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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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Karadoğan SK, Ulgen Altay B. Dermatology Quality of Life and Depression, Anxiety, and Stress Scale-42 in Scabies Patients. Dermatol Pract Concept 2024; 14:dpc.1402a112. [PMID: 38810073 PMCID: PMC11135924 DOI: 10.5826/dpc.1402a112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Scabies is a pruritic skin infestation with a globally increasing prevalence. Sleep problems and impaired social and personal interactions, mainly due to itching, have been reported. OBJECTIVES We aimed to determine the influence of scabies on quality of life and psychosocial health using Dermatology Life Quality Index (DLQI) and Depression Anxiety and Stress Scale-42 (DASS-42) and analyze whether there is a correlation between the two scales and any sociodemographic and clinical characteristic. METHODS Scabies patients (>16 years) who presented to our outpatient clinics were enrolled. Age, sex, occupation, marital status, and education level and clinical features were recorded. DLQI and DASS-42 were used. Possible influence of demographic and clinical characteristics on total scores were analyzed. The Spearman coefficient analysis was performed to determine whether there is a correlation between these scores. RESULTS Of 92 patients (mean age:37.76±15.355, Female/Male: 1.09/1), 63% were married and 35.9% were high-school graduates; 27.2% and 23.9% were housewives and officers, respectively. Disease was generalized in 57.6% and duration of disease was mostly <4 weeks. Mean DLQI and DASS-42 scores were 13.16±7.638 and 42.10±30.644, respectively. Symptoms/feelings were affected predominantly. DLQI was affected 'severely' in 41.3% of patients. CONCLUSIONS Impairment of DLQI is a significant predictive parameter for higher DASS levels. Scabies is not only associated with impairment in DLQI but may also lead to psychosocial problems. All scabies patients should be evaluated and consulted-if needed-for possible problems of psychosocial status, including depression, anxiety, and stress, as well as clinical symptoms and secondary complications.
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Affiliation(s)
| | - Berna Ulgen Altay
- Department of Dermatology, Izmir Democracy University Medical Faculty, Buca Seyfi Demirsoy Training and Research Hospital, Konak/İzmir, Turkey
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Jira SC, Matlhaba KL, Mphuthi DD. Healthcare users' knowledge and experiences regarding the management of scabies in the Deder district, Ethiopia. J Public Health Afr 2023; 14:2305. [PMID: 38162325 PMCID: PMC10755506 DOI: 10.4081/jphia.2023.2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/26/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Scabies is an ectoparasitic, highly contagious skin disease caused by a human itch mite infestation of the skin, and it is the leading cause of morbidity and disease burden in developing countries. The purpose of this study was to investigate healthcare users' current knowledge and experiences with scabies management provided at primary healthcare facilities. MATERIALS AND METHODS A qualitative research design was used to address the research objectives. Focus group interviews with 58 health care users were used to collect data. Thematic analysis was performed on the verbatim transcriptions using Tesch's approach. RESULTS The findings showed that the knowledge of healthcare users who participated in the study on scabies, its management, prevention, and control was limited. Health care users experience different challenges regarding scabies and the management thereof. Five themes emerged after data analysis. These were knowledge regarding scabies, knowledge regarding the management of scabies, knowledge regarding the prevention of scabies, perceptions regarding receiving treatment for scabies, and recommendations regarding the availability of materials and medication. CONCLUSIONS Healthcare users in the area had limited knowledge and experienced different challenges regarding scabies and their management. These challenges contribute to low-quality health services with undesirable health outcomes. To narrow this gap, consistent and programed health education was provided to the community through different modalities by using the existing health system to increase awareness regarding scabies. Following the implementation of community awareness, each community member was positioned to prevent and control scabies.
