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Lee PAT, Wong SSY, Ng KHL. Scabies in 604 Patients: A Glimpse into the Disease Burden and Its Associated Mortality in Hong Kong. Trop Med Infect Dis 2024; 9:245. [PMID: 39453272 DOI: 10.3390/tropicalmed9100245] [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: 09/25/2024] [Revised: 10/13/2024] [Accepted: 10/17/2024] [Indexed: 10/26/2024] Open
Abstract
Scabies is a worldwide parasitic dermatosis with a significant health burden on the young and the elderly. Statistics about the prevalence of scabies in Hong Kong are not available. This is a retrospective study of patients from a regional hospital cluster in Hong Kong with microscopy-documented Sarcoptes scabiei infestations from January 2018 to December 2022. The condition was categorised into classical scabies and crusted scabies upon clinical presentation. Demographic data, comorbid diseases, mobility and residential status, seasonal variability, secondary bacterial infection, treatment and outcomes were described. These were compared between classic and crusted scabies. In total, 604 patients were identified, representing 51.65 per 100,000 discharged patients during the study period. The median age was 84 years and 54.5% were male. The majority (506 or 83.8%) came from residential care homes for the elderly. The mean time from admission to diagnosis was 8.8 days for community-acquired infestation. There were 564 and 40 cases of classic and crusted scabies, respectively. The two groups of patients were comparable in terms of residence in elderly homes, co-existing chronic illnesses, mobility, and time from admission to diagnosis. Forty-five (7.5%) patients had positive blood cultures temporally associated with scabies. Patients with crusted scabies were at higher risk for bacteraemia (7/40 versus 38/564, p = 0.022). Permethrin and benzyl benzoate were the most popular treatment regimens, with treatment failure observed in 59/397 (14.4%) and 18/173 (10.4%), respectively. There were 172 (28.5%) mortalities within 30 days of scabies diagnosis. Thus, the burden of scabies infestation is significant in Hong Kong. Hospitalised patients diagnosed with scabies are mainly senior citizens living in residential care homes for the elderly, suggesting reservoirs of S. scabiei in the community. Of concern, bacteraemic illnesses are common and significant mortality is temporarily associated with infestation. With a rising elderly population, there is a pressing need to understand and control scabies in Hong Kong. Our study did not find that common medical illness, besides immunosuppressive therapy, predisposed patients to crusted scabies. The crusted form of scabies was associated with a higher risk of bacteraemia. The current study provides a better perspective of the disease load of scabies in Hong Kong.
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Affiliation(s)
- Pascoe Ao Ting Lee
- Department of Clinical Pathology, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Samson Sai-Yin Wong
- Department of Clinical Pathology, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Kenneth Ho Leung Ng
- Department of Clinical Pathology, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
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Asgedom AA, Debesay MH, Ugwu CLJ, Woldegerima WA. Detecting spatial clusters of human scabies in Tigray, Ethiopia from 2018 to 2023. BMC Infect Dis 2024; 24:1148. [PMID: 39396942 PMCID: PMC11475534 DOI: 10.1186/s12879-024-10049-0] [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: 06/15/2024] [Accepted: 10/03/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND Scabies is one of public health concerns among communicable disease in Ethiopia, especially among disadvantaged and the poor. This current study aims to detect the spatiotemporal patterns of scabies in Tigray from 2018 to 2023 using scabies data aggregated at the zonal level. The study also examined the persistent patterns in the spatial variation of scabies incidence across the administrative regions during the study period. METHOD We collected scabies data using a weekly disease surveillance reporting format of the country from 2018 to 2023 across all accessible district health facilities in Tigray region, Ethiopia. We conducted retrospective analyses using both purely spatial and spatiotemporal scan statistic approaches, employing a discrete Poisson probability model to identify statistically significant clusters of high scabies rates throughout the Tigray regional zones in Ethiopia. Our methodology involved the use of Kulldorff's spatial scan statistic software (SaTScan v10.1.3), R programming software version 4.3.1, and ArcGIS Pro for all analyses. RESULTS A total of 101,116 cases of scabies were reported from 2018 to 2023. Our study indicated a spatial heterogeneity in the pattern of scabies across Tigray region as well as its localization among geographically contiguous zones across space, except for the Western zone of Tigray where no data was collected. The detected statistically significant spatial clusters [Formula: see text] persisted mainly in the Central, Eastern and Northwestern zones of Tigray over the six years of the study period. The highest relative risk (RR) was recorded in year 2021 ([Formula: see text]. The central zone had the major clusters of scabies at district level from 2018 to 2023. The heterogeneous distribution of scabies across Tigray could be due to the spatial variations in the determinants of scabies (such as socioeconomic status, demographics, and material deprivation) across the region. CONCLUSION An enormous burden of scabies was reported over a period of six years. The present study found localized clusters of high scabies rates at district and zonal levels in Tigray, Ethiopia, possibly due to differences in various determinants of scabies such as access to WASH services. The findings could help the government and health authorities to develop and implement scabies control strategies in Tigray, with a focus on high-risk districts and zones to ensure optimal resource allocation.
