Outcome of an interventional program for scabies in an Indigenous community

Abstract

Objective To implement an intervention program for reducing the prevalence of scabies in a large Northern Territory Aboriginal community. Design Prospective, longitudinal screening, intervention and follow‐up study. Participants and setting All children aged 5 years and under in one of the largest Aboriginal communities in the Northern Territory, total population, approximately 2200 (95% Indigenous). Main outcome measures A decrease in prevalence of scabies, infected scabies and non‐scabies pyoderma over seven months. Results The number of children aged 5 years and under screened intially and at the three follow‐up screenings ranged from 201 to 242 (more than 98% of those eligible on each occasion). The prevalences of scabies, infected scabies and non‐scabies pyoderma before intervention were 35%, 12% and 11%, respectively. At 6 weeks postintervention these had decreased to 3%, 1 % and 4%, respectively; low prevalences were maintained at four and seven months. Conclusions This intervention, which was based on community motivation, involvement and control, successfully reduced the prevalence of scabies. Continuing community health education and regular screening will be crucial in controlling scabies. The methods and results of this study may be helpful in developing a coordinated program for all remote Aboriginal communities in the area.

High Burden of Impetigo and Scabies in a Tropical Country

“…Whilst mass drug treatment with scabicides can produce short-term reduction in scabies disease burden [29], most experts believe that a sustained reduction requires an integrated approach that includes the following elements: public health education, improved case management, improved drug supply and potentially improvements in personal hygiene practices [18],[30]. Intervention studies in the Pacific region aimed solely at scabies control have been shown to achieve their aim of controlling scabies with a flow-on effect on scabies-associated impetigo, but they have had less effect on non-scabies impetigo [10],[31]. The finding of a large burden of impetigo independent of scabies in school-aged children in our study suggests that the case may be the same in Fiji [9],[11].…”

Community Management of Endemic Scabies in Remote Aboriginal Communities of Northern Australia: Low Treatment Uptake and High Ongoing Acquisition

“…Substantial reductions in the prevalence of scabies in endemic settings have previously been described with mass community treatment using oral ivermectin [17] and topical permethrin [18],[19]. However, sustainability has been difficult to achieve [2],[12], particularly where there is high mobility between communities and households.…”

Increased transcription of Glutathione S-transferases in acaricide exposed scabies mites

“…In addition to the pathology directly attributable to scabies, it is a major initiating factor for streptococcal pyoderma, which in term is linked to renal and heart disease [1]. This association has led to concerted efforts to reduce prevalence of scabies and subsequent skin infections in settings where infestation is endemic, with studies demonstrating a link between scabies control and reduced incidence of post-streptococcal sequelae [2,3]. …”