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Affiliation(s)
- Sagni Challi Jira
- Department of Malaria and Neglected Tropical Disease, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - David Ditaba Mphuthi
- Department of Health Studies, University of South Africa, Pretoria, South Africa
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Behera P, Pal D, Sirka CS, Patro BK, Sahu DP, Dash S, Taywade M. Development and Validation of the ScAbIeS Tool for Diagnosing Scabies by Community Healthcare Workers in Resource-Limited Settings. Cureus 2023; 15:e42268. [PMID: 37605700 PMCID: PMC10440127 DOI: 10.7759/cureus.42268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/23/2023] Open
Abstract
Introduction Scabies can lead to community outbreaks if not diagnosed early. Developing and validating a relevant tool for diagnosing scabies at the community level is essential to bridging the early diagnosis and treatment gap. Objective The objective of this study is to develop and validate a newer tool to diagnose scabies at the community level by Community Healthcare Workers (CHWs) in resource-limited settings. Methods The developed "ScAbIeS" tool comprised five items divided into two major and three minor criteria. After its development, a longitudinal descriptive study validated the "ScAbIeS" tool. The eligible participants were included in the study through active screening in villages under the Rural Health Training Center (RHTC) Mendhasala. Those villages' Accredited Social Health Activists (ASHS) were included as CHWs for diagnosing scabies using the "ScAbIeS" tool. The participants with skin lesions and/or itching were diagnosed with scabies by CHWs using the "ScAbIeS" tool. The diagnosis of CHWs using the "ScAbIeS" tool was compared with those of physicians, including expert dermatologists, to determine the sensitivity and specificity. Results Kappa's agreement is found to be 0.896 for CHWs and trained physicians regarding the diagnosis of scabies by the "ScAbIeS" tool. Cronbach's alpha is 0.738 for major criteria and 0.565 for minor criteria. 0.778 is found to be Cronbach's alpha for the total scale. The "ScAbIeS" tool is 85% sensitive and 100% specific to diagnose scabies when used by CHWs. Conclusion The "ScAbIeS" tool can be used to diagnose scabies at the community level by CHWs with appropriate training. It will lead to the prevention of complications and community outbreaks of scabies.
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Affiliation(s)
- Priyamadhaba Behera
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Debkumar Pal
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Chandra S Sirka
- Dermatology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Binod K Patro
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Dinesh P Sahu
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Siddhartha Dash
- Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Manish Taywade
- Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Aždajić MD, Bešlić I, Gašić A, Ferara N, Pedić L, Lugović-Mihić L. Increased Scabies Incidence at the Beginning of the 21st Century: What Do Reports from Europe and the World Show? Life (Basel) 2022; 12:1598. [PMID: 36295033 PMCID: PMC9604680 DOI: 10.3390/life12101598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Reports from various countries have described increasing numbers of scabies cases, especially in the past two decades. The epidemiological data for various world regions showed prevalence estimates ranging from 0.2% to 71%, with the highest prevalence in the Pacific region and Latin America. Therefore, geographically, scabies occurs more commonly in the developing world, tropical climates, and in areas with a lack of access to water. According to results from specific regions of the world, the greatest burdens from scabies were recorded for East Asia, Southeast Asia, Oceania, tropical Latin America, and South Asia. Among countries with the highest rates, the top 10 were Indonesia, China, Timor-Leste, Vanuatu, Fiji, Cambodia, Laos, Myanmar, Vietnam, and the Seychelles. From Europe, available data shows an increasing trend in scabies infestation, particularly evident among populations with associated contributing factors, such as those who travel frequently, refugees, asylum seekers, those who regularly lack drinking water and appropriate hygiene and are of a younger age, etc. This increase in observed cases in the last 10-20 years has been evidenced by research conducted in Germany, France, Norway, and Croatia, among other countries. In addition, increased scabies transmission was also recorded during the COVID-19 pandemic and may have been the result of increased sexual intercourse during that time. Despite all the available treatment options, scabies commonly goes unrecognized and is therefore not treated accordingly. This trend calls for a prompt and synergistic reaction from all healthcare professionals, governmental institutions, and non-governmental organizations, especially in settings where population migration is common and where living standards are low. Furthermore, the proper education of whole populations and accessible healthcare are cornerstones of outbreak prevention. Accurate national data and proper disease reporting should be a goal for every country worldwide when developing strategic plans for preventing and controlling the community spread of scabies.