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Affiliation(s)
- Akeza Awealom Asgedom
- Department of Environmental Health Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Micheale Hagos Debesay
- Primary Health Care and Community Engagement Case Team, Tigray Health Bureau, Mekelle, Ethiopia
| | | | - Woldegebriel Assefa Woldegerima
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Department of Mathematics, College of Natural and Computational Sciences, Mekelle University, Tigray, Ethiopia
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Vink M, Coppoolse H, Bergmans A, Wennekes M, Pas S, Pattipeilohy-van Ommen J, Braks M, Bruisten S, Galimont-Collen A, Wintermans B, Fanoy E. Exploring transmission dynamics of the Sarcoptes scabiei mite in humans by combining molecular typing and epidemiological variables, the Netherlands 2016-2023. Parasit Vectors 2024; 17:419. [PMID: 39375755 PMCID: PMC11459799 DOI: 10.1186/s13071-024-06488-y] [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: 05/29/2024] [Accepted: 09/05/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Scabies, an infestation of the mite Sarcoptes scabiei, has seen an increase in clinical diagnoses in the Netherlands since 2011. This study aimed to analyse PCR-positive S. scabiei skin samples through partial genome sequencing and to link findings to patient epidemiological characteristics. METHODS Skin samples were collected from individuals in the Netherlands between January 2016 and January 2023. On the PCR-positive S. scabiei skin samples, partial mitochondrial cytochrome c oxidase subunit 1 gene (cox1) sequencing was performed to assess genetic variability. Epidemiological information was collected through interviews. We examined associations between cox1 subtypes, epidemiological factors and treatment outcomes. RESULTS Sequencing results were obtained from 128 patients, with epidemiological information available for 55 (43%) of these patients. Fifteen distinct cox1 subtypes were identified. Subtype 01 was most prevalent (45%) and present across all age groups and social settings. The remaining subtypes were less common and not consistently found in all contexts. Five clusters were identified, each with identical cox1 subtypes. Comparative analysis with GenBank sequences revealed genetic similarities with strains from Australia, the USA and China, suggesting the global distribution and transmission of specific subtypes. A substantial proportion (73%) of patients with scabies required multiple treatments to eradicate the infestation, with no subtype-related differences. CONCLUSIONS This is the first study linking S. scabiei sequencing results to patient epidemiological data. Several subtypes clustered in specific geographic regions and social contexts, underscoring localised transmission patterns. Further research with larger sample sizes is needed to enhance our understanding of the transmission of this mite. This study provides valuable insights that will strengthen scabies control efforts.
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Affiliation(s)
- Martijn Vink
- Department of Infectious Diseases, Public Health Service (GGD) of Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Hester Coppoolse
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Amsterdam, the Netherlands.
