Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area

Prevalence of scabies and its associated environmental risk factors among the Forcibly Displaced Myanmar Nationals living in the Cox's Bazar district of Bangladesh

Introduction

The Forcibly Displaced Myanmar Nationals (FDMNs) residing in refugee camps face various health challenges, including a rising prevalence of scabies, exacerbated by overcrowded conditions and limited healthcare access. This study aims to assess scabies prevalence, clinical features, and environmental factors among FDMNs, aiding interventions and recommendations for better health outcomes.

Methodology

A cross-sectional study was conducted from April to May 2023 in six camps of Teknaf/Ukhia Cox's Bazar. Using a multistage sampling technique, 12 blocks were identified, and FDMNs seeking healthcare services from Primary Health Care posts were invited to participate in the study. Participants were adults, and children who volunteered to participate in this study. Scabies diagnosis was based on clinical examinations of exposed body areas by trained health professionals. Data on sociodemographic factors, environmental risk factors, and scabies symptoms were obtained through a semi-structured questionnaire administered by trained interviewers. Statistical analysis included descriptive statistics, Chi-square tests, and binary logistic regression models to explore associations between scabies infection and other explanatory factors.

Result

A total of 679 FDMNs participated in the study, with a mean age of 29.13 years. Overall, 66.42 % of participants were diagnosed with scabies. Age, marital status, history of scabies infection, previous skin infection, family history of scabies and skin infection, floor type, pet animal, dust exposure, and seasonal exposure were significantly associated with the scabies infection. Binary logistic regression suggested that having history of scabies infection (OR 3.98, 95 % CI: 1.86 to 8.49, p < 0.001), skin infection (OR 2.46, 95 % CI: 1.32 to 4.58, p = 0.004), having family history of scabies infection (OR 3.06, 95 % CI: 1.29 to 7.23, p = 0.011), family history of skin infection (OR 27.41, 95% CI: 14.46 to 51.97, P < 0.001), having contact with street animal (OR 2.16, 95% CI: 1.27 to 3.66, P = 0.004), and winter season (OR 3.33, 95 % CI: 1.89 to 5.87, p < 0.001) were significantly associated with scabies infection.

Conclusion

Tailored public health measures targeting hygiene, living conditions, and animal contact can mitigate the spread of scabies, particularly among vulnerable groups like Rohingya refugees, necessitating collaboration between stakeholders.

Awareness and knowledge of scabies and ringworm among parents of school-age children in Calabar, Cross River State, Nigeria: Implications for prevention of superficial skin infestations

Context

Risk factors for the persistence of superficial skin infestations are prevalent in humid tropical environments, which are favorable for breeding of the causative vector mite Sarcoptes scabiei (ectoparasite) and dermatophyte fungi.

Aim

This study aimed at assessing the awareness and knowledge of childhood scabies and ringworm infestations among parents in Calabar, a highly humid rainforest tropical environment.

Settings and Design

Cross-sectional study design and systematic random sampling were used to recruit school-age children in selected primary schools in Calabar.

Materials and Methods

Researcher-driven administration of a structured questionnaire was conducted to obtain quantitative data from parents of recruited children.

Statistical Analysis Used

: Chi-square was used to assess factors associated with ever hearing or seeing scabies and ringworm infestations. Statistical significance was set at P < 0.05.

Results

One hundred and eighty-two (56.7%) and 218 (67.9%) of the respondents had heard of or seen scabies and ringworm infestation. Among respondents that were aware of scabies, 53.3% knew of the cause, 50.5% were aware of the risk factors while 68.1% and 78.0% knew their treatment and prevention, respectively; 98.6%, 60.6%, 76.6%, and 80.7% of respondents knew the cause, risk factors, treatment, and prevention of ringworm infestation, respectively. Fathers with at least secondary school literacy level and sharing beds were significantly associated with awareness of scabies.

Conclusion

There is a suboptimal level of awareness and knowledge of two of the most common superficial skin infestations among parents of primary school children in the study setting. There is a need to redouble our effort at sensitization of parents toward improved awareness of these common infestations.

Living in a large family and low daily water consumption substantially expose for human scabies in rural Ethiopia: a matched analysis

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.

Cloth sharing with a scabies case considerably explains human scabies among children in a low socioeconomic rural community of Ethiopia

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.

Prevalence of scabies worldwide-An updated systematic literature review in 2022

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.