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Affiliation(s)
- Marija Delaš Aždajić
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Iva Bešlić
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Ana Gašić
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Nikola Ferara
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- Department of Dermatovenereology, General Hospital Šibenik, 22000 Šibenik, Croatia
| | - Lovre Pedić
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- Department of Dermatovenereology, General Hospital Zadar, 23000 Zadar, Croatia
| | - Liborija Lugović-Mihić
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
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GÖÇER GÜROK N. Skabies insidansında artış: üçüncü basamak, retrospektif, tek merkez çalışması. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1086638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Amaç: Son yıllarda bölgemizde gözlemlediğimiz skabies olgularındaki artışı ve skabies hastalarının demografik özelliklerini araştırmayı amaçladık.
Gereç ve Yöntemler: Elazığ Fethi Sekin Şehir Hastanesi Dermatoloji Kliniğine Ocak 2019 ve Aralık 2021 tarihleri arasında başvuran ve skabies tanısı alan tüm hastalar retrospektif olarak değerlendirildi. Yaş, cinsiyet, vatandaşlık ve başvuru tarihleri hastane veri tabanından anonimleştirilerek elde edildi.
Bulgular: 2019-2021 yılları arasında dermatoloji polikliniğine başvuran toplam 191.925 hastanın 2.898’ine skabies tanısı kondu. Bu üç yılda gözlenen skabies hasta sıklıklarının istatistiksel olarak anlamlı artış gösterdiği gözlendi (χ2:296.158 ; p:0.000
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Affiliation(s)
- Neşe GÖÇER GÜROK
- UNIVERSITY OF HEALTH SCIENCES, ELAZIĞ HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, THE DEPARTMENT OF DERMATOLOGY
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Alharthi AS, Alsofyani MA, Alharthi WK, Alsalmi SA, Altalhi AS, Alswat KA. Assessment of Knowledge and Fear of Scabies in a Saudi Population. J Multidiscip Healthc 2021; 14:1361-1371. [PMID: 34135594 PMCID: PMC8197587 DOI: 10.2147/jmdh.s308236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives Scabies is a common contagious parasitic dermatological illness. In 2017, WHO recognized scabies as a neglected tropical disease. The aim of the present research was to assess the level of knowledge and fear of scabies among the Saudi population. Methods This is a cross-sectional online study conducted in the western region of Saudi Arabia from January to September 2019. We used a validated, 12-questions questionnaire to assess the scabies knowledge and the Fear of Scabies Scale-10 (FSS-10) to determine the level of fear toward scabies. Results A total of 3778 respondents were included with majorities of them being female and between the age of 15-30 years. About 93.3% of the respondents were considered to have good level of knowledge towards scabies and those were more likely to be females, live in an urban area, have heard about scabies in the past, younger in age, achieved higher educational level, and work for the medical and general education sector (all P <0.001). The total possible scores ranging from 10 (less fear) to 40 (greater fear). The mean total FSS-10 score was 33 ± 4.46 with 58.3% of them were considered to have greater fear and those were more likely to be female, younger in age, educated with higher educational degree, work for the general education sector and medical and, but less likely to be unemployed (all P <0.001). Partial correlation adjusting for potential confounders showed significant positive correlation between FSS-10 score and the scabies knowledge score (r = 0.152, P <0.001). Conclusion Despite the good level of scabies knowledge, the level of fear towards scabies is high. Further educational programs recommended decreasing the negative effect of scabies on the community and the individuals' quality of life.