| | - Anneke Bergmans
- Medical Microbiology & Immunology Brabant & Zeeland (Microvida), Roosendaal, the Netherlands
| | - Meike Wennekes
- Medical Microbiology & Immunology Brabant & Zeeland (Microvida), Roosendaal, the Netherlands
| | - Suzan Pas
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Marieta Braks
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Sylvia Bruisten
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Amsterdam, the Netherlands
| | | | - Bas Wintermans
- Medical Microbiology & Immunology Brabant & Zeeland (Microvida), Roosendaal, the Netherlands
| | - Ewout Fanoy
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Amsterdam, the Netherlands
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Fernando DD, Mounsey KE, Bernigaud C, Surve N, Estrada Chávez GE, Hay RJ, Currie BJ, Chosidow O, Fischer K. Scabies. Nat Rev Dis Primers 2024; 10:74. [PMID: 39362885 DOI: 10.1038/s41572-024-00552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 10/05/2024]
Abstract
Scabies is one of the most common and highest-burden skin diseases globally. Estimates suggest that >200 million people worldwide have scabies at any one time, with an annual prevalence of 455 million people, with children in impoverished and overcrowded settings being the most affected. Scabies infection is highly contagious and leads to considerable morbidity. Secondary bacterial infections are common and can cause severe health complications, including sepsis or necrotizing soft-tissue infection, renal damage and rheumatic heart disease. There is no vaccine or preventive treatment against scabies and, for the past 30 years, only few broad-spectrum antiparasitic drugs (mainly topical permethrin and oral ivermectin) have been widely available. Treatment failure is common because drugs have short half-lives and do not kill all developmental stages of the scabies parasite. At least two consecutive treatments are needed, which is difficult to achieve in resource-poor and itinerant populations. Another key issue is the lack of a practical, rapid, cheap and accurate diagnostic tool for the timely detection of scabies, which could prevent the cycle of exacerbation and disease persistence in communities. Scabies control will require a multifaceted approach, aided by improved diagnostics and surveillance, new treatments, and increased public awareness.
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Affiliation(s)
- Deepani D Fernando
- Scabies Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Kate E Mounsey
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Charlotte Bernigaud
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Nuzhat Surve
- Department of Microbiology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, India
| | - Guadalupe E Estrada Chávez
- State Institute of Cancer "Dr. Arturo Beltrán Ortega", Faculty of Medicine, Universidad Autónoma de Guerrero, Community Dermatology Mexico, Acapulco, Guerrero, Mexico
| | - Roderick J Hay
- St Johns Institute of Dermatology, King's College London, London, UK
| | - Bart J Currie
- Global and Tropical Health, Menzies School of Health Research, Charles Darwin University and Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Olivier Chosidow
- Hôpital Universitaire La Pitié-Salpêtrière, AP-HP, Paris, France
| | - Katja Fischer
- Scabies Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
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Simonart T, Lam Hoai XL. Escalating Threat of Drug-Resistant Human Scabies: Current Insights and Future Directions. J Clin Med 2024; 13:5511. [PMID: 39336998 PMCID: PMC11432065 DOI: 10.3390/jcm13185511] [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: 08/23/2024] [Revised: 09/12/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Scabies is a prevalent dermatological condition with significant public health implications. The recent rise in drug-resistant scabies presents new challenges for effective disease management and control. Methods: A comprehensive literature review was conducted using PubMed, Cochrane Library, and Web of Science. Studies published from 2000 to August 2024 were considered, focusing on those reporting drug-resistant scabies and advancements in treatment approaches. Results: Clinical studies, in vitro investigations, and case reports show significant resistance of human scabies to permethrin. Main resistance mechanisms involve genetic mutations in the mites' voltage-gated sodium channels (VGSCs) and enhanced activity or expression of the detoxifying enzyme glutathione S-transferase (GST). Resistance to ivermectin and benzyle benzoate, although suggested by some authors, seems less obvious. The clinical evidence of widespread ivermectin resistance in human scabies infestations is lacking, despite indications of increased tolerance in laboratory settings and anecdotal reports of resistance in patients with crusted scabies. Benzyl benzoate resistance in scabies mites remains unconfirmed. Conclusions: Permethrin-resistant scabies is an escalating threat requiring new management strategies and updated guidelines. Infection control measures, alternative treatments, and ongoing research into new therapeutics are crucial to mitigate the impact of drug-resistant scabies.
