⌚ Impetigo Research Paper
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Impetigo, Causes, Signs and Symptoms, Diagnosis and Treatment.
A total of 10, study participants were enrolled. Scabies was observed in 2, participants Prevalence was highest in children aged five to nine years Scabies was nearly twice as common in iTaukei Fijians Scabies was most prevalent in people living in the Northern division Taking into account the census distribution of age and geographical location by direct adjustment, the estimated national prevalence of scabies was There were no cases of crusted scabies detected in this study.
The prevalence of impetigo was also high, with lesions observed in Impetigo followed a similar age distribution to scabies, being more common in children aged five to nine years Similar to scabies, impetigo prevalence was twice as high in the iTaukei Fijians When taking into account the census distribution of age and geographical location the national prevalence of impetigo was The majority of impetigo lesions were mild The presence of impetigo was strongly associated with a diagnosis of scabies relative risk, RR, The population attributable risk of scabies as a cause of impetigo based on the national survey was Of those who reported prior treatment, the most common treatment was topical cream of an unspecified type At the time of the survey, permethrin cream was unavailable through the publicly funded clinics and could only be purchased through private pharmacies.
Ivermectin, an oral treatment for scabies, is not available in Fiji. This study is the first national survey of scabies and impetigo prevalence conducted in any country and indeed the only one that we are aware of that is based on a rigorous sampling methodology and covers a substantial population and geographic area. Our survey confirms that scabies and impetigo are widespread problems in Fiji. While we observed that children are the most affected population group, no age group is free of scabies or impetigo, and there is an indication that prevalence increases after middle age. Scabies and impetigo are highly prevalent across all geographical divisions and both genders and in both the main ethnic groups. High levels of scabies and related bacterial infections have previously been documented in tropical countries with low or medium socio-economic status and in disadvantaged populations, particularly in countries in the Pacific region [ 21 ].
However, all previous studies were conducted in smaller, localised areas, such as single provinces, schools or villages [ 21 ]. Prior reviews of the prevalence of scabies and impetigo have consistently documented high levels of both diseases in school-aged children [ 9 , 21 ]. Only a limited number of studies have described the tendency for scabies to reappear in older age groups, as we observed [ 7 , 14 , 22 ]. A possible explanation for this apparent phenomenon is that under the typical family structure in these countries, older community members frequently care for children, and are thereby exposed to a heightened risk of transmission of scabies from children. A further possible explanation is that repeated infestation in childhood leads to protective immunity in adulthood but this wanes in the elderly, although there are very few data to support this hypothesis.
Consistent with our findings, previous studies in Fiji have documented that scabies and impetigo are most prevalent in the iTaukei Fijian population [ 8 , 14 , 21 ]. The reason for this is not clear but may be possibly linked to a higher number of children per family and the tendency to live in single-room houses. Other bacterial infections including pneumonia, invasive streptococcal and staphylococcal infections, and rheumatic heart disease have been observed to be more common in iTaukei Fijians [ 6 , 23 — 25 ].
Impetigo is common in Fiji. This striking finding has considerable implications for public health efforts to control impetigo; that is, successful control measures directed at scabies would likely translate into significant reductions in the burden of impetigo. The survey had a number of methodological limitations. Our sample had an over-representation of younger children and an under-representation of older people, possibly due to sampling of areas with primary or secondary schools in proximity of the selected sites, and the relative absence of adults due to regional work commitments.
Further, there may have been weaknesses in the diagnosis of scabies and impetigo. Although diagnosis was entirely clinical, and did not use a microscope or scraping of scabies mites, we employed senior nurses, who received intensive training in relevant methods, and were paired to conduct the examination. However no further validation was conducted and we did not conduct any bacteriology tests to confirm the presence of bacterial infection of impetigo lesions. The Fiji Ministry of Health received a preliminary report of this survey Romani [ 10 ], and has since undertaken a number of measures to increase community and health care worker awareness and knowledge of scabies.
