Prevention of bacterial complications of scabies using mass drug administration: A population-based, before-after trial in Fiji, 2018–2020

Thean, Li Jun; Romani, Lucia; Engelman, Daniel; Wand, Handan; Jenney, Adam; Mani, Jyotishna; Paka, Jessica; Cua, Tuliana; Taole, Sera; Silai, Maciu; Ashwini, Komal; Sahukhan, Aalisha; Kama, Mike; Tuicakau, Meciusela; Kado, Joseph; Parnaby, Matthew; Carvalho, Natalie; Whitfeld, Margot; Kaldor, John; Steer, Andrew C.

doi:10.1016/j.lanwpc.2022.100433

Cited by 8 publications

(11 citation statements)

References 31 publications

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“…If parents selected more than one ethnicity, we determined a ‘prioritised’ ethnicity for analysis, consistent with standard practice in the New Zealand health sector 7 …”

Section: Methodsmentioning

confidence: 99%

“…A general practitioner conducted the screening procedures after training and testing from an experienced Paediatrician (DE), with expertise in the diagnosis of scabies. Training was based on programmes used in several previous studies 7–9 . Skin lesions were classified by appearance as either typical scabies, atypical for scabies or inconsistent with scabies, according to global consensus definitions (2020 IACS criteria) 10 .…”

Section: Methodsmentioning

confidence: 99%

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

Thornley,

Sundborn,

Engelman

et al. 2023

J Paediatrics Child Health

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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.

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“…If parents selected more than one ethnicity, we determined a ‘prioritised’ ethnicity for analysis, consistent with standard practice in the New Zealand health sector 7 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Thornley,

Sundborn,

Engelman

et al. 2023

J Paediatrics Child Health

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“…Although the population of LIP has access to high-quality healthcare, the scabies IR remained relatively stable in the province over the study period. This finding suggests that more drastic public health measures are needed to reduce the burden of scabies and associated SSTIs in LIP [30][31][32]. According to a recent WHO framework for scabies control [33,34], ivermectin-based mass drug administration (MDA) should be initiated in areas with a community prevalence �10% or a prevalence in school children � 15% (as measured using a school mapping strategy) and should be avoided in those with a community prevalence <2%.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Scabies incidence and association with skin and soft tissue infection in Loyalty Islands Province, New Caledonia: A 15-year retrospective observational study using electronic health records

Ducrot¹,

Bruno²,

Franco³

et al. 2022

PLoS Negl Trop Dis

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Background Scabies and its complications are a public health problem in the low- and middle-income countries of the Western Pacific region. However, no data are available for the relatively wealthy French territory of New Caledonia. This study aimed to determine the incidence of scabies and its association with skin and soft tissue infection (SSTI) in Loyalty Islands Province (LIP) (20,000 inhabitants), New Caledonia. Methodology/Principal findings This retrospective observational study reviewed cases of scabies and SSTI extracted from the electronic health record databases of LIP clinics for the period 2004–2018. Data were validated through double sampling. The overall scabies incidence rate (IR) and scabies IRs by sex and age group were calculated. Scabies seasonality was evaluated. For children <5 years, the presence of SSTI was compared between the 3-month period preceding scabies diagnosis/treatment and the 3-month period preceding the 1-year anniversary of scabies diagnosis/treatment (self-matching). A total of 16,843 scabies cases were extracted using a detection algorithm with a sensitivity of 96.7% and a specificity of 99.9%. From 2004 to 2018, the average overall scabies IR was 5.9% and the average scabies IR in children <1 year was 18.4%. Almost two-thirds of children aged 14 years had a history of scabies. Females were more affected, especially in the 20–39 age group (sex ratio>2). A strong seasonality was observed, with a 30% increase in winter. In children <5 years, SSTIs were 4.3 times more frequent in the 3 months preceding the scabies diagnosis than in the 3 months preceding the 1-year anniversary of scabies treatment (p<0.001). Conclusions Although health care is much better in New Caledonia than in neighboring countries, scabies is highly endemic in LIP. The disease is especially common in children <2 years and is associated with many SSTIs in children <5 years. Mass drug administration should be considered.

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“…These are major health burdens in the global south, with sequelae including glomerulonephritis, rheumatic fever and chronic kidney disease. 1 , 2 , 3 In a major step forward Li Jun Thean and colleagues 4 report in The Lancet Regional Health Western Pacific on the impact on skin infections of an oral ivermectin MDA targeting scabies in Fiji. Importantly, they show in the largest before-after trial of its kind that not only did scabies and impetigo prevalence reduce, but so too did hospitalisations with severe skin and soft tissue infections and attendance at primary care with scabies and skin infections.…”

mentioning

confidence: 99%

“…Against this regional and global background Thean and colleagues 4 report a 2018–2020 before-after MDA trial covering Fiji's Northern Division: first dose, 135,744 people (97% coverage); second dose, 121,760 people (87%). The prior MDA in Fiji had 716 participants enrolled in the ivermectin arm, 14 in the Solomon Islands 26,188.…”

mentioning

confidence: 99%

Can ivermectin mass drug administrations to control scabies also reduce skin and soft tissue infections? Hospitalizations and primary care presentations lower after a large-scale trial in Fiji

Middleton

2022

The Lancet Regional Health - Western Pacific

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Prevention of bacterial complications of scabies using mass drug administration: A population-based, before-after trial in Fiji, 2018–2020

Cited by 8 publications

References 31 publications

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

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

Scabies incidence and association with skin and soft tissue infection in Loyalty Islands Province, New Caledonia: A 15-year retrospective observational study using electronic health records

Can ivermectin mass drug administrations to control scabies also reduce skin and soft tissue infections? Hospitalizations and primary care presentations lower after a large-scale trial in Fiji

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