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dc.contributor.authorMatthews Aen
dc.contributor.authorLe Ben
dc.contributor.authorAmaral Sen
dc.contributor.authorArkell Pen
dc.contributor.authorMonteiro Men
dc.contributor.authorClarke Nen
dc.contributor.authorBarros Ten
dc.contributor.authorde Jesus Mendonça Jen
dc.contributor.authorGusmão SMEen
dc.contributor.authorDos Reis Seixas LMen
dc.contributor.authorda Piedade JHAen
dc.contributor.authorEngelman Den
dc.contributor.authorSteer ACen
dc.contributor.authorFancourt NSSen
dc.contributor.authorYan Jen
dc.contributor.authorKaldor, Johnen
dc.contributor.authorFrancis JRen
dc.contributor.authorNery SVen
dc.identifier.citationParasit Vectors. 2021 Mar 15;14(1):156. doi: 10.1186/s13071-021-04645-1.en
dc.description.abstractBACKGROUND: Scabies and impetigo are endemic in many tropical, low- and middle-income countries. Mass drug administration (MDA) with ivermectin has emerged as a control strategy for these conditions. In 2019, Timor-Leste Ministry of Health planned to implement MDA including ivermectin for the control of lymphatic filariasis, so we undertook a baseline assessment of scabies and impetigo to better understand local epidemiology and contribute to future surveys assessing the impact of MDA. METHODS: A cross-sectional school survey was conducted in April-May 2019 at six primary schools in a semi-urban (Dili) and two rural (Ermera and Manufahi) settings. Children under 19 years of age present at school on survey days were eligible to participate, of whom we enrolled 1183. Trained health workers interviewed and examined 1043 participants to clinically diagnose scabies using the 2020 International Alliance for the Control of Scabies (IACS) diagnostic criteria, as well as impetigo. Prevalence was adjusted for age and sex. Mixed-effects logistic regression models were used to analyse odds of scabies and impetigo infection. All models accounted for clustering at the school level through the use of random effect terms. Population attributable risk of scabies as a cause of impetigo was also estimated. RESULTS: The overall weighted prevalence of scabies was 30.6%. Children in rural Manufahi were more likely to have scabies than those in semi-urban Dili (53.6% vs 28.2%, adjusted odds ratio [AOR] 3.5). Most cases of scabies were mild (3 to 10 lesions), and lesions were usually distributed on more than one body region. Scabies prevalence was lower among 10 to 14 year olds compared to 5 to 9 year olds. Overall weighted prevalence of impetigo was 11.3%. Relative to Dili, children in rural Ermera and Manufahi were twice as likely to have impetigo. Impetigo was twice as common in children with scabies than in those without, corresponding to an attributable risk of scabies as a cause of impetigo of 22.7%. CONCLUSIONS: Scabies and impetigo prevalence in Timor-Leste is among the highest reported globally, particularly in rural areas. Scabies infestation was strongly associated with impetigo. Comprehensive control strategies are urgently needed in Timor-Leste.en
dc.titlePrevalence of scabies and impetigo in school-age children in Timor-Leste.en
dc.typeJournal Articleen
dc.identifier.journaltitleParasites & vectorsen
dc.description.affiliationRoyal Darwin Hospital, Darwin, Australia.
dc.description.affiliationThe Kirby Institute, University of New South Wales, Sydney, Australia.en
dc.description.affiliationMenzies School of Health Research, Charles Darwin University, Darwin, Australia.en
dc.description.affiliationTimor-Leste Ministry of Health, Dili, Timor-Leste.en
dc.description.affiliationHospital Nacional Guido Valadares, Dili, Timor-Leste.en
dc.description.affiliationTropical Diseases, Murdoch Children's Research Institute, Melbourne, Australia.en
dc.description.affiliationRoyal Darwin Hospital, Darwin, Australia.en
local.issue.number1756-3305 (Electronic)-
local.issue.number1756-3305 (Linking)-
Appears in Collections:(a) NT Health Research Collection

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