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ORIGINAL ARTICLE
Year : 2012  |  Volume : 6  |  Issue : 1  |  Page : 26-29

Prevalence of scabies among school-aged children in Katanga rural community in Kaduna state, Northwestern Nigeria


Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

Date of Web Publication28-Aug-2012

Correspondence Address:
Mohammed N Sambo
Department of Community Medicine, Ahmadu Bello University, Zaria
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0331-3131.100208

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   Abstract 

Background: Scabies is a common parasitic infestation of global proportion. It is a highly contagious skin disease which affects both males and females of all socioeconomic status and race. It is related primarily to poverty and overcrowding, which is also found in most rural communities. This study aimed at assessing the prevalence of scabies among school-aged children in Katanga community.
Materials and Methods: In a descriptive cross-sectional study, pre-tested semi-structured questionnaire was administered to 206 school children aged 5-12 years through a total population study in Katanga rural community. Data collected were analyzed using SPSS version 17.
Results: In this study, 45 (21.8%) children had skin infections, 33 (73.3%) of these skin infections were associated with itching and 6 cases of scabies were found giving a prevalence rate of 2.9% in the community.
Conclusion: This study has shown that scabies is a disease associated with poverty, overcrowding, and sometimes water shortage, and is still endemic in rural communities in Northern Nigeria causing a substantial burden. These findings, coupled with the potential for clinical complications and a heavy socioeconomic impact, suggest that it is time for more concerted actions in terms of provision of adequate domestic water supply and improvement of personal and environmental hygiene against this disease in Nigeria.

Keywords: Prevalence, rural community, scabies, school-aged children


How to cite this article:
Sambo MN, Idris SH, Umar AA, Olorukooba AA. Prevalence of scabies among school-aged children in Katanga rural community in Kaduna state, Northwestern Nigeria. Ann Nigerian Med 2012;6:26-9

How to cite this URL:
Sambo MN, Idris SH, Umar AA, Olorukooba AA. Prevalence of scabies among school-aged children in Katanga rural community in Kaduna state, Northwestern Nigeria. Ann Nigerian Med [serial online] 2012 [cited 2019 Jan 20];6:26-9. Available from: http://www.anmjournal.com/text.asp?2012/6/1/26/100208


   Introduction Top


Scabies is a common parasitic infestation of global proportion. Worldwide, an estimated 300 million cases occur annually. [1] The arthropod, Sarcoptes scabiei hominis, an ectoparasitic mite, causes an intensely pruritic and highly contagious skin infestation. Scabies is a highly contagious skin disease which affects both males and females of all socioeconomic status and race. [2] It is related primarily to poverty and overcrowding. The disease was first ascribed to the mite by Giovan Cosimo Bonomo in 1687. [3] It was the first human disease recognized to be caused by a specific pathogen. [4] The mite is an obligate parasite that completes its entire life cycle on humans. Only female mites burrow into the skin. The maturation process lasts about 15 days, with the larvae emerging 2-3 days after the eggs are laid. About 5-15 female mites live on a host infected with classic scabies, but the number can reach hundreds or even millions in cases of crusted scabies. [5],[6] The skin eruption of classic scabies is considered a consequence of both infestation and a hypersensitivity reaction to the mite. The incubation period before symptoms occur is 3-6 weeks for primary infestation but may be as short as 1-3 days in cases of re-infestation. Transmission of scabies is predominantly through direct skin-to-skin contact with infected persons, and for this reason, scabies can be transmitted sexually and thus has been classified a sexually transmitted disease. [7] A person infested with mites can spread scabies even if he or she is asymptomatic. [8],[9],[10] Scabies has been classified as a water shortage disease because of its association with inadequate water supply leading to poor personal hygiene and thus increased risk of transmission. [11],[12]

A recent review by the World Health Organization Department of Child and Adolescent Health and Development indicated that scabies is still an endemic disease in many tropical and subtropical countries. [4] This review concluded that more data documenting the burden of skin disease in children are required at the community level because of gaps in the evidence, particularly relating to disease burden in infants and the reporting of incidence data. This agrees with MDG 4 which calls for reduction in child morbidity and mortality. This study was aimed at assessing the prevalence of scabies among school-aged children in Katanga rural community Sabon Gari Local Government Area, Kaduna state, Nigeria.


