The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines

White, Lucy; Lanza, Stefania; Middleton, Jo; Hewitt, Kirsty; Freire-Moran, L.; Edge, Chantal; Nicholls, M; Rajan-Iyer, J; Cassell, Jackie A

doi:10.1017/s0950268816001746

Cited by 25 publications

(39 citation statements)

References 27 publications

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“…These outbreaks are typically challenging to identify and manage, leading to lengthy delays in confirmation and control as well as substantial cost. [70][71][72][73] Changes in social demography, particularly aging, mean that these outbreaks may become more common, and the development of appropriate public health strategies is therefore warranted.…”

Section: Epidemiology and Mappingmentioning

confidence: 99%

The public health control of scabies: priorities for research and action

et al. 2019

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Scabies is a parasitic disease of the skin that disproportionately affects disadvantaged populations. Scabies causes considerable morbidity and leads to severe bacterial infection and immune-mediated disease. Recent scientific advances suggest that scabies is amenable to population-level control, particularly through mass drug administration. In recognition of these issues, WHO added scabies to the list of neglected tropical diseases (NTDs) in 2017. In order to develop a global control program, key operational research questions must now be addressed. Standardised approaches to diagnosis and methods for mapping are required to further understand the burden of disease. The safety of treatments for young children, including with ivermectin and moxidectin, should be investigated. Studies are needed to inform optimum implementation of mass treatment, including the threshold for intervention, target, dosing, and frequency. Frameworks for surveillance, monitoring and evaluation of control strategies are also necessary.

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Section: Epidemiology and Mappingmentioning

confidence: 99%

The public health control of scabies: priorities for research and action

et al. 2019

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“…Whilst there are no UK national guidelines on scabies outbreaks in RNC [17], NICE guidelines for other cases of scabies infestation recommend simultaneously treating all household and close contacts [19]. Despite this advice, a recent systematic review by Fitzgerald et al .…”

Section: Discussionmentioning

confidence: 99%

“…The control of outbreaks in RNC is time-consuming and cost-intensive, requiring mass treatment of infected cases and contacts. It is complicated by issues including atypical presentation, close proximity of residents, carers and visitors, mental capacity issues, financial responsibility for treatment and logistical barriers of mass treatment [15, 17, 18]. Here we focus on outbreaks in RNCs only.…”

Section: Introductionmentioning

confidence: 99%

Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality

et al. 2019

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Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.

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“…The management of scabies outbreaks requires considerable resources and a high workload, and having appropriate evidence‐based guidelines in place is an essential step for successful containment. The financial cost of a recent outbreak in a Netherlands hospital was 9724 EU for medication and equipment, plus an estimated 40 000 EU for direct extra costs including personnel.…”

Section: Commentmentioning

confidence: 99%

“…to delayed recognition and diagnosis of an individual with crusted sca- guidelines in place is an essential step for successful containment 41 .…”

Section: Scabies Outbreaks In Healthcare Institutions Most Often Occumentioning

confidence: 99%

Scabies-An ancient itch that is still rampant today

et al. 2017

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The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines

Abstract: (2016) The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines. Epidemiology and Infection, 144 (15).

Cited by 25 publications

References 27 publications

The public health control of scabies: priorities for research and action

The public health control of scabies: priorities for research and action

Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality

Scabies-An ancient itch that is still rampant today

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