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Affiliation(s)
- Thierry Simonart
- Department of Dermatology, Delta Hospital, CHIREC, Université Libre de Bruxelles, 1160 Bruxelles, Belgium
| | - Xuân-Lan Lam Hoai
- Department of Dermatology, St Pierre-Brugmann-HUDERF University Hospitals, Université Libre de Bruxelles, 1000 Brussels, Belgium
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Chiriac A, Diaconeasa A, Miulescu R, Chiriac AE, Wollina U. Scabies in infants and children - a narrative review. Eur J Pediatr 2024; 183:2527-2536. [PMID: 38536458 DOI: 10.1007/s00431-024-05535-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024]
Abstract
Scabies is a human ectoparasitosis caused by Sarcoptes scabei var. hominis. World-wide around 300 million patients are affected. Infants and children have the highest incidence rates. Poverty and overcrowding are social factors contributing to a higher risk of transmission and treatment failure. The leading symptom of the infestation is itch. Complications are bacterial infections that are responsible for mortality. Diagnosis is clinical. Non-invasive imaging technologies like dermoscopy can be used. Polymerase chain reaction (PCR) is less sensitive and specific than microscopy of skin scrapings. Treatment of choice is topical permethrin 5%. Ivermectin is the only oral drug FDA-approved for scabies. It should be used in cases non-responsive to topical therapy and in case of high number of infested patients in addition to topical therapy. Pseudo-resistance to treatment is not uncommon. New drugs are on the horizon. What is Known: • Pruritus is the leading symptom causing sleep disturbances and scratching with the risk of secondary bacterial infections. • Treatment failure is related to inappropriate application of topical drugs and asymptomatic family members. What is New: • COVID-19 pandemic and migration are contributing to an increased incidence of scabies. • New compounds to treat scabies are on the horizon.
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Affiliation(s)
- Anca Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
- Apollonia University, Iasi, Romania
- Romanian Academy, P. Poni Institute of Macromolecular Chemistry, Iasi, Romania
| | - Adriana Diaconeasa
- Dermatology Ambulatory Care Center, "Grigore Alexandrescu" Clinical Emergency Hospital for Children, Bucharest, Romania
| | | | - Anca E Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
- Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067, Dresden, Germany.
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CONTARINO FABIO, BELLA FRANCESCA, DI PIETRO ERMINIO, RANDAZZO CONCETTA, CONTRINO MARIALIA. Impact of the COVID-19 pandemic on infectious diseases reporting. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2024; 65:E145-E153. [PMID: 39430999 PMCID: PMC11487736 DOI: 10.15167/2421-4248/jpmh2024.65.2.3197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Abstract
Introduction COVID-19 pandemic had impacted the reporting of notifiable communicable diseases. Since the beginning of the pandemic and the introduction of relate public health measures, notifications for most notifiable diseases have declined compared to previous years. In this study, we aim to quantify the changes in the incidences of notifiable infectious diseases during and after the pandemic in Siracusa Local Health Authority, Italy. Methods We collected and analysed the infectious disease notifications made in two different three-years periods, 2017-2019 and 2020-2022 in Siracusa Local Health Authority, Italy. Descriptive statistics were used to find the percentages and the 95% confidence interval (CI). Exact "F-tests" was performed to compare the mean values between the studied periods to evaluate the hypothesis that the number of reported cases would not differ significantly between the two periods. Significance was assessed at the p < 0.05 level. Results The total number of notifications significantly decreased by 69.3% in the pandemic period compared to the pre-pandemic one, with the highest reduction of air-borne transmission diseases (-86.5%), followed by food-borne diseases (-68.2%) and sexually transmitted diseases (-39.3%). Conversely, an increase in number of notifications was found only for legionellosis. Conclusions The COVID-19 pandemic had the potential to influence communicable disease reporting at multiple points. While the effects could vary considerably, the results would be expected to reduce the number and the detection of notifiable cases. Included would be changes in exposures, diagnostic testing, reporting to public health agencies, and public health investigations.
