieving elimination and the number of DALYs averted. Our results suggest that acute reduction of scabies prevalence by MDA can support a transition to improved treatment access. This study demonstrates how modelling can be used to estimate the expected impact of MDAs by projecting future epidemiological dynamics and health gains under alternative scenarios.
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Affiliation(s)
- Nefel Tellioglu
- School of Computing and Information Systems, The University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca H. Chisholm
- Department of Mathematical and Physical Sciences, La Trobe University, Bundoora, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Patricia Therese Campbell
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Shelui Collinson
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Joseph Timothy
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Angela Devine
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jodie McVernon
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Hospital for Tropical Diseases, University College London Hospital, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Melbourne, VIC, Australia
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Willis GA, Kearns T, Mayfield HJ, Sheridan S, Thomsen R, Naseri T, David MC, Engelman D, Steer AC, Graves PM, Lau CL. Scabies prevalence after ivermectin-based mass drug administration for lymphatic filariasis, Samoa 2018-2019. PLoS Negl Trop Dis 2023; 17:e0011549. [PMID: 37607196 PMCID: PMC10497159 DOI: 10.1371/journal.pntd.0011549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 09/12/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Scabies is a common skin infestation caused by the Sarcoptes scabei mite. Ivermectin, one of three drugs used in mass drug administration (MDA) for lymphatic filariasis, is also effective for treating scabies. Ivermectin-based MDA was first conducted in Samoa in August 2018, with ivermectin being offered to those aged ≥5 years. Here, we report scabies prevalence in Samoa after MDA. METHODS We conducted household surveys 1.5-3.5 months (Survey 1) and 6-8 months (Survey 2) after the 2018 MDA in 35 primary sampling units. We conducted clinical examination for scabies-like rash and used International Alliance for the Control of Scabies classification criteria. We estimated scabies prevalence by age, gender and region. Multivariable logistic regression was used to assess factors associated with prevalence. RESULTS We surveyed 2868 people (499 households) and 2796 people (544 households) aged 0-75 years in Surveys 1 and 2, respectively. Scabies prevalence increased from 2.4% (95% CI 2.1-2.7%) to 4.4% (95% CI 4.0-4.9%) between surveys. Scabies was associated with younger age (0-4 years: aOR 3.5 [2.9-4.2]; 5-15 years: aOR 1.6 [1.4-1.8] compared to ≥16 years), female gender (aOR 1.2 [95% CI 1.1-1.4]; region (aOR range from 1.4 [1.1-1.7] to 2.5 [2.1-3.1] between regions), large households (aOR 2.6 [2.0-3.4] households ≥13), and not taking MDA in 2018 (aOR 1.3 [95% CI 1.1-1.6]). CONCLUSIONS We found moderate prevalence of scabies in two population-representative surveys conducted within 8 months of the 2018 MDA for lymphatic filariasis. Prevalence appeared to increase between the surveys, and ongoing surveillance is recommended, particularly in young children.
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Affiliation(s)
- Gabriela A. Willis
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Therese Kearns
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Helen J. Mayfield
- Research School of Population Health, Australian National University, Canberra, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Sarah Sheridan
- National Centre for Immunisation Research and Surveillance, Sydney, Australia
| | | | | | - Michael C. David
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Daniel Engelman
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Andrew C. Steer
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
| | - Colleen L. Lau
- Research School of Population Health, Australian National University, Canberra, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Gnimavo RS, Fajloun F, Al-Bayssari C, Sodjinou E, Habib A, Ganlonon L, Claco E, Agoundoté I, Houngbo OA, Anagonou EG, Biaou CAO, Ayélo AG, Houezo JG, Boccarossa A, Moussa EH, Gomez B, Gine A, Sopoh GE, Marion E, Johnson RC, Kempf M. Importance of consultations using mobile teams in the screening and treatment of neglected tropical skin diseases in Benin. PLoS Negl Trop Dis 2023; 17:e0011314. [PMID: 37172044 DOI: 10.1371/journal.pntd.0011314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/24/2023] [Accepted: 04/15/2023] [Indexed: 05/14/2023] Open
Abstract
CONTEXT Since 2013, the World Health Organization has recommended integrated control strategies for neglected tropical diseases (NTDs) with skin manifestations. We evaluated the implementation of an integrated approach to the early detection and rapid treatment of skin NTDs based on mobile clinics in the Ouémé and Plateau areas of Benin. METHODS This descriptive cross-sectional study was performed in Ouémé and Plateau in Benin from 2018 to 2020. Consultations using mobile teams were performed at various sites selected by reasoned choice based on the epidemiological data of the National Program for the Control of Leprosy and Buruli Ulcer. All individuals presenting with a dermatological lesion who voluntarily approached the multidisciplinary management team on the day of consultation were included. The information collected was kept strictly anonymous and was entered into an Excel 2013 spreadsheet and analyzed with Stata 11 software. RESULTS In total, 5,267 patients with various skin conditions consulted the medical team. The median age of these patients was 14 years (IQR: 7-34 years). We saw 646 (12.3%) patients presenting NTDs with skin manifestations, principally scabies, in 88.4% (571/646), followed by 37 cases of Buruli ulcer (5.8%), 22 cases of leprosy (3.4%), 15 cases of lymphatic filariasis (2.3%) and one case of mycetoma (0.2%). We detected no cases of yaws. CONCLUSION This sustainable approach could help to decrease the burden of skin NTDs in resource-limited countries.