   Materials and Methods Top


A cross-sectional descriptive study was carried out among school-aged children (5-12 years) in Katanga community, Sabon Gari LGA of Kaduna state. The community is a small community with a total population of about 1454 people. There were 237 women of reproductive age group and about 225 school-aged children. Major tribe of the people is hausa, and they are predominantly muslims. The major occupation is farming and hunting. This study was part of a community diagnosis posting of 600 level medical students. Total sampling study of all school-aged children was conducted. Data were collected by medical students using interviewer administered structured questionnaires containing closed-ended questions. Prior to data collection, a pretesting of the questionnaire was done in Zabi community about 3 km away from the Katanga community. The study was conducted during holiday when the primary school pupils were on holidays and the children were interviewed in the presence of mothers and/or caregivers who supplied information especially for the relatively younger children. The skins of the children were examined for the presence of scattered groups of pruritic vesicles and pustules in "runs" or "burrows" on the sides of the fingers, palms, wrists, elbows, axillae, as well as around the waist and groin. Episodes of itching especially at night were asked. However, specimens for microbiological investigations were not collected which means the diagnosis for scabies was made clinically. Consent was obtained from the local authority and the head of households before the commencement of the survey and data collection respectively. The data obtained were analyzed using SPSS version 17.


   Results Top


Out of 225 school-aged children in the community, 206 (91.6%) were interviewed and examined. Of this figure, more than half (115, 55.8%) were within the age bracket 5-8 years, whereas 91 (44.2%) were within the age range 9-12 years. Males constituted 100 (48.5%), whereas females constituted 106 (51.5%) given a male to female ratio of almost 1:1. The enrollment rate among the respondents was 168 (81.5%) with 107 (51.9%) in classes 1-3 and 61 (29.6%) in classes 4-6 as shown in [Table 1]. A total of 45 (21.8%) of the children in Katanga had skin rashes out of which 36 (80%) had it for more than 1 month, 33 (73.3%) of the skin rashes were associated with skin itching. About 7 (15.6%) of the skin rashes were centrifugal in distribution, 6 (13.3%) had inter-digital distribution and 23 (51.1%) were sparsely distributed, 6 (13.3%) of the skin rashes exhibited typical characteristic features of scabies as shown in [Table 2]. Among those that exhibited classical features of scabies 4 (66.7%) of them sought for treatment. Majority, 3 (75%) of them sought traditional medicine treatment and the remaining 1 (25%) sought for orthodox method of medication as shown in [Table 2].
Table 1: Socio-demographic characteristics of children examined in Katanga community (n = 206)

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Table 2: Characteristics and nature of skin rashes in school-aged children in Katanga community

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   Discussion Top


The results of our study revealed that scabies, a skin disease associated with poverty, overcrowding, and sometimes water scarcity, is prevalent among school-aged children in rural communities in Northern Nigeria. In this study, despite the fact that school children were on holiday, as much as 91.6% response rate was recorded. More than half (55.8%) of them were in the early school-aged years, 5-8 years compared with older age group, this demographic characteristics if depicted in a population pyramid will exhibit typical characteristics of population of developing communities. [13] The male to female ratio from the study is about 1:1 with marginal increase in favor of female, this ratio is also typical to what is obtained in the Nigerian census. [14] The study also revealed that 18.5% of the children were not enrolled in school, this high figure might be alarming in view of the massive enlightenment toward achieving universal basic education. However, the figure might be explained by the fact that in most of the rural communities in the north of Nigeria, school enrollment is delayed till about age of 6-7 years as the children are not exposed to nursery school.

The study revealed a high prevalence of skin disease among school-aged children. Almost a quarter of the children had skin infections with close to three-quarter associated with skin itching. This is an indication of the high burden of skin infections in this community. The pattern of distribution of skin rashes on the body showed that majority (51.1%) had sparse distribution then followed by centrifugal (15.6%), and inter-digital distribution (13.3%). Most of the skin rashes have been on for more than 1 month on the body of the affected children. A total of 13.3% were diagnosed clinically as scabies infection. On the whole, about 2.9% of the population of under-5 children had scabies infestation when compared with the southern parts of the country which was found to have a prevalence of 4.7% among school children. [15] Among the children who had scabies infestation, 66.7% sought for at least one form of treatment; however, 75% of those who sought treatment used traditional methods like the use of local herbs and creams.

This study clearly indicates that there is a large burden of skin diseases especially scabies among the children of Katanga. Over a quarter of the children (21.8%) in the community during this cross-sectional study had active skin infection with a prevalence of scabies of 2.9% in the community. This is in keeping with a recent review of the prevalence of childhood skin diseases in developing tropical and subtropical countries which concluded that the prevalence of scabies is in the range of 1-2%. [4] Many of the studies included in this review were from sub-Saharan Africa. Studies from the Pacific suggest that the prevalence of scabies is significantly higher in the Pacific region. [9],[16],[17] Scabies has been considered to be a public health problem in the developing countries for decades; however, there has been little progress in the control on a global scale. [18],[19],[20]


   Conclusion Top


This study has shown that scabies, a disease associated with poverty, overcrowding, and sometimes water shortage, is still endemic in rural communities in Northern Nigeria causing a substantial burden. These findings, coupled with the potential for clinical complications and a heavy socioeconomic impact, suggest that it is time for more concerted actions in terms of provision of adequate domestic water supply and improvement of personal and environmental hygiene against this disease in Nigeria.

