Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study

Abstract

Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of scabies and impetigo, or community attitudes towards the strategy of mass drug administration that is emerging as a public health option for scabies and impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji’s Northern Division. Thematic analysis examined participants’ lived experiences of scabies and impetigo; community knowledge and perceptions about scabies and impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of scabies and impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of scabies. Scabies and impetigo were perceived as diseases affecting children, impacting on school attendance and families’ quality of sleep. Awareness of scabies and impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards mass drug administration to control scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned scabies elimination programme. Findings from this first study to document perspectives and experiences related to scabies and impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to scabies and impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of scabies transmission, and a campaign of education and community engagement prior to mass drug administration.

Health-related quality of life impact of scabies in the Solomon Islands

“… 4 Scabies may impact a person in a number of ways: the intense itch can affect sleep and concentration at school or work and the appearance of lesions and the highly infectious nature of the disease can lead to stigma. 5 Secondary complications can result in hospitalisation, cause long-term disability and may even be fatal. 1 Four previous studies have investigated health-related quality of life (HRQoL) impacts in individuals with scabies.…”

Community perceptions and acceptability of mass drug administration for the control of neglected tropical diseases in Asia-Pacific countries: A systematic scoping review of qualitative research

“…Twenty papers reported on community perceptions, and 15 papers reported on stakeholder perceptions. Regarding study design, 11 papers reported on mixed methods studies, 11 papers reported on qualitative study designs, one paper reported on a Papers reporting on studies from India [14,[40][41][42][43][44][45][46][47][48][49], Indonesia [50][51][52], Philippines [15,[53][54][55], Bangladesh [19,56], Laos [57], American Samoa [18], Papua New Guinea [58] and Fiji [25].…”

“…These included one mixed methods study and two qualitative studies in the Philippines [53][54][55]; two mixed methods studies in Bangladesh [19,56]; one qualitative study in India [49]; and one rapid ethnography in Laos [57]. One qualitative study focused on scabies in Fiji [25].…”

“…To date there has been limited insight from qualitative studies in NTD research and control efforts [23,24]. The transmission of NTDs, community attitudes towards programs that seek to control and eliminate NTDs, such as mass drug administration, and people's willingness to be treated or consume tablets are influenced by a variety of socio-cultural, religious, political, economic and environmental contexts within any given community setting [25,26]. This paper reviews published qualitative literature-documenting primary data collected from community members and stakeholders involved in the implementation of mass drug administration programs-to examine the diverse social and contextual factors influencing community perceptions on and acceptability of mass drug administration approaches to control NTDs in the Asia-Pacific region.…”

Paediatrics: how to manage scabies

“… 7 , 8 Furthermore, poor sleep, poor school engagement, social stigma and school days lost due to infestation are psychosocial implications that may be deprioritized in the context of managing the acute infestation. 9 , 10 The cost and accessibility of treatment along with primordial factors, including overcrowding, are issues in some communities. 11 Successful treatment for children with scabies requires synchronous environmental and pharmacological management.…”