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Affiliation(s)
- Ronald Sètondji Gnimavo
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
- Institut Régional de Santé Publique- Comlan Alfred Quenum, Université d'Abomey Calavi, Ouidah, Bénin
| | - Faraj Fajloun
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Ecole Doctorale en Sciences et Technologie, Université Libanaise, Campus Rafic Hariri, Hadath, Liban
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Campus Pierre Gemayel, Fanar, Liban
| | - Charbel Al-Bayssari
- Departement of Medical Laboratory Sciences, Faculty of Health Sciences, University of Balamand, Tripoli, Lebanon
| | - Espoir Sodjinou
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Akimath Habib
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Line Ganlonon
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Eric Claco
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Irvine Agoundoté
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Odile Adjouavi Houngbo
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Esaï Gimatal Anagonou
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | | | - Adjimon Gilbert Ayélo
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | - Jean Gabin Houezo
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | - Alexandra Boccarossa
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | - Elie Hajj Moussa
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Campus Pierre Gemayel, Fanar, Liban
| | | | - Anna Gine
- Fondation Anesvad, Henao, Bilbao, Spain
| | - Ghislain Emmanuel Sopoh
- Institut Régional de Santé Publique- Comlan Alfred Quenum, Université d'Abomey Calavi, Ouidah, Bénin
| | - Estelle Marion
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | | | - Marie Kempf
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Département de Biologie des Agents Infectieux, UF de Bactériologie, Centre Hospitalier Universitaire Angers, Angers, France
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One versus two doses of ivermectin-based mass drug administration for the control of scabies: A cluster randomised non-inferiority trial. PLoS Negl Trop Dis 2023; 17:e0011207. [PMID: 36930667 PMCID: PMC10058081 DOI: 10.1371/journal.pntd.0011207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/29/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Mass drug administration (MDA) based on two doses of ivermectin, one week apart, substantially reduces prevalence of both scabies and impetigo. The Regimens of Ivermectin for Scabies Elimination (RISE) trial assessed whether one-dose ivermectin-based MDA would be as effective. METHODS RISE was a cluster-randomised trial in Solomon Islands. We assigned 20 villages in a 1:1 ratio to one- or two-dose ivermectin-based MDA. We planned to test whether the impact of one dose on scabies prevalence at 12 and 24 months was non-inferior to two, at a 5% non-inferiority margin. RESULTS We deferred endpoint assessment to 21 months due to COVID-19. We enrolled 5239 participants in 20 villages at baseline and 3369 at 21 months from an estimated population of 5500. At baseline scabies prevalence was similar in the two arms (one-dose 17·2%; two-dose 13·2%). At 21 months, there was no reduction in scabies prevalence (one-dose 18·7%; two-dose 13·4%), and the confidence interval around the difference included values substantially greater than 5%. There was however a reduction in prevalence among those who had been present at the baseline assessment (one-dose 15·9%; two-dose 10·8%). Additionally, we found a reduction in both scabies severity and impetigo prevalence in both arms, to a similar degree. CONCLUSIONS There was no indication of an overall decline in scabies prevalence in either arm. The reduction in scabies prevalence in those present at baseline suggests that the unexpectedly high influx of people into the trial villages, likely related to the COVID-19 pandemic, may have compromised the effectiveness of the MDA. Despite the lack of effect there are important lessons to be learnt from this trial about conducting MDA for scabies in high prevalence settings. TRIAL REGISTRATION Registered with Australian New Zealand Clinical Trials Registry ACTRN12618001086257.
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Armitage EP, Keeley AJ, de Crombrugghe G, Senghore E, Camara FE, Jammeh M, Bittaye A, Ceesay H, Ceesay I, Samateh B, Manneh M, Sesay AK, Kampmann B, Kucharski A, de Silva TI, Marks M. Streptococcus pyogenes carriage acquisition, persistence and transmission dynamics within households in The Gambia (SpyCATS): protocol for a longitudinal household cohort study. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18716.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Streptococcus pyogenes (StrepA) causes a significant burden of disease globally from superficial infections to invasive disease. It is responsible for over 500,000 deaths each year, predominantly in low- and middle-income countries (LMIC). Superficial StrepA infections of the skin and pharynx can lead to rheumatic heart disease, the largest cause of StrepA-related deaths in LMIC. StrepA can also asymptomatically colonise normal skin and the pharynx (carriage), potentially increasing infection risk. Streptococcus dysgalactiae subsp. equisimilis (SDSE) carriage is also common in LMIC and may interact with StrepA. This study aims to investigate StrepA and SDSE carriage and infection epidemiology, transmission dynamics and naturally acquired immunity within households in The Gambia. Methods A longitudinal household observational cohort study will be conducted over one year. 45 households will be recruited from the urban area of Sukuta, The Gambia, resulting in approximately 450 participants. Households will be visited monthly, and available participants will undergo oropharyngeal and normal skin swabbing. Incident cases of pharyngitis and pyoderma will be captured via active case reporting, with swabs taken from disease sites. Swabs will be cultured for the presence of group A, C and G beta-haemolytic streptococci. Isolates will undergo whole genome sequencing. At each visit, clinical, socio-demographic and social mixing data will be collected. Blood serum will be collected at baseline and final visit. Oral fluid and dried blood spot samples will be collected at each visit. Mucosal and serum anti-StrepA antibody responses will be measured. Outcome This study will report StrepA and SDSE clinical epidemiology, risk factors, transmission dynamics, and serological responses to carriage and infection. Detailed social mixing behaviour will be combined with phylogenetic relatedness to model the extent of transmission occurring withing and between households. The study will provide data to help meet global strategic StrepA research goals.
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Teng Y, Li S, Tang H, Tao X, Fan Y, Huang Y. Medical Applications of Hydrogels in Skin Infections: A Review. Infect Drug Resist 2023; 16:391-401. [PMID: 36714352 PMCID: PMC9882970 DOI: 10.2147/idr.s396990] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023] Open
Abstract
Skin infections are common diseases for which patients seek inpatient and outpatient medical care. Globally, an increasing number of people are affected by skin infections that could lead to physical and psychological damage. Skin infections always have a broad spectrum of clinical presentations that require physicians to make an aggressive and accurate diagnosis for prescribing the proper symptomatic antimicrobials. In most instances, the treatment for skin infections mainly includes oral or topical anti-infective drugs. However, some of the classical anti-infective drugs have limitations, such as poor water solubility, low bioavailability, and poor targeting efficiency, which can lead to poor efficacy, adverse effects, and drug resistance. Therefore, research priorities should focus on the development of more effective drug delivery systems with new materials. Hydrogels are a highly multifunctional class of medical materials with potential applications in dermatology. Several hydrogel dressings with anti-infective functions have been formulated and demonstrated to improve the efficacy and tolerance of oral or topical classical anti-infective drugs to a certain degree. In this study, the medical applications of hydrogels for the treatment of various skin infections are systematically reviewed to provide an important theoretical reference for future research studies on the treatment options for skin infections.