Prevalence of scabies and associated factors among children aged 5-14 years in Meta Robi District, Ethiopia

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.

Prevalence of skin Neglected Tropical Diseases and superficial fungal infections in two peri-urban schools and one rural community setting in Togo

INTRODUCTION

Skin neglected tropical diseases (NTDs), are endemic and under-diagnosed in many lower-income communities. The objective of this study was to determine the prevalence of skin NTDs and fungal infections in two primary schools and a community setting in rural Togo.

METHOD

This was a cross-sectional study that took place between June-October 2021. The two primary schools are located on the outskirts of Lomé, the capital city. The community setting was Ndjéi, in north-east Togo. Study sites were purposively selected. Dermatologists examined the skin of study participants. Diagnosis of skin NTDs were made clinically.

RESULTS

A total of 1401 individuals were examined, 954 (68.1%) from Ndjéi community, and 447 (31.9%) were children in the schools. Cutaneous skin infections were diagnosed in 438 (31.3%) participants, of whom 355 (81%) were in community settings. There were 105 observed skin NTDs (7.5%). Within the school setting, there were 20 individuals with NTDs (4.5% of 447 participants), and 85 NTDs (8.9%) from 954 community participants. Across all settings 68/1020 (6.7%) NTDs were in children, and 37/381 (9.7%) in adults. In addition, there were 333 observed mycoses (23.8% prevalence). The main cutaneous NTDs diagnosed were scabies (n = 86; 6.1%) and suspected yaws (n = 16, 1.1%). The prevalence of scabies in schools was 4.3%, and 7.0% in the rural community. One case of leprosy was diagnosed in each school and the rural community, and one suspected Buruli Ulcer case in the community. In the school setting, five (6%) children with a skin NTD reported being stigmatised, four of whom had refused to attend school because of their dermatosis. In Ndjéi, 44 (4.6%) individuals reported having experienced stigma and 41 (93.2%) of them missed at least one day of school or work.

CONCLUSION

This study shows that the burden of scabies and skin infections such as superficial mycoses is high in the school and rural community settings in Togo, with associated presence of stigma. Improved health promotion and education across institutional and community settings may reduce stigma and encourage early reporting of skin infection cases to a health facility.

Prevalence and determinants of scabies among school-age children in Central Armachiho district, Northwest, Ethiopia

Background

Scabies is a major global public health issue that might affect people from all socioeconomic levels. Globally, scabies affects more than 200 million people at any time. It remains one of the commonest skin diseases seen in developing countries including Ethiopia. Therefore, this study aimed to assess the prevalence and determinants of scabies among school-age children in Central Armachiho district, Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from August to September 2020. A multi-stage sampling technique was used to select 850 study populations. Data was checked for its completeness, coded, and entered by using EPI-INFO version 7 and exported to the SPSS version 20 for analysis. A Binary logistic regression model was fitted to identify the determinants of scabies. Crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% CI were used as measurements for the associations. P-values <0.005 were considered significant.

Result

Prevalence of scabies among the 850 participants studied was 10.82% (95% CI: 8.7–12.9). Contact history with confirmed scabies patient (AOR = 5.28,95% CI: 2.96–9.44), child not attending school (AOR = 3.08, 95% CI;1.45–6.54), rarely changing clothes (AOR = 2.43,95% CI: 1.27–4.62), sleeping on the floor (AOR = 4.11, 95% CI:1.95–8.67), bed sharing; (AOR = 3.38, 95% CI:2.86–6.15), rarely washing cloth: (AOR = 5.08,95% CI:2.75–9.36), living with internally displaced people; (AOR,95% CI: 3.47 (1.30–9.24) and using only water to wash hands; (AOR = 3.18,95% CI:1.74–5.80) had a statistically significant association with scabies infestation among school-age children.

Conclusion

The current study found nearly one out of ten school-age children had scabies. Not attended school, contact history with confirmed scabies patient, not washing cloth, infrequent changing clothes, bedding sharing, sleeping on the floor, living with internally displaced people, and only using water for handwashing practice were the independent predictors for the occurrence of scabies. Health education better to given to the parents or caregivers about the washing of clothing, changing clothes at least once per week, and avoid physical contact with known scabies cases.

