Scabies Epidemiology and Management Strategies

Scabies, a parasitic skin infection caused by Sarcoptes scabiei, affects over 200 million people worldwide, with the highest burdens observed in tropical and resource-limited settings. Transmission occurs primarily through prolonged skin-to-skin contact, with outbreaks common in overcrowded households, institutional settings and among marginalised communities. The clinical spectrum ranges from classical papular eruptions and intense pruritus to crusted scabies, a severe form associated with immunosuppression. Epidemiological studies reveal age- and region-specific prevalence peaks in children and the elderly, underscoring the need for targeted interventions. Management strategies combine individual treatments with topical acaricides, primarily permethrin, or systemic ivermectin, with repeated dosing regimens to address mite life cycles. At the population level, mass drug administration has demonstrated rapid reductions in prevalence when integrated with community engagement and water-sanitation improvements. Challenges include diagnostic variability, emerging drug resistance and pseudo-resistance, and logistical constraints in mass campaigns. Institutional outbreaks, particularly in care homes, demand tailored control measures, encompassing thorough clinical screening and environmental decontamination. Recent developments in standardised diagnostic criteria and treatment algorithms aim to harmonise research and surveillance, while novel therapeutic agents and combination regimens are under evaluation. Effective scabies control relies on an integrated approach bridging epidemiology, clinical management, public health policy and ongoing research to reduce morbidity and interrupt transmission globally.

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Scabies Epidemiology and Management Strategies publication trend

The graph below shows the total number of articles in scabies epidemiology and management strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Sarcoptes scabiei: Mite species that burrows into the skin causing scabies.

Mass drug administration (MDA): Community-wide distribution of treatment to interrupt transmission.

Crusted scabies: Severe form of infestation with thick skin crusts and high mite density.

Pseudo-resistance: Apparent treatment failure due to factors such as reinfection or improper application rather than true drug resistance.

Diagnostic certainty levels: Standardised categories (confirmed, clinical, suspected) defining scabies cases based on clinical and confirmatory evidence.

References

1. A review of Sarcoptes scabiei: past, present and future. Parasites & Vectors (2017).
2. The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015. The Lancet Infectious Diseases (2017).
3. Toward the Global Control of Human Scabies: Introducing the International Alliance for the Control of Scabies. PLOS Neglected Tropical Diseases (2013).
4. Consensus criteria for the diagnosis of scabies: A Delphi study of international experts. PLOS Neglected Tropical Diseases (2018).
5. Resistance and Pseudo-resistance to permethrin: the importance of controlling scabies. Frontiers in Cellular and Infection Microbiology (2023).
6. Scabies outbreaks in ten care homes for elderly people: a prospective study of clinical features, epidemiology, and treatment outcomes. The Lancet Infectious Diseases (2018).
7. Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. PLOS Neglected Tropical Diseases (2015).