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. 2020 Apr 10;70(8):1591-1595.
doi: 10.1093/cid/ciz444.

Prevalence of Scabies and Impetigo 3 Years After Mass Drug Administration With Ivermectin and Azithromycin

Michael Marks  1   2 , Lucia Romani  3   4 , Oliver Sokana  5 , Lazarus Neko  6 , Relmah Harrington  7 , Titus Nasi  5 , Handan Wand  3 , Margot J Whitfeld  8 , Daniel Engelman  4   9 , Anthony W Solomon  1   2 , John M Kaldor  3 , Andrew C Steer  3   9
Affiliations

Prevalence of Scabies and Impetigo 3 Years After Mass Drug Administration With Ivermectin and Azithromycin

Michael Marks et al. Clin Infect Dis. .

Abstract

Background: Ivermectin-based mass drug administration has emerged as a promising strategy for the control of scabies and impetigo in settings where the diseases are endemic. Current follow-up data are limited to 12 months for the majority of studies. Longer-term data are vital to inform the sustainability of interventions.

Methods: We conducted a prevalence survey for scabies and impetigo in 10 villages in Choiseul Province of the Solomon Islands 36 months after a single round of ivermectin and azithromycin mass drug coadministration. In the primary analysis, we compared the prevalence of scabies and impetigo at 36 months to the prevalence at baseline.

Results: At 36 months, the prevalence of scabies was 4.7% (95% confidence interval [CI], 3.6-6.1), which was significantly lower than at baseline (18.7%; relative reduction, 74.9%; 95% CI, 61.5%-87.7%; P < .001). The prevalence of impetigo was 9.6% (95% CI, 8.1%-11.4%), significantly lower than at baseline (24.7%; relative reduction, 61.3%; 95% CI, 38.7%-100%; P < .001). The highest prevalence of scabies was among children aged <5 years (12.5%; adjusted odds ratio, 33.2; 95% CI, 6.6-603.2), and the highest prevalence of impetigo was among children aged 5-9 years (16.4%; adjusted odds ratio, 8.1; 95% CI, 3.6-21.8).

Conclusions: There was a sustained impact of a single round of ivermectin and azithromycin mass drug coadministration on the prevalence of scabies and impetigo 3 years after the intervention. Our data provide further support to adopt this intervention as a central component of global scabies control efforts.

Clinical trials registration: Australian and New Zealand Trials Registry (ACTRN12615001199505).

Keywords: impetigo; ivermectin; mass drug administration; neglected tropical diseases; scabies.

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