Bahir Dar University, Bahir Dar, Ethiopia.
Amhara Public Health Institution, Bahir Dar, Ethiopia.
J Infect Dev Ctries. 2020 Jun 29;14(6.1):78S-85S. doi: 10.3855/jidc.11892.
After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA). In May 2017, we collected data to assess the impact of the treatment on the scabies control.
We retrieved baseline data from the 2015/16 burden assessment: campaign organization and administration information. We did a community based cross-sectional study using a structured questionnaire on disease and treatment history plus the presence or absence of active scabies in three Zones. We selected households using stratified random sampling deployed 7581 questionnaires and performed key informant interviews.
46.3% had a previous scabies diagnosis in the last 2 years of which 86.1% received treatment, and the cure rate was 90.6%. Fifteen months after intervention the scabies prevalence was 21.0 % (67.3% new cases and 32.7% recurrences). The highest burden of new cases (93.1%) was found in the North Gondar zone. The likelihood of treatment failure was higher for treatments offered in clinics (12.2%) as opposed to via the campaign (7.9%). Failure to follow the guidelines, shortage of medicine and lack of leadership prioritization were identified as reasons for resurgence of the disease.
We demonstrated that community engagement is essential in the success of scabies MDA, alongside strong political commitment, and guideline adherence. Effectiveness and sustainability of the MDA was compromised by the failing of proper contact treatment, surveillance and case management.
2015/2016 年埃塞俄比亚阿姆哈拉地区爆发疥疮疫情后，地区卫生局进行了大规模药物治疗。2017 年 5 月，我们收集数据评估了治疗对疥疮控制的影响。
我们从 2015/16 年负担评估中检索基线数据：活动组织和管理信息。我们在三个区进行了基于社区的横断面研究，使用结构化问卷了解疾病和治疗史以及是否存在活动性疥疮。我们采用分层随机抽样选择家庭，共部署了 7581 份问卷并进行了关键知情人访谈。
46.3%的人在过去 2 年内有过疥疮诊断，其中 86.1%接受了治疗，治愈率为 90.6%。干预 15 个月后，疥疮患病率为 21.0%（新病例占 67.3%，复发占 32.7%）。新病例负担最高（93.1%）的是北贡德尔区。与通过活动提供的治疗（7.9%）相比，诊所提供的治疗（12.2%）失败的可能性更高。未能遵循指南、药品短缺和缺乏领导层优先排序被确定为疾病复发的原因。
我们证明了社区参与是大规模药物治疗成功的关键，同时还需要有强烈的政治承诺和遵守指南。适当的接触治疗、监测和病例管理失败影响了 MDA 的有效性和可持续性。
