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The use of ivermectin in controlling an outbreak of scabies in a prison
1Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Background:
Ivermectin is a potentially useful treatment for scabies.
Objectives:
We aimed to evaluate the efficacy of ivermectin in the treatment of scabies in an institutional environment.
Methods:
A single dose of ivermectin 150 microg kg-1 was given under supervision to 1153 prisoners in a prison in northern Tanzania where there was an outbreak of scabies.
Results:
Thirty per cent of the prisoners were cured after 1 week, 88% after 4 weeks and 95.5% after 8 weeks. Of 16 prisoners with crusted scabies, seven (44%) still had scabies after 8 weeks. Those who were not cured were then treated with 1% lindane lotion topically, as were the prison staff who had scabies. This regimen eradicated scabies from the prison for the next 2 years.
Conclusions:
Ivermectin is an effective and safe treatment for scabies, particularly in a closed community, such as a prison, where it is easy to administer and avoids problems with compliance. It was of limited efficiency in crusted scabies as a single dose and we recommend that for such patients oral ivermectin is used in combination with a topical scabicide.
Insights
Ivermectin effectively treated scabies in a Tanzanian prison, with 95.5% cure rates after 8 weeks. It proved particularly useful in institutional settings, though less so for crusted scabies as a single dose.
Area of Science:
- Medical Entomology
- Parasitology
- Public Health
Background:
- Scabies is a contagious skin infestation.
- Ivermectin shows promise as a scabies treatment.
Purpose of the Study:
- To assess ivermectin's efficacy for scabies in an institutional setting.
- To evaluate treatment outcomes in a large cohort.
Main Methods:
- A single oral dose of ivermectin (150 microg kg-1) was administered to 1153 prisoners during an outbreak.
- Follow-up assessments were conducted at 1, 4, and 8 weeks.
Main Results:
- Overall cure rates reached 95.5% by 8 weeks.
- Crusted scabies showed lower response rates (44% cured after 8 weeks).
- Combined ivermectin and topical lindane eradicated scabies from the prison for two years.
Conclusions:
- Ivermectin is an effective and safe scabies treatment in closed communities.
- Oral ivermectin combined with topical treatment is recommended for crusted scabies.
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