Prevention of bacterial complications of scabies using mass drug administration: A population-based, before-after trial in Fiji, 2018-2020.
Impetigo
Ivermectin
Mass drug administration
Scabies
Skin and soft tissue infections
Journal
The Lancet regional health. Western Pacific
ISSN: 2666-6065
Titre abrégé: Lancet Reg Health West Pac
Pays: England
ID NLM: 101774968
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
entrez:
29
3
2022
pubmed:
30
3
2022
medline:
30
3
2022
Statut:
epublish
Résumé
Scabies is an important predisposing factor of impetigo which can lead to serious bacterial complications. Ivermectin-based mass drug administration can substantially reduce scabies and impetigo prevalence in endemic settings, but the impact on serious bacterial complications is not known. We conducted a before-after trial in the Northern Division of Fiji (population: 131,914) of mass drug administration for scabies control. Prospective surveillance was conducted from 2018 to 2020. Mass drug administration took place in 2019, involving two doses of oral ivermectin or topical permethrin, delivered alongside diethylcarbamazine and albendazole for lymphatic filariasis. The primary outcomes were incidence of hospitalisations with skin and soft tissue infections, and childhood invasive infections and post-streptococcal sequelae. Secondary outcomes included presentations to primary healthcare with skin infections and community prevalence of scabies and impetigo. The incidence of hospitalisations with skin and soft tissue infections was 17% lower after the intervention compared to baseline (388 vs 467 per 100,000 person-years; incidence rate ratio 0.83, 95% CI, 0.74 to 0.94; Mass drug administration for scabies control was associated with a substantial reduction in hospitalisations for skin and soft tissue infections. National Health and Medical Research Council of Australia and Scobie and Claire Mackinnon Trust.
Sections du résumé
Background
UNASSIGNED
Scabies is an important predisposing factor of impetigo which can lead to serious bacterial complications. Ivermectin-based mass drug administration can substantially reduce scabies and impetigo prevalence in endemic settings, but the impact on serious bacterial complications is not known.
Methods
UNASSIGNED
We conducted a before-after trial in the Northern Division of Fiji (population: 131,914) of mass drug administration for scabies control. Prospective surveillance was conducted from 2018 to 2020. Mass drug administration took place in 2019, involving two doses of oral ivermectin or topical permethrin, delivered alongside diethylcarbamazine and albendazole for lymphatic filariasis. The primary outcomes were incidence of hospitalisations with skin and soft tissue infections, and childhood invasive infections and post-streptococcal sequelae. Secondary outcomes included presentations to primary healthcare with skin infections and community prevalence of scabies and impetigo.
Findings
UNASSIGNED
The incidence of hospitalisations with skin and soft tissue infections was 17% lower after the intervention compared to baseline (388 vs 467 per 100,000 person-years; incidence rate ratio 0.83, 95% CI, 0.74 to 0.94;
Interpretation
UNASSIGNED
Mass drug administration for scabies control was associated with a substantial reduction in hospitalisations for skin and soft tissue infections.
Funding
UNASSIGNED
National Health and Medical Research Council of Australia and Scobie and Claire Mackinnon Trust.
Identifiants
pubmed: 35345391
doi: 10.1016/j.lanwpc.2022.100433
pii: S2666-6065(22)00048-7
pmc: PMC8956868
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100433Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
None of the authors have any conflict of interest to declare.
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