Hansmann Andreas, Wamba Lékémo Genevia, Fomba Chiaka, Kaddoura Jade, Toure Ramatoullaye, Diop Assane, Ndiaye Maodo, Chosidow Olivier, Marks Michael, Ly Fatimata
Department of Neonatology and Paediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Service de Dermatologie, Institut d'Hygiène Sociale, Université Cheikh Anta Diop, Dakar, Sénégal.
PLOS Glob Public Health. 2024 Feb 28;4(2):e0002942. doi: 10.1371/journal.pgph.0002942. eCollection 2024.
Scabies, a parasitic infection caused by Sarcoptes scabiei var. hominis, is a public health problem with significant morbidity worldwide, particularly in low-resource countries. Impetigo, a complication of scabies infection, is a risk factor for sepsis, glomerulonephritis and possibly acute rheumatic fever. Currently, the majority of epidemiological data has been collected in rural populations in the Pacific with limited applicability to urban populations in sub-Saharan Africa, where scabies is also believed to be a problem. To inform future public health programs, more reliable information about the burden of disease is required.
METHODOLOGY/PRINCIPAL FINDINGS: In July/August 2022, we conducted a cross sectional, cluster-randomised, household survey in Pikine/Dakar using the 'International Association for the Control of Scabies (IACS)' criteria to diagnose scabies and impetigo. All participants underwent a standardised clinical examination by post-graduate dermatology students. For those diagnosed with scabies, an age-adapted 'Dermatology Life Quality Index (DLQI)' questionnaire was filled. We recruited and examined 1697 participants to detect 27 cases of scabies (prevalence: 1.6%, 95% CI 0.8-3.2), mostly in school aged children. Ten participants suffered from impetigo (prevalence: 0.6%, 95% CI 0.3-1.3), 5 of which were dually infected with scabies. Risk factors for scabies infection were young age, male gender and Koranic school attendance. Of those found to have scabies, in 7 out of 22 cases (31.8%) it had a large effect on their lives according to the DLQI questionnaires filled.
CONCLUSIONS/SIGNIFICANCE: This study adds to the mapping of the burden of scabies across Africa to support public health action. With a low prevalence of scabies that is concentrated amongst poor households and children attending Koranic schools, a focused public health approach targeting Koranic schools and poor households seems to be most appropriate in this community.
疥疮是由人型疥螨引起的一种寄生虫感染，是一个全球性的公共卫生问题，发病率很高，在资源匮乏的国家尤为如此。脓疱病是疥疮感染的一种并发症，是败血症、肾小球肾炎以及可能的急性风湿热的一个危险因素。目前，大多数流行病学数据是在太平洋地区的农村人口中收集的，对撒哈拉以南非洲城市人口的适用性有限，而在这些城市地区，疥疮也被认为是一个问题。为了为未来的公共卫生项目提供信息，需要更可靠的疾病负担信息。
方法/主要发现：2022年7月/8月，我们在达喀尔皮金地区进行了一项横断面、整群随机的家庭调查，使用“国际疥疮控制协会（IACS）”的标准来诊断疥疮和脓疱病。所有参与者都接受了皮肤科研究生的标准化临床检查。对于那些被诊断为疥疮的人，填写了一份适合其年龄的“皮肤病生活质量指数（DLQI）”问卷。我们招募并检查了1697名参与者，发现27例疥疮病例（患病率：1.6%，95%置信区间0.8 - 3.2），大多数为学龄儿童。10名参与者患有脓疱病（患病率：0.6%，95%置信区间0.3 - 1.3），其中5人同时感染了疥疮。疥疮感染的危险因素包括年龄小、男性以及就读古兰经学校。根据填写的DLQI问卷，在22例被发现患有疥疮的病例中，有7例（31.8%）对他们的生活产生了很大影响。
结论/意义：这项研究补充了非洲疥疮负担的分布图，以支持公共卫生行动。由于疥疮患病率较低且集中在贫困家庭和就读古兰经学校的儿童中，针对古兰经学校和贫困家庭的重点公共卫生方法在这个社区似乎最为合适。
