Outbreak of scabies among school pupils, Accra, Ghana, 2017

Abstract

Introduction : though ubiquitous, scabies presents a major public health threat to developing countries. Post-infective complications from secondary infections cause renal and cardiovascular morbidities. Globally, its prevalence varies from 0.3% to 46%; with an estimated 1.5 million years lived with disability. Its prevalence in Ghana is estimated at 5.1%. We report the findings of a scabies outbreak investigation among schoolchildren in Ghana that aimed at stopping the outbreak and instituting preventive measures to minimize the risk of future outbreaks. Methods : between March 14 and May 17, 2017, we conducted an outbreak investigation of scabies in Presec Staff Basic School situated in an urban community in Accra. A case was defined as a schoolchild who on clinical examination, had an intensely pruritic rash on at least one typical predilection site with or without a burrow or positive skin scrapings on microscopy. We line listed cases and captured data which included socio-demographic and other risk factors, body parts affected and complications of scabies. We conducted an environmental assessment and performed descriptive statistics on the data. Results : a total of 823 school children were screened. Overall attack rate was 11.2% (92/823). The attack rate among the nursery category was 25.1% (52/207). Their ages ranged from one to seven years; with a modal age of 3 years. Males affected were 51% and frequently affected body parts were: face (77.2%) and neck (54.3%). Nearly 10.0% of cases had pyoderma from secondary infection. Pupils sat close together in pairs and share sleeping mats. Conclusion : a scabies outbreak affecting mostly children aged 3 years occurred in a basic school in Accra. We recommend avoidance of sharing of sleeping mats by school children. Benzyl benzoate mass treatment, disinfecting of classrooms and sleeping mats, and health education were done.