Control Strategies for Scabies

Engelman, Daniel; Steer, Andrew C.

doi:10.3390/tropicalmed3030098

Cited by 60 publications

(66 citation statements)

References 69 publications

(81 reference statements)

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“…However, to facilitate scabies research, the International Alliance for the Control of Scabies (IACS) proposed criteria for the diagnosis of scabies in 2018; specifically, they introduced criteria for the confirmed diagnosis of scabies, the clinical diagnosis of scabies and the suspected diagnosis of scabies. The diagnostic criteria have been acknowledged and are likely to be incorporated by heath care providers during their evaluation of patients in whom the possibility of scabies is being considered [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Classic and Non-classic (Surrepticius) Scabies: Diagnostic and Treatment Considerations

Cohen¹

2020

Cureus

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The morphology of scabies, a mite infestation of worldwide proportion, is characterized by a variety of cutaneous lesions. Patients with classic scabies present with characteristic burrows often located on the web spaces of the fingers and toes. Scabies surrepticius refers to the nonclassic atypical presentation of scabies; establishing the diagnosis of scabies in these individuals can be difficult. To facilitate the diagnosis of scabies, criteria have been proposed by the International Alliance for the Control of Scabies (IACS). These criteria are intended for scabies research; however, they can be utilized by clinicians to establish either a confirmed diagnosis, a clinical diagnosis or a suspected diagnosis of scabies. Visualization of mites, eggs or feces is necessary for a confirmed diagnosis of scabies. A clinical diagnosis can be established by observation of either genital lesions in men or burrows or classically distributed classical lesions in individuals with two historic features: pruritus and close contact with an individual who itches and has classically distributed classical scabetic lesions. The clinical features and management of a woman residing in an assisted living environment with a confirmed diagnosis of scabies and a man with a clinical diagnosis of scabies are described. The criteria for the suspected diagnosis of scabies require either one historic feature and typical lesions in a typical distribution or both historic features and the presence of atypical lesions or an atypical distribution of the skin lesions. Once the diagnosis of scabies is established, not only the patient but also close contacts should receive treatment with either a topical medication (such as permethrin 5% cream) or a systemic drug (ivermectin) or both. The number and frequency of treatments are variable; classic scabies typically is managed with a total of two treatments performed weekly to biweekly. Patients with crusted scabies usually require multiple topical and oral antiscabetic treatments in addition to topical keratolytic therapy. Bacterial impetiginization or infection (most commonly by Staphylococcus aureus or Streptococcus pyogenes) can complicate scabies infestation and potentially result in cellulitis, abscess, sepsis, rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis; therefore, in some patients, systemic antimicrobial therapy may be necessary in addition to scabiesdirected treatment. In addition to systemic antihistamines, oral and/or topical corticosteroids may be used to provide symptomatic pruritus relief once the diagnosis of scabies has been established and mite-directed treatment has been initiated. The clinician should consider several potential causes (such as inadequate treatment, reinfection, mite resistance, delusions of parasitosis and the development of a new non-scabetic dermatosis) in scabies patients who fail to respond to treatment with a topical or oral scabicide therapy.

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Section: Introductionmentioning

confidence: 99%

Classic and Non-classic (Surrepticius) Scabies: Diagnostic and Treatment Considerations

Cohen¹

2020

Cureus

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“…6,150 Recent data from studies using MDA have led to renewed interest in the potential of MDA to contribute to sustained population-level control. 151,152 Programs of mass treatment combined with additional screening and case management in Panama and Australia (using permethrin) 6,9,153 and the Solomon Islands (using ivermectin) considerably reduced scabies prevalence. Indirect evidence from Zanzibar suggested a reduction in consultations and prescriptions for scabies following annual MDA of ivermectin and albendazole for lymphatic filariasis 155,156 but a study from a lower prevalence setting in mainland Tanzania did not show a sustained effect.…”

Section: Population-level Controlmentioning

confidence: 99%

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

et al. 2019

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

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“…9 Compared with interventions in individuals, a lot of data is now available in endemic or epidemic settings from mass drug administration for treatment of scabies, whether adults or children, or other diseaseseg, onchocerciasis. 11,12 Which drug should be used for scabies and whether it should be combined with antibiotics are important decisions. David Taplin 13 first used a mass drug administration approach in 1986 for control of scabies in Panama, and showed that application of 5% permethrin cream substantially decreased the prevalence of scabies for up to 3·8 years after treatment (33% at baseline to 12% at 3·8 years).…”

Section: Control Of Scabies and Secondary Impetigo: Optimising Treatmmentioning

confidence: 99%

“…sero types 6B (0·16 µg/mL), and 2·2 times higher than that for serotype 19F (1·17 µg/mL). 7,11 In summary, Temple and colleagues' study showing non-inferiority of PCV10 versus PCV13 in terms of immunogenicity against invasive pneumococcal disease provides important endorsement of existing WHO advice on the use of PCVs for infant immunisation. 12 Furthermore, these data indicate that an individual country's decision on which vaccine to use in a 2 + 1 schedule to directly protect against vaccine-serotype invasive pneumococcal disease might well be influenced primarily by the cost of vaccine procurement.…”

mentioning

confidence: 97%