Determinants of Scabies Out-Break in Takusa District of Amhara Region, Northwest Ethiopia
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Journal of Public Health in Africa 2020; volume 11:1325 Determinants of scabies out- break in Takusa district of Introduction Correspondence: Melese Linger Endalifer, Amhara Region, Northwest Human scabies is an ectoparasitic infes- College of Health Science, Woldia University, tation of human skin caused by a micro- Woldia, Ethiopia. Tel.:+251927690730. Ethiopia scopic female mite known as Sarcoptes sca- E-mail: [email protected] biei variety hominis.1 Scabies occurs when 1 Etsehiwot Debe Worku, the pregnant female mite burrows into Key words: Determinant factors, Ethiopia, Mulusew Andualem Asemahagn,2 superficial layers of the skin, forming a Scabies, Outbreak, Takusa district. Melese Linger Endalifer3 slightly elevated narrow tunnel where it deposits eggs and feces. The mite requires Acknowledgments: We would like to forward 1Public health emergency management human skin to complete its life cycle and is our deepest gratitude to the school of Public officer, North Showa Zone, Amhara unable to survive the host at room tempera- Health, Bahir Dar University, Amhara 2 Regional Health Bureau; School of ture for more than 2-3 days.2 Regional Health Bureau, data collectors, and Public Health, College of Medicine and Scabies occurs worldwide and its global study participants for the valuable help they Health Sciences, Bahir Dar University, prevalence is estimated to be about 300 mil- did during the study period. Bahir Dar; 3College of Health Science, lion cases per year.1,3 Contributions: EDW: designed research pro- Woldia University, Woldia, Ethiopia The prevalence and complications of posal, supervised data collection, analyzed scabies make it a significant public health data, wrote, edited approved the manuscript. problem in the developing world, with a MAA: participated in the design of the study, Abstract disproportionate burden among children performed the statistical analysis, reviewed, living in poor, and overcrowded tropical edited, and approved the proposal and manu- Background: Human scabies is a highly 4,5 areas. As evidenced from a narrative script. MLE: participated in drafting the man- contagious human dermatitis disease. As review the distribution of Scabies at the uscript, critical revision of the manuscript, and indicated by the national and regional population level in the developing countries final approval. reports, the epidemic of scabies became a lies between 0.4-31%.6 major public health problem in Ethiopia Countries in the tropical climate zone Conflict of interest: The authors declare no since 2015. accounted for 25% of the global scabies potential conflict of interest. Objective: To identify the determinant incidence. It reached 50% in some commu- Funding: None. factors of scabies outbreak in Takusa dis- nities of the South Pacific and Northern trict, Northwest Ethiopia, 2017. Australia where poverty and overcrowding Consent for publication: Not applicable. Methods: A community based are the main risk factors.7 unmatched case-control study among 188 6 Multiple factors like overcrowding, Availability of data and materials: can be 1 participants (63 cases and 125 controls) was poor public health education, overcrowded accessed from the corresponding author upon conducted in Takusa district from sleeping space, sharing of clothes, sharing reasonable request. September to October 2017. Data were col- of towels,8 improper personal hygiene prac- lected using a pretested structured question- tices,4,6,9 family size,10,11 dementia,12 age Received for publication: 26 December 2019. naire. Multivariable logistic regression below 15 years, homes affected by Revision received: 9 July 2020. analysis was computed using SPSS version flooding.13 and traveling from non-endemic Accepted for publication: 21 Ovtober 2020. 22 to identify factors associated with sca- to scabies endemic areas,3,5,7 residing in bies. Odds ratio at 95% CI and p-value less This work is licensed under a Creative rural areas, family history of scabies, educa- Commons Attribution NonCommercial 4.0 than 0.05 were used to describe the strength tional status, household density, the exis- License (CC BY-NC 4.0). of the association and statistical signifi- tence of livestock or rodents at home, sea- cance. sonal conditions, occupation, type of build- ©Copyright: the Author(s),2020 Results: The median age of cases was ing for living, family history of itchy rash, Licensee PAGEPress, Italy 20 years (ranges1-61). Presence of person poverty, low socioeconomic status and pres- Journal of Public Health in Africa 2020; 11:1325 with itching in the family (AOR=7.7, 95% ence of head lice were identified as determi- doi:10.4081/jphia.2020.1325 CI:1.9-30.5), sleeping with scabies patient nant factors in the previous studies from (AOR=3.99, 95% CI:1.37-11.7), travel to different parts of the world.3,13-17 scabies epidemic area in the last six weeks According to a study conducted in there were about 13975(8.9%) scabies cases (AOR=3.79, 95%CI:1.28-11.1) and infre- Pakistan, the