1Tropical Diseases Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
2Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Am J Trop Med Hyg. 2021 May 24;105(1):230-237. doi: 10.4269/ajtmh.20-1459.
Scabies, impetigo, and other skin and soft tissue infections (SSTIs) are highly prevalent in many tropical, low-middle income settings, but information regarding their burden of disease is scarce. We conducted surveillance of presentations of scabies and SSTIs, including impetigo, abscesses, cellulitis, and severe SSTI, to primary health facilities in Fiji. We established a monthly reporting system over the course of 50 weeks (July 2018-June 2019) for scabies and SSTIs at all 42 public primary health facilities in the Northern Division of Fiji (population, ≈131,914). For each case, information was collected regarding demographics, diagnosis, and treatment. There were 13,736 individual primary healthcare presentations with scabies, SSTI, or both (108.3 presentations per 1000 person-years; 95% confidence interval [CI], 106.6-110 presentations). The incidence was higher for males than for females (incidence rate ratio [IRR], 1.15; 95% CI, 1.11-1.19). Children younger than 5 years had the highest incidence among all age groups (339.1 per 1000 person-years). The incidence was higher among the iTaukei (indigenous) population (159.9 per 1000 person-years) compared with Fijians of Indian descent (30.1 per 1000 person-years; IRR, 5.32; 95% CI, 5.03-5.61). Abscess was the condition with the highest incidence (63.5 per 1,000 person-years), followed by scabies (28.7 per 1,000 person-years) and impetigo (21.6 per 1,000 person-years). Scabies and SSTIs impose a substantial burden in Fiji and represent a high incidence of primary health presentations in this population. The incidence in low-middle income settings is up to 10-times higher than that in high-income settings. New public health strategies and further research are needed to address these conditions.
疥疮、脓疱疮和其他皮肤和软组织感染（SSTI）在许多热带和中低收入国家/地区非常普遍，但有关其疾病负担的信息却很少。我们对斐济初级保健机构的疥疮和 SSTI（包括脓疱疮、脓肿、蜂窝织炎和严重 SSTI）的就诊情况进行了监测。我们在 50 周（2018 年 7 月至 2019 年 6 月）期间为斐济北部地区的所有 42 家公立初级保健机构建立了每月报告系统（人口约为 131,914 人）。对于每例病例，均收集了人口统计学、诊断和治疗方面的信息。有 13,736 例单独的初级保健就诊病例患有疥疮、SSTI 或两者兼有（每 1000 人年有 108.3 例；95%置信区间 [CI]，106.6-110 例）。男性的发病率高于女性（发病率比 [IRR]，1.15；95%CI，1.11-1.19）。所有年龄段中，5 岁以下儿童的发病率最高（每 1000 人年 339.1 例）。伊塔基人（土著）的发病率高于斐济印度裔（每 1000 人年 30.1 例；IRR，5.32；95%CI，5.03-5.61）。脓肿是发病率最高的疾病（每 1000 人年 63.5 例），其次是疥疮（每 1000 人年 28.7 例）和脓疱疮（每 1000 人年 21.6 例）。疥疮和 SSTI 在斐济造成了沉重的负担，代表了该人群中初级保健就诊的高发病率。在中低收入国家/地区，发病率比高收入国家/地区高 10 倍。需要制定新的公共卫生策略和进一步的研究来解决这些问题。
