Abstract
After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA). In May 2017, we collected data to assess the impact of the treatment on the scabies control. We retrieved baseline data from the 2015/16 burden assessment: campaign organization and administration information. We did a community based cross-sectional study using a structured questionnaire on disease and treatment history plus the presence or absence of active scabies in three Zones. We selected households using stratified random sampling deployed 7581 questionnaires and performed key informant interviews. 46.3% had a previous scabies diagnosis in the last 2 years of which 86.1% received treatment, and the cure rate was 90.6%. Fifteen months after intervention the scabies prevalence was 21.0 % (67.3% new cases and 32.7% recurrences). The highest burden of new cases (93.1%) was found in the North Gondar zone. The likelihood of treatment failure was higher for treatments offered in clinics (12.2%) as opposed to via the campaign (7.9%). Failure to follow the guidelines, shortage of medicine and lack of leadership prioritization were identified as reasons for resurgence of the disease. We demonstrated that community engagement is essential in the success of scabies MDA, alongside strong political commitment, and guideline adherence. Effectiveness and sustainability of the MDA was compromised by the failing of proper contact treatment, surveillance and case management.
Highlights
After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA)
The 2016 Global Burden of Disease (GBD) estimated that scabies causes about 3.8 million Disability-Adjusted Life-Years (DALYs), making an age adjusted morbidity burden similar to lymphoid leukemia, Haemophilus influenzaand type B meningitis [2,3,4,5,6,7]
The median time between the previous treatment and the interview was 15 months. The majority of those who received treatment got it through the MDA
Summary
After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA). In May 2017, we collected data to assess the impact of the treatment on the scabies control. We did a community based cross-sectional study using a structured questionnaire on disease and treatment history plus the presence or absence of active scabies in three Zones. Fifteen months after intervention the scabies prevalence was 21.0 % (67.3% new cases and 32.7% recurrences). Scabies is one of the world’s commonest Neglected Tropical Diseases with a global point prevalence of about 147 million and annual incidence of 455 million cases [1,2]. The 2016 Global Burden of Disease (GBD) estimated that scabies causes about 3.8 million Disability-Adjusted Life-Years (DALYs), making an age adjusted morbidity burden similar to lymphoid leukemia, Haemophilus influenzaand type B meningitis [2,3,4,5,6,7]. A range of effective topical and systemic treatments are available for scabies [9]
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