A scabies outbreak in the North East Region of Ghana: The necessity for prompt intervention

Abstract

Background There is a dearth of data on scabies from Ghana. In September 2019, local health authorities in the East Mamprusi district of northern Ghana received reports of scabies from many parts of the district. Due to on-going reports of more cases, an assessment team visited the communities to assess the effect of the earlier individual treatment on the outbreak. The assessment team furthermore aimed to contribute to the data on scabies burden in Ghana and to demonstrate the use of the International Alliance for the Control of Scabies (IACS) diagnostic tool in a field survey in a resource limited setting. Methodology/Principal findings This was a cross sectional study. Demographic information and medical history was collected on all participants using a REDCap questionnaire. A standardised skin examination of exposed regions of the body was performed on all participants. Scabies was diagnosed based on the criteria of the International Alliance for the Control of Scabies (IACS). Participants were mostly female (61.5%) and had a median age of 18.8 years (IQR 13–25). Two hundred out of 283 (71%) of participants had scabies with most (47%) presenting with moderate disease. Impetigo was found in 22% of participants with scabies and 10.8% of those without scabies [RR 2.27 (95% CI 1.21–4.27)]. 119 participants who received scabies treatment in the past months still had clinical evidence of the disease. 97% of participants reported a recent scabies contact. Scabies was commoner in participants ≤16 years compared to those >16 years [RR 3.06 (95% CI 1.73–5.45)]. Conclusion/Significance The prevalence of scabies was extremely high. The lack of a systematic approach to scabies treatment led to recurrence and ongoing community spread. The IACS criteria was useful in this outbreak assessment in Ghana. Alternative strategies such as Mass drug administration may be required to contain outbreaks early in such settings.

Prevalence of Scabies Cases in Two Public Hospitals Aden / Yemen

“…This finding is aligned with the results of studies done previously in Ethiopia, Iraq and Egypt with a prevalence of 2.5%, 3.3%, and 7% respectively [15][16][17]. However, it is lower than studies from Pakistan (38.15%), (47.6%, Nigeria (65.0%), and Ghana (71%) [18][19][20]. The difference in prevalence rates could be attributed to the density of population, might be attributed to family size variation, educational status variation, and might also be related to variation in sociodemographic.…”

Prevalence of scabies and associated factors among children aged 5–14 years in Meta Robi District, Ethiopia

“…This study showed more than half of scabies diagnosed were moderate in severity which is harmonious with the findings from the Solomon Islands [ 29 ]. However, studies undertaken in Ghana and Liberia among the general population and in northern Ethiopia among school-aged children reported severe scabies among high proportions of study participants [ 17 , 40 , 41 ]. The severity of scabies infestation is directly related to the number of mites found on the skin and the lengthy of time between initial infestation and subsequent diagnosis and treatment [ 20 , 28 ].…”

“…Also, low monthly family income was among the identified factors affecting scabies in children aged 5-14 years. Scabies more commonly affects disadvantaged populations, including PLOS ONE poverty, household crowding, and poor access to healthcare [1,40]. Low-incomes expose families to scabies in two dimensions.…”

Beliefs, attitudes and practices towards scabies in central Ghana

“…It is common among persons living in poor and overcrowded communities but is also a common condition among patients presenting to hospital with dermatologic conditions in resource poor settings [2,3]. Scabies has also been reported among prisoners, preschool children [4] and within communities of Africa [5][6][7]. The greatest burden of scabies is in low-and middle-income countries where overcrowding and inadequate access to effective treatment serve as drivers of disease transmission.…”