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. 2020 Dec 22;14(12):e0008902.
doi: 10.1371/journal.pntd.0008902. eCollection 2020 Dec.

A scabies outbreak in the North East Region of Ghana: The necessity for prompt intervention

Yaw Ampem Amoako  1   2 , Richard Odame Phillips  2   3 , Joshua Arthur  1 , Mark Ayaaba Abugri  4 , Emmanuel Akowuah  2 , Kwabena Oppong Amoako  2 , Benjamin Aboagye Marfo  5 , Michael Frimpong  2 , Tjip van der Werf  6 , Sofanne Jacobine Ravensbergen  6 , Ymkje Stienstra  6
Affiliations

A scabies outbreak in the North East Region of Ghana: The necessity for prompt intervention

Yaw Ampem Amoako et al. PLoS Negl Trop Dis. .

Abstract

Background: There is a dearth of data on scabies from Ghana. In September 2019, local health authorities in the East Mamprusi district of northern Ghana received reports of scabies from many parts of the district. Due to on-going reports of more cases, an assessment team visited the communities to assess the effect of the earlier individual treatment on the outbreak. The assessment team furthermore aimed to contribute to the data on scabies burden in Ghana and to demonstrate the use of the International Alliance for the Control of Scabies (IACS) diagnostic tool in a field survey in a resource limited setting.

Methodology/principal findings: This was a cross sectional study. Demographic information and medical history was collected on all participants using a REDCap questionnaire. A standardised skin examination of exposed regions of the body was performed on all participants. Scabies was diagnosed based on the criteria of the International Alliance for the Control of Scabies (IACS). Participants were mostly female (61.5%) and had a median age of 18.8 years (IQR 13-25). Two hundred out of 283 (71%) of participants had scabies with most (47%) presenting with moderate disease. Impetigo was found in 22% of participants with scabies and 10.8% of those without scabies [RR 2.27 (95% CI 1.21-4.27)]. 119 participants who received scabies treatment in the past months still had clinical evidence of the disease. 97% of participants reported a recent scabies contact. Scabies was commoner in participants ≤16 years compared to those >16 years [RR 3.06 (95% CI 1.73-5.45)].

Conclusion/significance: The prevalence of scabies was extremely high. The lack of a systematic approach to scabies treatment led to recurrence and ongoing community spread. The IACS criteria was useful in this outbreak assessment in Ghana. Alternative strategies such as Mass drug administration may be required to contain outbreaks early in such settings.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Scabies lesions seen on exposed body regions in four selected participants
See this image and copyright information in PMC

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