National Prevalence of Scabies in Fiji

Background: Scabies and skin sores are recognised public health problems in Fiji and other countries in the Pacific region. The World Health Organization estimates that 300 million people worldwide are affected with scabies each year. Scabies and its complications particularly affect young children, the immuno-suppressed, as well as people who are malnourished, elderly or institutionalised. The direct effect of scabies is debilitating itching, followed by complications due to bacterial infection of the skin, ranging from impetigo, abscesses and cellulitis, through to septicaemia, renal failure and rheumatic heart disease. The Pacific region has among the highest rates of both these diseases. 

Methodology/Results: We conducted an epidemiological cross-sectional study to assess the prevalence of scabies and skin sores in Fiji. The study enrolled 13,294 participants across all age groups and ethnicities. A total of 96 sites, including villages, settlements and schools were selected. The results of the survey showed a scabies prevalence of 23% (3,092) of the population sampled, with 51% of the children aged 4-7 being infected, and 37% of the 0-3 year olds, but no age group was free of scabies. The prevalence of infected sores in the participants with scabies was 21% (641). This is to date the only national prevalence study existing on scabies worldwide.

Conclusions: Scabies is a major cause of morbidity in many developing countries, and leads to economic disadvantage and reduced quality of life. These results suggest that scabies and skin sores are epidemic diseases in Fiji. A comprehensive and well-coordinated scabies elimination program is urgently needed. A study to assess the efficacy of a mass drug administration program is planned, comparing oral with topical treatment regimens. We aim to find the most appropriate and cost-effective solution to justify the investment of time, manpower and money to reduce the prevalence of scabies.