The Epidemiology of Scabies and Impetigo in Relation to Demographic and Residential Characteristics: Baseline Findings from the Skin Health Intervention Fiji Trial

Abstract

Scabies and associated impetigo are under-recognized causes of morbidity in many developing countries. To strengthen the evidence base for scabies control we undertook a trial of mass treatment for scabies. We report on the occurrence and predictors of scabies and impetigo in participants at baseline. Participants were recruited in six island communities and were examined for the presence of scabies and impetigo. In addition to descriptive analyses, logistic regression models were fit to assess the association between demographic variables and outcome of interest. The study enrolled 2051 participants. Scabies prevalence was 36.4% (95% confidence interval [CI] 34.3-38.5), highest in children 5-9 years (55.7%). Impetigo prevalence was 23.4% (95% CI 21.5-25.2) highest in children aged 10-14 (39.0%). People with scabies were 2.8× more likely to have impetigo. The population attributable risk of scabies as a cause of impetigo was 36.3% and 71.0% in children aged less than five years. Households with four or more people sharing the same room were more likely to have scabies and impetigo (odds ratios [OR] 1.6, 95% CI 1.2-2.2 and OR 2.3, 95% CI 1.6-3.2 respectively) compared to households with rooms occupied by a single individual. This study confirms the high burden of scabies and impetigo in Fiji and the association between these two conditions, particularly in young children. Overcrowding, young age, and clinical distribution of lesion are important risk factors for scabies and impetigo. Further studies are needed to investigate whether the decline of endemic scabies would translate into a definite reduction of the burden of associated complications.

Skin bacterial colonizations and superinfections in immunocompetent patients with scabies

“…In the last study, it was observed that people with scabies were 2.8 times more likely to develop impetigo. Households with four or more people sharing the same room were more likely to develop scabies and impetigo compared to households with rooms occupied by a single individual . In Indigenous communities in Northern Australia, the prevalence of superinfected scabies in children aged less than 5 years was 12% .…”

“…In an Indian study, secondary pyoderma was detected in 42.8% of children with scabies . Three studies were carried out in Fiji Islands . The first one showed that impetigo was more common in Indigenous Fijian children when compared with children of other ethnicities .…”

“…Islands. [3][4][5] The first one showed that impetigo was more common in Indigenous Fijian children when compared with children of other ethnicities. 3 In the second study, the prevalence of impetigo in patients with scabies was 19.6%, with a peak of 34.2% in children aged 5-9 years.…”

“…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

“…Scabies is one of the most important skin diseases worldwide particularly in developing countries, caused by mite Sarcoptes scabiei [1,2]. Sexually transmitted is the main way of infection and is a common between family members [3].…”