Risk factors for scabies, tungiasis, and tinea infections among schoolchildren in southern Ethiopia: A cross-sectional Bayesian multilevel model

Abstract

Background Skin problems cause significant sickness in communities with poor living conditions, but they have received less attention in national or global health studies because of their low mortality rates. In many developing regions, the prevalence of parasitic skin diseases among schoolchildren is not reported. Previous studies thus have attempted to identify risk factors for these conditions using the frequentist approach. This study aimed to assess the occurrence and risk factors of skin infections among rural schoolchildren in southern Ethiopia by combining a frequentist and a Bayesian approach. Methodology/Principal findings Using three-stage random sampling, we assessed 864 schoolchildren aged 7–14 years from the Wonago district in southern Ethiopia. We detected potential risk factors for scabies, tungiasis, and tinea infections and recorded their hygienic practices and socio-demographic information. The frequentist model revealed a clustering effect of 8.8% at the classroom level and an insignificant effect at the school level. The Bayesian model revealed a clustering effect of 16% at the classroom level and 5.3% at the school level. Almost three-fourths of the sample had at least one type of skin problem, and boys were at higher overall risk than girls (adjusted odds ratio [aOR] 1.55 [95% Bayesian credible interval [BCI] 1.01, 2.28). Risk factors included unclean fingernails (aOR 1.85 [95% BCI 1.08, 2.97]); not washing the body (aOR 1.90 [95% BCI 1.21, 2.85]) and hair (aOR 3.07 [95% BCI 1.98, 4.57]) with soap every week; sharing a bed (aOR 1.97 [95% BCI 1.27, 2.89]), clothes (aOR 5.65 [95% BCI 3.31, 9.21]), or combs (aOR 3.65 [95% BCI 2.28, 5.53]); and living in a poor household (aOR 1.76 [95% BCI 1.03, 2.83]). Washing legs and feet with soap daily was identified as a protective factor for each of the three skin diseases (aOR 0.23 [95% BCI 0.15, 0.33]). Conclusions/Significance We observed high variation in skin problems at the classroom level, indicating the presence of shared risk factors in these locations. The findings suggest the need to improve children’s personal hygiene via health education by schoolteachers and health workers.

A rapid assessment method to estimate the prevalence of ectoparasitoses in Brazil: tungiasis and scabies as case studies

“…It is one of the most common skin diseases and a public health problem in many resource-poor communities; hundreds of millions of people are affected worldwide [23] . Scabies and tungiasis are characterized by seasonal fluctuations of occurrence and severity, with peaks in the cold (scabies) and hot/dry seasons (tungiasis) [1] .…”

“…Ectoparasitoses such as tungiasis, scabies, and pediculosis are distributed worldwide but are neglected by the scientific community and health professionals [1] . Typically, ectoparasitoses occur in resource-poor communities with poor living conditions [2] , and prevalences may be particularly high in vulnerable groups [3] .…”

Personal Hygiene as Scabies Factors Incidence in the Institute Rehabilitation Center of the Vagrants, Scrounger and Mental Disabilities in South Sumatra Region

“…Scabies is an infectious skin disease resulting from infestation by a mite. The mite responsible for scabies is named Sarcoptes scabiei Var Hominis (1). It is a parasite of the family Sarcoptidae, class Arachnida, which infests the skin.…”

Living in a large family and low daily water consumption substantially expose for human scabies in rural Ethiopia: a matched analysis

“…Scabies is a critical public health concern where there is societal breakdown, congestion, and poor domestic and personal hygiene. It is typically transmitted by prolonged skin contact with a mite-infested person or seldom by sharing infested personal entities, and zoonotic transmission does not occur [ 8 – 11 ]. Scabies transmission increases in high population density circumstances; a proxy of high endemicity in poorest communities resulted from crowded housing and was observed at outbreaks in institutions, such as prisons, aged care facilities, schools, hospitals and refugee camps [ 12 , 13 ].…”

“…In prior studies, illiteracy [ 9 , 10 , 14 – 17 ], large family [ 3 ], low socioeconomic status [ 8 , 9 , 17 , 18 ], overcrowding [ 9 , 16 , 18 , 19 ], inadequate hygiene [ 8 , 14 , 16 ], sharing fomites [ 3 , 8 – 10 , 15 ], absence of healthcare service [ 20 , 21 ], environmental sanitation [ 8 , 11 , 22 – 24 ], and dementia [ 13 ] were identified as underlying factors for scabies infestation.…”