Impact of socio-demographic factors on knowledge, attitude and practices toward scabies among syrian refugees in Jordan: A prospective cross sectional study

Background

Scabies is one of the prevalent dermatological conditions, accounting for a substantial proportion of skin diseases in developing countries. It represents a significant health challenge when an outbreak appears in homecare and refugee camps as it may lead to enormous morbidity and high treatment costs. Because Scabies can be easily prevented through education, the purpose of this study was to assess the impact of socio-demographic factors on the level of knowledge, attitude, and practices among Syrian refugees in Jordan's northern region.

Methods

A prospective cross-sectional study was conducted among Syrian refugees attending primary health centers in northern Jordan, Ramtha, Mafraq, and Irbid, from February 2021 to May 2021. The targeted population was adult Syrian refugees above the age of 18. Two thousand participants were included in this study using simple random selection. The study questionnaire included socio-demographic characteristics and knowledge questions such as hearing about Scabies, causes of Scabies, signs and symptoms of Scabies, and its way of transmission. The data was analyzed using (SPSS) version 25.

Results

Females with a mean age of 37.9 years old comprised the majority of the participants. The majority of the participants were married and had intermediate levels of education. The knowledge about Scabies lacked among the majority of the respondents (N = 1259); 321 respondents had moderate knowledge, while only 650 had good knowledge. A statistically significant association was found between knowledge scores and all demographic characteristics, including gender, marital status, income, and educational level.

Conclusion

The general knowledge about Scabies among Syrian refugees is relatively low, with 1259 out of 2000 participants having a bad knowledge score. Moreover, the level of knowledge, attitude, and practices toward Scabies is highly affected by the demographic factors of the Syrian refugees' Health education for refugees is needed to improve their knowledge and help implement prevention programs.

•

Scabies is quite a common medical problem among Syrian Refugees in Jordan.

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The socio-demographics of Syrian Refugees affect the level of knowledge and attitude toward scabies infestation.

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The level of knowledge regarding scabies infestation is poor among Syrian Refugees in Jordan.

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Health education for refugees is needed to improve their knowledge and help implement prevention programs.

Assessment of Knowledge and Fear of Scabies in a Saudi Population

Background and Objectives

Scabies is a common contagious parasitic dermatological illness. In 2017, WHO recognized scabies as a neglected tropical disease. The aim of the present research was to assess the level of knowledge and fear of scabies among the Saudi population.

Methods

This is a cross-sectional online study conducted in the western region of Saudi Arabia from January to September 2019. We used a validated, 12-questions questionnaire to assess the scabies knowledge and the Fear of Scabies Scale-10 (FSS-10) to determine the level of fear toward scabies.

Results

A total of 3778 respondents were included with majorities of them being female and between the age of 15-30 years. About 93.3% of the respondents were considered to have good level of knowledge towards scabies and those were more likely to be females, live in an urban area, have heard about scabies in the past, younger in age, achieved higher educational level, and work for the medical and general education sector (all P <0.001). The total possible scores ranging from 10 (less fear) to 40 (greater fear). The mean total FSS-10 score was 33 ± 4.46 with 58.3% of them were considered to have greater fear and those were more likely to be female, younger in age, educated with higher educational degree, work for the general education sector and medical and, but less likely to be unemployed (all P <0.001). Partial correlation adjusting for potential confounders showed significant positive correlation between FSS-10 score and the scabies knowledge score (r = 0.152, P <0.001).

Conclusion

Despite the good level of scabies knowledge, the level of fear towards scabies is high. Further educational programs recommended decreasing the negative effect of scabies on the community and the individuals' quality of life.

Risk factors associated with scabies infestation among primary schoolchildren in a low socio-economic area in southeast of Iran

Background

Scabies is a neglected tropical disease caused by the mite Sarcoptes scabiei that burrows under the skin. It is a major health problem in tropical areas, largely affecting children. Scabies is common and highly contagious and in schoolchildren spreads quite rapidly, due to overcrowding and close contact within the schools. This study aimed to determine the risk factors associated with scabies infestation among primary schoolchildren in Bashagard County, one of the low socio-economic areas in southeast of Iran.

Methods

To conduct this community-based, descriptive, and cross-sectional study, four primary schools were randomly selected in the Bashagard County. All students in these schools were selected and examined for scabies. Clinical examination and sociodemographic profile of students were assessed using a pre-tested structured questionnaire. Chi-square test, and binary logistic regression were used to analyse the factors associated with scabies infestation by SPSS version 21 software.

