Prevalence and determinants of scabies: A global systematic review and meta-analysis

Scabies is a neglected skin disease that disproportionately affects people from resource poor and overcrowded countries. Global data on prevalence and risk factors are limited. This article aims to estimate the global burden of scabies and identifies the risks associated with it.

Databases (PubMed, Scopus and Cochrane Reviews) were accessed to identify studies of scabies prevalence published between 2000 and 2024. Results were pooled to estimate prevalence and identify factors, which explained between-study heterogeneity. Odds ratios (ORs), risk of bias, subgroup analyses and meta-regression were used to describe variation in effect size and heterogeneity based on country-level demographic and economic variables.

Seventy studies yielded a pooled prevalence of 11.9% (95% confidence interval [CI]: 9.60-14.7) with substantial heterogeneity $\left(I^2=100\%,{\tau }^2=1.04\right)$ . Prevalence was highest in Oceania (17.9%; 95% CI: 13.9-22.8) compared to other regions. Pooled risk factors for scabies showed significant associations for demographic and behavioural factors including contact history with household members with itch (OR 11.3; 95% CI 4.82-26.51; $I^2=96\%$ ; n = 7), lack of soap use (OR 3.41; 95% CI: 2.56-4.54; $I^2=44\%$ ; n = 7), bed-sharing (OR 2.64; 95% CI: 1.50-4.63; $I^2=76\%$ ; n = 7), sharing of clothes (OR 2.52; 95% CI: 1.58-4.03; $I^2=85\%$ ; n = 7), infrequent bathing (OR 2.13; 95% CI: 1.41-3.22; $I^2=77\%$ ; n = 6), presence of pets (OR 1.76; 95% CI: 1.08-2.87; $I^2=84\%$ ; n = 4) and being a male (OR = 1.19; 95% CI: 1.04-1.37; $I^2=83\%$ ; n = 22). Socioeconomic factors were not convincingly associated with scabies prevalence.

Prevalence of scabies is associated with geographic location and behavioural factors, but not between-country socioeconomic status. In addition to mass drug administration, risk factors are identified which may be included in health promotion programmes to reduce scabies prevalence and its sequelae in the long term.