Does mass drug administration for community-based scabies control works? The experience in Ethiopia

  • Wendemagegn Enbiale Bahir Dar University, Bahir Dar, Ethiopia
  • Ashenafi Ayalew Amhara Public Health Institution, Bahir Dar, Ethiopia
  • Teklehaymanot Gebrehiwot Amhara Public Health Institution, Bahir Dar, Ethiopia
  • Yared Mulu Bahir Dar University, Bahir Dar, Ethiopia
  • Muluken Azage Bahir Dar University, Bahir Dar, Ethiopia
  • Rony Zachariah UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
  • Lucia Romani The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
  • Kristien Verdonck Institute of Tropical Medicine, Antwerp, Belgium
  • Johan van Griensven Institute of Tropical Medicine, Antwerp, Belgium
  • Henry JC de Vries Department of dermatology, Amsterdam Institute for Infection and Immunity (AI and II), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
Keywords: Scabies outbreak, operational research, Amhara region, public health emergency

Abstract

Introduction: After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA). In May 2017, we collected data to assess the impact of the treatment on the scabies control.

Methodology. We retrieved baseline data from the 2015/16 burden assessment: campaign organization and administration information. We did a community based cross-sectional study using a structured questionnaire on disease and treatment history plus the presence or absence of active scabies in three Zones. We selected households using stratified random sampling deployed 7581 questionnaires and performed key informant interviews.

Results: 46.3% had a previous scabies diagnosis in the last 2 years of which 86.1% received treatment, and the cure rate was 90.6%. Fifteen months after intervention the scabies prevalence was 21.0 % (67.3% new cases and 32.7% recurrences). The highest burden of new cases (93.1%) was found in the North Gondar zone. The likelihood of treatment failure was higher for treatments offered in clinics (12.2%) as opposed to via the campaign (7.9%). Failure to follow the guidelines, shortage of medicine and lack of leadership prioritization were identified as reasons for resurgence of the disease.

Conclusions: We demonstrated that community engagement is essential in the success of scabies MDA, alongside strong political commitment, and guideline adherence. Effectiveness and sustainability of the MDA was compromised by the failing of proper contact treatment, surveillance and case management.

Published
2020-06-30
How to Cite
1.
Enbiale W, Ayalew A, Gebrehiwot T, Mulu Y, Azage M, Zachariah R, Romani L, Verdonck K, van Griensven J, de Vries HJ (2020) Does mass drug administration for community-based scabies control works? The experience in Ethiopia. J Infect Dev Ctries 14:78S-85S. doi: 10.3855/jidc.11892
Section
The Ethiopian SORT IT Course