Results

Out of 480 studied schoolchildren, 15 cases of scabies with a prevalence of 3.1 % were observed. The frequency of infestation in males was 1.6 % and it was 4.7 % in females. Independent factors associated with a high risk of scabies infestation in unadjusted analysis were being student of grade 5–6 (cOR = 13.12, 95 % CI 2.92–58.89, p = 0.0001), low educational level of father (cOR = 4.37, 95 % CI 0.97–19.59, p = 0.036), low educational level of mother (cOR = 4.14, 95 % CI 1.92–18.57, p = 0.045), joblessness of father (cOR = 14.77, 95 % CI 4.97–43.89, p = 0.0001), employment of mother (cOR = 5.28, 95 % CI 1.38–20.16, p = 0.007), large family size (cOR = 3.34, 95 % CI 1.05–10.64, p = 0.031), use of shared articles (cOR = 33.37, 95 % CI 10.82–102.90, p = 0.0001), and absence of bathroom in the house (cOR = 11.77, 95 % CI 2.16–63.94, p = 0.0001).

Conclusions

Results of this study confirmed that scabies is still one of the most important health problems in the primary schools of the Bashagard County. Low socioeconomic status and personal hygiene of the schoolchildren were the most important factors influencing the prevalence of scabies. Improvement of socioeconomic conditions and implementation of appropriate educational programs and active surveillance system to quickly detect and treat scabies cases are necessary in order to reduce the prevalence of scabies in schoolchildren in this area.

Determinants of scabies outbreak in Takusa district of Amhara Region, Northwest Ethiopia

Background

Human scabies is a highly contagious human dermatitis disease. As indicated by the national and regional reports, the epidemic of scabies became a major public health problem in Ethiopia since 2015.

Objective

To identify the determinant factors of scabies outbreak in Takusa district, Northwest Ethiopia, 2017.

Methods

A community based unmatched case-control study among 188 participants (63 cases and 125 controls) was conducted in Takusa district from September to October 2017. Data were collected using a pretested structured questionnaire. Multivariable logistic regression analysis was computed using SPSS version 22 to identify factors associated with scabies. Odds ratio at 95% CI and p-value less than 0.05 were used to describe the strength of the association and statistical significance.

Results

The median age of cases was 20 years (ranges1-61). Presence of person with itching in the family (AOR=7.7, 95% CI:1.9-30.5), sleeping with scabies patient (AOR=3.99, 95% CI:1.37-11.7), travel to scabies epidemic area in the last six weeks (AOR=3.79, 95%CI:1.28-11.1) and infrequent use of detergent for showering (AOR=4.85; 95% CI: 1.3-17.9)) were found to be determinant factors of scabies outbreak.

Conclusion

Frequent contact with people who develop scabies at home, not using detergents for washing, and mobility of people from non-epidemic to the epidemic areas were determinant factors. Giving special emphasis on regular awareness creation to the rural community is important to prevent scabies outbreak.

Scabies education in secondary schools: A multicenter study

Background

The aim of this study was to educate secondary school students on etiology, risk factors, clinical features, treatment, and prevention of scabies; to evaluate their knowledge base on scabies before and after an educational intervention; and to reassess this knowledge base and behavioral change, 6 months after, on a second visit.

Methods

Questionnaires with standard questions on scabies, graded to a maximum score of 10, were administered to students in junior secondary Classes 1 and 2 across 4 states in Nigeria. Information obtained included subjects' demographics, scabies symptomatology, risks, and preventive behaviors. Students with active scabies were diagnosed and treated. Data were analyzed with STATA.

Results

The mean test scores for the pretest and posttest at first visit were 2.82 ± 1.38 and 6.30 ± 1.09, respectively. This difference was statistically significant at t = 3.95, P = 0.004. Six months later, when the same schools were re-visited, the mean test scores for the pretest and posttest were 4.63 ± 0.54 and 5.87 ± 0.25, respectively. This difference was also significant at t = 4.13, P = 0.003. The prevalence of scabies was 3.5% at first visit and 4.34% at second visit; t = 0.24, P = 0.41.

Conclusions

Secondary school students lack basic education on scabies and exhibit high-risk behaviors for scabies transmission. Knowledge on scabies needs constant reinforcement.