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Affiliation(s)
- Ahmad S Alharthi
- Department of Otorhinolaryngology - Head and Neck Surgery, Taif University, Taif, Saudi Arabia
| | | | | | | | | | - Khaled A Alswat
- Department of Medicine, School of Medicine, Taif University, Taif, Saudi Arabia
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Ständer S, Ständer S. Itch in Scabies-What Do We Know? Front Med (Lausanne) 2021; 8:628392. [PMID: 33598472 PMCID: PMC7882483 DOI: 10.3389/fmed.2021.628392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/05/2021] [Indexed: 12/14/2022] Open
Abstract
Scabies is a common parasitic skin infestation characterized by severe itch and a heterogenous clinical presentation. Itch, as the cardinal symptom of scabies, is imposing a high burden on affected patients and is often difficult to manage. Decreased life quality and secondary complications, caused by an itch-related disruption of the epidermal barrier and subsequent superinfections, illustrate the need to treat scabies and to understand the underlying mechanisms of itch in respective patients. This review summarizes available data on itch in scabies with a special focus on the clinical aspects and its underlying pathomechanisms.
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Affiliation(s)
- Sascha Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Sonja Ständer
- Department of Dermatology, Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
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Engelman D, Yoshizumi J, Hay R, Osti M, Micali G, Norton S, Walton S, Boralevi F, Bernigaud C, Bowen A, Chang A, Chosidow O, Estrada‐Chavez G, Feldmeier H, Ishii N, Lacarrubba F, Mahé A, Maurer T, Mahdi M, Murdoch M, Pariser D, Nair P, Rehmus W, Romani L, Tilakaratne D, Tuicakau M, Walker S, Wanat K, Whitfeld M, Yotsu R, Steer A, Fuller L. The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Br J Dermatol 2020; 183:808-820. [PMID: 32034956 PMCID: PMC7687112 DOI: 10.1111/bjd.18943] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods. OBJECTIVES To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings. METHODS Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods. RESULTS The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library. CONCLUSIONS The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.
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Assessment of the Quality of Life in Patients with Scabies in an Urban Tertiary Care Centre in North India. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2020. [DOI: 10.2478/sjdv-2020-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction. Scabies is a highly contagious parasitic skin infestation caused by Sarcoptesscabiei mite causing social stigma in patients owing to skin lesions over the exposed body-parts. The present study was aimed at assessing the quality of life in scabies patients. Material and Methods. This non-interventional and cross section study included a total of a hundred newly diagnosed scabies cases above 5 years of age. The patients were given the questionnaire on the life quality affected by their disease and a detailed analysis was done afterwards. Results. Out of a hundred patients, 52% were females. The age group 21-40 years was most affected: 25.7% of adult patients had moderate effect while 55.9% of children suffered no effect on their quality of life. Conclusion. Scabies moderately affected the quality of life of the patients in the present study in the form of feeling of embarrassment, stigmata and shame associated with disease.
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An Increasing Scabies Incidence in Croatia: A Call for Coordinated Action Among Dermatologists, Physicians and Epidemiologists. Zdr Varst 2020; 59:264-272. [PMID: 33133283 PMCID: PMC7583432 DOI: 10.2478/sjph-2020-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction The aim of our study was to examine the scabies incidence in the Croatian population and to analyse potential related factors. Methods This mixed ecological study is based on a retrospective medical record review. National data from communicable disease reports was sourced and analysed for an 11-year period (2007-2017), with more focus on the period 2014-2017. Descriptive statistics were used to calculate trends. Differences between the groups were studied using Chi-square test and Kendall's tau (τ) correlation coefficient. Levels of significance were set at p<0.05 or p<0.01. Results From 2007 to 2017, scabies infestation in Croatia increased by 6-fold, particularly affecting children and young adults (19 years or younger). In the period 2014-2017, border counties which are part of migration flows were the counties with the highest average scabies incidences. A linear trend of increase in the number of tourists, immigrants and scabies infestations was noted on the national level for the analysed period, although a significant association was not observed. Regarding outbreaks of scabies within institutions, more than 80% of outbreaks occurred in institutions for adults. In the capital, Zagreb, the crude incidence rate increased 3-fold between 2014 and 2017. Conclusions The increased incidence of scabies, large disparities between counties, and prolonged outbreaks within families due to under-recognition and misdiagnoses points to a need for increased awareness among health practitioners. To the best of our knowledge, this is the first recent epidemiologic analysis on this topic, not only in Croatia but within the wider geographic region as well.