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Affiliation(s)
- Yan Teng
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Sujing Li
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, 233030, People’s Republic of China
| | - Hui Tang
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, 233030, People’s Republic of China
| | - Xiaohua Tao
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Yibin Fan
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China
| | - Youming Huang
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China,Correspondence: Youming Huang; Yibin Fan, Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Tel +86-18368023136; +86-18806538451, Email ;
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Ararsa G, Merdassa E, Shibiru T, Etafa W. Prevalence of scabies and associated factors among children aged 5-14 years in Meta Robi District, Ethiopia. PLoS One 2023; 18:e0277912. [PMID: 36595503 PMCID: PMC9810185 DOI: 10.1371/journal.pone.0277912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/05/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Scabies is a public health problem that affects children and elders predominantly. Its burden is higher in resource-poor settings, and scabies has a significant impact on the long-term health of children. In Ethiopia, there is limited information about scabies in children. Therefore, the purpose of this study was to determine the prevalence of scabies and its associated factors among children aged 5-14 years in Meta Robi District, Ethiopia. METHODS A community-based cross-sectional study design using a multistage sampling technique was used to collect data from 457 participants by systematic random sampling. Scabies was diagnosed based on the clinical criteria set by the International Alliance for the Control of Scabies (IACS, 2020). FINDINGS The prevalence of scabies among children aged 5-14 years old was 19.26% (95%CI: 17.20-22.52). In addition, over half (54.6%) of identified cases of scabies were of moderate severity. Factors like families' low income (aOR = 2.72; 95%CI: 1.32-5.59), being a male child (aOR = 1.96, 95%CI: 1.61-4.01), using only water for hand washing (aOR = 2.01, 95%CI: 1.84-4.79), having a contact history of scabies/skin lesions (aOR = 4.15, 95%CI: 2.02-13.67), and sharing sleeping beds (aOR = 6.33, 95%CI: 2.09-19.13) were significantly associated with scabies. CONCLUSION The study highlights a high prevalence of scabies among children aged 5-14 years in the district. Provision of adequate health education for the community and children about the scabies and delivering mass drug administration to the district is suggested.
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Affiliation(s)
- Gemechu Ararsa
- Gemechu Ararsa, West Shoa Zone Health Bureau, Oromia Region, Ambo, Ethiopia
| | - Emiru Merdassa
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- Department of Pediatrics and Child Health, School of Medicine, Wallaga University, Nekemte, Ethiopia
| | - Werku Etafa
- Department of Pediatrics and Child Health Nursing, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
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Wang T, Gasser RB, Korhonen PK, Young ND, Ang CS, Williamson NA, Ma G, Samarawickrama GR, Fernando DD, Fischer K. Proteomic analysis of Sarcoptes scabiei reveals that proteins differentially expressed between eggs and female adult stages are involved predominantly in genetic information processing, metabolism and/or host-parasite interactions. PLoS Negl Trop Dis 2022; 16:e0010946. [PMID: 36472966 PMCID: PMC9725168 DOI: 10.1371/journal.pntd.0010946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Presently, there is a dearth of proteomic data for parasitic mites and their relationship with the host animals. Here, using a high throughput LC-MS/MS-based approach, we undertook the first comprehensive, large-scale proteomic investigation of egg and adult female stages of the scabies mite, Sarcoptes scabiei-one of the most important parasitic mites of humans and other animals worldwide. In total, 1,761 S. scabiei proteins were identified and quantified with high confidence. Bioinformatic analyses revealed differentially expressed proteins to be involved predominantly in biological pathways or processes including genetic information processing, energy (oxidative phosphorylation), nucleotide, amino acid, carbohydrate and/or lipid metabolism, and some adaptive processes. Selected, constitutively and highly expressed proteins, such as peptidases, scabies mite inactivated protease paralogues (SMIPPs) and muscle proteins (myosin and troponin), are proposed to be involved in key biological processes within S. scabiei, host-parasite interactions and/or the pathogenesis of scabies. These proteomic data will enable future molecular, biochemical and physiological investigations of early developmental stages of S. scabiei and the discovery of novel interventions, targeting the egg stage, given its non-susceptibility to acaricides currently approved for the treatment of scabies in humans.
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Affiliation(s)
- Tao Wang
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
- * E-mail:
| | - Robin B. Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
| | - Pasi K. Korhonen
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
| | - Neil D. Young
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
| | - Ching-Seng Ang
- Bio21 Mass Spectrometry and Proteomics Facility, The University of Melbourne, Parkville, Australia
| | - Nicholas A. Williamson
- Bio21 Mass Spectrometry and Proteomics Facility, The University of Melbourne, Parkville, Australia
| | - Guangxu Ma
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
- College of Animal Sciences, Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Zhejiang University, Hangzhou, China
| | - Gangi R. Samarawickrama
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Veterinary Science, University of Queensland, Gatton, Australia
| | - Deepani D. Fernando
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Katja Fischer
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Hume-Nixon M, Ratu T, Clark S, Nguyen CD, Neal EFG, Pell CL, Bright K, Watts E, Hart J, Mulholland K, Fong J, Rafai E, Sakumeni K, Tuibeqa I, Satzke C, Steer A, Russell FM. Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial. BMJ Open 2022; 12:e061157. [PMID: 36456016 PMCID: PMC9716885 DOI: 10.1136/bmjopen-2022-061157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Infections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis. METHODS AND ANALYSIS We are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019. ETHICS AND DISSEMINATION This trial was approved and is being conducted according to the protocol approved by The Royal Children's Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER NCT03925480.
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Affiliation(s)
- Maeve Hume-Nixon
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tupou Ratu
- Asia-Pacific Health, Murdoch Children's Research Institute, Suva, Fiji
| | - Stephanie Clark
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Cattram Duong Nguyen
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Eleanor F G Neal
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Casey L Pell
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kathryn Bright
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emma Watts
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Hart
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kim Mulholland
- New Vaccines, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Ministry of Health and Medical Services, Suva, Fiji
| | - Eric Rafai
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Ilisapeci Tuibeqa
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Catherine Satzke
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Steer
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Fiona M Russell
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Jelousi S, Sharma D, Alexis A, Murase JE. The Impact of Global Health Disparities on Atopic Dermatitis in Displaced Populations: Narrowing the Health Equity Gap for Patients with Skin of Color. Dermatol Ther (Heidelb) 2022; 12:2679-2689. [PMID: 36261772 DOI: 10.1007/s13555-022-00823-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/26/2022] [Indexed: 11/03/2022] Open
Abstract
Atopic dermatitis (AD) is a relatively common inflammatory skin disease marked by eczematous lesions and pruritus often leading to significant morbidity and quality of life impairment for those affected. Recent studies have shown that patients with skin of color (SOC) carry a larger disease burden than patients of European descent. In the USA, these disparities are partly due to structural, environmental, and interpersonal racism. From a global perspective, there is a paucity of research on the burden of atopic dermatitis and other inflammatory skin diseases experienced by the record numbers of refugees, migrants, and asylum seekers around the world. Although it is still unclear whether the true prevalence of AD in displaced communities is higher compared with the general population, those who are displaced suffer from unique risk factors that render them especially vulnerable. In this review, we outline a number of factors contributing to AD susceptibility and/or aggravation in displaced communities. These include poor living conditions, climate change events, psychological stress, and lack of access to medical care and health-related behaviors.
