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      Control Strategies for Scabies

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          Abstract

          Scabies is a neglected tropical disease of the skin, causing severe itching and stigmatizing skin lesions. Further, scabies leads to impetigo, severe bacterial infections, and post-infectious complications. Around 200 million people are affected, particularly among disadvantaged populations living in crowded conditions in tropical areas. After almost 50 years, research into scabies control has shown great promise, particularly in highly-endemic island settings, but these findings have not been widely adopted. Newer approaches, utilizing ivermectin-based mass drug administration, appear feasible and highly effective. Inclusion of scabies in the WHO portfolio of neglected tropical diseases in 2017 may facilitate renewed opportunities and momentum toward global control. However, further operational research is needed to develop evidence-based strategies for control in a range of settings, and monitor their impact. Several enabling factors are required for successful implementation, including availability of affordable drug supply. Integration with existing health programs may provide a cost-effective approach to control.

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          Prevalence of scabies and impetigo worldwide: a systematic review.

          Lucia Romani, Andrew Steer, Margot Whitfeld … (2015)
          Scabies is a skin disease that, through secondary bacterial skin infection (impetigo), can lead to serious complications such as septicaemia, renal disease, and rheumatic heart disease. Yet the worldwide prevalence of scabies is uncertain. We undertook a systematic review, searching several databases and the grey literature, for population-based studies that reported on the prevalence of scabies and impetigo in a community setting. All included studies were assessed for quality. 2409 articles were identified and 48 studies were included. Data were available for all regions except North America. The prevalence of scabies ranged from 0·2% to 71·4%. All regions except for Europe and the Middle East included populations with a prevalence greater than 10%. Overall, scabies prevalence was highest in the Pacific and Latin American regions, and was substantially higher in children than in adolescents and adults. Impetigo was common, particularly in children, with the highest prevalence in Australian Aboriginal communities (49·0%). Comprehensive scabies control strategies are urgently needed, such as a community-based mass drug administration approach, along with a more systematic approach to the monitoring of disease burden.
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            Efficacy, Safety, and Pharmacokinetics of Coadministered Diethylcarbamazine, Albendazole, and Ivermectin for Treatment of Bancroftian Filariasis.

            Edward Thomsen, Nelly Sanuku, Manasseh Baea … (2016)
            Available treatments for lymphatic filariasis (LF) are limited in their longterm clearance of microfilaria from the blood. The safety and efficacy of a single-dose triple-drug therapy of the antifilarial drugs diethylcarbamazine (DEC), ivermectin (IVM), and albendazole (ALB) for LF are unknown.
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              Problems in diagnosing scabies, a global disease in human and animal populations.

              Shelley Walton, Bart Currie (2007)
              Scabies is a worldwide disease and a major public health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia, prevalences of up to 50% among children have been described, despite the availability of effective chemotherapy. Sarcoptic mange is also an important veterinary disease engendering significant morbidity and mortality in wild, domestic, and farmed animals. Scabies is caused by the ectoparasitic mite Sarcoptes scabiei burrowing into the host epidermis. Clinical symptoms include intensely itchy lesions that often are a precursor to secondary bacterial pyoderma, septicemia, and, in humans, poststreptococcal glomerulonephritis. Although diagnosed scabies cases can be successfully treated, the rash of the primary infestation takes 4 to 6 weeks to develop, and thus, transmission to others often occurs prior to therapy. In humans, the symptoms of scabies infestations can mimic other dermatological skin diseases, and traditional tests to diagnose scabies are less than 50% accurate. To aid early identification of disease and thus treatment, a simple, cheap, sensitive, and specific test for routine diagnosis of active scabies is essential. Recent developments leading to the expression and purification of S. scabiei recombinant antigens have identified a number of molecules with diagnostic potential, and current studies include the investigation and assessment of the accuracy of these recombinant proteins in identifying antibodies in individuals with active scabies and in differentiating those with past exposure. Early identification of disease will enable selective treatment of those affected, reduce transmission and the requirement for mass treatment, limit the potential for escalating mite resistance, and provide another means of controlling scabies in populations in areas of endemicity.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Trop Med Infect Dis
                Journal ID (iso-abbrev): Trop Med Infect Dis
                Journal ID (publisher-id): tropicalmed
                Title: Tropical Medicine and Infectious Disease
                Publisher: MDPI
                ISSN (Electronic): 2414-6366
                Publication date (Electronic): 05 September 2018
                Publication date Collection: September 2018
                Volume: 3
                Issue: 3
                Electronic Location Identifier: 98
                Affiliations
                [1 ]Tropical Diseases, Murdoch Children’s Research Institute, Parkville VIC 3052, Australia; Andrew.Steer@ 123456rch.org.au
                [2 ]Department of Paediatrics, University of Melbourne, Parkville VIC 3052, Australia
                [3 ]Department of General Medicine, Royal Children’s Hospital, Parkville VIC 3052, Australia
                [4 ]International Alliance for the Control of Scabies, Parkville VIC 3052, Australia
                Author notes
                [* ]Correspondence: Daniel.Engelman@ 123456rch.org.au ; Tel.: +613-9345-5522
                Author information
                https://orcid.org/0000-0002-4909-1287
                Article
                Publisher ID: tropicalmed-03-00098
                DOI: 10.3390/tropicalmed3030098
                PMC ID: 6160909
                PubMed ID: 30274494
                SO-VID: f7124b81-f903-4d4d-bfc7-c50927e36e41
                Copyright © © 2018 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 12 August 2018
                Date accepted : 03 September 2018
                Categories
                Subject: Review

                Keywords: scabies,neglected tropical diseases,impetigo,mass drug administration,ivermectin
                Data availability:
                Keywords: scabies, neglected tropical diseases, impetigo, mass drug administration, ivermectin

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