31.4.8 Incidence/Prevalence of Scabies in Sialkot

Original Article

 

Prevalence of Scabies

Incidence / Prevalence of Scabies
                        in Sialkot

M Naeem1, Abdul Rehman3, Shafiq ur Rehman Jamil4 and Anwar Khan2

ABSTRACT

Objective: To study the incidence/prevalence of Scabies in Sialkot.

Study Design: Retrospective study

Place and Duration of Study: This study was conducted at Idris Teaching Hospital Sialkot from Jan 2019 to
December 2019.

Materials and Methods: There were 2520 patients of scabies were included in this study Male 1297(51.46%) and female 1223 (48.51%), the history and family history were recorded. The examination was conducted on all the patients. The demographic bio data and incidence of patients of scabies from Jan-Dec 2019 were recorded.  The written informed consent was taken before the study of patients. The permission of ethical committee was considered for collection of data and publishing it in medical journal. The data was analyzed on SPSS version 10 for results.

Results: The incidence of scabies was the highest at the age of 5-15 years 621 (24.64%) of total patients. The incidence of scabies was the lowest at age below 5 years 100(3.96%). The incidence of scabies was the highest in lower class 1263(49.72%) and the incidence of scabies were lowest in high class 400(15.74%). The incidence of scabies was highest in rural area 1581(62.73%) and in urban area it was lowest 939(37.26%). The incidence of scabies was the highest in month of MAY-June 501 (19.88%) patients and lowest in the month of Jan-Feb 310 (12.30%) patients.

Conclusion: It was concluded that the incidence of scabies was highest in the rural area and in the lower class at age of 5-15 years and highest in hot weather and lowest in cold weather.

Key Words: Scabies, Incidence, Prevalence, Sialkot, itching

Citation of article: Naeem M, Rehman A, Jamil SR, Khan A. Incidence/Prevalence of Scabies in Sialkot. Med Forum 2020;31(4):33-35.

 

 

INTRODUCTION

Scabies is a skin infestation caused by the burrowing action of a female parasite, Sarcoptes scabies (Itch mite) resulting in irritation and vesicle or pustule formation1. Human scabies has played a modest, but not nugatory role in the history of dermatology. Hebra, Beeson, Heilesen and Friedman have related the story of scabies in detail2-5.

Scabies infestation is ubiquitous and age, sex or skin colour plays no part in its aetiology6. Scabies affects all races and social classes worldwide7.

 

 

1. Department of Dermatology / Forensic Medicine2, Islam Medical College Sialkot.

3. Department of DPT, Imran Idris Institute of rehabilitation Sciences.

4. Neuro Surgeon, Aziz Bhatti Hospital Gujrat.

 

 

Correspondence: Dr, M Naeem Associate Professor of Dermatology, Islam Medical College Sialkot.

Contact No: 0345-4758069

Email: hrd.smc@yahoo.com

 

 

Received:  January, 2020

Accepted:  February, 2020

Printed:      April, 2020

 

 

Accurate figures of its incidence are difficult to obtain and most reports are based on hospital outpatient attendance records8. The incidence of scabies in developed countries shows cyclical fluctuations for which, there is, as yet, no satisfactory explanation9. The reported incidence of scabies for Karachi is 22.7%, which is more than other infections10.

Medical staffs, especially General Medical Practitioners (GPs) are an integral part of any health care system. Treatment of scabies is domiciliary, so mostly patients are in contact with GPs. GPs are not only involved in the management of scabies but they are also responsible for providing health education to the patients about this disease. The patients’ queries about scabies, such as mode of spread, prevention and protection of family members, are often directed at the GPs, as they are more readily available than the skin specialists.
Although national data for scabies is not available but reports based on hospital outpatient attendance records shows alarming prevalence indicating a lack of awareness about this common skin problem among GPs11.

MATERIALS AND METHODS

There were 2520 patients of scabies were included in this study Male 1297(51.46%) and female 1223 (48.53%), the history and family history were recorded. The examination was conducted on all the patients. The demographic bio data and incidence of patients of scabies from Jan-Dec 2019 were recorded.  The written informed consent was taken before the study of patients. The permission of ethical committee was considered for collection of data and publishing it in medical journal.

