The Prevalence of Scabies and Impetigo in the Solomon Islands: A Population-Based Survey

Abstract

BackgroundScabies and impetigo are common, important and treatable skin conditions. Reports from several Pacific island countries show extremely high prevalence of these two conditions, but for many countries, including the Solomon Islands, there is a paucity of epidemiological data.MethodologyTen rural villages in the Western Province of the Solomon Islands were included in the study, chosen so that data collection could be integrated with an existing project investigating clinical and serological markers of yaws. All residents were eligible to participate, and 1908 people were enrolled. Participants were interviewed and examined by a paediatric registrar, who recorded relevant demographic information, and made a clinical diagnosis of scabies and/or impetigo, severity and distribution.Principal FindingsThe total unweighted prevalence of scabies was 19.2% (95% confidence interval [CI] 17.5–21.0), and age and gender weighted prevalence 19.2% (95%CI 16.7–21.9). The adult prevalence of scabies was 10.4% (95%CI 8.2–13.2), and the highest prevalence was found in infants < 1 year of age (34.1%, adjusted odds ratio [AOR] compared with adults: 3.6, 95%CI 2.2–6.0) and children aged 1–4 years (25.7%, AOR 2.6, 95%CI 1.7–3.9). Scabies affected two or more body regions in 80.9% of participants, and 4.4% of scabies cases were classified as severe. The total unweighted prevalence of active impetigo was 32.7% (95%CI 30.6–34.8), and age and gender weighted prevalence 26.7% (95%CI 24.2–29.5). The highest prevalence was found in children aged 1–4 years (42.6%, AOR compared with adults: 4.1, 95%CI 2.9–5.8). Scabies infestation was associated with active impetigo infection (AOR 2.0, 95%CI 1.6–2.6); with 41.1% of active impetigo cases also having scabies.Conclusions and SignificanceScabies and impetigo are very common in the rural Western Province of the Solomon Islands. Scabies infestation is strongly associated with impetigo. Community control strategies for scabies may reduce the burden of both conditions and their downstream complications.

Skin bacterial colonizations and superinfections in immunocompetent patients with scabies

“…In American Samoan children with scabies, 53% of them had a bacterial superinfection . In the Solomon Islands, 41.1% of patients with impetigo also had scabies . The close relationship between scabies and skin bacterial colonizations and superinfections was demonstrated by two studies which were performed in an Australian Aboriginal community and the Solomon Islands, respectively.…”

“…Skin bacterial colonizations and superinfections in patients with scabies are very common in some tropical and subtropical countries. Several studies have been carried out in India, 1,2 some countries of Pacific area (Fiji, [3][4][5] Australia, [6][7][8][9][10] and Solomon Islands 12,13 ), and Trinidad. 14 However, only very rare epidemiologic-bacteriologic studies have been performed in immunocompetent patients with scabies living in Western countries.…”

Epidemiological study of patients infected with scabies caused by Sarcoptes scabiei in Al-Najaf Governorate, Iraq

“…These results are in agreement with Nair et al [8] that they are proved there were 52 patients (50.98%) were males and 50 patients (49.01%) were females in Gujarat, India. Also, Mason et al [7] demonstrated that out of total 515870 patients infected with scabies in Solomon Islands there were 51.3% males and 48.7% females. In Iraq, in Tikrit Governorate in 2009, Alsamarai [16] proved that out of total 11194 patients infected with scabies there were 13.5% and 8.6% were male and female, respectively.…”

“…Patients infected with scabies suffer from skin redness and severe itching in different body parts such as arms, legs and between the thighs [4,5]. Most patients infected with this disease are lived in rural areas without health care and without health awareness [6][7][8]. About more than 100 million patients infected with scabies worldwide [9,10].…”

A Review of Scabies: An Infestation More than Skin Deep

“…Opportunities for integration range from diagnosis and surveillance to mass drug administration and morbidity management. These activities have already been successfully combined with existing programmes for trachoma and yaws in the Solomon Islands for the purpose of coordinating mass treatment studies [91]. Initiatives to support the provision of oral ivermectin for scabies are needed in low-resource settings, in the way that the Mectizan Donation Program provides for onchocerciasis and lymphatic filariasis.…”