Prevention of bacterial complications of scabies using mass drug administration: A population-based, before-after trial in Fiji, 2018–2020

• DOI: 10.1016/j.lanwpc.2022.100433
• Publication Date: 2022-03-22T22:30:06Z
• Authors: Li Jun Thean; Lucia Romani; Daniel Engelman; Handan Wand; Adam Jenney; Jyotishna Mani; Jessica Paka; Tuliana Cua; Sera Taole; Maciu Silai; Komal Ashwini; Aalisha Sahukhan; Mike Kama; Meciusela Tuicakau; Joseph Kado; Matthew Parnaby; Natalie Carvalho; Margot Whitfeld; John Kaldor; Andrew C. Steer
• Keywords: Impetigo; Rate ratio

Scabies is an important predisposing factor of impetigo which can lead to serious bacterial complications. Ivermectin-based mass drug administration substantially reduce scabies and prevalence in endemic settings, but the impact on complications not known.We conducted a before-after trial Northern Division Fiji (population: 131,914) for control. Prospective surveillance was from 2018 2020. Mass took place 2019, involving two doses oral ivermectin or topical permethrin, delivered alongside diethylcarbamazine albendazole lymphatic filariasis. The primary outcomes were incidence hospitalisations with skin soft tissue infections, childhood invasive infections post-streptococcal sequelae. Secondary included presentations healthcare community impetigo.The 17% lower after intervention compared baseline (388 vs 467 per 100,000 person-years; rate ratio 0.83, 95% CI, 0.74 0.94; P = 0.002). There no difference Incidence 21% (89.2 108 1000 person-years, ratio, IRR 0.79, 0.78 0.82). Crude declined 14.2% 7.7% (cluster-adjusted 12.5% 8.9%; 0.71, 0.28 1.17). Cluster-adjusted 15.3% 6.1% (prevalence 0.4, 0.18 0.86).Mass control associated substantial reduction infections.National Health Medical Research Council Australia Scobie Claire Mackinnon Trust.