Scabies: update on treatment and efforts for prevention and control in highly endemic settings

Abstract

Scabies is a contagious parasitic skin disease caused by Sarcoptes scabiei infestation which can be transmitted through direct or indirect contact. WHO classified scabies as a neglected tropical disease. The prevalence of scabies is high in certain countries ranging from 32.1% to 74%, especially in crowded conditions such as prisons, boarding schools, and orphanages. Indonesia is one of the most heavily affected countries worldwide. Scabies might cause great impact on patients, which includes decreased concentration and academic achievement at school, social stigma, sleep disturbances, and decreased economic productivity in community. Management of scabies with anti-scabies needs to be carried out appropriately, accompanied with treatment for all contacts. Mass treatment with permethrin cream or ivermectin can be given directly to patients. Prevention is conducted by providing medical treatment and breaking the chain of transmission. Source elimination and disinfection of fomites is very important. Participation of non-medical personnel such as teachers, cadres, and parents together with the local health workers (primary health care) is highly recommended. Using checklists or application can aid non-medical personnel to determine suspected cases, thus contributing to scabies elimination. Cooperation between patients, patient's family, health workers and other non-medical personnel will greatly reduce the prevalence of scabies and ultimately improve patient's quality of life. The aim of this review is to provide an update on scabies treatment and efforts for prevention and elimination, with focus on the situation in Indonesia.