High burden of impetigo and scabies in a tropical country
Open accessAbstract
BACKGROUND: Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific. METHODOLOGY/PRINCIPAL FINDINGS: We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months) and one study was performed in infants (cross-sectional). The prevalence of active impetigo was 25.6% (95% CI 24.1-27.1) in primary school children and 12.2% (95% CI 9.3-15.6) in infants. The prevalence of scabies was 18.5% (95% CI 17.2-19.8) in primary school children and 14.0% (95% CI 10.8-17.2) in infants. The incidence density of active impetigo, group A streptococcal (GAS) impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6-3.7) and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7-4.7). The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants). CONCLUSIONS/SIGNIFICANCE: These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control.
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In Oceania, sub-Saharan Africa, southeast Asia, and tropical Americas, skin infections accounted for a higher proportion of the skin disease burden.
“In Oceania, sub-Saharan Africa, southeast Asia, and the tropical Americas, skin infections assume a higher proportion of the disease burden (Leekassa et al., 2005;Steer et al., 2009).”
From The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions (2014) · cites this paper as Steer et al., 2009
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Self-citation
- Authors
- Steer, A. C., Jenney, A. W. J., Kado, J., Batzloff, M. R., La Vincente, S., Waqatakirewa, L., Mulholland, E. K., & Carapetis, J. R.
- Affiliations
- The University of Melbourne (AU)
- Ministry Of Health (FJ)
- QIMR Berghofer Medical Research Institute (AU)
- Corresponding author
- Steer, Andrew C.
- Venue
- PLoS neglected tropical diseases
- Publisher
- Public Library of Science (PLoS)
- Published
- 2009-06-23
- Volume
- 3
- Issue
- 6
- Pages
- e467
- ISSN
- 1935-2727 (ISSN-L)
- 1935-2735
- PMC
- PMC2694270
- OpenAlex
- W2078183490
- Cited by
- 170
- References
- 28
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 10 · 2023: 10 · 2022: 14 · 2021: 10 · 2020: 6 · 2019: 12 · 2018: 20 · 2017: 9 · 2016: 8 · 2015: 13 · 2014: 10 · 2013: 10 · 2012: 9
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS neglected tropical diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- CDU eSpace Institutional Repository (Charles Darwin University) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Allergy and Infectious Diseases (U01AI60579, U01AI060579)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Dermatological diseases and infestations
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Keywords
- impetigo, scabies, disease burden, prevalence, incidence, elementary school students, infants, Fiji, Pacific Islands, tropical endemic diseases
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Fiji, Humans, Impetigo, Infant, Male, Scabies, Staphylococcal Infections, Staphylococcus aureus, Streptococcal Infections, Streptococcus pyogenes, Comorbidity, Prevalence
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