Clinical presentation and risk factors of increased scabies cases in the Western region of Saudi Arabia in 2016-2018

OBJECTIVES

To describe the clinical characteristics of scabies in the Makkah province and analyze risk factors associated with the outbreak.  Methods: A cross-sectional study was conducted between June 2016 and June 2018 by collecting the data of patients reported to have infestations at King Abdulaziz Medical City, Makkah, Saudi Arabia. A comparative analysis was conducted of patients reported before and during the outbreak of scabies.  Results: Of the 352 patients identified, the range of cases was 0-24 cases per month before the months of the outbreak (March to April 2018). However, the actual number of cases reported increased 2.8 times the expected maximum in April 2018. Saudi nationals were 2.5 times more affected than non-Saudi nationals during the outbreak period compared to before the outbreak (95%CI: 1.02, 6.05, p=0.045). Symptoms involving upper arms, axillae (53.7% versus 68.7%, p=0.048), and torso (50% versus 66.4%, p=0.033) were significantly under-represented among outbreak patients. The presence of additional comorbidities was reported more frequently in patients diagnosed with scabies before versus during the outbreak months (25.8% versus 8.2%, p=0.014). Permethrin prescriptions increased (75.6% versus 41%), crotamiton prescriptions decreased (13.5% versus 48%), and the hospitalization was lower (3.8% versus 13.5%) during the outbreak.  Conclusion: The clinical presentation and risk factors of scabies change significantly with scabies outbreaks, and consequently so do the lines of treatment in Saudi Arabia. The present study highlights the importance of adopting strategies related to community infection control and prevention.

Prevalence and associated factors of scabies among schoolchildren in Dabat district, northwest Ethiopia, 2018

Background

Scabies is a skin infestation caused by the mite Sarcoptes scabiei that causes a pruritic skin eruption. In Ethiopia, the disease is common especially during natural or manmade disasters such as flooding, drought, civil war and conflict, poor water supply and sanitation, and overcrowding living condition. Though scabies is becoming a major public health problem, especially in low resource settings, there has been no study that reported the prevalence of scabies in the study area. The aim of this study, therefore, was to assess the prevalence of scabies and associated factors among students in primary schools in Dabat district, northwest Ethiopia.

Method

An institutional-based cross-sectional study was employed to determine the prevalence of scabies and associated factors among schoolchildren in Dabat district. A total of 494 students selected by a multi-stage sampling technique were included in this study. Scabies was diagnosed by medical practitioners based on lesions observed on body surfaces after a physical examination. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at p value < 0.05.

Result

The prevalence of scabies was 9.3% (46/494) with 95% CI (5.66%, 12.94%). Among schoolchildren who were infested by scabies, 65.22% (30/46) had a mild, 28.26% (13/46) had moderate, and 6.52% (3/46) had severe lesions. Studying at a rural school (AOR = 2.99, 95% CI 1.33, 6.71), had illiterate father (AOR = 5.11, 95% CI 2.25, 11.58), being grade level 1–4 (AOR = 3.91, 95% CI 1.69, 9.05), rarely taking a bath (AOR = 3.54, 95% CI 1.36, 9.25), contact with a person with itching symptom (AOR = 2.66, 95% CI 1. 21, 5.83), a family member with itchy symptoms (AOR = 4.76, 95% CI 2.20, 10.28), not living with both parents (AOR = 2.49, 95% CI 1.02, 6.06), and using water only for hand washing (AOR = 4.38, 95% CI 1.78, 10.76) were factors associated with scabies infestation among schoolchildren.

Conclusion

The prevalence of human scabies among schoolchildren in Dabat district northwest Ethiopia was high. The school localization, first cycle level of education, paternal educational status, frequency of taking a bath, and contact with a person having itchy lesions, presence of a family member with itchy lesion, and type of frequently used hand washing material were the factors significantly impacting the occurrence of scabies. Special attention should be given to students at first cycle education as they are at the highest risk of infestation.

Factors associated with scabies outbreaks in primary schools in Ethiopia: a case-control study

Background

Scabies is a neglected tropical disease affecting more than 200 million people worldwide every year. Scabies in school adolescents and young adults could affect their school performance. The current study investigates the factors associated with an outbreak of scabies at primary schools in southern Ethiopia.

