The Outbreak of Classic and Norwegian Type Scabies, in Mentally Handicapped Persons in a Rehabilitation Centre-Iran

Abstract

Introduction: Scabies is an ectoparasitic infection caused in humans by the scabies mite Sarcoptes scabiei variety hominis. Aim: The aim of this study was to detect early disease scabies, finding its risk factors, and prevention of epidemic diseases among the people who are susceptible to scabies, because of disability and mental retardation. Materials and Methods: This was a descriptive cross-sectional study which was managed in a rehabilitation centre, which is responsible for the care of disabled and mentally retarted in Iran for a period of two months from July 27, 2018 until September 28, 2018. This centre had five units (A, B, C, D and E) comprising of 46 employers (34 staff; 2 nurses and 10 service personnel) who were catering to 110 handicapped persons. The index case of scabies in disability centre was a 16-year-old child with Down Syndrome, who was in contact with the patients in Unit E. On July 27, 2018, it reported one outbreak of scabies in this rehabilitation dormitory to one Centre Care Health (CCH) of Iran. All of 19 patients had symptom including: skin itching; papule on testis and penis and generalised rash on the body and two patients had thick crust on skin in armpit and anal area. Four service personnels had itching and papule on the neck. The patients were examined by a team including entomologists and dermatologists and demographic information of the patients was collected by completing the questionnaire (with regard to the principles of medical ethics). Mentally retarded persons were treated with 5% permethrin cream and for staff; nurses and service personnel 10% crotamiton cream was given except for pregnant women who used 10% sulfur ointment. Results: A total of 110 individuals with mental and physical disorders (23.6% males and 76.4% females) were resident in five units out of which 19% of individuals were exposed and 81% unexposed. The sex ratio of male to female was 1:3.2. The mean age of patients was 27 years (SD=7.09, Range 14-48 years) that most affected age group was 21-30 years (45.4%), 92% of exposed group was females and 8% were males. Using of sharing towels (odds ratio: 23.25, 95% CI: 8.91-60.64), sharing bathroom supplies (odds ratio: 3.31, 95% CI: 1.03- 10.64), sleeping in a common bed (odds ratio: 23.25, 95% CI: 8.91-60.64) and sharing glove (odds ratio: 0.86, 95% CI: 0.28- 2.18) were the most important risk factors of the scabies. Conclusion: It is an urgent need that in social places, including hospitals, centres for the care of the elderly and mentally handicapped people, the nurses and service personnel get trained about the importance of urgent report of epidemic diseases especially scabies to Health care centres.