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Osti MH, Sokana O, Phelan S, Marks M, Whitfeld MJ, Gorae C, Kaldor JM, Steer AC, Engelman D. Prevalence of scabies and impetigo in the Solomon Islands: a school survey. BMC Infect Dis 2019; 19:803. [PMID: 31519153 PMCID: PMC6743115 DOI: 10.1186/s12879-019-4382-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/15/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Scabies, a parasitic disease of the skin, is a major public health problem, largely affecting children. Scabies is often complicated by impetigo which can result in serious complications including invasive infections and immune mediated diseases. Scabies and impetigo are reported to have high prevalence in tropical settings including the Solomon Islands. METHODS We conducted a cross-sectional prevalence survey at Gizo Primary School in the Western Province of the Solomon Islands in August 2018. The diagnosis of scabies was based on criteria developed by the International Alliance for the Control of Scabies in 2018. Population attributable risk was calculated to determine the effect of scabies on the prevalence of impetigo, and both adjusted and unadjusted risk ratios were calculated to identify differences between sexes and age groups. RESULTS A total of 324 students were assessed (47.5% of those enrolled at the school). The prevalence of scabies was 54.3% (95% confidence interval [CI] 48.7-59.8) and most disease was mild (68.8%). The prevalence was higher in males (63.5%; adjusted risk ratio [ARR] 1.4, 95% CI 1.1-1.7), and in those aged 10-12 years (61.4%; ARR 1.8, 95% CI 1.1-2.9 when compared to those aged 4-6 years). The prevalence of impetigo was 32.1%, with males more likely to be affected (41.7%, ARR 1.7, 95% CI 1.2-2.4) but with no significant differences between age groups. 63.5% of those with impetigo had scabies, corresponding to a population attributable risk of 11.8%. CONCLUSIONS There is a very high burden of scabies and impetigo among primary school students in Gizo. There is a critical need for the development and implementation of control programs in areas where scabies is endemic.
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Affiliation(s)
- Millicent H Osti
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - Oliver Sokana
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Sophie Phelan
- Kirby Institute, University of New South Wales, Sydney, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Margot J Whitfeld
- St Vincent's Hospital, Sydney, Australia.,Department of Medicine, University of New South Wales, Sydney, Australia
| | - Christina Gorae
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - John M Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Andrew C Steer
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - Daniel Engelman
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia. .,Department of Paediatrics, University of Melbourne, Melbourne, Australia. .,Melbourne Children's Global Health, Melbourne, Australia.
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Ejigu K, Haji Y, Toma A, Tadesse BT. Factors associated with scabies outbreaks in primary schools in Ethiopia: a case-control study. Res Rep Trop Med 2019; 10:119-127. [PMID: 31695552 PMCID: PMC6717729 DOI: 10.2147/rrtm.s214724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/12/2019] [Indexed: 12/28/2022] Open
Abstract
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.
