title: Long Term Control of Scabies Fifteen Years after an Intensive Treatment Programme.
abstract: BACKGROUND
  Scabies is a major public health problem in the Pacific and is associated with an increased risk of bacterial skin infections, glomerulonephritis and rheumatic fever. Mass drug administration with ivermectin is a promising strategy for the control of scabies. Mass treatment with ivermectin followed by active case finding was conducted in five communities in the Solomon Islands between 1997 and 2000 and resulted in a significant reduction in the prevalence of both scabies and bacterial skin infections.
  
  
  METHODS
  We conducted a prospective follow-up study of the communities where the original scabies control programme had been undertaken. All residents underwent a standardised examination for the detection of scabies and impetigo.
  
  
  RESULTS
  Three hundred and thirty eight residents were examined, representing 69% of the total population of the five communities. Only 1 case of scabies was found, in an adult who had recently returned from the mainland. The prevalence of active impetigo was 8.8% overall and 12.4% in children aged 12 years or less.
  
  
  CONCLUSIONS
  We found an extremely low prevalence of scabies 15 years after the cessation of a scabies control programme. The prevalence of impetigo had also declined further since the end of the control programme. Our results suggest that a combination of mass treatment with ivermectin and intensive active case finding may result in long term control of scabies. Larger scale studies and integration with other neglected tropical disease control programmes should be priorities for scabies control efforts.
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.|Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Marks
authors.affiliation: Department of Paediatrics, National Referral Hospital, Ministry of Health and Medical Services, Honiara, Solomon Islands.
authors.forename: Betty
authors.initials: B
authors.lastname: Taotao-Wini
authors.affiliation: National Health Training Research Institute, Ministry of Health and Medical Services, Honiara, Solomon Islands.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Satorara
authors.affiliation: Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia.|Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Group A Streptococcal Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Engelman
authors.affiliation: Department of Paediatrics, National Referral Hospital, Ministry of Health and Medical Services, Honiara, Solomon Islands.
authors.forename: Titus
authors.initials: T
authors.lastname: Nasi
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.|Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, United Kingdom.
authors.forename: David C
authors.initials: DC
authors.lastname: Mabey
authors.affiliation: Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia.|Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Group A Streptococcal Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Steer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003140:Communicable Disease Control / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007169:Impetigo / Q000453:epidemiology / Q000517:prevention & control; D007306:Insecticides / Q000627:therapeutic use*; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008542:Melanesia / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012532:Scabies / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D055815:Young Adult
chemical_list: D007306:Insecticides; D007559:Ivermectin