The data was analyzed on SPSS version 10 for results.

RESULTS

At age below 5 years, male 40(3.08%) and female 60(4.90%) patients of scabies were observed, At the age of 5-15 years male patients 321(24.74%) and female 300(24.52%) were observed. At the age of 16-25 years male patients 215(16.57%) and female 207(16.92%) , at the age of 27-37 years male patients 187(14.41%) and female 210(17.17), at the age of 38-48 years male patients 262((20.20%) and female patients 181(14.79%) of scabies , at the age of 49-60 years male patients 152(11.71%) and female patients 150(12.26%) , at age above 60 male patients 120(9.25%) and female patients 115(9.40%) of scabies were observed. As shown in table 1.

In high gentry the male patients 134(11.91%) and female 266(18.79%) of scabies were observed. In middle class male patients 370(32.88%) and female patients507(35.83%) of scabies were observed. In lower class the male patients 621(55.20%) and female patients 642(45.37%) of scabies were found. As shown in
table 2. It was seen that in urban area 402(35.57%) male patients and 537(38.63%) female patients of scabies were found, in rural areas the incidence of scabies in male patients 728(64.42%) and 853(61.36) female patients was found. As shown in table 3. In month of Jan-Feb the male patients 107(9.12%) and female patients of scabies 203(15.05%),In month March-April the male patients 176(15.01%) and female patients 221(16.39%), in month of May-June the male patients 246(20.98%) and female patients 255(18.91%), in July-August the male patients were 215(18.34%) and female patients 235(17.43%), in Sept-Oct the male patients 217(18.51%) and female patients 213(15.80%), in Nov-Dec male patients 211(18.00%) and female patients 221(16.39%) of scabies were found. As shown in table 4.

 

 

 

Table No 1: Age and Gender distribution in scabies at Sialkot

Sr. No.

Age (years)

 

                               Gender

Male                                                    Female

Total Patients

1

Below 5yr

40 (3.08%)                                        60  (4.90 %)                              

100(3.96%)

2

5-15

321(24.74%)                                 300 (24.52%)

621(24.64%)

3

16-25

215 ( 16.57%)                              207 (16.92%)

412(16.34%)

4

27-37

187  (14.41%)                              210(17.17%)

397(15.75%)

5

38-48

262(20.20%)                                181 (14.79%)

443(17.57%)

6

49-60

152 (11.71%)                                150 (12.26%)

302(11.98%)

7

Above 60

120(9.25%)                                    115 (9.40%)

235(9.32%)

 

Total

1297 (100%)                                 1223(100%)

2520(100%)

Table No2: Socio economic Status distributions in scabies

Sr. No

Social economic status

Male

Female

Total Patients

1

High

134(11.91%)

266(18.79%)

380(15.07%)

2

Middle

370(32.88%)

507(35.83%)

877(34.52%)

3

Lower

621(55.20%)

642(45.37%)

1263(49.72%)

 

Total

1125(100%)

1415(100%)

2520(100%)

Table No.3: Area distribution in scabies

Sr. No

Area

Male

Female

Total Patients

1

Urban

402(35.57%)

537(38.63%)

939(37.26%)

2

Rural

728(64.42%)

853(61.36%)

1581(62.73%)

 

Total

1130(100%)

1390(100%)

2520(100%)

Table No.4: Monthly distributions of patients of scabies

Sr. No.

Month

Male

Female

Total patients

1

Jan-Feb

107(9.12%)

203(15.05%)

310(12.30%)

2

March-April

176(15.01%)

221(16.39%)

397(15.75%)

3

May-June

246(20.98%)

255(18.91%)

501(19.88%)

4

July-August

215(18.34%)

235(17.43%)

450(17.85%)

5

Sep-Oct

217(18.51%)

213(15.80%)

430(17.06%)

6

Nov-Dec

211(18.00%)

221(16.39%)

432(17.14%)

 

Total

1172(100%)

1348(100%)

2520(100%)

 

 

DISCUSSION

“Very little epidemiological work has been done in dermatology, as this branch of medicine has been neglected in Pakistan due to lack of interest by medical professionals.” “To the best of our knowledge, this is the first study of its kind among GPS of Sialkot in Pakistan.” “So we are unable to compare the results of this study with other studies.” “Scabies is a condition that may involve the whole body and medical and paramedical staffs working in all disciplines of medicine are involved in its management14.”
“The present study showed that substantial numbers of GPs have inadequate knowledge regarding the causative parasite for scabies, the importance of scrapping the burrow and its examination in the diagnosis and health education for patients and family members”. “At the same time, however, there is reasonably good awareness about practical aspects such as mode of spread of the disease, clinical features and treatment of scabies.”