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Affiliation(s)
- FABIO CONTARINO
- Department of Public Health, Epidemiology Unit, Siracusa Local Health Authority, Italy
| | - FRANCESCA BELLA
- Siracusa Cancer Registry, Siracusa Local Health Authority, Italy
| | - ERMINIO DI PIETRO
- Department of Public Health, Epidemiology Unit, Siracusa Local Health Authority, Italy
| | - CONCETTA RANDAZZO
- Department of Public Health, Epidemiology Unit, Siracusa Local Health Authority, Italy
| | - MARIA LIA CONTRINO
- Head of Department of Public Health, Siracusa Local Health Authority, Italy
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Genuino RNF, Villanueva EQ, Ang VRC, Cagayan MSFS. Scabies in the Philippines: A Secondary Analysis of Local Patient Registries. ACTA MEDICA PHILIPPINA 2024; 58:6-16. [PMID: 38966616 PMCID: PMC11219521 DOI: 10.47895/amp.vi0.7210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Background Scabies is the second most common cause of disability among skin diseases in the Philippines as of 2019. There is no large nationwide study describing the epidemiologic profile of scabies in the country. Objective This study aimed to describe the demographic, seasonal, and geographic profile of scabies in the Philippines. Methods We compared secondary data of two local patient registries (Philippine Dermatological Society, PDS, 2010 to 2021; and Philippine Pediatric Society, PPS, 2009 to 2021) for reported cases of scabies in the Philippines. We reported the frequency and percentage distribution according to age, sex, month, year, and type of diagnosis, and region. Results The median annual frequency of scabies cases (mostly outpatient) for PDS (from year 2010) was 4087 (range ([QR], 342-6422 [3271.5]), while it was 183 (range [IQR], 64-234 [96.5]) (all inpatient) for PPS (from year 2009). There was a reduction to one-third (PDS) and one-fourth (PPS) of pre-pandemic numbers during the pandemic years (2020-2021). The peak months for scabies cases were the cooler months: January (median, 12.1% of annual cases; range [IQR], 2.6%-31.4% [3.6%]) to February (median, 10.0% of annual cases; range [IQR], 1.5%-27.8% [2.5%]) based on PDS data, and November (median, 10.0% of annual cases; range [IQR], 0.0%-24.3% [7.0%]) to January (median, 9.0% of annual cases; range [IQR], 0.0%-24.3% [6.6%]) for PPS data. Overall, for PDS, age 1-4 years is the most affected age group (median, PDS, 17.5% of annual cases; range [IQR], 11.9%-25.4% [8.1%]), while it was the less than 1-year-olds (median annual cases, 48.9%; range [IQR], 29.1%-67.3% [13.20%]) among PPS pediatric population aged 0 to 18 years. Males (median, 53.9% of annual cases; range [IQR], 45.0%-67.2% [8.8%]) were more affected than females in PPS. While for PDS during earlier years (prior to 2015), males (median, 51.6% of annual cases from 2010 to 2014; range [IQR], 47.4%-52.9% [0.2%]) were more affected than females. However, males became less affected than females with median, 44.7% of annual cases from 2015 onwards (range [IQR], 43.4%-46.5% [1.2%]). NCR was the region with the highest frequency of cases in PPS (median, 52.6% of annual cases; range [IQR], 22.7%-75.0% [20.4%]). The 2nd most affected regions were Central/Eastern Visayas (34.2%, 2009-2013; range [IQR], 17.9%-54.1% [5.3%]), Bicol region (12%; 2014 to 2018; range [IQR], 17.9%-54.1% [7.4%]), Central Luzon (18%; 2019), Central/Eastern Visayas (29%, 2020), and Northern/Central Mindanao (17%, 2021). Conclusion Scabies was commonly seen in the younger age group, slightly more in females in the PDS, while slightly more among males in the PPS, in the cooler months of the year, and in the urbanized NCR.