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Affiliation(s)
- Sami Jelousi
- San Francisco School of Medicine, University of California, San Francisco, CA, USA
| | - Divya Sharma
- Department of Medicine, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Jenny E Murase
- Department of Dermatology, University of California, San Francisco, CA, USA. .,Department of Dermatology, Palo Alto Foundation Medical Group, 701 East El Camino Real (31-104), Mountain View, CA, 94040, USA.
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Increased Scabies Incidence at the Beginning of the 21st Century: What Do Reports from Europe and the World Show? LIFE (BASEL, SWITZERLAND) 2022; 12:life12101598. [PMID: 36295033 PMCID: PMC9604680 DOI: 10.3390/life12101598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022]
Abstract
Reports from various countries have described increasing numbers of scabies cases, especially in the past two decades. The epidemiological data for various world regions showed prevalence estimates ranging from 0.2% to 71%, with the highest prevalence in the Pacific region and Latin America. Therefore, geographically, scabies occurs more commonly in the developing world, tropical climates, and in areas with a lack of access to water. According to results from specific regions of the world, the greatest burdens from scabies were recorded for East Asia, Southeast Asia, Oceania, tropical Latin America, and South Asia. Among countries with the highest rates, the top 10 were Indonesia, China, Timor-Leste, Vanuatu, Fiji, Cambodia, Laos, Myanmar, Vietnam, and the Seychelles. From Europe, available data shows an increasing trend in scabies infestation, particularly evident among populations with associated contributing factors, such as those who travel frequently, refugees, asylum seekers, those who regularly lack drinking water and appropriate hygiene and are of a younger age, etc. This increase in observed cases in the last 10–20 years has been evidenced by research conducted in Germany, France, Norway, and Croatia, among other countries. In addition, increased scabies transmission was also recorded during the COVID-19 pandemic and may have been the result of increased sexual intercourse during that time. Despite all the available treatment options, scabies commonly goes unrecognized and is therefore not treated accordingly. This trend calls for a prompt and synergistic reaction from all healthcare professionals, governmental institutions, and non-governmental organizations, especially in settings where population migration is common and where living standards are low. Furthermore, the proper education of whole populations and accessible healthcare are cornerstones of outbreak prevention. Accurate national data and proper disease reporting should be a goal for every country worldwide when developing strategic plans for preventing and controlling the community spread of scabies.
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Global trends of pulmonary infections with nontuberculous mycobacteria: a systematic review. Int J Infect Dis 2022; 125:120-131. [PMID: 36244600 DOI: 10.1016/j.ijid.2022.10.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/21/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To describe the global trends of pulmonary nontuberculous mycobacteria (NTM) infection and disease. METHODS A systematic review of studies including culture-based NTM data over time. Studies reporting on pulmonary NTM infection and/or disease were included. Information on the use of guideline-based criteria for disease were collected, in which, infection is defined as the absence of symptoms and radiological findings compatible with NTM pulmonary disease. The trends of change for incidence/prevalence were evaluated using linear regressions, and the corresponding pooled estimates were calculated. RESULTS Most studies reported increasing pulmonary NTM infection (82.1%) and disease (66.7%) trends. The overall annual rate of change for NTM infection and disease per 100,000 persons/year was 4.0% (95% confidence interval [CI]: 3.2-4.8) and 4.1% (95% CI: 3.2-5.0), respectively. For absolute numbers of NTM infection and disease, the overall annual change was 2.0 (95% CI: 1.6-2.3) and 0.5 (95% CI: 0.3-0.7), respectively. An increasing trend was also seen for Mycobacterium avium complex infection (n = 15/19, 78.9%) and disease (n = 10/12, 83.9%) and for Mycobacterium abscessus complex (n = 15/23, 65.2%) infection (n = 11/17, 64.7%) but less so for disease (n = 2/8, 25.0%). CONCLUSION Our data indicate an overall increase in NTM worldwide for both infection and disease. The explanation to this phenomenon warrants further investigation.
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Meumann EM, Krause VL, Baird R, Currie BJ. Using Genomics to Understand the Epidemiology of Infectious Diseases in the Northern Territory of Australia. Trop Med Infect Dis 2022; 7:tropicalmed7080181. [PMID: 36006273 PMCID: PMC9413455 DOI: 10.3390/tropicalmed7080181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
The Northern Territory (NT) is a geographically remote region of northern and central Australia. Approximately a third of the population are First Nations Australians, many of whom live in remote regions. Due to the physical environment and climate, and scale of social inequity, the rates of many infectious diseases are the highest nationally. Molecular typing and genomic sequencing in research and public health have provided considerable new knowledge on the epidemiology of infectious diseases in the NT. We review the applications of genomic sequencing technology for molecular typing, identification of transmission clusters, phylogenomics, antimicrobial resistance prediction, and pathogen detection. We provide examples where these methodologies have been applied to infectious diseases in the NT and discuss the next steps in public health implementation of this technology.
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Affiliation(s)
- Ella M. Meumann
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
- Correspondence:
| | - Vicki L. Krause
- Northern Territory Centre for Disease Control, Northern Territory Government, Darwin 0810, Australia
| | - Robert Baird
- Territory Pathology, Royal Darwin Hospital, Darwin 0810, Australia
| | - Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
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Ricciardo BM, Kessaris HL, Kumarasinghe SP, Carapetis JR, Bowen AC. The burden of bacterial skin infection, scabies and atopic dermatitis among urban-living Indigenous children in high-income countries: a protocol for a systematic review. Syst Rev 2022; 11:159. [PMID: 35945624 PMCID: PMC9361683 DOI: 10.1186/s13643-022-02038-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/28/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Bacterial skin infections and scabies disproportionately affect children in resource-poor countries as well as underprivileged children in high-income countries. Atopic dermatitis is a common childhood dermatosis that predisposes to bacterial skin infection. In Australia, at any one time, almost half of all Aboriginal and Torres Strait Islander children living remotely will have impetigo, and up to one-third will also have scabies. Yet, there is a gap in knowledge of the skin infection burden for urban-living Australian Aboriginal and Torres Strait Islander children, as well as atopic dermatitis which may be a contributing factor. The objective of this study is to provide a global background on the burden of these disorders in Indigenous urban-living children in high-income countries. These countries share a similar history of colonisation, dispossession and subsequent ongoing negative impacts on Indigenous people. METHODS This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols statement. Observational studies reporting incidence and/or prevalence data on bacterial skin infection, scabies and/or atopic dermatitis in urban-living Indigenous children in high-income countries will be included. Literature searches will be conducted in several international electronic databases (from 1990 onwards), including MEDLINE, Embase, EmCare, Web of Science and PubMed. Reference lists and citation records of all included articles will be scanned for additional relevant manuscripts. Two investigators will independently perform eligibility assessment of titles, abstract and full-text manuscripts, following which both investigators will independently extract data. Where there is disagreement, the senior author will determine eligibility. The methodological quality of selected studies will be appraised using an appropriate tool. Data will be tabulated and narratively synthesised. We expect there will be insufficient data to perform meta-analysis. DISCUSSION This study will identify and evaluate epidemiological data on bacterial skin infection, scabies and atopic dermatitis in urban-living Indigenous children in high-income countries. Where available, the clinical features, risk factors, comorbidities and complications of these common childhood skin disorders will be described. The evidence will highlight the burden of disease in this population, to contribute to global burden of disease estimates and identify gaps in the current literature to provide direction for future research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021277288.
