Scabies in the Philippines: A Secondary Analysis of Local Patient Registries

Abstract

Background: Scabies is the second most common cause of disability among skin diseases in the Philippines as of 2019. There is no large nationwide study describing the epidemiologic profile of scabies in the country.

Objective: This study aimed to describe the demographic, seasonal, and geographic profile of scabies in the Philippines.

Methods: We compared secondary data of two local patient registries (Philippine Dermatological Society, PDS, 2010 to 2021; and Philippine Pediatric Society, PPS, 2009 to 2021) for reported cases of scabies in the Philippines. We reported the frequency and percentage distribution according to age, sex, month, year, and type of diagnosis, and region.

Results: The median annual frequency of scabies cases (mostly outpatient) for PDS (from year 2010) was 4087 (range ([QR], 342-6422 [3271.5]), while it was 183 (range [IQR], 64-234 [96.5]) (all inpatient) for PPS (from year 2009). There was a reduction to one-third (PDS) and one-fourth (PPS) of pre-pandemic numbers during the pandemic years (2020-2021). The peak months for scabies cases were the cooler months: January (median, 12.1% of annual cases; range [IQR], 2.6%-31.4% [3.6%]) to February (median, 10.0% of annual cases; range [IQR], 1.5%-27.8% [2.5%]) based on PDS data, and November (median, 10.0% of annual cases; range [IQR], 0.0%-24.3% [7.0%]) to January (median, 9.0% of annual cases; range [IQR], 0.0%-24.3% [6.6%]) for PPS data. Overall, for PDS, age 1-4 years is the most affected age group (median, PDS, 17.5% of annual cases; range [IQR], 11.9%-25.4% [8.1%]), while it was the less than 1-year-olds (median annual cases, 48.9%; range [IQR], 29.1%-67.3% [13.20%]) among PPS pediatric population aged 0 to 18 years. Males (median, 53.9% of annual cases; range [IQR], 45.0%-67.2% [8.8%]) were more affected than females in PPS. While for PDS during earlier years (prior to 2015), males (median, 51.6% of annual cases from 2010 to 2014; range [IQR], 47.4%-52.9% [0.2%]) were more affected than females. However, males became less affected than females with median, 44.7% of annual cases from 2015 onwards (range [IQR], 43.4%-46.5% [1.2%]). NCR was the region with the highest frequency of cases in PPS (median, 52.6% of annual cases; range [IQR], 22.7%-75.0% [20.4%]). The 2^nd most affected regions were Central/Eastern Visayas (34.2%, 2009-2013; range [IQR], 17.9%-54.1% [5.3%]), Bicol region (12%; 2014 to 2018; range [IQR], 17.9%-54.1% [7.4%]), Central Luzon (18%; 2019), Central/Eastern Visayas (29%, 2020), and Northern/Central Mindanao (17%, 2021).

Conclusion: Scabies was commonly seen in the younger age group, slightly more in females in the PDS, while slightly more among males in the PPS, in the cooler months of the year, and in the urbanized NCR.

Keywords: Philippines; database; epidemiology; registry; scabies; secondary data.

Figure 1

Annual time series of cases with scabies from 2009 to 2021. (A) Philippine Dermatological Society (PDS), (B) Philippine Pediatric Society (PPS).

Figure 2

Cycle plot of distribution of patients with scabies from 2009 to 2021. (A) Philippine Dermatological Society (PDS), (B) Philippine Pediatric Society (PPS).

Figure 3

Annual distribution of patients with scabies as to region/Philippine Pediatric Society (PPS) chapter. Note: PPS chapters cover all 17 regions in the Philippines; each chapter may cover more than one political region. Northern Luzon – Region I and CAR; Northeastern Luzon – Region II and proximal areas of Ifugao and Kalinga-Apayao; Central Luzon – Region III; National Capital Region; Southern Tagalog – Region IV; Bicol – Region V; Western Visayas – Region VI; Central/Eastern Visayas – Regions VII and VIII; Northern/Central Mindanao – Regions IX, X, and XIII; Southern Mindanao – Regions XI, XII, BARMM, and parts of Zamboanga.