A community-based validation of the International Alliance for the Control of Scabies Consensus Criteria by expert and non-expert examiners in Liberia

Walker, Sharyn M.; Collinson, Shelui; Timothy, Joseph; Zayay, S; Kollie, Karsor; Lebas, Eve; Halliday, Katherine E.; Pullan, Rachel L.; Fallah, Mosoka; Marks, Michael

doi:10.1101/2020.06.08.20125682

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…For example, our results show that the dorsal aspect of the finger web spaces is much more commonly involved than the palmar web spaces. One previous study showed an increased frequency of involvement of the dorsal hand compared to the palmar hand 18 . Similarly, where previous studies have reported the arms to be common sites for lesions, 14,23,31 our study and choropleth figures reveal this in greater detail, including the preponderance for lesions on the medial and anterior arm 14,25,32 …”

Section: Discussionsupporting

confidence: 84%

“…An even more limited examination such as only the hands and wrists (sensitivity 93%) or only the arms (sensitivity 97%) could also be considered. These sensitivities are slightly higher than previous estimates of limited examinations which ranged from 92% to 93% 17,18 . Focused examination may miss a small number of cases in infants and young children (sensitivity 88% for hands and wrists, 96% for arms).…”

Section: Discussioncontrasting

confidence: 61%

“…These sensitivities are slightly higher than previous estimates of limited examinations which ranged from 92% to 93%. 17,18 Focused examination may miss a small number of cases in infants and young children (sensitivity 88% for hands and wrists, 96% for arms). While a reduced sensitivity in infants may not significantly alter community prevalence estimates during mapping, these results underline the importance of whole-body examination for the individual clinical diagnosis of scabies in those aged less than 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…A simplified, abbreviated approach to examination, whereby only a limited area of the skin is examined, has been proposed for scabies mapping and prevalence surveys, in an attempt to reduce the logistical challenges for privacy in field settings 16 . One retrospective study and one prospective study found that a simplified examination had high sensitivity for diagnosis 17,18 . However, further evidence to support the use of focused examinations is required 6 …”

Section: Introductionmentioning

confidence: 99%

“…16 One retrospective study and one prospective study found that a simplified examination had high sensitivity for diagnosis. 17,18 However, further evidence to support the use of focused examinations is required. 6 Therefore, the aim of this study was to investigate and generate a detailed description of, the body distribution of skin lesions in individuals with scabies.…”

Section: Introductionmentioning

confidence: 99%

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The body distribution of scabies skin lesions

Osti

Sokana²,

Lake

et al. 2022

JEADV Clinical Practice

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Background: The clinical diagnosis of scabies relies on the assessment of signs and symptoms and an improved understanding of the distribution of skin lesions may lead to improved diagnostic performance.Objectives: To investigate the detailed body distribution of scabies lesions and to explore the accuracy of simplified, focused examination approaches.Methods: We did a prospective, cross-sectional study in the Western Province of Solomon Islands (2019). Consenting individuals of all ages were eligible. The entire skin surface was examined, and the presence and number of typical scabies lesions were recorded at 98 topographic body sites, corresponding to 5 regions and 16 subregions. We compared the distribution at sites, regions and subregions overall, and by age and sex. We also calculated the expected sensitivity of examination of limited body areas. Choropleth maps were generated to provide detailed descriptions of the distribution of lesions.Results: A total of 467 individuals were enrolled (median age: 9 years [range: 0-86]; female: 54.6%) of whom 269 (57.6%) participants had typical scabies lesions.The most common sites for scabies lesions were the dorsal fingers (65.7% of participants with scabies lesions), dorsal finger web spaces (62.1%) and dorsal hands (61.7%). Of those less than 2 years old with scabies, eight (30.8%) had lesions at the head and neck region compared to 10.8% of those aged 2-5. Genital lesions were more common in males than females (27.3% vs. 7%, relative risk 3.9, 95% confidence interval: 1.2-2.1). Simplified, focused examinations were estimated have very high sensitivity (hands and wrists only: 93.3%; exposed arms and legs: 99.3%) compared to whole-body examinations. Conclusion:We report highly detailed descriptions of the body distribution of scabies lesions, including differences by age and sex. These data are valuable for training and diagnosis and support the use of simplified, focused examinations for scabies mapping.

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Section: Discussionsupporting

confidence: 84%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The body distribution of scabies skin lesions

Osti

Sokana²,

Lake

et al. 2022

JEADV Clinical Practice

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Methods and Approaches for Buruli Ulcer Surveillance in Africa: Lessons Learnt and Future Directions

Timothy

Pullan

Yotsu

2021

Methods in Molecular Biology

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Over 95% of the global burden of Buruli ulcer disease (BU) caused by Mycobacterium ulcerans occurs in equatorial Africa. National and sub-national programmes have implemented various approaches to improve detection and reporting of incident cases over recent decades.Regional incidence rates are currently in decline, however, surveillance targets outlined in 2012 by WHO have been missed and detection bias may contribute to these trends. In light of the new 2030 NTD roadmap and disease-specific targets, BU programmes are required to strengthen case detection and begin a transition towards integration with other skin-NTDs. This transition comes with new opportunities to enhance existing BU surveillance systems and develop novel approaches for implementation and evaluationIn this review, we present a breakdown and assessment of the methods and approaches that have been the pillars of BU surveillance systems in Africa i) Passive case detection ii) Data systems iii) Clinical training iv) Active case finding v) Burden estimation vi) Laboratory confirmation pathways. We discuss successes, challenges and relevant cases studies before highlighting opportunities for future development and evaluation including i) Novel data collection tools ii) Risk-based surveillance iii) Integrated skin-NTD surveillance. We draw on both experience and available literature to critically evaluate methods of BU surveillance in Africa and highlight new approaches to help achieve 2030 roadmap targets.

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The prevalence of scabies in Monrovia, Liberia: a population-based survey

Collinson

Timothy

Zayzay

et al. 2020

Preprint

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Background Scabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking. Methods We conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression. Results 1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies. Conclusions Our study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.

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A community-based validation of the International Alliance for the Control of Scabies Consensus Criteria by expert and non-expert examiners in Liberia

Cited by 5 publications

References 14 publications

The body distribution of scabies skin lesions

The body distribution of scabies skin lesions

Methods and Approaches for Buruli Ulcer Surveillance in Africa: Lessons Learnt and Future Directions

The prevalence of scabies in Monrovia, Liberia: a population-based survey

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