 
   References Top

1.CDC. Scabies fact sheet. Centers for Disease Control and Prevention; Atlanta GA 30333, USA 2005.  Back to cited text no. 1
    
2.Rinnert K. Infectious diseases: Occupational exposures, infection control, and standard precautions. In: Tintinalli J, Kelen G, Stapczynski S, editors. Emergency Medicine: A Comprehensive Study Guide. 6 th ed. New York: The McGraw-Hill Companies Inc.; 2004. p. 1005-13.  Back to cited text no. 2
    
3.Ramos-e-Silva M. Giovan Cosimo Bonomo (1663-1696): Discoverer of the etiology of scabies. Int J Dermatol 1998;37:625-30.  Back to cited text no. 3
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4.World Health Organization: Epidemiology and management of common skin diseases in children in developing countries. Geneva: World Health Organization; 2005. p. 54.  Back to cited text no. 4
    
5.Lucas AO, Gilles HM. Short Textbook of Public Health Medicine for the Tropics, 4 th ed. Lodon: Edward Arnold 2003.  Back to cited text no. 5
    
6.Parks K. Park's Textbook of Preventive and Social Medicine, 18 th ed. India: M/s Banarsidas Bhanot 2005.  Back to cited text no. 6
    
7.Feldmeier H, Heukelbach J. Epidermal parasitic skin diseases: A neglected category of poverty-associated plagues. Bull World Health Organ 2009;87:152-9.  Back to cited text no. 7
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8.Heukelbach J, Wilcke T, Winter B, Feldmeier H. Epidemiology and morbidity of scabies and pediculosis capitis in resource-poor communities in Brazil. Br J Dermatol 2005;153:150-6.  Back to cited text no. 8
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9.Sardana K, Mahajan S, Sarkar R, Mendiratta V, Bhushan P, Koranne RV, et al. The spectrum of skin disease among Indian children. Pediatr Dermatol 2009;26:6-13.  Back to cited text no. 9
    
10.Feldmeier H, Jackson A, Ariza L, Calheiros CM, Soares Vde L, Oliveira FA, et al. The epidemiology of scabies in an impoverished community in rural Brazil: Presence and severity of disease are associated with poor living conditions and illiteracy. J Am Acad Dermatol 2009;60:436-43.  Back to cited text no. 10
    
11.Brook I. Microbiology of secondary bacterial infection in scabies lesions. J Clin Microbiol 1995;33:2139-40.  Back to cited text no. 11
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12.Scheinfeld N. Controlling scabies in institutional settings: A review of medications, treatment models, and implementation. Am J Clin Dermatol 2004;5:31-7.  Back to cited text no. 12
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13.Adamu YM, Sambo MN, Aliyu AA. Socio-demographic characteristics of a semi-urban community in Northern Nigeria. J Community Med Prim Health Care 2004;16:55-9.  Back to cited text no. 13
    
14.National Populations Commission (NPC) [Nigeria] and ORC Macro. Nigeria Demographic and Health survey 2003. Calverton, Maryland: National Populations Commission & ORC Macro; 2004.  Back to cited text no. 14
    
15.Ogunbiyi AO, Owoaje E, Ndahi A. Prevalence of skin disorders in school children in Ibadan, Nigeria. Pediatr Dermatol 2005;22:6-10.  Back to cited text no. 15
    
16.Schleicher SM, Stewart P. Scabies: The mite that roars. Emerg Med 1997;6:54-8.  Back to cited text no. 16
    
17.Walton SF, Holt DC, Currie BJ, Kemp DJ. Scabies: New future for a neglected disease. Adv Parasitol 2004;57:309-76.  Back to cited text no. 17
    
18.Heukelbach J, Feldmeier H. Ectoparasites--The underestimated realm. Lancet 2004;363:889-91  Back to cited text no. 18
    
19.Parish LC. Infection control and isolation recommendations. In: Orkin M, Maibach HI, Parish LC, editors. "History of Scabies" in Scabies and Pediculosis. Schwartzman RM: J.B. Lippincott; 1977. p. 675.  Back to cited text no. 19
    
20.Fraser V, Elward A. Infection control and isolation recommendations. In: Green G, Harris I, Lin G, Moylan K, editors. The Washington Manual of Medical Therapeutics. 363(9412) ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004. p. 67.  Back to cited text no. 20
    



 
 
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