Does training of Health Extension Workers reduce scabies load in district health facilities in rural Ethiopia?

  • Tigist Gezmu Arba Minch University, Collaborative Research and Training Center for Neglected Tropical Diseases, Arba Minch, Ethiopia
  • Wendemagegn Enbiale Bahir Dar University, Bahir Dar, Ethiopia
  • Mekuria Asnakew Arba Minch University, Collaborative Research and Training Center for Neglected Tropical Diseases, Arba Minch, Ethiopia
  • Alemayehu Bekele Arba Minch University, Collaborative Research and Training Center for Neglected Tropical Diseases, Arba Minch, Ethiopia
  • Gelila Beresaw Arba Minch University, Collaborative Research and Training Center for Neglected Tropical Diseases, Arba Minch, Ethiopia
  • Mekdes Nigussie Federal Ministry Of Health, Addis Ababa, Ethiopia
  • Kudakwashe Takarinda Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
  • Marcel Manzi Médicines Sans Frontieres, LuxOR, Luxembourg city, Luxembourg
  • Rony Zachariah UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
Keywords: Operational research, capacity building, health systems

Abstract

Introduction: In 2017, Ethiopia included scabies management within the responsibility of health extension workers. In Kamba (the intervention district) workers were trained on scabies management. Whereas, in Arba Minch Zuria (the control district) there was no such training. This study assesses whether decentralization of scabies management to communities would reduce the load on health facilities and allow earlier scabies treatment access.

Methodology: All individuals presenting with scabies before (January – June 2018) and after (August 2018-January 2019) the introduction of training (July 2018) in Kamba district and the Arba Minch Zuria district were included. We compared between the two districts in the period before and after training, the numbers of scabies cases presenting to health facilities, their demography, clinical characteristics and treatment.

Results: There were 1,891 scabies cases in the intervention district and 809 in the control district. Scabies cases declined in the intervention district from 7.6 to 1.6 per 1,000 population (a 4.8-fold reduction). In the control district, scabies cases increased from 1.3 to 2.4 per 1,000 population (a 1.8-fold increase). In intervention district, the proportion of scabies patients with secondary skin infections reduced from 1,227 (78%, n = 1,565) to 156 (48%, n = 326, P < 0.001). In the control district the difference was insignificant 39 (14%, n = 288) to 86 (17%, n = 521, P = 0.2).

Conclusions: Introducing trained health extension workers at community level were associated with reductions in health facility load for scabies and secondary infections. This is a wider community health benefit.

Published
2020-06-30
How to Cite
1.
Gezmu T, Enbiale W, Asnakew M, Bekele A, Beresaw G, Nigussie M, Takarinda K, Manzi M, Zachariah R (2020) Does training of Health Extension Workers reduce scabies load in district health facilities in rural Ethiopia?. J Infect Dev Ctries 14:36S-41S. doi: 10.3855/jidc.11730
Section
The Ethiopian SORT IT Course