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Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, Western Australia, Australia. .,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia. .,Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
| | | | | | - Jonathan R Carapetis
- University of Western Australia, Crawley, Western Australia, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, Western Australia, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Perth Children's Hospital, Nedlands, Western Australia, Australia
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Mange in Rabbits: An Ectoparasitic Disease with a Zoonotic Potential. Vet Med Int 2022; 2022:5506272. [PMID: 35880196 PMCID: PMC9308540 DOI: 10.1155/2022/5506272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Mange in rabbits is a very important parasitic disease causing high losses. The disease is caused mainly by Sarcoptes scabiei, Psoroptes cuniculi, Cheyletiella parasitovorax, and Notoedres cati. Body mange and ear mange are the most common forms of this disease in rabbits. Animals can get mite infestation through direct contact with infected animals or contaminated fomites. This infestation is characterized by zoonotic nature and public health burden. The skin affection is characterized by pruritus, alopecia, severe cachexia, and sometimes death. Infestation is diagnosed mainly by skin scraping and microscopic examination. Control measures mainly depend on the use of different types of systemic and topical acaricides and the use of natural products and supportive elements. Vaccine is not commercially available and is still under investigation. Accordingly, this review article was designed to shed the light on the mange disease in rabbits in terms of mite's infestation and susceptibility, clinical manifestations, zoonosis, diagnosis, and control strategies.
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Anissa L, Indriatmi W, Wibawa LP, Widaty S. Efficacy and side effects of Blacksoap® as adjuvant therapy of scabies: a randomized control trial. MEDICAL JOURNAL OF INDONESIA 2022. [DOI: 10.13181/mji.oa.225965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy.
METHODS This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-parametric tests.
RESULTS The cure rate of the intervention group was lower than the control in the first week with 75% versus 81% but higher in the fourth week with 97% versus 92%. There was no significant difference in the scores of pruritus VAS and TEWL, as well as side effects between the two groups.
CONCLUSIONS The efficacy and safety of scabies treatment were similar between Blacksoap® and placebo adjunctive to standard treatment. Blacksoap®, on top of standard scabies treatment, might benefit patients by providing a higher cure rate in 4 weeks without any considerable adverse effects.
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Fernando DD, Fischer K. Spinosad topical suspension (0.9%): a new topical treatment for scabies. Expert Rev Anti Infect Ther 2022; 20:1149-1154. [PMID: 35799317 DOI: 10.1080/14787210.2022.2099376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Scabies is a highly contagious skin disease caused by the parasitic mite Sarcoptes scabiei. There is no vaccine and for the past 30 years, the first line treatments have been topical permethrin and oral ivermectin. These drugs target mainly the parasite nervous system, killing only the motile stages. As they lack ovicidal activities, repeat treatments are required to achieve complete cure. Incompliance to repeat treatments causing prolonged drug usage, has contributed to emerging drug resistances. In addition, they are not appropriate for all patient categories, specifically for infants and young children or pregnant and breast feeding women. Consequently, new single dose scabicides are urgently needed. AREAS COVERED In 2021, spinosad, a drug previously used to treat head lice, was approved by the US FDA as a topical scabies treatment. Here the pharmacology, clinical efficacy and tolerability of this drug are discussed. EXPERT OPINION As the first single dose scabicide the formulated 0.9% topical Spinosad solution shows significant efficacy, little systemic absorption and no serious adverse reactions, making it a promising treatment for classical scabies in patients older than four years.
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Affiliation(s)
- Deepani D Fernando
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
| | - Katja Fischer
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
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Tellioglu N, Chisholm RH, McVernon J, Geard N, Campbell PT. The efficacy of sampling strategies for estimating scabies prevalence. PLoS Negl Trop Dis 2022; 16:e0010456. [PMID: 35679325 PMCID: PMC9216578 DOI: 10.1371/journal.pntd.0010456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/22/2022] [Accepted: 04/30/2022] [Indexed: 11/22/2022] Open
Abstract
Background Estimating community level scabies prevalence is crucial for targeting interventions to areas of greatest need. The World Health Organisation recommends sampling at the unit of households or schools, but there is presently no standardised approach to scabies prevalence assessment. Consequently, a wide range of sampling sizes and methods have been used. As both prevalence and drivers of transmission vary across populations, there is a need to understand how sampling strategies for estimating scabies prevalence interact with local epidemiology to affect the accuracy of prevalence estimates. Methods We used a simulation-based approach to compare the efficacy of different scabies sampling strategies. First, we generated synthetic populations broadly representative of remote Australian Indigenous communities and assigned a scabies status to individuals to achieve a specified prevalence using different assumptions about scabies epidemiology. Second, we calculated an observed prevalence for different sampling methods and sizes. Results The distribution of prevalence in subpopulation groups can vary substantially when the underlying scabies assignment method changes. Across all of the scabies assignment methods combined, the simple random sampling method produces the narrowest 95% confidence interval for all sample sizes. The household sampling method introduces higher variance compared to simple random sampling when the assignment of scabies includes a household-specific component. The school sampling method overestimates community prevalence when the assignment of scabies includes an age-specific component. Discussion Our results indicate that there are interactions between transmission assumptions and surveillance strategies, emphasizing the need for understanding scabies transmission dynamics. We suggest using the simple random sampling method for estimating scabies prevalence. Our approach can be adapted to various populations and diseases. Scabies is a parasitic infestation that is commonly observed in disadvantaged populations. A wide range of sampling sizes and methods have been used to estimate scabies prevalence. With differing key drivers of transmission and varying prevalence across populations, it can be challenging to determine an effective sampling strategy. In this study, we propose a simulation approach to compare the efficacy of different sampling methods and sizes. First, we generate synthetic populations and then assign a scabies status to individuals to achieve a specified prevalence using different assumptions about scabies epidemiology. Second, we calculate an observed prevalence for different sampling methods and sizes. Our results indicate that there are interactions between transmission assumptions and surveillance strategies. We suggest using the simple random sampling method for estimating prevalence as it produces the narrowest 95% confidence interval for all sampling sizes. We propose guidelines for determining a sample size to achieve a desired level of precision in 95 out 100 samples, given estimates of the population size and a priori estimates of true prevalence. Our approach can be adapted to various populations, informing an appropriate sampling strategy for estimating scabies prevalence with confidence.
