Mass-drug administration curbs scabies for asylum seekers in the Netherlands
In a new article published in PLOS Neglected Tropical Diseases, Sofanne J. Ravensbergen of the University of Groningen, and colleagues, found that a scabies intervention program (SIP) was effective in reducing the severity of scabies when introduced to the newly arrived Eritrean and Ethiopian asylum seekers who volunteered to take part in the program.
Scabies, a skin infestation caused by the tiny mite Sarcoptes scabiei burrowing into the outer layer of skin, is a major risk factor in the development of bacterial skin infections, relentless itching, and rashes. Nurses and physicians working at national receptions centers in the Netherlands noticed the Eritrean and Ethiopian asylum seekers were particularly affected by scabies. In response, the Dutch national reception centers introduced a SIP for these asylum seekers from January 2014 to March 2016. The authors of this study found that, before the SIP was initiated, 12.3% of 462 asylum seekers developed complications of scabies. Once the SIP was launched, only 4.6% of 897 asylum seekers showed signs of scabies complications.
The researchers were unable to determine how long these volunteer asylum seekers stayed in the asylum centers that implemented the SIP, which made it impossible to calculate the exact incidence rate of scabies. Additionally, since asylum seekers frequently relocate to other asylum centers without a SIP, reinfestations could occur through contact with untreated contagious individuals. However, the number of scabies reinfestations after treatment and the number of complicated forms of scabies were both reduced after introduction of the program.
"Controlling scabies amongst asylum seekers is important to reduce the risk of complicated cases and to prevent the spread of scabies amongst asylum seekers at asylum centres in the Netherlands," notes the authors, "The centralized health care system for asylum seekers that is used in the Netherlands allows accurate follow up of asylum seekers and provides unique retrospective data on the programme."