A facility and community-based assessment of scabies in rural Malawi.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Cristina Galván-Casas, Oriol Mitjá, Sara Esteban, Jacob Kafulafula, Texon Phiri, Íñigo Navarro-Fernández, Concepción Román-Curto, Hassani Mtenje, Gerald Thauzeni, Elizabeth Harawa, Stephano Kaluzi, Mphatso Diere, Mary Mkandawire, Shaibu Malizani, Alex Chifundo, Marta Utrera-Busquets, Mónica Roncero-Riesco, Sara López Martín-Prieto, Iosune Vilanova-Urdániz, Gisela H Petiti, María Victoria de Gálvez Aranda, Nuria No Pérez, María Rueda Gómez-Calcerrada, Pilar Iranzo, Pilar Escalonilla García-Patos, Magdalena de Troya-Martín, Javier Romero Gomez, Esther Cardeñoso-Alvarez, Sofia Lucas Truyols, Libe Aspe Unanue, Cristina Bajo Del Pozo, Alicia Comunión Artieda, Maria Isabel Martínez González, Omar F López-López, Esther Moreno-Artero, Xavier Cubiró, Iago Meilán-Sánchez, Alejandra Tomás-Velázquez, Cristina López-Sánchez, Eva M Sánchez-Martínez, Harrison A Edwards, Maria Herrera Morueco, Julia Zehe Rubiera, Laura Salguero Caldera, Urbano Blanes-Moreno, Maria Uribarren-Movilla, Michael Marks
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2021
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.1371/journal.pntd.0009386; https://doaj.org/article/9cb5eb957546416c8fec0071e684ff5e

Background Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. Methodology/principal findings From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. Conclusions/significance Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control.