Method

A team of health professionals investigated an outbreak of scabies that occurred in primary schools from May 1 to 30, 2018. An unmatched case–control study was employed to assess factors which predisposed for the scabies outbreak. Cases of scabies were individuals having a skin lesion compatible with the WHO case definitions of scabies. Controls were from the same locality with no skin lesions. Data on sociodemographic and behavioral variables were collected using questionnaires. Data on clinical presentations of scabies among cases were recorded by two trained and experienced health professionals. Factors associated with scabies were assessed using bivariate and multivariate logistic regression, and strength of association was described using odds ratio (OR) and 95% confidence intervals (CIs).

Results

A total of 711 (237 cases and 474 controls) study subjects participated in the study. The mean age of study participants was 17.56±2.66 years. Poor knowledge about scabies, adjusted odds ratio (AOR)=4.32 (95% CI: 2.93, 6.36); male sex, AOR=2.69 (95% CI: 1.82, 3.96); and parental illiteracy, AOR =3.49 (95% CI: 2.06, 5.94) predicted scabies infestation. Additionally, socioeconomic variables like sharing clothes/beds or contact with others, AOR=3.12 (95% CI: 2.12, 4.59); low household annual income, AOR=2.13 (95% CI: 1.32, 3.44); and family size greater than five, AOR=1.77 (95% CI: 1.04, 3.01) were significantly associated with scabies infestation. Inaccessibility and poor utilization of water, AOR=1.64 (95% CI: 1.12, 2.40) and poor personal hygiene, AOR=1.69 (95% CI: 1.14, 2.51) were also factors independently associated with scabies.

Conclusion

Modifiable risk factors such as personal hygiene and literacy level were found to be independent predictors of scabies infestation. Access to and utilization of water were also important predictors. Strategies for poverty alleviation and awareness creation on personal hygiene and efficient use of water are recommended for effective prevention of scabies infestation in closed institutions.

The public health control of scabies: priorities for research and action

Scabies is a parasitic disease of the skin that disproportionately affects disadvantaged populations. The disease causes considerable morbidity and leads to severe bacterial infection and immune-mediated disease. Scientific advances from the past 5 years suggest that scabies is amenable to population-level control, particularly through mass drug administration. In recognition of these issues, WHO added scabies to the list of neglected tropical diseases in 2017. To develop a global control programme, key operational research questions must now be addressed. Standardised approaches to diagnosis and methods for mapping are required to further understand the burden of disease. The safety of treatments for young children, including with ivermectin and moxidectin, should be investigated. Studies are needed to inform optimum implementation of mass treatment, including the threshold for intervention, target, dosing, and frequency. Frameworks for surveillance, monitoring, and evaluation of control strategies are also necessary.

Scabies outbreak investigation and risk factors in Kechabira district, Southern Ethiopia: unmatched case control study

Objective

Scabies is an infection of the skin, which caused by human itch mite Sarcoptes scabiei. It is a common health problem in Ethiopia, especially during disasters, poor sanitation and overcrowded living condition. However, investigation on scabies outbreak and associated factors was absent or scarce in the country in general and in the study area in particular. Hence, this study was intended to investigate scabies outbreak, identify risk factors, and recommend preventive measures in Kechabira district, Kembata Tembaro zone, Southern Ethiopia.

Result

We identified a total of 243 scabies cases line listed with overall prevalence of 2.5% and attack rate of (AR) 20.5 per 1000 populations and no death was reported. Of the suspected cases 126 (51.9%) were males and 117 (48.1%) were females. The median age was 24 years with inter-quartile range (IQR) of 22 years. The highest cases were seen in children aged 5–14 (50.6%) years. The cases were seen in three villages and the highest incidence was in Burchana, 23.9 per 1000 population. Identified determinant factors for scabies outbreak were sharing clothes with scabies patients (AOR = 6.08, 95% CI [1.54–23.92], and households having greater than six family members AOR = 38.755, 95% CI [8.084–185.787].

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4317-x) contains supplementary material, which is available to authorized users.