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Affiliation(s)
| | - Emilio Q. Villanueva
- Department of Pathology, College of Medicine, University of the Philippines Manila
| | | | - Maria Stephanie Fay S. Cagayan
- Department of Pharmacology and Toxicology, College of Medicine, University of the Philippines Manila
- Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines Manila
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Kaur B, Blavo C, Parmar MS. Ivermectin: A Multifaceted Drug With a Potential Beyond Anti-parasitic Therapy. Cureus 2024; 16:e56025. [PMID: 38606261 PMCID: PMC11008553 DOI: 10.7759/cureus.56025] [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: 01/18/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Ivermectin was first discovered in the 1970s by Japanese microbiologist Satoshi Omura and Irish parasitologist William C. Campbell. Ivermectin has become a versatile pharmaceutical over the past 50 years. Ivermectin is a derivative of avermectin originally used to treat parasitic infections. Emerging literature has suggested that its role goes beyond this and may help treat inflammatory conditions, viral infections, and cancers. Ivermectin's anti-parasitic, anti-inflammatory, anti-viral, and anticancer effects were explored. Its traditional mechanism of action in parasitic diseases, such as scabies and malaria, rests on its ability to interfere with the glutamate-gated chloride channels in invertebrates and the lack of P-glycoprotein in many parasites. More recently, it has been discovered that the ability of ivermectin to block the nuclear factor kappa-light-chain enhancer of the activated B (NF-κB) pathway that modulates the expression and production of proinflammatory cytokines is implicated in its role as an anti-inflammatory agent to treat rosacea. Ivermectin has also been evaluated for treating infections caused by viruses, such as SARS-CoV-2 and adenoviruses, through inhibition of viral protein transportation and acting on the importin α/β1 interface. It has also been suggested that ivermectin can inhibit the proliferation of tumorigenic cells through various pathways that lead to the management of certain cancers. The review aimed to evaluate its multifaceted effects and potential clinical applications beyond its traditional use as an anthelmintic agent.
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Affiliation(s)
- Baneet Kaur
- Department of Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Cyril Blavo
- Department of Public Health, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Mayur S Parmar
- Department of Foundational Sciences, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
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Buettcher M, Stebler AK, Theiler M, Kobylinski K, Pfister M. National survey in Switzerland calls for improved diagnosis and treatment in children with scabies. Swiss Med Wkly 2023; 153:40129. [PMID: 38579328 DOI: 10.57187/smw.2023.40129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
AIM OF THE STUDY The global prevalence of scabies is estimated to be up to 200 million cases annually, with young children particularly affected. In Europe, most cases are thought to originate in migrant populations. Scabies management is challenging in children. To identify knowledge gaps and research needs, we aimed to descriptively evaluate the management of children with scabies by different Swiss healthcare providers. METHODS An invitation for an anonymous online survey (36 questions) was sent to members of Swiss societies of dermatologists, general practitioners, paediatricians, paediatric dermatologists, paediatric infectious diseases specialists, and tropical medicine specialists, inviting clinicians to participate from 25th May to 8th August 2020. One reminder invitation was sent. Hospital pharmacies and the distributor of permethrin were contacted to report consumption trends of scabicides in 2018 and 2019. RESULTS The survey was completed by 248 clinicians: 146 (59%) paediatricians, 47 (19%) dermatologists, 28 (11%) general practitioners, 6 (2%) paediatric dermatologists, 13 (5%) paediatric infectious diseases specialists, and 8 (3%) tropical medicine specialists. Most consulted up to 10 scabies cases within a 16-month period, with similar numbers in migrant and Swiss children. Dermoscopy was used by 24% of non-dermatologists. Non-dermatologists did not consider co-treatment of close contacts in up to 59% of cases. While permethrin was the first-line treatment, treatment failures were frequently reported in children aged <5 years. Up to 67% of paediatric dermatologists regularly used oral ivermectin off-label in children weighing <15 kg. None of the paediatric dermatologists, 15% of the dermatologists, and 9% of the non-dermatologists used only one treatment cycle.Scabicide consumption increased. Treatment studies on ivermectin use in children weighing <15 kg had the highest research priority. CONCLUSION In Switzerland, scabies is a frequent dermatosis in migrant and Swiss children. While accessible, optimal diagnostics are underutilised, and treatment is suboptimal. Permethrin resistance appears to be an increasing problem. Dermatologists regularly use ivermectin off-label in children weighing <15 kg. Treatment studies on ivermectin use in children weighing <15 kg, user-friendly diagnostic tools, new treatment protocols, and child-friendly dosage forms are needed to improve the diagnosis and treatment of children with scabies.
