Rate and factors for scabies recurrence in children in Saudi Arabia: a retrospective study

Abstract

Background Despite the fact that several scabies outbreaks emerged in schools in Saudi Arabia in 2018, no study has investigated the risk of scabies recurrence among children in Saudi Arabia. This study aimed to estimate the rate of scabies recurrence and identify factors that were associated with an increased risk of recurrence among children. Methods This is a multi-center retrospective study of children (age < 14 years) who were diagnosed between May 20, 2015 and September 12, 2018 with one or multiple recurrent scabies at the Ministry of National Guard Health Affairs (MNGHA) hospitals and clinics in Saudi Arabia. Data were obtained from an electronic health system, BestCare database. Results A sample of 264 children analyzed (mean age of 6.7 years) resulted in a cumulative number of 316 scabies diagnoses in which 86 (27.2%) experienced scabies recurrence (at least once). Independent factors associated with a high risk of scabies recurrence: older children (adjusted hazard ratio [aHR], 1.036; 95% CI, 1.002–1.072; P = 0.039), female gender (aHR, 1.734; 95% CI, 1.329–2.262; P = 0.001), Western region of Saudi Arabia (aHR, 1.548; 95% CI, 1.115–2.151; P = 0.009), and 2nd tertile season [May to August] (aHR, 2.368; 95% CI, 1.706–3.288; P = 0.001). Conclusions The study demonstrated that the recurrence rate of scabies among children is high. Older children, the female gender, the Western region of Saudi Arabia, and the seasonality were independently associated with an increased risk of scabies recurrence. High temperature and low humidity should be explored as leading factors for scabies infestations in Saudi Arabia. Findings derived from this study may be useful for clinicians and governments in optimizing clinical management of scabies cases and contacts.

Climate factors and incidence of Middle East respiratory syndrome coronavirus

“…This is similar to previous reports where MERS-CoV cases increased with low humidity [9,[11][12][13]. Our findings may clarify viral seasonality, as it explains why most MERS-CoV outbreaks occurred between April and August, where temperatures reached the highest and humidity reached the lowest [14]. This timing may facilitate an optimal environment for the virus to survive and transmit.…”

Assessing knowledge of scabies among physicians working in primary health care setting

“…[ 18 26 ] Therefore, the inadequate knowledge observed in the current study may have contributed to some degree to the recent scabies outbreaks reported in Saudi Arabia. [ 14 15 ]…”

“…In the last few years, there has been an increase in the number of cases diagnosed with scabies in Saudi Arabia. [ 14 15 ] Actually, outbreaks have been documented in 2018 among school children in the Western and Central regions. [ 14 15 ] As the primary care system is considered the frontline in managing such outbreaks,[ 16 ] there has been international concern about the awareness of primary care physicians about scabies.…”

Recurrence rate of scabies in patients 14 years or older in Saudi Arabia

“…Saudi Med J 2019; Vol. 40 (12) www.smj.org.sa W orldwide, it has been estimated that 300 million cases of scabies occur annually. 1 Scabies can be transmitted by direct contact with the person's skin, or indirectly by sharing clothes, towels, bedding, and others objects used by an infected person.…”

“…More description of the methods can be found in our previous report on children. 12 We defined the study outcome to be the number of scabies recurrences after an initial diagnosis during the study period. The number of scabies recurrences was found to be clustered (from 0 to 7), where "0" indicates a single diagnosis or no recurrence, and 1 to 7 indicate the number of recurrences.…”