Scabies prevalence after ivermectin-based mass drug administration for lymphatic filariasis, Samoa 2018-2019

PLoS Negl Trop Dis. 2023 Aug 22;17(8):e0011549. doi: 10.1371/journal.pntd.0011549. eCollection 2023 Aug.

Abstract

Background: Scabies is a common skin infestation caused by the Sarcoptes scabei mite. Ivermectin, one of three drugs used in mass drug administration (MDA) for lymphatic filariasis, is also effective for treating scabies. Ivermectin-based MDA was first conducted in Samoa in August 2018, with ivermectin being offered to those aged ≥5 years. Here, we report scabies prevalence in Samoa after MDA.

Methods: We conducted household surveys 1.5-3.5 months (Survey 1) and 6-8 months (Survey 2) after the 2018 MDA in 35 primary sampling units. We conducted clinical examination for scabies-like rash and used International Alliance for the Control of Scabies classification criteria. We estimated scabies prevalence by age, gender and region. Multivariable logistic regression was used to assess factors associated with prevalence.

Results: We surveyed 2868 people (499 households) and 2796 people (544 households) aged 0-75 years in Surveys 1 and 2, respectively. Scabies prevalence increased from 2.4% (95% CI 2.1-2.7%) to 4.4% (95% CI 4.0-4.9%) between surveys. Scabies was associated with younger age (0-4 years: aOR 3.5 [2.9-4.2]; 5-15 years: aOR 1.6 [1.4-1.8] compared to ≥16 years), female gender (aOR 1.2 [95% CI 1.1-1.4]; region (aOR range from 1.4 [1.1-1.7] to 2.5 [2.1-3.1] between regions), large households (aOR 2.6 [2.0-3.4] households ≥13), and not taking MDA in 2018 (aOR 1.3 [95% CI 1.1-1.6]).

Conclusions: We found moderate prevalence of scabies in two population-representative surveys conducted within 8 months of the 2018 MDA for lymphatic filariasis. Prevalence appeared to increase between the surveys, and ongoing surveillance is recommended, particularly in young children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Elephantiasis, Filarial* / drug therapy
  • Elephantiasis, Filarial* / epidemiology
  • Female
  • Humans
  • Ivermectin / therapeutic use
  • Mass Drug Administration
  • Prevalence
  • Samoa / epidemiology
  • Scabies* / drug therapy
  • Scabies* / epidemiology

Substances

  • Ivermectin

Grants and funding

This work received financial support from the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD), which is funded at The Task Force for Global Health primarily by the Bill & Melinda Gates Foundation, the United Kingdom Department for International Development, and the United States Agency for International Development through its Neglected Tropical Diseases Program. C.L.L. was funded by Australian National Health and Medical Research Council Fellowships (APP1109035 and APP1158469). ACS is funded by a Viertel Senior Medical Research Fellowship and a National Health and Medical Research Council Fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This work was supported in whole or in part, by the Bill & Melinda Gates Foundation [Grant Number OPP1053230]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. DE was funded by a National Health and Medical Research Council Fellowship.