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Affiliation(s)
- Michael Buettcher
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, Basel, Switzerland
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Lucerne Children's Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland
- Faculty of Health Science and Medicine, University Lucerne, Lucerne, Switzerland
| | - Anita K Stebler
- Master of Medicine Student, Faculty of Medicine, University Basel, Basel, Switzerland
| | - Martin Theiler
- Paediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Kevin Kobylinski
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Marc Pfister
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, Basel, Switzerland
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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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Hamed A, Amir R, Tahereh S, Parastoo T, Amir Hossein N, Mohadese M. A New Herbal Medicine Formulation with Potential Anti-scabies Properties to Treat Demodex and Sarcoptes Parasites. ARCHIVES OF RAZI INSTITUTE 2023; 78:1472-1482. [PMID: 38590675 PMCID: PMC10998946 DOI: 10.22092/ari.2023.78.5.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/16/2023] [Indexed: 04/10/2024]
Abstract
Scabies is considered an external parasite notorious for its high prevalence causing severe and contagious skin lesions in humans and animals worldwide. This study has introduced a medicine to treat dogs infested with scabies (variants of Demodex, Sarcoptes, Psoroptes, Otodectes, etc.). The present study offers a no-side-effect herbal formulation to treat dogs infested with scabies. Unlike oral and injectable medicines, which take the form of an ointment and are topically applied on-site, this medicinal formulation can be easily used without concerns over its side effects or consumption dosages. This medicinal formulation requires no skin rinsing due to its herbal and high skin absorption properties, as recovery may take less than a month with a maximum of two times of application. To carry out the experiment, 25 sick dogs with various breeds and ages suspected of scabies were gathered. Following accurate morphological examinations of all the samples, a deep skin chip of the lesion site was provided, which was examined by a microscope. Then, 13 dogs (Mix, Terrier, Pug, Husky, Spitz) were infested with Demodex scabies and 12 dogs (Pittbull, Mix, Shih Tzu, Terrier, Boxer, Setter) with Sarcoptic scabies. The prepared product was topically administered at a constant 2% dosage to the bodies of all the samples. To prepare the ointment, 1 g of Borax (Na2B4O7·10H2O) was first dissolved in 35 g deionized water and heated to 70°C. Then, 45 g of liquid paraffin (CnH2n+2) was mixed with 1 g of Carvacrol (C10H14O) and 1 g of geranium (C10H18O) and stirred well to become a phase. Later, 17 g of the melted beeswax (C15H31COOC30H61) was added to the liquid paraffin compound. In the end, the aqueous phase was added to the oil phase, and the mixture process immediately began in one direction with a glass stirrer and continued until the product cooled down. Essential oils (EO) was obtained by steam distillation of fresh Thyme and Rose-Acented Geranium in a stainless steel distillation apparatus (alembic) for 3 h. The main components of the essential oils used in the formulation were performed using a Hewlett-Packard GC system interfaced with a mass spectrometer equipped with an HP5-MS capillary column (30 m, 0.32 mm, 0.25 µm film thicknesses). For GC-MS detection, electron ionization with ionization energy of 70 eV was used. To examine the presence of scabies, weekly skin sampling was performed, and the treatment continued until 30 days, when no skin chip of the scabies was noted. The findings revealed that the formulation developed no side effects and removed the daily use, as it could be administered once or twice a week. Also, complete recovery of scabies in all the breeds was found to be less than a month at most. This medicinal formulationcan be easily used without concerns over its side effects or consumption dosages. This study introduced a herbal formulation with effective herbal ingredients without any side effects to treat the sarcoptes and demodex parasites; unlike other chemical compounds, this medicinal formulation has no side effects, while some other formulations could develop side effects.