Scabies in Resource-Poor Communities in Nasarawa State, Nigeria: Epidemiology, Clinical Features and Factors Associated with Infestation

Epidemiology and clinical features of scabies remain largely unknown in Nigeria’s rural communities. To fill this gap, we performed a cross-sectional study in three rural communities in north central Nigeria. A total of 500 individuals were included and examined for scabies infestation; a questionnaire was applied to collect socio-demographic and behavioral data. Scabies was diagnosed in 325 (65.0%) participants. Excoriations (68.6%), vesicles (61.8%), and papules (58.8%) were common skin lesions. Itching was the most common symptom (77.5%); 64% complained of sleep disturbances. Lymphadenopathy was identified in 48.3%. Lesions were most commonly encountered on the abdomen (35.5%), inguinal area (19.1%), and interdigital spaces (14.2%). Poverty-related variables, such as illiteracy (OR: 7.15; 95% CI: 3.71–13.95), low household income (7.25; 1.19–88.59), absence of a solid floor inside house (12.17; 2.83–52.34), and overcrowding (1.98; 1.08–2.81) were significantly associated with infestation. Individual behavior, such as sharing of beds/pillows (2.11; 1.42–3.14) and sharing of clothes (2.51; 1.57–3.99), was also highly significantly associated with scabies. Regular bathing habits (0.37; 0.24–0.56) and regular use of bathing soap (0.36; 0.21–0.53) were protective factors. Scabies is extremely common in the communities under study and is associated with considerable morbidity. The disease is intrinsically linked with extreme poverty.

Environmental risk factors and the associated morbidity in a periurban area, Alexandria, Egypt

BACKGROUND

According to the WHO, nearly 24% of the global disease burden is attributable to environmental risk factors (RFs). People living in periurban areas are particularly at risk due to lack of basic sanitation requirements.

OBJECTIVE

To investigate the possible association between environmental RFs and disease prevalence for a community living in a periurban area in Alexandria, Egypt.

MATERIALS AND METHODS

A cross-sectional study was conducted in 2012. The study sample consisted of 355 families. An interviewing questionnaire and an observation checklist were used for data collection. In addition, 10 drinking water samples were randomly collected for physical, chemical, and bacteriological analyses. The questionnaire included questions on indoor environmental RFs as well as morbidity in the study sample, and the observation checklist covered outdoor environmental RFs. The environmental risk was determined using a risk score whose calculation was based upon the presence/absence of 10 indoor and 12 outdoor environmental RFs. The association between risk scores and 14 morbidities was investigated using unconditional logistic regression analysis, expressed as odds ratio (OR) and 95% confidence interval (CI).

RESULTS

A significant association was found between the total environmental risk score and respiratory diseases (OR=2.298, 95% CI: 1.231-4.291), diarrhea (OR=2.083, 95% CI: 1.102-3.939), liver diseases (OR=2.491, 95% CI: 1.067-5.819), skin diseases (OR=1.821, 95% CI: 1.012-3.310), and bronchial asthma (OR=2.228, 95% CI: 1.066-4.565). Noncommunicable diseases such as cardiovascular diseases and musculoskeletal diseases did not show any significant association with environmental RFs.

CONCLUSION AND RECOMMENDATIONS

Environmental RFs have an adverse impact on health within communities living in periurban areas. It is recommended that sanitation be improved and various outdoor environmental RFs be addressed in these underprivileged areas, as well as health education campaigns be organized aiming at raising the awareness of residents on indoor environmental RFs and ways to prevent them.

Laboratory Diagnosis of Scabies Using a Simple Saline Mount: A Clinical Microbiologist's Report

Scabies is a skin condition caused by infestation of the mite Sarcoptes scabiei. Sarcoptes scabiei var. hominis is an arthropod member belonging to the order Acarina. Scabies is present throughout the world and is prevalent in all age groups, mostly involving people frequently in contact with animals, children, women, and elderly people. Predisposing factors for scabies include individuals with immunosuppressive conditions and people residing under low socioeconomic conditions. Skin lesions that occur during mite infestation closely resemble dermatological disorders caused by microbes, including fungi, parasites, and viruses. Laboratory diagnosis of scabies greatly relies on an accurate clinical suspicion and the demonstration of mites in the skin scrapings could be used for confirmation. It should be noted that a greater understanding between a clinician or a dermatologist and a clinical microbiologist is required to successfully diagnose scabies. This report details an easily performed, cost-effective method, the simple saline mount, that a clinical microbiology laboratory should follow to successfully identify mites in skin scrapings.

Prevalence and drivers of human scabies among children and adolescents living and studying in Cameroonian boarding schools

Background

The dire lack of information concerning the epidemiology of human scabies in Cameroon, especially in school milieus brought us to undertake the present study which aimed to determine the prevalence and associated factors of scabies in Cameroonian boarding schools.