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Affiliation(s)
- Kefele Ejigu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yusuf Haji
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Alemayehu Toma
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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van der Linden N, van Gool K, Gardner K, Dickinson H, Agostino J, Regan DG, Dowden M, Viney R. A systematic review of scabies transmission models and data to evaluate the cost-effectiveness of scabies interventions. PLoS Negl Trop Dis 2019; 13:e0007182. [PMID: 30849124 PMCID: PMC6426261 DOI: 10.1371/journal.pntd.0007182] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 03/20/2019] [Accepted: 01/23/2019] [Indexed: 01/12/2023] Open
Abstract
Background Scabies is a common dermatological condition, affecting more than 130 million people at any time. To evaluate and/or predict the effectiveness and cost-effectiveness of scabies interventions, disease transmission modelling can be used. Objective To review published scabies models and data to inform the design of a comprehensive scabies transmission modelling framework to evaluate the cost-effectiveness of scabies interventions. Methods Systematic literature search in PubMed, Medline, Embase, CINAHL, and the Cochrane Library identified scabies studies published since the year 2000. Selected papers included modelling studies and studies on the life cycle of scabies mites, patient quality of life and resource use. Reference lists of reviews were used to identify any papers missed through the search strategy. Strengths and limitations of identified scabies models were evaluated and used to design a modelling framework. Potential model inputs were identified and discussed. Findings Four scabies models were published: a Markov decision tree, two compartmental models, and an agent-based, network-dependent Monte Carlo model. None of the models specifically addressed crusted scabies, which is associated with high morbidity, mortality, and increased transmission. There is a lack of reliable, comprehensive information about scabies biology and the impact this disease has on patients and society. Discussion Clinicians and health economists working in the field of scabies are encouraged to use the current review to inform disease transmission modelling and economic evaluations on interventions against scabies. Scabies is a neglected tropical disease affecting more than 130 million people, with major costs on health care systems worldwide. While effective treatments exist, it is unknown which treatment strategies result in the best outcomes against the lowest costs, and to what extent this differs between communities. Health economic modelling can help answer these questions, but has rarely been used in this disease area. This review discusses all available scabies transmission models (n = 4), and uses them to create a new, comprehensive modelling framework. This framework can be used as aid for creating a scabies transmission model, the details of which will be determined by the context (population) and the question being addressed. The current paper also reviews the data that is needed to inform scabies modelling: on scabies biology, quality of life and resource use. Unfortunately, available data is limited and particularly data on crusted scabies (associated with high morbidity and mortality rates) is rare. With this review, we hope to assist researchers and policy makers to predict and/or evaluate the cost-effectiveness of interventions against scabies in their population(s) of interest. To tackle scabies, it is key to use effective treatment strategies in a cost-effective and sustainable way. The models and data described in this review, may help researchers, clinicians and funding bodies to facilitate this.
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Affiliation(s)
- Naomi van der Linden
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
- * E-mail:
| | - Kees van Gool
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Karen Gardner
- Public Service Research Group, School of Business UNSW Canberra, Canberra, Australia
| | - Helen Dickinson
- Public Service Research Group, School of Business UNSW Canberra, Canberra, Australia
| | - Jason Agostino
- Academic Unit of General Practice, Australian National University, Canberra, Australia
| | | | | | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
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Assessing skin disease and associated health-related quality of life in a rural Lao community. BMC DERMATOLOGY 2018; 18:11. [PMID: 30509232 PMCID: PMC6278038 DOI: 10.1186/s12895-018-0079-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/19/2018] [Indexed: 11/15/2022]
Abstract
Background Skin diseases are common and often have an impact on an individual’s health-related quality of life. In rural communities where access to healthcare may be limited and individuals rely on farming for food and income, the impact of skin diseases may be greater. The objectives for this study were to perform an assessment of skin disease prevalence in a rural village in Laos and assess the associated impact of any skin disease found using the Dermatology Life Quality Index (DLQI). Methods A rural village was purposively selected and 340 participants examined by dermatologists over a four day period. Brief questionnaires were performed, followed by full body skin examinations and DLQI questionnaires completed were relevant. The data were analysed using chi square and Wilcoxon signed rank tests. Results One hundred and eighty-one participants were found to have a skin disease (53%). The six most common skin diseases were: eczema (22%), dermatophyte infections (19%), acne (10%), scabies infestation (9%), melasma (8%) and pityriasis versicolor (4%). Just over half of those with skin disease (51%) completed the DLQI, with scores ranging from 0 to 24. Those with skin problems on examination were significantly more likely to be farmers, have had a previous skin problem, be older or live in a smaller family. Conclusions This study represents the first formal documentation of skin disease prevalence in Laos and establishes the high rate of skin disease in the rural community and the associated impact these diseases have on health-related quality of life.
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Kandi V. Laboratory Diagnosis of Scabies Using a Simple Saline Mount: A Clinical Microbiologist's Report. Cureus 2017; 9:e1102. [PMID: 28435762 PMCID: PMC5398661 DOI: 10.7759/cureus.1102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
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