![]() Transmission occurs through skin-to-skin contact with a person who is currently infested with the scabies mite. In tropical regions, the impact of this is heightened in children (age 1–4) and the geriatric population, with DALYs being lowest during adulthood 17. Scabies also carries a greater burden than psoriasis and melanoma when DALYs were compared across dermatological conditions 16. Scabies has been found to contribute more age-adjusted DALYs than other significant conditions such as acute lymphocytic leukaemia and arrhythmias 15. The highest prevalence of impetigo is noted among Australian indigenous aboriginal communities, with 49% of children having impetigo 8.ĭisease burden is calculated with disability-adjusted life years (DALYs) one DALY is thought of as 1 year of healthy life lost. In Fiji and the Solomon Islands, two trials suggested the attributable risk of scabies on impetigo was between 60% and 90% 8, 14. People with scabies are reported to be 2.8 times more likely to have impetigo 13. Since the 1970’s, it has been known that impetigo is a common complication of scabies, especially in children 12. The possible role of immune senescence in the elderly needs further research. Possible explanations for why children are disproportionally affected are overcrowding, bed sharing, under recognition, and that pruritus may be absent in infants 11. Eight studies have been found to directly compare scabies in adults versus children the prevalence of scabies among children was higher in all eight studies 8. Scabies is more prevalent in vulnerable groups such as young children and the elderly. Scabies was the cause of 58% of infectious disease/dermatology consultations among migrants arriving to Italy and 56.5% of consultations among the homeless populations of Paris 10. It can also be spread primarily through sexual transmission, again due to close contact 6. In developed countries, scabies occurs sporadically, or at higher levels in situations of close living, such as institutions including schools, aged care facilities, prisons, and refugee camps, as well as in the homeless 6, 9. It is not known whether this is purely due to socioeconomic factors or whether the scabies mite thrives in humid climates. ![]() Although more research is needed, the reported prevalence of scabies in Europe and Middle Eastern countries is low (<2.2%) 8. In Fiji, a survey reported that over one-third of residents had scabies and more than one in two children were affected 6. The Pacific islands, Central America, and the indigenous population of Northern Australia have the highest documented levels. Scabies occurs worldwide, with the highest prevalence documented in countries with hot, tropical climates 7, 8. The economic burden for these communities is considerable, with direct costs relating to medications, sick days, and hospitalisation 6. Those who live in these endemic areas and seek treatment commonly experience rapid re-infestation when they come into contact with untreated households 5. As a result of poor access to treatment combined with domestic crowding, transmission of the mite can become widespread. Scabies is endemic to resource-scarce communities where overcrowding and poverty are more common. Scabies is an intensely itchy parasitic disease of the skin caused by microscopic scabies mites that are transmitted from person to person via close contact. This review will outline advances in the mite biology, epidemiological understanding, diagnosis, and treatment of scabies. Advances over the past 5 years indicate that mass drug administration is an effective strategy to treat scabies. This can have fatal consequences, such as septicaemia, glomerulonephritis, and rheumatic heart disease. Scratching of the lesions can lead to secondary bacterial infections of the skin, such as impetigo, most commonly caused by Streptococcus pyogenes or Staphylococcus aureus. Scabies causes a host immune response which is intensely itchy. ![]() ![]() Scabies is endemic in many developing countries, with the highest prevalence being in hot, humid climates such as the Pacific and Latin American regions. An estimated 200 million people currently have scabies worldwide. In 2017, scabies was recognised by the World Health Organisation as a disease of public importance and was consequently added to the list of neglected tropical diseases. Scabies is an infestation of the skin caused by the mite Sarcoptes scabiei.
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