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      The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015

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          Summary

          Background

          Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015.

          Methods

          We identified scabies epidemiological data sources from an extensive literature search and hospital insurance data and analysed data sources with a Bayesian meta-regression modelling tool, DisMod-MR 2·1, to yield prevalence estimates. We combined prevalence estimates with a disability weight, measuring disfigurement, itch, and pain caused by scabies, to produce years lived with disability (YLDs). With an assumed zero mortality from scabies, YLDs were equivalent to disability-adjusted life-years (DALYs). We estimated DALYs for 195 countries divided into 21 world regions, in both sexes and 20 age groups, between 1990 and 2015.

          Findings

          Scabies was responsible for 0·21% of DALYs from all conditions studied by GBD 2015 worldwide. The world regions of east Asia (age-standardised DALYs 136·32), southeast Asia (134·57), Oceania (120·34), tropical Latin America (99·94), and south Asia (69·41) had the greatest burden of DALYs from scabies. Mean percent change of DALY rate from 1990 to 2015 was less than 8% in all world regions, except North America, which had a 23·9% increase. The five individual countries with greatest scabies burden were Indonesia (age-standardised DALYs 153·86), China (138·25), Timor-Leste (136·67), Vanuatu (131·59), and Fiji (130·91). The largest standard deviations of age-standardised DALYs between the 20 age groups were observed in southeast Asia (60·1), Oceania (58·3), and east Asia (56·5), with the greatest DALY burdens in children, adolescents, and the elderly.

          Interpretation

          The burden of scabies is greater in tropical regions, especially in children, adolescents, and elderly people. As a worldwide epidemiological assessment, GBD 2015 provides broad and frequently updated measures of scabies burden in terms of skin effects. These global data might help guide research protocols and prioritisation efforts and focus scabies treatment and control measures.

          Funding

          Bill & Melinda Gates Foundation.

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          Most cited references15

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          Global Skin Disease Morbidity and Mortality : An Update From the Global Burden of Disease Study 2013

          Chante Karimkhani, Robert Dellavalle, Luc E. Coffeng … (2017)
          Question What is the burden of skin disease worldwide? Findings In this observational study, skin diseases contributed 1.79% to the global burden of disease measured in disability-adjusted life years (DALYs). Skin diseases arranged in order of decreasing global DALYs are as follows: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma, decubitus ulcer, and alopecia areata. Meaning Skin diseases remain a major cause of disability worldwide. An objective measure of burden, such as the DALY, allows for comparison of diverse diseases across geography and time. This study measures the burden of skin diseases worldwide. Importance Disability secondary to skin conditions is substantial worldwide. The Global Burden of Disease Study 2013 includes estimates of global morbidity and mortality due to skin diseases. Objective To measure the burden of skin diseases worldwide. Data Sources For nonfatal estimates, data were found by literature search using PubMed and Google Scholar in English and Spanish for years 1980 through 2013 and by accessing administrative data on hospital inpatient and outpatient episodes. Data for fatal estimates were based on vital registration and verbal autopsy data. Study Selection Skin disease data were extracted from more than 4000 sources including systematic reviews, surveys, population-based disease registries, hospital inpatient data, outpatient data, cohort studies, and autopsy data. Data metrics included incidence, prevalence, remission, duration, severity, deaths, and mortality risk. Data Extraction and Synthesis Data were extracted by age, time period, case definitions, and other study characteristics. Data points were modeled with Bayesian meta-regression to generate estimates of morbidity and mortality metrics for skin diseases. All estimates were made with 95% uncertainty intervals. Main Outcomes and Measures Disability-adjusted life years (DALYs), years lived with disability, and years of life lost from 15 skin conditions in 188 countries. Results Skin conditions contributed 1.79% to the global burden of disease measured in DALYs from 306 diseases and injuries in 2013. Individual skin diseases varied in size from 0.38% of total burden for dermatitis (atopic, contact, and seborrheic dermatitis), 0.29% for acne vulgaris, 0.19% for psoriasis, 0.19% for urticaria, 0.16% for viral skin diseases, 0.15% for fungal skin diseases, 0.07% for scabies, 0.06% for malignant skin melanoma, 0.05% for pyoderma, 0.04% for cellulitis, 0.03% for keratinocyte carcinoma, 0.03% for decubitus ulcer, and 0.01% for alopecia areata. All other skin and subcutaneous diseases composed 0.12% of total DALYs. Conclusions and Relevance Skin and subcutaneous diseases were the 18th leading cause of global DALYs in Global Burden of Disease 2013. Excluding mortality, skin diseases were the fourth leading cause of disability worldwide.
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            Prevalence of scabies and impetigo worldwide: a systematic review.

