(SYDNEY, AUSTRALIA (16 June 2015) Released today, the first ever review of the prevalence of scabies and impetigo worldwide shows clearly where the hotspots and gaps are for these debilitating infectious diseases.
According to a systematic review from the Kirby Institute at UNSW Australia and other collaborators, published today in The Lancet Infectious Diseases, these often neglected diseases disproportionately affect children, with the highest rates so far reported from surveys in Panama (78% prevalence among children under two), Fiji (43% prevalence among children aged 5-9) and two remote Australian Aboriginal communities where the scabies prevalence among children was 35% and 32%.
“The data compiled in this review represents what is likely to be the tip of the iceberg for scabies and impetigo prevalence worldwide” says study author Lucia Romani from the Kirby Institute. “This review has revealed a number of gaps in prevalence data, for instance in Central America, where only two countries had data we were able to analyse. In undertaking this global review we wanted to create a picture of the global prevalence of scabies, as well as highlight countries or regions where data is missing, in order to prompt further study into prevalence and prevention of scabies worldwide.”
In 2013 the World Health Organization added scabies to the list of neglected tropical diseases. Scabies is a skin disease caused by a tiny mite that burrows under the skin and is transmitted through close personal contact. It can cause debilitating itching, leading to scratching, which often leads to bacterial infections of the skin, most commonly impetigo, as bacteria gain access via broken skin. These skin infections can develop into more serious and potentially deadly infections of the kidney, the heart and blood. The impetigo rates were highest (45%) in the studies of children from remote Aboriginal communities.
The systematic review analysed findings from 48 surveys, almost all from developing countries, particularly in the Pacific, Latin America and Africa.
“Scabies and impetigo have never been accorded priority in health programs and research, despite regular reports of high prevalence and impact. Perhaps this is because their impact is spread across a broad range of disciplines including dermatology, infectious disease and paediatrics,” says Romani. “This review shows us that while the global prevalence of scabies varies greatly by region, there are pockets of the population all over the world that are disproportionally affected by the disease. In many cases, like in island countries in the Pacific, the disease is considered endemic”.
The study was conducted with the support of the National Health and Medical Research Council and undertaken in collaboration with the Murdoch Childrens Research Institute.
The investigators, along with the Fiji Ministry of Health and other partners, are currently involved in research in Fiji that is looking into the efficacy of mass drug administration to control scabies and its health complications. The results of this trial are expected to be published later this year.
The Kirby Institute, UNSW Australia
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