Education about scabies has been conducted through the hospitals, clinics and health centres. This tremendous burden of disease at a population level strongly supports the need for investment into research to investigate the best strategies for public health control of scabies in communities where resources are limited and scabies and it complications endemic. Our data suggest that an effective public health control measure for scabies will also likely lead to a considerable reduction in the burden of impetigo. Performed the experiments: LR. Analyzed the data: LR HW. Designed the software used in analysis: LR AS. Abstract Background Scabies is recognised as a major public health problem in many countries, and is responsible for significant morbidity due to secondary bacterial infection of the skin causing impetigo, abscesses and cellulitis, that can in turn lead to serious systemic complications such as septicaemia, kidney disease and, potentially, rheumatic heart disease.
Conclusions As far as we are aware, this is the first national survey of scabies and impetigo ever conducted. Author Summary Recently added to the World Health Organization list of neglected tropical diseases, scabies is an under-recognised cause of morbidity in many developing countries, due to secondary bacterial infection of the skin that can in turn lead to serious systemic complications such as kidney disease and, potentially, rheumatic heart disease. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Data Availability: All relevant data are within the paper and its Supporting Information files.
Introduction Scabies is a skin disease caused by infestation with a tiny mite Sarcoptes scabiei that burrows under the skin and is transmitted through close personal contact [ 1 ]. Methods Setting Fiji is an island nation located in the South Pacific region. Study design A cross-sectional survey of the national population was conducted to assess the prevalence of scabies and impetigo. Study sampling For the lymphatic filariasis survey, the Fiji population was divided into 23 strata designated by medical area within which there were administrative units [ 18 ]. Study procedures For each community selected, approval of the chief was first sought.
Case definitions Scabies was diagnosed on the basis of characteristic clinical findings, defined as the presence of pruritic inflammatory papules with a typical acral distribution [ 19 ]. Download: PPT. Table 1. Demographic characteristics of the study sample compared to national census data. Discussion This study is the first national survey of scabies and impetigo prevalence conducted in any country and indeed the only one that we are aware of that is based on a rigorous sampling methodology and covers a substantial population and geographic area.
Supporting Information. S1 Checklist. References 1. Heukelbach J, Feldmeier H Scabies. Lancet — Med J Aust 2: — Lancet Infect Dis 5: — View Article Google Scholar 6. Cardiol Young 62— Papua New Guinea Medical Journal — World Health Organization Epidemiology and management of common skin diseases in children in developing countries. Romani L Assessment of Scabies in Fiji. A Study of 13, people.
International Congress on Dermatological Care for All. Ecthyma Open pop-up dialog box Close. Ecthyma A more serious form of impetigo, called ecthyma, penetrates deeper into the skin — causing painful fluid- or pus-filled sores that turn into deep ulcers. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references AskMayoExpert. Mayo Clinic; Baddour LM. Accessed Jan. Ferri FF, et al. Diseases and disorders. Elsevier; Kliegman RM, et al. Cutaneous bacterial infections.
In: Nelson Textbook of Pediatrics. Cherry JD, et al. Skin infections. Taylor SC. Bullous and pustular disorders. In: Treatments for Skin of Color. Office of Patient Education. Kermott CA, et al. Time; Kang S, et al. Superficial cutaneous infections. In: Fitzpatrick's Dermatology. McGraw-Hill; Impetigo and ecthyma. Merck Manual Professional Version. Gibson LE expert opinion. Mayo Clinic.Essays Essays FlashCards. Univariate and multivariate logistic Impetigo Research Paper models Impetigo Research Paper used Impetigo Research Paper identify factors independently associated with Stephen King Anger high Impetigo Research Paper of scabies and Impetigo Research Paper. The CI and I were assigned Impetigo Research Paper provide the therapy in the room due to scabies infection precautions. Consistent with our findings, previous studies in Impetigo Research Paper have Impetigo Research Paper that Impetigo Research Paper and impetigo are most prevalent in the Impetigo Research Paper The Dual Function Of Gaze Summary population [ 8 Impetigo Research Paper, 1421 Impetigo Research Paper.