Increase in scabies incidence: a retrospective cohort study

Objectives: Recently, there are studies from many countries reporting that scabies incidence has increased. Similarly, there was an increase in the frequency of scabies admitted to our outpatient clinic. Our aim in this study is to draw attention to the increasing incidence of scabies in our region. Methods: The cases diagnosed with scabies in dermatology outpatient clinic between 2010-2019, their demographics and treatments were retrospectively analyzed. Results: It was detected that 949 (0.55%) scabies cases were diagnosed between 2010-2019. When it was analyzed by years, the 3.5 times increase in cases with scabies in 2014 compared to the previous year was found statistically significant (p < 0.05). When data from 2018 was compared with the data from 2010, an increase in the number of cases by 7.6 times was detected in the outpatient numbers with scabies and by 4.7/1000 person-years times in the general population (p < 0.05). Besides, it was determined that the Syrian asylum seekers started to apply to our outpatient clinic as of 2014, and that the scabies incidence was very high within the same year in these patients (27.6%). It was detected that permethrin was prescribed by 88.4% to 868 cases whose treatment details were achieved, and that the ratio of response to treatment was 95.8%. Conclusion: The results we obtained reveal that there was an increased scabies incidence from 2014 in our region. The necessity to immediately and effectively intervene the affected cases to prevent possible epidemic attacks has formed.

___

  • 1. Anderson KL, Strowd LC. Epidemiology, diagnosis, and treatment of scabies in a dermatology office. J Am Board Fam Med 2017;30:78-84.
  • 2. Falay T, Gürel MS. [Scabies]. Turkiye Klinikleri J Dermatol Special Topics 2017;10:143-53. [Article in Turkish]
  • 3. Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016;388:1545-602.
  • 4. Liu JM, Hsu RJ, Chang FW, Yeh CL, Huang CF, Chang ST, et al. Increase the risk of intellectual disability in children with scabies: A nationwide population-based cohort study. Medicine (Baltimore) 2017;96:e7108.
  • 5. Chen JY, Liu JM, Chang FW, Chan H, Cheng KC, Yeh CL, et al. Scabies increased the risk and severity of COPD: a nationwide population-based study. Int J Chron Obstruct Pulmon Dis 2016;11:2171-8.
  • 6. Çetinkaya Ü, Şahin S, Ulutabanca RÖ. The epidemiology of scabies and pediculosis in Kayseri. Turkiye Parazitol Derg 2018;42:134-7.
  • 7. Aktaş H, Cebecik A. Changes in incidence and age distribution of scabies: A retrospective cohort study in a tertiary hospital. Arch Clin Exp Med 2019;4:21-4.
  • 8. Seyedi Arani HR, Dehghani R, Ghannaee Arani M, Seyyedi Arani HR, Zarghi I. Scabies contamination status in Iran: A review. Int J Epidemiol Res 2016;3:86-94.
  • 9. Pişkin S, Görgülü A, Akgün N, Öztürk A, Şen Ö, Gürkök F. Epidemiology of scabies in Edirne. Balkan Med J 1993;10:157-61.
  • 10. Tüzün Y, Kotoğyan A, Cenesizoğlu E, Baransü O, Ozarmağan G, Ural A, et al. The epidemiology of scabies in Turkey. Int J Dermatol 1980;19:41-4.
  • 11. Çiftçi IH, Karaca S, Dogru Ö, Cetinkaya Z, Kulaç M. Prevalence of pediculosis and scabies in preschool nursery children of Afyon, Turkey. Korean J Parasitol 2006;44:95-8.
  • 12. Yılmaz M, Korkmaz E, Karakoç S, Yaztürk Ş, Kizirgil A, Yakupoğulları Y. Investigation of intestinal parasites and ectoparasites in three primary school students in Elazığ. Türkiye Parazitol Derg 2007;31:139-41.
  • 13. Sunderkötter C, Aebischer A, Neufeld M, Löser C, Kreuter A, Bialek R, et al. Increase of scabies in Germany and development of resistant mites? Evidence and consequences. J Dtsch Dermatol Ges 2019;17:15-23.
  • 14. Onyekonwu CL, Okoh N, Ofondu E, Nwobi E, Onyekonwu CG. Incidence, pattern and trend of scabies infection in Nigeria: A retrospective study of 366 cases. Int J Med Health Dev 2018;23:227-30.
  • 15. Amato E, Dansie LS, Grøneng GM, Blix HS, Bentele H, Veneti L, et al. Increase of scabies infestations, Norway, 2006 to 2018. Euro Surveill 2019;24:190020.
  • 16. İrgil E. Suriyeli sığınmacılarda bulaşıcı olmayan hastalıklar sorunu. In: Savaş, göç ve sağlık. Ankara, Türk Tabipleri Birliği Yayınları; 2016;p.76-82.
  • 17. Öztürk R. Göç ve enfeksiyonlar. Sağlık Düşüncesi ve Tıp Kültürü Dergisi 2014;32:58-9.
  • 18. World Health Organization (WHO). Regional situation report, January 2015 WHO response to the Syrian crisis. Available at: http://www.who.int/hac/crises/syr/sitreps/en/ Accessed December 8, 2018.
  • 19. Greco D, Caputo SL, Binkin N, Panatta M, Squarcione S, Germinario C. Health response to a large and rapid influx of Albanian refugees in southern Italy, 1991. Disasters 1993;17:61-9.
  • 20. Kawa N, Hanna E and Bizri AR. Transmissible dermatological diseases affecting Syrian refugees in Lebanon. J Refug Glob Health 2019;2:4.
  • 21. Wollina U, Gaber B, Mansour R, Langner D, Hansel G, Koch A. Dermatologic challenges of health care for displaced people. Lessons from a German emergency refugee camp. Our Dermatol Online 2016;7:136-8.
  • 22. van Berlaer G, Bohle Carbonell F, Manantsoa S, de Béthune X, Buyl R, Debacker M, et al. A refugee camp in the centre of Europe: clinical characteristics of asylum seekers arriving in Brussels. BMJ Open 2016;6:e013963.
  • 23. Refaat M, Mohanna K. Syrian refugees in Lebanon: facts and solutions. Lancet 2013;382:763-4.
  • 24. Abdel-Raheem TA, Méabed EM, Nasef GA, Abdel Wahed WY, Rohaim RM. Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies. J Dermatolog Treat 2016;27:473-9.
  • 25. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev 2007;3:CD000320.
  • 26. Elgart ML. Cost-benefit analysis of ivermectin, permethrin and benzyl benzoate in the management of infantile and childhood scabies. Expert Opin Pharmacother 2003;4:1521-4.
  • 27. Bagati KD, Agarwal P, Sharma J. A comparative study to assess the efficacy of permethrin (topical) and benzyl benzoate (topical) for the treatment of scabies patients. Int J Res Pharm Sci 2019;10:3688-93.
  • 28. Pasay C, Arlian L, Morgan M, Vyszenski Moher D, Rose A, Holt D, et al. High-resolution melt analysis for the detection of a mutation associated with permethrin resistance in a population of scabies mites. Med Vet Entomol 2008;22:82-8.
  • 29. Khalil S, Abbas O, Kibbi AG, Kurban M. Scabies in the age of increasing drug resistance. PLoS Negl Trop Dis 2017;11:e0005920.