Health-related quality of life impact of scabies in the Solomon Islands.

Susanna J Lake,Oliver Sokana,Andrew C Steer,Titus Nasi,Natalie Carvalho,Dickson Boara,Michael Marks,John M Kaldor,Daniel Engelman,Margot J Whitfeld,Lucia Romani

doi:10.1093/trstmh/trab096

Abstract

BackgroundScabies causes intense itching and skin lesions. A small number of studies have shown that scabies impacts health-related quality of life (HRQoL), but no studies have been conducted in the Pacific region. We assessed the impact of scabies on HRQoL in a high-prevalence setting using the Children's Dermatology Life Quality Index (CDLQI) and Dermatology Life Quality Index (DLQI). We also assessed the validity of these tools in a Pacific Island population.MethodsThe study was conducted in the Solomon Islands. Participants with and without skin disease were randomly selected. HRQoL indices were scored on a scale of 0–30.ResultsWe surveyed 1051 adults (91 with scabies) and 604 children (103 with scabies). Scabies had a small impact on HRQoL, with a median DLQI score of 2 (interquartile range [IQR] 0–6) and a CDLQI score of 2 (IQR 0–4). Scores increased linearly with severity. The greatest impact on QoL was due to itch, sleep disturbance and impacts on education and employment.ConclusionsScabies has a small but measurable impact on HRQoL. The DLQI and CDLQI scores were discriminated between the skin-related QoL of patients with scabies and the control group, indicating that these tools are appropriate to measure skin-related QoL in the Solomon Islands.

Highlights

Scabies is caused by an infestation with the microscopic mite Sarcoptes scabiei var. hominis
This estimate of disability-adjusted life years (DALYs) and disability weight accounted for the primary effects of scabies but did not consider the secondary effects of bacterial infection, nor mortality related to crusted scabies or bacterial complications, including invasive bacterial infections and immune-mediated diseases, or broader impacts of scabies on quality of life
The sample was largely representative of those enrolled in the Regimens of Ivermectin for Scabies Elimination (RISE) trial and the general population, there was a lower proportion of younger children and male adults compared with the RISE trial (Table 1)

Summary

Introduction

Scabies is caused by an infestation with the microscopic mite Sarcoptes scabiei var. hominis. This parasitic mite burrows into the skin and reproduces, causing intense itch and skin lesions. These lesions can become infected with bacteria, leading to impetigo, invasive bacterial infections and serious immune-mediated complications.[1] Scabies is estimated to cause 455 million annual incident cases globally, with the vast majority of cases occurring in disadvantaged populations.[2] According to the 2015 Global Burden of Disease Study, scabies was responsible for 0.21% of disability-adjusted life years (DALYs) of all 315 conditions included in the study.[3] The disability weight assigned to scabies was 0.027 on a scale of 0 (perfect health)–1 (death).[3] This estimate of DALYs and disability weight accounted for the primary effects of scabies (itch and skin lesions) but did not consider the secondary effects of bacterial infection, nor mortality related to crusted scabies or bacterial complications, including invasive bacterial infections and immune-mediated diseases, or broader impacts of scabies on quality of life. We assessed the validity of these tools in a Pacific Island population

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