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Affiliation(s)
- Aghazadeh Hamed
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Pharmaceutical Engineering, University of Tehran, Tehran, Iran
| | - Rigi Amir
- Young Researchers and Elites Club, Islamic Azad University, Zahedan Branch, Zahedan, Iran
| | - Sangchooli Tahereh
- Department of Pharmaceutical Engineering, Faculty of Chemical Engineering, NaghsheJahan University, Isfahan, Iran
- Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Taheri Parastoo
- Department of Pharmaceutical Engineering, University of Tehran, Tehran, Iran
- Department of Research and Development, Vitabiotics Ltd, Tehran, Iran
| | - Nasiraei Amir Hossein
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Islamic Azad University, Garmsar Branch, Garmsar, Iran
| | - Mohammadi Mohadese
- Department of Chemistry, K. N. Toosi University of Technology, Tehran, Iran
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13
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FACCIOLÀ ALESSIO, LAGANÀ ANTONIO, GENOVESE GIOVANNI, ROMEO BRUNO, SIDOTI SALVATORE, D’ANDREA GIUSEPPA, RACO CATERINA, VISALLI GIUSEPPA, DI PIETRO ANGELA. Impact of the COVID-19 pandemic on the infectious disease epidemiology. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E274-E282. [PMID: 38125993 PMCID: PMC10730051 DOI: 10.15167/2421-4248/jpmh2023.64.3.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/26/2023] [Indexed: 12/23/2023]
Abstract
Introduction COVID-19 pandemic has exerted a huge impact on different aspects of public health. Mandatory notifications are a fundamental tool to have a general picture of infection disease spread in a population. The aim of this study was to evaluate the impact the COVID-19 pandemic had on infectious disease epidemiology. Methods We collected and analyzed all the infectious disease notifications made in the pre-pandemic (2017-2019) and the pandemic (2020-2022) three-years periods in the provincial territory of Messina, Italy. Results The total number of notifications significantly decreased by 41% in the pandemic period compared to the pre-pandemic one, with very high reduction of certain disease notifications such as measles and varicella. Similarly, other airborne infections, such as meningococcal meningitis and tuberculosis, underwent an important decrease. Conversely, an increase was found for some infections such as syphilis and, especially, scabies that reported a percentage value of +159.9%. Conclusions The COVID-19 pandemic, reducing the possibility of microbial spread following to the lockdown and, in addition, to the constant use of face masks and other personal protective equipment, the frequent hand-washing, more ventilation of the living locals, and less gathering, surely reduced the occasions and the possibility to get many infections. On the other hands, the pandemic had a negative impact on scabies diffusion probably due to different causes among which the worsening of some poor realities, the restrictions that forced people to live in strict contact and, especially, the worsening of the conditions of the elderly living in care homes.
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Affiliation(s)
- ALESSIO FACCIOLÀ
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - ANTONIO LAGANÀ
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Istituto Clinico Polispecialistico C.O.T. Cure Ortopediche Traumatologiche S.p.A., Messina, Italy
| | - GIOVANNI GENOVESE
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - BRUNO ROMEO
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - SALVATORE SIDOTI
- Department of Prevention, Provincial Health Agency, Messina, Italy
| | | | - CATERINA RACO
- Department of Prevention, Provincial Health Agency, Messina, Italy
| | - GIUSEPPA VISALLI
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - ANGELA DI PIETRO
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Vázquez-Prieto S, Vaamonde A, Paniagua E. Study of the Use of Permethrin 5% Cream in Galicia (Spain) between 2018 and 2021. Infect Dis Rep 2023; 15:222-230. [PMID: 37102983 PMCID: PMC10138315 DOI: 10.3390/idr15020023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Drug utilization studies can provide direct insights into how a drug is used in real-world conditions and can give a rough estimate of the proportion of the study population treated with it. In the present work, we examined the consumption of permethrin 5% cream in the four provinces of Galicia (a Spanish autonomous community) and described the seasonal variability and the annual evolution of its consumption between 2018 and 2021. A descriptive, cross-sectional, and retrospective study of the consumption of this drug, expressed in defined daily dose per 1000 inhabitants per day (DID), was carried out. The results obtained revealed differences between the amounts consumed in the four Galician provinces (p < 0.001). No specific geographical pattern was observed; however, the results suggested a marked seasonality and a slightly increasing global trend in the consumption of permethrin 5% cream throughout the study period. Since the only authorized indication of this drug in the study area is the treatment of scabies, this work may give an idea of the epidemiological situation of the disease in Galicia and serve to establish public health strategies against this parasitosis.
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Affiliation(s)
- Severo Vázquez-Prieto
- Universidad de Los Lagos, Osorno, Chile
- Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - Antonio Vaamonde
- Departamento de Estadística e Investigación Operativa, Universidad de Vigo, 36310 Vigo, Spain
| | - Esperanza Paniagua
- Laboratorio de Parasitología, Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain
- Instituto de Investigación en Análisis Químicos y Biológicos (IAQBUS), Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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