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Cited by 268Dermatological diseases and infestationsParasitic Diseases Research and TreatmentDermatology and Skin Diseases

Mass drug administration for scabies control in a population with endemic disease.

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Romani, Lucia, Whitfeld, Margot J., Koroivueta, Josefa, Kama, Mike, Wand, Handan, Tikoduadua, Lisi, Tuicakau, Meciusela, Koroi, Aminiasi +3 more·2015·New England Journal of Medicine
DOI 10.1056/nejmoa1500987
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Abstract

BACKGROUND: Scabies is an underrecognized cause of illness in many developing countries. It is associated with impetigo, which can lead to serious systemic complications. We conducted a trial of mass drug administration for scabies control in Fiji. METHODS: We randomly assigned three island communities to one of three different interventions for scabies control: standard care involving the administration of permethrin to affected persons and their contacts (standard-care group), mass administration of permethrin (permethrin group), or mass administration of ivermectin (ivermectin group). The primary outcome was the change in the prevalence of scabies and of impetigo from baseline to 12 months. RESULTS: A total of 2051 participants were enrolled; 803 were in the standard-care group, 532 in the permethrin group, and 716 in the ivermectin group. From baseline to 12 months, the prevalence of scabies declined significantly in all groups, with the greatest reduction seen in the ivermectin group. The prevalence declined from 36.6% to 18.8% in the standard-care group (relative reduction in prevalence, 49%; 95% confidence interval [CI], 37 to 60), from 41.7% to 15.8% in the permethrin group (relative reduction, 62%; 95% CI, 49 to 75), and from 32.1% to 1.9% in the ivermectin group (relative reduction, 94%; 95% CI, 83 to 100). The prevalence of impetigo also declined in all groups, with the greatest reduction seen in the ivermectin group. The prevalence declined from 21.4% to 14.6% in the standard-care group (relative reduction, 32%; 95% CI, 14 to 50), from 24.6% to 11.4% in the permethrin group (relative reduction, 54%; 95% CI, 35 to 73), and from 24.6% to 8.0% in the ivermectin group (relative reduction, 67%; 95% CI, 52 to 83). Adverse events were mild and were reported more frequently in the ivermectin group than in the permethrin group (15.6% vs. 6.8%). CONCLUSIONS: Mass drug administration, particularly the administration of ivermectin, was efficacious for the control of scabies and impetigo. (Funded by the Australian National Health and Medical Research Council; Australian New Zealand Clinical Trials Registry number, ACTRN12613000474752.).

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Crossref · 10.1056/nejmoa1500987

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  • Mass treatment with oral ivermectin is highly effective in decreasing prevalence in settings where scabies is endemic.

    “Mass treatment with oral ivermectin is highly effective in decreasing prevalence in settings where scabies is endemic (1422).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1422]

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Authors
Romani, L., Whitfeld, M. J., Koroivueta, J., Kama, M., Wand, H., Tikoduadua, L., Tuicakau, M., Koroi, A., Andrews, R., Kaldor, J. M., & Steer, A. C.
Affiliations
  • Royal Children's Hospital (AU)
  • St Vincent's Hospital Melbourne (AU)
  • UNSW Sydney (AU)
  • Charles Darwin University (AU)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2015-12-10
Volume
373
Issue
24
Pages
2305-2313
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1500987
OpenAlex
W2317702186
Cited by
268
References
39
Citations by year
2026: 12 · 2025: 16 · 2024: 21 · 2023: 26 · 2022: 20 · 2021: 37 · 2020: 30 · 2019: 30 · 2018: 33 · 2017: 23 · 2016: 19 · 2015: 1
FWCI
19.68
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • CDU eSpace Institutional Repository (Charles Darwin University) (submittedVersion)
  • UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Dermatological diseases and infestations
  • Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords
scabies, mass drug administration, ivermectin, permethrin, impetigo, scabies control, endemic disease, Fiji, adverse events, community-based intervention, contact treatment
MeSH terms
Administration, Cutaneous, Adolescent, Adult, Anti-Bacterial Agents, Child, Child, Preschool, Female, Fiji, Humans, Impetigo, Insecticides, Ivermectin, Male, Scabies, Prevalence, Endemic Diseases, Permethrin, Young Adult, Skin Cream

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