Exploration of a simplified clinical examination for scabies to support public health decision-making.
Introduction In most settings, the diagnosis of scabies is reliant on time-consuming and potentially intrusive clinical examination of all accesible regions of skin. With the recent recognition of scabies as a neglected tropical disease by the World Health Organization there is a need for standardis...
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ftdoajarticles:oai:doaj.org/article:5d1d087a079e4263822a13f4e6a961aa 2023-05-15T15:16:01+02:00 Exploration of a simplified clinical examination for scabies to support public health decision-making. Michael Marks Daniel Engelman Lucia Romani Daniel Mason Oliver Sokana Mike Kama Margot Whitfeld Andrew C Steer John Kaldor 2018-12-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006996 https://doaj.org/article/5d1d087a079e4263822a13f4e6a961aa EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0006996 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006996 https://doaj.org/article/5d1d087a079e4263822a13f4e6a961aa PLoS Neglected Tropical Diseases, Vol 12, Iss 12, p e0006996 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006996 2022-12-31T09:15:21Z Introduction In most settings, the diagnosis of scabies is reliant on time-consuming and potentially intrusive clinical examination of all accesible regions of skin. With the recent recognition of scabies as a neglected tropical disease by the World Health Organization there is a need for standardised approaches to disease mapping to define populations likely to benefit from intervention, and to measure the impact of interventions. Development and validation of simplified approaches to diagnose scabies would facilitate these efforts. Methods We utilised data from three population-based surveys of scabies. We classified each individual as having scabies absent or present overall, based on whole body assessment, and in each of 9 regions of the body. We calculated the sensitivity of diagnosing the presence of scabies based on each individual body region compared to the reference standard based on whole body examination and identified combinations of regions which provided greater than 90% sensitivity. We assessed the sensitivity according to gender, age group, severity of scabies and the presence or absence of impetigo. Results We included 1,373 individuals with scabies. The body regions with highest yield were the hands (sensitivity compared to whole body examination 51.2%), feet (49.7%), and lower legs (48.3%). Examination of the exposed components of both limbs provided a sensitivity of 93.2% (95% CI 91.2-94.4%). The sensitivity of this more limited examination was greater than 90% regardless of scabies severity or the presence or absence of secondary impetigo. Discussion We found that examination limited to hands, feet and lower legs was close to 90% for detecting scabies compared to a full body examination. A simplified and less intrusive diagnostic process for scabies will allow expansion of mapping and improved decision-making about public health interventions. Further studies in other settings are needed to prospectively validate this simplified approach. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 12 e0006996 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Michael Marks Daniel Engelman Lucia Romani Daniel Mason Oliver Sokana Mike Kama Margot Whitfeld Andrew C Steer John Kaldor Exploration of a simplified clinical examination for scabies to support public health decision-making. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Introduction In most settings, the diagnosis of scabies is reliant on time-consuming and potentially intrusive clinical examination of all accesible regions of skin. With the recent recognition of scabies as a neglected tropical disease by the World Health Organization there is a need for standardised approaches to disease mapping to define populations likely to benefit from intervention, and to measure the impact of interventions. Development and validation of simplified approaches to diagnose scabies would facilitate these efforts. Methods We utilised data from three population-based surveys of scabies. We classified each individual as having scabies absent or present overall, based on whole body assessment, and in each of 9 regions of the body. We calculated the sensitivity of diagnosing the presence of scabies based on each individual body region compared to the reference standard based on whole body examination and identified combinations of regions which provided greater than 90% sensitivity. We assessed the sensitivity according to gender, age group, severity of scabies and the presence or absence of impetigo. Results We included 1,373 individuals with scabies. The body regions with highest yield were the hands (sensitivity compared to whole body examination 51.2%), feet (49.7%), and lower legs (48.3%). Examination of the exposed components of both limbs provided a sensitivity of 93.2% (95% CI 91.2-94.4%). The sensitivity of this more limited examination was greater than 90% regardless of scabies severity or the presence or absence of secondary impetigo. Discussion We found that examination limited to hands, feet and lower legs was close to 90% for detecting scabies compared to a full body examination. A simplified and less intrusive diagnostic process for scabies will allow expansion of mapping and improved decision-making about public health interventions. Further studies in other settings are needed to prospectively validate this simplified approach. |
format |
Article in Journal/Newspaper |
author |
Michael Marks Daniel Engelman Lucia Romani Daniel Mason Oliver Sokana Mike Kama Margot Whitfeld Andrew C Steer John Kaldor |
author_facet |
Michael Marks Daniel Engelman Lucia Romani Daniel Mason Oliver Sokana Mike Kama Margot Whitfeld Andrew C Steer John Kaldor |
author_sort |
Michael Marks |
title |
Exploration of a simplified clinical examination for scabies to support public health decision-making. |
title_short |
Exploration of a simplified clinical examination for scabies to support public health decision-making. |
title_full |
Exploration of a simplified clinical examination for scabies to support public health decision-making. |
title_fullStr |
Exploration of a simplified clinical examination for scabies to support public health decision-making. |
title_full_unstemmed |
Exploration of a simplified clinical examination for scabies to support public health decision-making. |
title_sort |
exploration of a simplified clinical examination for scabies to support public health decision-making. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006996 https://doaj.org/article/5d1d087a079e4263822a13f4e6a961aa |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 12, p e0006996 (2018) |
op_relation |
https://doi.org/10.1371/journal.pntd.0006996 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006996 https://doaj.org/article/5d1d087a079e4263822a13f4e6a961aa |
op_doi |
https://doi.org/10.1371/journal.pntd.0006996 |
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PLOS Neglected Tropical Diseases |
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12 |
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12 |
container_start_page |
e0006996 |
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