“Improper application of topical medications often occurs because the patient fails to fully understand the necessity and importance of application of topical preparations on whole body and treatment of whole family at the same time. Not only must patients be taught to take their medications, but they must also gain sufficient understanding of disease and its treatment, in order to become convinced that this is necessary.” “This study evinced that GPs are not clear about health education to be imparted to scabies patients. Consequently, the responsibilities of GPs have been increased manifold14.”

“Another important observation was that neither increasing age nor increasing years of experience of GPs improved the level of satisfactory awareness among the GPs. This reflects the total lack of refresher courses or continuous medical education programmes for the GPs”.13,14

“Some limitations of our study need to be acknowledged. First, the study is limited by cross-sectional design so temporal or cause-effect relationship cannot be established. Final and most important is small sample size with networking sampling strategy for selection of GPs”.

“In our study, the incidence of scabies was  the highest at the age of 5-15 years 621 (24.64%) of total patients .The incidence of scabies was the lowest at age below 5 years 100(3.96%).The incidence of scabies was the highest in lower class 1263(49.72%) and the incidence of scabies were lowest in high class 400(15.74%).” “The incidence of scabies was highest in rural area 1581(62.73%) and in urban area it was lowest  939(37.26%).The incidence of scabies was the highest in moth of MAY-June 501 (19.88%) patients and lowest in the month of  Jan-Feb  310 (12.30%) patients. The results of our study also co relates with other study.14

CONCLUSION

It was concluded that the incidence of scabies was highest in the rural area and in the lower class at age of 5-15 years and highest in hot weather and lowest in cold weather.

Author’s Contribution:

Concept & Design of Study:

M Naeem, Abdul Rehman

Drafting:

Shafiq ur Rehman Jamil

Data Analysis:

Anwar Khan

Revisiting Critically:

Shafiq ur Rehman Jamil, Kamran Hamid

Final Approval of version:

M Naeem

Conflict of Interest: The study has no conflict of interest to declare by any author.

REFERENCES

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2.     Hebra FV. On diseases of the skin including the Exanthemata. The New Sydenham Society 1868; 2:164-252.

3.     Beeson BB. Acarus scabiei: Study of its history. Arch Dermatot Syphilol 1927;16:294-307.

4.     Heilesen B. Studies on Acarus scabiei and scabies. Arch Derm Veneral 1946; 14(Suppl):1-30.

5.     Friedman R. The story of scabies. New York: Froben; 1948.

6.     Funaki B, Elpern Di. Scabies epidemiology, Kauai, Hawaii, 198-1985. Int J Dermatol 1987;26: 590-92.

7.     Arlian LG, Estes SA, Vyszenski-Moher DL. Prevalence of Sarcoptes scabiei in the homes and nursing homes of scabietic patients. J Am Acad Dermatol 1988;19:806-11.

8.     Fain A. Epidemiological problems of scabies. Int J Dermatol 1978;17:20-30.

9.     Orkin M, Maibach HI. The Scabies Pandemic. N. Eng J Med 1978;298:496-98.

10.            Haroon TS. Pattern of skin diseases in Karachi. J Pak Med Assoc 1985;35: 73-78.

11.            Shamim SM. Scabies: A common skin problem often misdiagnosed. J Pak Assoc Dermatol 2000; 11: 12-18.

12.            District census report. Census publication No. 617. Population census organization. Statistics division. Government of Pakistan, Islamabad, 1998.

13.            Schloss PJ. Smith MA, eds. Conducting Research. 1st ed. New Jersey;1999.p.89.

14.            Epi Info: A word processing, database and statistics program for Public Health.