Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
PLoS Negl Trop Dis. 2023 Feb 22;17(2):e0011175. doi: 10.1371/journal.pntd.0011175. eCollection 2023 Feb.
Scabies commonly affects poor populations in low-middle-income countries. The WHO has advocated for country-driven and country-owned control strategies. Knowledge of context specific issues will be important for design and implementation of scabies control interventions. We aimed to assess beliefs, attitudes and practices towards scabies in central Ghana.
METHODOLOGY/PRINCIPAL FINDINGS: Data was collected via semi-structured questionnaires for people who had active scabies or scabies in the past year and people who never had scabies in the past. The questionnaire covered several domains: knowledge about the causes and risk factors; perceptions towards stigmatisation and consequences of scabies in daily life; and treatment practices. Out of 128 participants, 67 were in the (former) scabies group and had a mean age of 32.3 ± 15.6 years. Overall scabies group participants less often indicated a factor to predispose to scabies than community controls; only 'family/friends contacts' was more often mentioned in the scabies group. Scabies causation was attributed to poor hygiene, traditional beliefs, heredity and drinking water. Individuals with scabies delay care seeking (median time from symptom onset to visiting the health centre was 21 [14 - 30] days) and this delay is enhanced by their beliefs (like witchcraft and curses) and a perception of limited disease severity. Compared to past scabies participants in the dermatology clinic, participants with past scabies in the community tended to have a longer delay (median [IQR] 30 [14-48.8] vs 14 [9.5-30] days, p = 0.002). Scabies was associated with health consequences, stigma, and loss of productivity.
CONCLUSION/SIGNIFICANCE: Early diagnosis and effective treatment of scabies can lead to persons less frequently associating scabies with witchcraft and/ or curses. There is the need to enhance health education to promote early care seeking, enhance knowledge of communities on impact and dispel negative perceptions about scabies in Ghana.
疥疮在中低收入国家的贫困人口中较为常见。世界卫生组织主张采取国家主导和国家拥有的控制策略。了解特定背景下的问题对于设计和实施疥疮控制干预措施非常重要。我们旨在评估加纳中部地区人们对疥疮的信念、态度和实践。
方法/主要发现：通过半结构化问卷收集了有活动性疥疮或过去一年中有疥疮的人和过去从未有过疥疮的人的数据。问卷涵盖了几个领域：对病因和危险因素的认识；对疥疮在日常生活中的污名化和后果的看法；以及治疗实践。在 128 名参与者中，有 67 名处于（前）疥疮组，平均年龄为 32.3 ± 15.6 岁。总体而言，疥疮组参与者比社区对照组更不容易指出导致疥疮的因素；只有“家庭/朋友接触”在疥疮组中被更多地提及。疥疮的病因归因于卫生条件差、传统观念、遗传和饮用水。患有疥疮的人会延迟就医（从症状出现到就诊的中位数时间为 21 [14-30] 天），而这种延迟是由于他们的信念（如巫术和诅咒）和对疾病严重程度的有限认识所导致的。与皮肤科诊所的过去疥疮参与者相比，社区中过去有过疥疮的参与者往往延迟时间更长（中位数 [IQR] 30 [14-48.8] 与 14 [9.5-30] 天，p = 0.002）。疥疮会导致健康后果、污名和生产力损失。
结论/意义：早期诊断和有效治疗疥疮可以使人们较少将疥疮与巫术和/或诅咒联系在一起。需要加强健康教育，以促进早期求医，提高社区对疥疮影响的认识，并消除对疥疮的负面看法。