prevalence of scabies was from a total population of 147,626. There quent use of detergent for showering 9.13% and it varies among sex, socioeco- were 7229 (51.7%) male cases; while preg- (AOR=4.85; 95% CI: 1.3-17.9)) were found nomic status, and living conditions (house- nant and lactating mothers comprised 788 to be determinant factors of scabies out- hold standards).18 Similarly, the prevalence (6%) of all cases in the district. The distri- break. of scabies was 9.3% and 11% in Northwest Conclusion: Frequent contact with peo- and southern Ethiopia.13,19 bution of the scabies incidence was varied ple who develop scabies at home, not using Ethiopia is one of the countries affected across kebeles, smallest administrative detergents for washing, and mobility of by the scabies outbreaks, which is aggravat- units in the district, where Dinblagsa, people from non-epidemic to the epidemic ed by climate change, Latino. The distribu- Quardiba, and Konta kebeles accounted for areas were determinant factors. Giving spe- tion of scabies outbreak varied across 39.5%, 36.3%, and 31.4% of the scabies cial emphasis on regular awareness creation regions and districts of Ethiopia, with the incidence, respectively. The incidence of to the rural community is important to pre- highest magnitude to places with poor scabies is high in the district. As a result, we vent scabies outbreak. access to water sources, infrastructures, and intended to identify the determinant factors food security.20 Based on the office report of scabies there. This study will be impor- from Takusa district, Northwest Ethiopia, tant to take evidence-based interventions to [page 122] [Journal of Public Health in Africa 2020; 11:1325] Article prevent scabies outbreak and its burden. Three kebeles, namely: Dinblagsa, Epidata version 3.1 and exported to the Quardiba, and Konta were selected random- Statistical Package for Social Sciences ly from 16 kebeles reporting scabies case. (SPSS) version 22 (Chicago, IL, USA) for Due to time and resource constraints and further data clearance and analysis. Methods and materials the district is remote. we limit the number Descriptive frequency statistics (measures Ethical considerations of studied kebeles to three. Then, the cases of central tendency, proportions, and cross- The study was conducted as per the were randomly selected from the line list tabulations were conducted to describe Helsinki Declaration for biomedical and two controls were selected through a study participants and variables. Bivariate research. The ethical review committee of simple random technique. and multivariable logistic regression analy- Bahir Dar University has reviewed and ses were computed to identify the determi- approved the research protocol and gave a Data collection tools and techniques nant factors of scabies. Variables having a supporting letter together with the Amhara The data were collected at the house- P-Value <0.2 in bivariate analysis entered Regional Health Bureau to proceed with the hold level through an interviewer-adminis- into the multivariable logistic regression model to control the effect of confounding research work. Study participants were well tered questionnaire. It was based on evi- variables. Finally, variables having a P- informed about the purpose of the study, dence about cases collected from the health value <0.05 at 95%CI were considered as data collection procedures, and data confi- posts (least primary health care facilities) determinant factors to scabies infection. dentiality issues before the actual data col- and health centers that scabies cases were lection period. For study participants less traced to their houses. The questionnaire than 18 years, informed consent was taken was developed by reviewing related litera- from their families and caregivers after tures on scabies and scabies assessment Results being informed about the research. check-list of Ethiopia. Three trained clinical Descriptive-statistics Participation was fully voluntary based nurses under the supervision of the princi- The median age of cases was 20±16.5 including the right to withdraw from the pal investigators collected the data after get- years (ranges:1-61 years).Similarly, the study at any time without any precondi- ting informed consent from each study par- median ages of controls was 18 years tions. Data confidentiality was assured by ticipant. removing any personal identifiers (using (ranges1-70). Over half, 103 (54.7%) of the study participants were females. The major- codes) and using data anonymity. Critically Data quality assurance ill scabies cases were referred to the nearby ity, 54 (85.7%) of the scabies cases and Developing the questionnaire by refer- 105(84%) controls were from rural areas. health center for healthcare services. On the ring various literature, training of data col- other hand, to non-critical cases, education About 44(70%) of cases and 82 (65.6%) lectors, regular supportive supervision of controls lived in families that have five and was given to prevent themselves and the data collectors, checking data completeness above family size (Table 1).