Brighton and Sussex Medical School, Brighton, UK.
School of Life Sciences, University of Sussex, Brighton, UK.
Epidemiol Infect. 2019 Aug 5;147:e250. doi: 10.1017/S0950268819001249.
Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
目前，英国的养老院或护理院没有针对疥疮爆发的管理的国家指南。在这种情况下，疥疮爆发的诊断和治疗常常被延迟，并且最佳药物治疗、环境控制措施甚至是结果衡量标准都不明确。我们进行了系统评价，以确定爆发管理干预措施的效果，并确定基于证据的建议。我们检索了四个电子数据库中与研究相关的文章，并使用基于 STROBE 指南的质量评估工具来评估观察数据的质量。确定了 19 份关于药物治疗和环境管理措施的爆发报告。数据质量很差；没有报告所有的结果衡量标准，只有 4 份报告了症状缓解措施。我们无法做出明确的基于证据的建议。我们借鉴结果，为未来的疥疮爆发观察研究提出了数据收集框架。虽然需要高质量的随机对照试验来确定最佳的药物治疗方法，但需要通过其他文献研究来增加环境措施的证据。设计的质量评估工具是报告包括未来爆发中的患者报告措施等结果衡量标准的有用资源。