            Lucia Romani, Andrew Steer, Margot Whitfeld … (2015)
            Scabies is a skin disease that, through secondary bacterial skin infection (impetigo), can lead to serious complications such as septicaemia, renal disease, and rheumatic heart disease. Yet the worldwide prevalence of scabies is uncertain. We undertook a systematic review, searching several databases and the grey literature, for population-based studies that reported on the prevalence of scabies and impetigo in a community setting. All included studies were assessed for quality. 2409 articles were identified and 48 studies were included. Data were available for all regions except North America. The prevalence of scabies ranged from 0·2% to 71·4%. All regions except for Europe and the Middle East included populations with a prevalence greater than 10%. Overall, scabies prevalence was highest in the Pacific and Latin American regions, and was substantially higher in children than in adolescents and adults. Impetigo was common, particularly in children, with the highest prevalence in Australian Aboriginal communities (49·0%). Comprehensive scabies control strategies are urgently needed, such as a community-based mass drug administration approach, along with a more systematic approach to the monitoring of disease burden.
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              Mass Drug Administration for Scabies Control in a Population with Endemic Disease.

              Lucia Romani, Margot Whitfeld, Josefa Koroivueta … (2015)
              Scabies is an underrecognized cause of illness in many developing countries. It is associated with impetigo, which can lead to serious systemic complications. We conducted a trial of mass drug administration for scabies control in Fiji.
              Article 0 comments Cited 114 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Chante Karimkhani
                Journal
                Journal ID (nlm-ta): Lancet Infect Dis
                Journal ID (iso-abbrev): Lancet Infect Dis
                Title: The Lancet. Infectious Diseases
                Publisher: Elsevier Science ;, The Lancet Pub. Group
                ISSN (Print): 1473-3099
                ISSN (Electronic): 1474-4457
                Publication date PMC-release: 1 December 2017
                Publication date (Print): December 2017
                Volume: 17
                Issue: 12
                Pages: 1247-1254
                Affiliations
                [a ]Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
                [b ]Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
                [c ]Department of Dermatology, Brown University, Providence, RI, USA
                [d ]Department of Dermatology, Children's National Medical Center, NW Washington DC, USA
                [e ]Department of Dermatology, King's College Hospital, Denmark Hill, London, UK
                [f ]Centre for International Child Health and Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Melbourne, VIC, Australia
                [g ]Department of Dermatology, St Vincent's Hospital, Darlinghurst, Sydney, NSW, Australia
                [h ]Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
                [i ]Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health System, Denver, CO, USA
                Author notes
                [* ]Correspondence to: Dr Chante Karimkhani, Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USACorrespondence to: Dr Chante KarimkhaniDepartment of DermatologyUniversity of Colorado Anschutz Medical CampusAuroraCO80045USA ck2525@ 123456caa.columbia.edu
                Article
                Publisher ID: S1473-3099(17)30483-8
                DOI: 10.1016/S1473-3099(17)30483-8
                PMC ID: 5700804
                PubMed ID: 28941561
                SO-VID: 4ceb8800-2ad3-4faa-a6aa-fef0193794f9
                Copyright © © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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                ScienceOpen disciplines: Infectious disease & Microbiology

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