Methods

A cross-sectional study was conducted from February to March 2015 in four boarding schools in Yaoundé and Buea (Cameroon). Participants were students currently residing in one of the study sites, volunteering to participate in the study and whose parents or guardians had given their consent in this respect. The diagnosis was based on clinical assessment independently performed by two dermatologists.

Results

A total of 1,902 students were recruited (50.5 % boys), with a mean age of 14.3 ± 2.5 years. Overall, 338 participants (17.8 %) were diagnosed with scabies. Age ≤ 15 years, male sex, number of students in the school > 500, no access to the school infirmary, sleeping with others, sharing beddings, clothes or toilet stuffs, pruritus in the close entourage and complaining of pruritus were significantly associated with the presence of mites in univariable logistic regression analyses. On the other hand, at least two baths per day, usage of soap for baths and finger nails always cut short appeared as protective factors. After multivariable analysis, male sex (adjusted OR (aOR) 2.06, 95 % CI: 1.40–3.01, P < 0.0001), first cycle level of education (aOR 1.67, 95 % CI: 1.02–2.71, P = 0.040), number of students per dormitory ≤ 10 (aOR 6.99, 95 % CI: 3.34–14.71, P < 0.0001), no access to the school infirmary (aOR 1.62, 95 % CI: 1.12–2.32, P = 0.009) and complaining of pruritus (aOR 93.37, 95 % CI: 60.04–145.19, P < 0.0001) were the independent factors associated with scabies.

Conclusions

The prevalence of scabies was 17.8 %. The male sex, first cycle level of education, a number of students per dormitory ≤ 10, no access to the school infirmary and complaining of pruritus were the independent factors significantly impacting the occurrence of scabies.

Demographic, socioeconomic and environmental changes affecting circulation of neglected tropical diseases in Egypt

Egypt has been plagued by many neglected tropical diseases since Pharaonic time. These diseases are Schistosomiasis, soil-transmitted helminthiasis, lymphatic filariasis, leishmaniasis and fascioliasis beside the epidermal parasitic skin diseases. Indeed, theses diseases still persist as public health problem in the country by the influence of demographic, socioeconomic and environmental obstacles. This study seeks for understanding the contribution of each factor in each obstacle in neglected tropical diseases perpetuation which in turn could help the governorate in planning integrated control strategies. It was found that poverty, unregulated urbanization and inadequate sanitation are important socioeconomic factors that have great effect on the transmission dynamics of the diseases. The environmental factors which affect the epidemiology of these diseases in the country are scarcity of water, construction of dams, land reclamation for agriculture beside the climate factors. Unfortunately, the panic increase in the population growth rate minimizes the efforts done by the governorate to elevate the public health services. These conditions also affect the transmission of epidermal parasitic skin diseases including scabies, head lice and hookworm-related cutaneous larva migrans. The control programs and the recommendations to combat the diseases were discussed. The present study showed that the ecological factors affecting each neglected tropical disease in Egypt are somewhat similar which makes it worthy to develop an integrated control approaches aiming at improving the leading factors of neglected tropical diseases circulation in the country.

Features of human scabies in resource-limited settings: the Cameroon case

Background

The persistent high prevalence of human scabies, especially in low- and middle-income countries prompted us to research the sociodemographic profile of patients suffering from it, and its spreading factors in Cameroon, a resource-poor setting.

Methods

We conducted a cross-sectional survey from October 2011 to September 2012 in three hospitals located in Yaoundé, Cameroon, and enrolled patients diagnosed with human scabies during dermatologists’ consultations who volunteered to take part in the study.

Results

We included 255 patients of whom 158 (62 %) were male. Age ranged from 0 to 80 years old with a median of 18 (Inter quartile range: 3–29) years. One to eight persons of our patients’ entourage exhibited pruritus (mean = 2.1 ± 1.8). The number of persons per bed/room varied from 1 to 5 (mean = 2.1 ± 0.8). The first dermatologist’s consultation occurred 4 to 720 days after the onset of symptoms (mean = 77.1 ± 63.7). The post-scabies pruritus (10.2 % of cases) was unrelated to the complications observed before correct treatment (all p values > 0.05), mainly impetiginization (7.1 %) and eczematization (5.9 %).

Conclusion

Human scabies remains preponderant in our milieu. Populations should be educated on preventive measures in order to avoid this disease, and clinicians’ knowledges must be strengthened for its proper diagnosis and management.