"Stopping the itch": mass drug administration for scabies outbreak control covered for over nine million people in Ethiopia.

Wendemagegn Enbiale,Misganaw Ayalew,Tekilehayimanot Gebrehiwot,Kuda Takarinda,Marcel Manzi,Tariku Belachew Baynie,Rony Zachriah,Ashenafie Ayalew,Tesfa Getanew,Henry Jc De Vries,Alie Ayal

doi:10.3855/jidc.11701

Abstract

In 2018, the Ethiopian Ministry of Health embarked on a Mass Drug Administration (MDA) campaign that involved over 9 million people in Ethiopia - the largest scabies MDA campaign ever conducted on a global level. We describe its implementation and report on a) numbers screened and identified with scabies, b) treatment category and drug type and c) human resources used, duration, and cost of the campaign. The MDA campaign was conducted according to national guidelines and activities including: planning and organization, engagement of local leaders, community mobilisation and advocacy, awareness-raising among health workers, field implementation, and monitoring and evaluation. The campaign was conducted between July and August 2018. The MDA campaign was implemented by about 15,000 people, mostly from the community, over an average of 6 days and reached 9, 057, 427 people. A total of 875,890 (9.7%) scabies cases were detected and 995,471 (11.0%) contacts received treatment. (Contact-to-case ratio = 1.3). Scabies prevalence varied, the highest prevalence was seen in Central Gondar (39.2%), South Gondar (16.7%) and North Gondar (15.0%), these neighbouring zones contributing more than two third of all scabies cases in the region. Of 1,738,304 (93%) who received treatment, 94% received ivermectin, the rest topical permethrin and sulfur. The average coverage capacity of an MDA campaign staff member was 84 people per day. The total cost was 11,696,333 United States Dollars (USD). Cost per 100,000 population = 129,135 USD. This experience of rapid-large scale implementation would be useful to scale up similar interventions and "stop the itch" in other regions of Ethiopia.

Highlights

In 2018, the Ethiopian Ministry of Health embarked on a Mass Drug Administration (MDA) campaign that involved over 9 million people in Ethiopia – the largest scabies Mass drug administration (MDA) campaign ever conducted on a global level
Mass drug administration (MDA) campaigns which involve administration of scabies treatments to large communities is known to be useful for controlling scabies and reducing community prevalence by more than 90% [8,9,10]
We aimed to describe the implementation of a mass drug administration campaign conducted for scabies outbreak control in the Amhara region of Ethiopia between June and August 2018

Summary

Introduction

In 2018, the Ethiopian Ministry of Health embarked on a Mass Drug Administration (MDA) campaign that involved over 9 million people in Ethiopia – the largest scabies MDA campaign ever conducted on a global level. We describe its implementation and report on a) numbers screened and identified with scabies, b) treatment category and drug type and c) human resources used, duration, and cost of the campaign. Human scabies, caused by the mite Sarcoptes scabiei var hominis is transmitted through person-toperson contact. It is a Neglected Tropical Disease (NTD) of public health importance [1] and one of the “commonest dermatological conditions” in tropical climates where overcrowding and poverty exist [2]. Mass drug administration (MDA) campaigns which involve administration of scabies treatments (ivermectin and permethrin) to large communities is known to be useful for controlling scabies and reducing community prevalence by more than 90% [8,9,10].

Objectives

Methods

Results

Conclusion