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Affiliation(s)
- Nefel Tellioglu
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | - Rebecca H. Chisholm
- Department of Mathematics and Statistics, La Trobe University, Bundoora, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jodie McVernon
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, Australia
| | - Patricia Therese Campbell
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- * E-mail:
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Kurcheid J, Gordon CA, Clarke NE, Wangdi K, Kelly M, Lal A, Mutombo PN, Wang D, Mationg ML, Clements ACA, Muhi S, Bradbury RS, Biggs B, Page W, Williams G, McManus DP, Gray D. Neglected tropical diseases in Australia: a narrative review. Med J Aust 2022; 216:532-538. [DOI: 10.5694/mja2.51533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Johanna Kurcheid
- Australian National University Canberra ACT
- Swiss Tropical and Public Health Institute Basel Switzerland
| | | | - Naomi E Clarke
- Australian National University Canberra ACT
- Kirby Institute University of New South Wales Sydney NSW
| | | | | | - Aparna Lal
- Australian National University Canberra ACT
| | - Polydor N Mutombo
- National Centre for Naturopathic Medicine Southern Cross University Lismore NSW
| | | | | | | | - Stephen Muhi
- Victorian Infectious Diseases Service Royal Melbourne Hospital Melbourne VIC
| | | | - Beverley‐Ann Biggs
- Victorian Infectious Diseases Service Royal Melbourne Hospital Melbourne VIC
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Manfredi L, Sciannameo V, Destefanis C, Prisecaru M, Cossu G, Gnavi R, Macciotta A, Catalano A, Pepe RR, Sacerdote C, Ricceri F. Health status assessment of a population of asylum seekers in Northern Italy. Global Health 2022; 18:57. [PMID: 35659014 PMCID: PMC9164173 DOI: 10.1186/s12992-022-00846-0] [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: 11/25/2021] [Accepted: 05/02/2022] [Indexed: 11/11/2022] Open
Abstract
Background Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world’s most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy). Methods A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival. Results Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0–27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September–November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma). Conclusions This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00846-0.
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Affiliation(s)
- Luca Manfredi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.
| | - Veronica Sciannameo
- Department of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Marta Prisecaru
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Giorgia Cossu
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute E Della Scienza University-Hospital, Turin, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Thean LJ, Romani L, Engelman D, Wand H, Jenney A, Mani J, Paka J, Cua T, Taole S, Silai M, Ashwini K, Sahukhan A, Kama M, Tuicakau M, Kado J, Parnaby M, Carvalho N, Whitfeld M, Kaldor J, Steer AC. Prevention of bacterial complications of scabies using mass drug administration: A population-based, before-after trial in Fiji, 2018-2020. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 22:100433. [PMID: 35345391 PMCID: PMC8956868 DOI: 10.1016/j.lanwpc.2022.100433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Scabies is an important predisposing factor of impetigo which can lead to serious bacterial complications. Ivermectin-based mass drug administration can substantially reduce scabies and impetigo prevalence in endemic settings, but the impact on serious bacterial complications is not known. METHODS We conducted a before-after trial in the Northern Division of Fiji (population: 131,914) of mass drug administration for scabies control. Prospective surveillance was conducted from 2018 to 2020. Mass drug administration took place in 2019, involving two doses of oral ivermectin or topical permethrin, delivered alongside diethylcarbamazine and albendazole for lymphatic filariasis. The primary outcomes were incidence of hospitalisations with skin and soft tissue infections, and childhood invasive infections and post-streptococcal sequelae. Secondary outcomes included presentations to primary healthcare with skin infections and community prevalence of scabies and impetigo. FINDINGS The incidence of hospitalisations with skin and soft tissue infections was 17% lower after the intervention compared to baseline (388 vs 467 per 100,000 person-years; incidence rate ratio 0.83, 95% CI, 0.74 to 0.94; P = 0.002). There was no difference in incidence of childhood invasive infections and post-streptococcal sequelae. Incidence of primary healthcare presentations with scabies and skin infections was 21% lower (89.2 vs 108 per 1000 person-years, incidence rate ratio, IRR 0.79, 95% CI, 0.78 to 0.82). Crude community prevalence of scabies declined from 14.2% to 7.7% (cluster-adjusted prevalence 12.5% to 8.9%; prevalence ratio 0.71, 95% CI, 0.28 to 1.17). Cluster-adjusted prevalence of impetigo declined from 15.3% to 6.1% (prevalence ratio 0.4, 95% CI, 0.18 to 0.86). INTERPRETATION Mass drug administration for scabies control was associated with a substantial reduction in hospitalisations for skin and soft tissue infections. FUNDING National Health and Medical Research Council of Australia and Scobie and Claire Mackinnon Trust.
