Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia.
PLoS Negl Trop Dis. 2020 Dec 4;14(12):e0008825. doi: 10.1371/journal.pntd.0008825. eCollection 2020 Dec.
Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of scabies and impetigo, or community attitudes towards the strategy of mass drug administration that is emerging as a public health option for scabies and impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji's Northern Division. Thematic analysis examined participants' lived experiences of scabies and impetigo; community knowledge and perceptions about scabies and impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of scabies and impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of scabies. Scabies and impetigo were perceived as diseases affecting children, impacting on school attendance and families' quality of sleep. Awareness of scabies and impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards mass drug administration to control scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned scabies elimination programme. Findings from this first study to document perspectives and experiences related to scabies and impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to scabies and impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of scabies transmission, and a campaign of education and community engagement prior to mass drug administration.
疥疮在斐济流行，是发病率的重要原因。人们对影响疥疮和脓疱疮发生的社会文化信仰和习俗知之甚少，也不了解社区对大规模药物管理策略的态度，而这种策略正在成为斐济和其他国家控制疥疮和脓疱疮的一种公共卫生选择。数据是在斐济北部地区四个地点对 33 名社区成员进行半结构化访谈时收集的。主题分析研究了参与者对疥疮和脓疱疮的生活体验；社区对疥疮和脓疱疮病因和传播的知识和看法；基于社区的治疗和预防措施；以及对大规模药物管理的态度。许多斐济本土居民（iTaukei）参与者指出，他们的家庭和社区中儿童有广泛和持续的疥疮和脓疱疮经历，但只有一名印度裔斐济人（Indo-Fijian）表示自己有过儿童时期的疥疮经历。疥疮和脓疱疮被认为是影响儿童的疾病，会影响到他们的上学和家庭的睡眠质量。人们对疥疮和脓疱疮的认识相当高，但对疾病的病因和传播存在重大误解。传统疗法是治疗疥疮的首选，其次是当地卫生中心和医院提供的生物医学疗法。没有优先治疗密切接触的家庭成员。社区对大规模药物管理控制疥疮的态度大多是积极的，尽管有人担心会有不良反应，并对参与计划中的疥疮消除方案犹豫不决。这是第一份在亚太地区记录与疥疮和脓疱疮及其管理相关的观点和经验的研究，结果表明，需要采取以社区为中心的方法来控制斐济的疥疮和脓疱疮，而且很可能在其他受影响的国家也需要这种方法。这包括针对疥疮传播的社会动态进行社区为基础的健康促进宣传，以及在大规模药物管理之前开展教育和社区参与活动。
