title: Protocol for the systematic review of the prevention, treatment and public health management of impetigo, scabies and fungal skin infections in resource-limited settings.
abstract: BACKGROUND
  Impetigo, scabies, and fungal skin infections disproportionately affect populations in resource-limited settings. Evidence for standard treatment of skin infections predominantly stem from hospital-based studies in high-income countries. The evidence for treatment in resource-limited settings is less clear, as studies in these populations may lack randomisation and control groups for cultural, ethical or economic reasons. Likewise, a synthesis of the evidence for public health control within endemic populations is also lacking. We propose a systematic review of the evidence for the prevention, treatment and public health management of skin infections in resource-limited settings, to inform the development of guidelines for the standardised and streamlined clinical and public health management of skin infections in endemic populations.
  
  
  METHODS
  The protocol has been designed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. All trial designs and analytical observational study designs will be eligible for inclusion. A systematic search of the peer-reviewed literature will include PubMed, Excertpa Medica and Global Health. Grey literature databases will also be systematically searched, and clinical trials registries scanned for future relevant studies. The primary outcome of interest will be the clinical cure or decrease in prevalence of impetigo, scabies, crusted scabies, tinea capitis, tinea corporis or tinea unguium. Two independent reviewers will perform eligibility assessment and data extraction using standardised electronic forms. Risk of bias assessment will be undertaken by two independent reviewers according to the Cochrane Risk of Bias tool. Data will be tabulated and narratively synthesised. We expect there will be insufficient data to conduct meta-analysis. The final body of evidence will be reported against the Grades of Recommendation, Assessment, Development and Evaluation grading system.
  
  
  CONCLUSIONS
  The evidence derived from the systematic review will be used to inform the development of guidelines for the management of skin infections in resource-limited settings. The evidence derived will be intended for use by clinicians, public health practitioners and policy makers in the treatment of skin infections and the development of skin infection control programmes. The review will identify any gaps in the current evidence to provide direction for future research.
  
  
  BACKGROUND
  PROSPERO CRD42015029453.
authors.affiliation: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia. Philippa.may@telethonkids.org.au.
authors.forename: Philippa
authors.identifier: http://orcid.org/0000-0002-9295-0278
authors.initials: P
authors.lastname: May
authors.affiliation: Telethon Kids Institute, University of Western Australia, West Perth, Australia.
authors.forename: Asha
authors.initials: A
authors.lastname: Bowen
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Tong
authors.affiliation: Murdoch Children's Research Institute, University of Melbourne, Parkville, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steer
authors.affiliation: One Disease, Tiwi, Australia.
authors.forename: Sam
authors.initials: S
authors.lastname: Prince
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Andrews
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.
authors.forename: Bart
authors.initials: B
authors.lastname: Currie
authors.affiliation: Telethon Kids Institute, University of Western Australia, West Perth, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carapetis
keywords: Endemic diseases; Impetigo; Public health; Scabies; Therapeutics; Tinea