A cross-sectional survey of knowledge and attitudes towards scabies control in Australian aged care facilities

Abstract

Scabies outbreaks cause significant morbidity and disruption in aged care facilities and other institutional settings. Failure to manage scabies outbreaks may be attributable to low awareness amongst healthcare workers. A survey was distributed to healthcare workers across aged care facilities in South-East Queensland, Australia. The survey captured demographics, prior scabies experience, knowledge-based questions, and attitudes. Scabies was common in aged care facilities, with 41% of 128 respondents encountering the disease while working in aged care. Participants demonstrated sound theoretical knowledge regarding scabies (median knowledge score 82%). Scabies knowledge was not associated with years of experience in the sector or educational level but was associated with respondent age (p = 0.017). Knowledge gaps were evident regarding diagnosis, incubation periods, and treatment. Respondents demonstrated an inconsistent ability to identify atypical clinical presentations of scabies, showing discordance between theoretical knowledge and its practical application. The ability to identify crusted scabies was low, reflecting the high frequency of misdiagnosis of index cases in scabies outbreaks. Respondents considered scabies to be a problem and were supportive of improved management guidelines. These study outcomes will inform the design of accessible, targeted educational resources for scabies to help prevent and reduce the impact of outbreaks.

Keywords: KAP; Sarcoptes scabiei; aged care; education; infection control; nursing homes; scabies.

Figure 1.

Survey participants prior experiences of scabies. The proportion of respondents that had observed scabies in their workplace during their time working in aged care (a) or reported or observed occupational exposure to scabies (b). This includes those who said their family members had caught scabies from them via their occupation. n = 128, missing responses were treated as a ‘no’ response.

Figure 2.

Survey participants’ knowledge of scabies. Distributions of overall knowledge construct scores (a) and across age groups (b). *p = 0.017, n = 59.

Figure 3.

Ability of survey participants to correctly identify representative images of scabies. Respondents were shown a series of colour images representing non-scabies (‘not scabies’ panel), ordinary scabies (‘scabies’ panel) and crusted scabies (‘crusted scabies’ panel) and asked to distinguish which images were suggestive of scabies. The x-axis shows a description of the images, and y-axis proportions of correct versus incorrect. Only respondents making an attempt at this section of the survey were included in calculation of correct/incorrect proportions (n = 99).