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Affiliation(s)
- Li Jun Thean
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Lucia Romani
- Kirby Institute, University of New South Wales, Kensington, New South Wales 2052, Australia
| | - Daniel Engelman
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria 3052, Australia
- Melbourne Children's Global Health, Melbourne Children's Campus, The Royal Children's Hospital, Parkville, 3052 Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Kensington, New South Wales 2052, Australia
| | - Adam Jenney
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Jyotishna Mani
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Jessica Paka
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Tuliana Cua
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Sera Taole
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Maciu Silai
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Komal Ashwini
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | | | - Mike Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Joseph Kado
- Ministry of Health and Medical Services, Suva, Fiji
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia 6009, Australia
| | - Matthew Parnaby
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
| | - Natalie Carvalho
- School of Population and Global Health, University of Melbourne, Carlton, Victoria 3053, Australia
| | - Margot Whitfeld
- Department of Dermatology, St. Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia
- School of Medicine, University of New South Wales, Kensington, New South Wales 2052, Australia
| | - John Kaldor
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Andrew C. Steer
- Tropical Diseases Group, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria 3052, Australia
- Melbourne Children's Global Health, Melbourne Children's Campus, The Royal Children's Hospital, Parkville, 3052 Australia
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Can ivermectin mass drug administrations to control scabies also reduce skin and soft tissue infections? Hospitalizations and primary care presentations lower after a large-scale trial in Fiji. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 22:100454. [PMID: 35462879 PMCID: PMC9018377 DOI: 10.1016/j.lanwpc.2022.100454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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MHLANGA A, MUPEDZA TV, MAZIKANA TM. Optimal Control and Cost-Effective Analysis of a Scabies Model with Direct and Indirect Transmissions. J BIOL SYST 2022. [DOI: 10.1142/s0218339022500097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Scabies is caused by sarcoptes scabiei var. hominis, which is also referred to as itch mice. The disease is transmitted through direct contact with an infected person, or from contact with infested bedding or clothing. In this paper, a mathematical model for the spread of scabies was proposed and analyzed. Sensitivity analysis of the model parameters was carried out. Optimal control theory was applied to our proposed model, with the controls representing treatment and vaccination. Our aim was to minimize cumulative infectious cases and susceptible individuals through treatment and vaccination, respectively. Pontryagin’s maximum principle was utilized to characterize the optimal levels of the two controls. The resulting optimality system was then solved numerically. The optimal control result was further highlighted by applying the results realized from the cost objective functional, the IAR, and the ICER.
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Affiliation(s)
- A. MHLANGA
- Department of Mathematics and Computational Sciences, University of Zimbabwe, Box MP 167 Mount Pleasant, Harare, Zimbabwe
| | - T. V. MUPEDZA
- Department of Mathematics and Computational Sciences, University of Zimbabwe, Box MP 167 Mount Pleasant, Harare, Zimbabwe
| | - T. M. MAZIKANA
- Department of Mathematics and Computational Sciences, University of Zimbabwe, Box MP 167 Mount Pleasant, Harare, Zimbabwe
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Campbell M, van der Linden N, Gardner K, Dickinson H, Agostino J, Dowden M, O’Meara I, Scolyer M, Woerle H, Viney R, van Gool K. Health care cost of crusted scabies in Aboriginal communities in the Northern Territory, Australia. PLoS Negl Trop Dis 2022; 16:e0010288. [PMID: 35344551 PMCID: PMC8989313 DOI: 10.1371/journal.pntd.0010288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 04/07/2022] [Accepted: 02/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background Crusted scabies is a debilitating dermatological condition. Although still relatively rare in the urban areas of Australia, rates of crusted scabies in remote Aboriginal communities in the Northern Territory (NT) are reported to be among the highest in the world. Objective To estimate the health system costs associated with diagnosing, treating and managing crusted scabies. Methods A disease pathway model was developed to identify the major phases of managing crusted scabies. In recognition of the higher resource use required to treat more severe cases, the pathway differentiates between crusted scabies severity grades. The disease pathway model was populated with data from a clinical audit of 42 crusted scabies patients diagnosed in the Top-End of Australia’s Northern Territory between July 1, 2016 and May 1, 2018. These data were combined with standard Australian unit costs to calculate the expected costs per patient over a 12-month period, as well as the overall population cost for treating crusted scabies. Findings The expected health care cost per patient diagnosed with crusted scabies is $35,418 Australian dollars (AUD) (95% CI: $27,000 to $43,800), resulting in an overall cost of $1,558,392AUD (95% CI: $1,188,000 to $1,927,200) for managing all patients diagnosed in the Northern Territory in a given year (2018). By far, the biggest component of the health care costs falls on the hospital system. Discussion This is the first cost-of-illness analysis for treating crusted scabies. Such analysis will be of value to policy makers and researchers by informing future evaluations of crusted scabies prevention programs and resource allocation decisions. Further research is needed on the wider costs of crusted scabies including non-financial impacts such as the loss in quality of life as well as the burden of care and loss of well-being for patients, families and communities. Crusted scabies is characterised by thick skin crusting and fissuring and can lead to serious secondary infections and death from complications. Rates of crusted scabies in remote Aboriginal communities in the Northern Territory (NT) are among the highest in the world. Efforts are on the way in Australia to prevent, if not eliminate, crusted scabies. We use data from a clinical audit of 42 patients diagnosed with crusted scabies in the Top-End of the NT to estimate the health system costs associated with diagnosing, treating and managing crusted scabies for patients and their households. This cost of illness study can provide a valuable starting point for policy makers and evaluators in estimating the potential economic impact of crusted scabies prevention programs on health care service use and costs.
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Affiliation(s)
- Margaret Campbell
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Naomi van der Linden
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Karen Gardner
- Public Service Research Group, School of Business, UNSW Canberra, Canberra, Australia
| | - Helen Dickinson
- Public Service Research Group, School of Business, UNSW Canberra, Canberra, Australia
| | - Jason Agostino
- Academic Unit of General Practice, Australian National University, Canberra, Australia
| | | | | | | | | | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kees van Gool
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Sydney, Australia
- * E-mail:
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The national burden of scabies in Germany: a population-based approach using Internet search engine data. Infection 2022; 50:915-923. [PMID: 35133608 PMCID: PMC9338126 DOI: 10.1007/s15010-022-01763-5] [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: 10/27/2021] [Accepted: 01/26/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Scabies is a World Health Organization-defined neglected tropical disease and a growing public health issue worldwide. It is difficult to obtain reliable data on prevalence due to the lack of standardized tests. The aim of this study was to assess scabies online search behavior in Germany to identify local differences using Google search volume. METHODS Google Ads Keyword Planner was used to investigate the scabies-related search volume for Germany as a whole, its 16 federal states, and 15 large cities for the period from January 2016 to December 2019. The identified search terms were qualitatively categorized and critically analyzed. RESULTS A total of 572 keywords with an overall search volume of 11,414,180 searches regarding scabies were identified in Germany. The number of searches was higher in winter than in summer, with a national peak in March 2018. Around 30.6% of the searches regarding scabies therapy (n = 978,420) were related to home remedies. Regarding body localization, most searches focused on the whole body (n = 109,050), followed by head (n = 89,360) and the genital area (n = 28,640). CONCLUSIONS The analysis of Google search data provides an overview of the populations' interest regarding scabies. The analysis can detect local peaks and assess the relevance of scabies at individual localizations of the body. The study highlighted current possible shortcomings in the therapy of scabies. It also underlined the importance of improving awareness regarding scabies so that affected individuals can consult a doctor earlier for treatment.
