Children's scabies survey indicates high prevalence and misdiagnosis in Auckland educational institutions

Abstract

AimHere, we present results of a survey of scabies prevalence in childcare centres and primary schools in Auckland.MethodsChildren whose parents agreed to take part in participating centres in the Auckland region were examined for scabies by general practitioners and given questionnaires of relevant symptoms. Diagnoses of clinical or suspected scabies were made according to the International Alliance for the Control of Scabies (IACS) criteria. The survey was a stratified random sample of schools and early childcare centres. A quantitative polymerase chain reaction (PCR) test was also used to complement the IACS criteria.ResultsA total of 181 children were examined, with 145 children with history information, 16 of whom (11.0%) met the criteria for ‘clinical’ or ‘suspected’ scabies. Weighted analysis, accounting for the survey design, indicated that the prevalence of scabies in early childcare centres was 13.2% (95% CI: 4.3 to 22.1), with no school‐aged children fulfilling these criteria. A higher proportion had clinical signs of scabies with 23 (12.7%) having typical scabies lesions and a further 43 (23.8%) had atypical lesions. A total of 64 PCR tests were taken and 15 (23%) were positive. None of these cases were receiving treatment for scabies. Five were undergoing topical skin treatment: three with topical steroid and two with calamine lotion.ConclusionsThe prevalence of children with scabies is high in early childcare centres in Auckland. Misdiagnosis is suggested by several PCR positive cases being treated by topical agents used to treat other skin conditions.

Prevalence and determinants of scabies: a global systematic review and meta-analysis

“…The sample size of each of the constituent studies ranged from 50 to 9,057,427 participants. Of the 54 eligible studies, nine were conducted in Ethiopia [30][31][32][33][34][35][36][37][38], eight in Fiji [14] [39][40][41][42][43], six in the Solomon Islands [13][ [16][17][ [43][44][45][46], four in Timor-Leste [43] [47][48][49], four in India [11][50-52], three in Ghana [53][54][55], two in Australia [15][56], two in Nigeria [57][58], two in Malaysia [59][60] and one each in Cameroon [61], Egypt [62], Gambia [63], Iran [64], Lao [65], Liberia [66], Malawi [12], New Zealand [67], Samoa [68], Sri Lanka [69], Tanzania [18], Turkey [70], United Kingdom…”