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Lake SJ, Kaldor JM, Hardy M, Engelman D, Steer AC, Romani L. Mass drug administration for the control of scabies: a systematic review and meta-analysis. Clin Infect Dis 2022; 75:959-967. [PMID: 35088849 PMCID: PMC9522411 DOI: 10.1093/cid/ciac042] [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: 10/11/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Scabies is a neglected tropical disease of the skin that can lead to impetigo, serious secondary bacterial infections and immune-mediated diseases. Mass drug administration (MDA) has been reported in several studies to reduce the prevalence of scabies and impetigo. We aimed to assess the efficacy of MDA for scabies on scabies and impetigo. METHODS We conducted a systematic review and meta-analysis of reports on the impact of MDA on scabies and impetigo. We included randomised control trials and observational evaluations reported from January 1970 to April 2021 and involving human participants. We searched PubMed, Ovid Medline, Embase and Cochrane. We considered MDA as treatment intended for the whole population, regardless of individual infection status or symptoms. The main outcome assessed was the change in scabies and impetigo prevalence following MDA. This review is registered with PROSPERO (CRD42020169839). RESULTS We identified 1110 records, of which 11 met inclusion criteria for the review and 9 were deemed suitable for meta-analysis for scabies and four for impetigo. Most studies were in small populations. There was a high degree of heterogeneity between studies (I 2 value 96·19%). The overall relative reduction of the impact of MDA on scabies prevalence was 79%. The effect size was comparable for MDA based on ivermectin and permethrin. MDA for scabies also led to a reduction in impetigo prevalence with a relative reduction of 66%. CONCLUSIONS MDA for scabies is highly effective in reducing the prevalence of scabies and impetigo. Further research is needed to determine the durability of impact, and the effectiveness of MDA regimens in larger populations.
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Affiliation(s)
- Susanna J Lake
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - John M Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Myra Hardy
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - Daniel Engelman
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - Andrew C Steer
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - Lucia Romani
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Kirby Institute, University of New South Wales, Sydney, Australia
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Sartorio MUA, Munari AM, Carlucci P, Erba P, Calcaterra V, Fabiano V. MRSA Femoral Osteomyelitis from Superinfected Scabies Lesions: A Pediatric Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021007. [PMID: 35055830 PMCID: PMC8775834 DOI: 10.3390/ijerph19021007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 02/01/2023]
Abstract
Scabies is a skin infestation from the Sarcoptes scabiei. It is considered a public health issue causing concern in developing countries and is considered a “neglected tropical disease” by the World Health Organization (WHO). Scabies skin lesions may cause severe itching and can be the portal of entry for opportunistic and pathogenic bacteria, which can cause serious systemic infections. We report the case of a 3-year-old boy with recurrent scabies infections who presented to the emergency department because of a fever and refusal to walk. Blood tests showed neutrophilic leukocytosis and significantly increased C reactive protein (CRP) and procalcitonin. Upon medical examination, his right thigh was extremely painful upon palpation, knee flexion was lost and he was unable to stand, so magnetic resonance imaging (MRI) was performed. MRI showed osteomyelitis of metaphysis and distal diaphysis of the right femur with associated subperiosteal purulent collection and concomitant pyomyositis and fasciitis of the distal right thigh. Blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA). The patient received a long course of intravenous antibiotic therapy and his condition slowly improved. Follow-up femur X-ray showed a mixed pattern of erosion and sclerosis at the meta-diaphyseal region and periosteal reaction at the diaphyseal region. This case highlights the importance of early scabies diagnosis even in Western countries where poverty and household overcrowding are uncommon. Early diagnosis, timely initiation of proper treatment and evidence of clinical resolution are important elements to prevent recurrence of infection and serious systemic superinfections even from multi-drug resistant bacteria. Clinical consequences from unrecognized disease or inadequate eradication are preventable.
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Affiliation(s)
- Marco Ugo Andrea Sartorio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy; (P.C.); (P.E.); (V.C.); (V.F.)
- Correspondence:
| | - Alice Marianna Munari
- Pediatric Radiology and Neuroradiology, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy;
| | - Patrizia Carlucci
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy; (P.C.); (P.E.); (V.C.); (V.F.)
| | - Paola Erba
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy; (P.C.); (P.E.); (V.C.); (V.F.)
| | - Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy; (P.C.); (P.E.); (V.C.); (V.F.)
- Pediatrics and Adolescentology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Valentina Fabiano
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy; (P.C.); (P.E.); (V.C.); (V.F.)
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49
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Yulfi H, Zulkhair M, Yosi A. Scabies infection among boarding school students in Medan, Indonesia: Epidemiology, Risk Factors, and Recommended Prevention. Trop Parasitol 2022; 12:34-40. [PMID: 35923265 PMCID: PMC9341144 DOI: 10.4103/tp.tp_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/11/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022] Open
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50
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Gazi U, Taylan-Ozkan A, Mumcuoglu KY. Immune mechanisms in human Sarcoptes scabiei (Acari: Sarcoptidae) infestations. Parasite Immunol 2021; 44:e12900. [PMID: 34923637 DOI: 10.1111/pim.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
Scabies is a parasitic infestation of human and animal skin caused by different strains of the itch mite, Sarcoptes scabiei. The World Health Organization (WHO) has declared scabies in human as a neglected tropical disease, and today over 200 million people worldwide are affected. The two most commonly reported clinical manifestation of the condition are ordinary (OS) and crusted scabies (CS). CS, which can lead to fatal consequences due to secondary bacterial infections, is mostly observed in immunocompromised subjects but can also, although rarely, be detected in immunocompetent individuals. Innate and adaptive immune system components are involved in protection and pathogenesis of scabies, although with some differences between OS and CS. While the cutaneous immune response is dominated by CD4+ T-cells in OS, it is mainly mediated by CD8+ T-cells in CS. The two clinical conditions also differ in CD4+ T-cell-mediated immune responses with mixed TH 1/TH 2 (protective) and TH 2/TH 17 (non-protective) immunoprofiles in OS and CS, respectively. Moreover, the development of CS is associated with early immunosuppression that is followed by deleterious immune response to uncontrolled mite proliferation. However, the immune response to scabies still needs further attention due to inconsistent results in the literature. The aim of this study is to attract more attention to this area by summarizing the current literature on innate and adaptive immune responses triggered against S. scabiei mites.
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Affiliation(s)
- Umut Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - Kosta Y Mumcuoglu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
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