Scabies and other ectoparasitoses

Ectoparasitoses are caused by organisms that parasitize their host's skin. They affect a considerable proportion of the global population, with a disproportionately greater burden in disadvantaged individuals and communities, although any human is susceptible. They are more prevalent in tropical climates. They can have a major impact on infected individuals' quality of life and on affected populations, and they can result in severe complications. Despite their contribution to the global burden of disease, ectoparasitoses remain largely neglected. Making their characteristics visible and understood is fundamental to achieving the goals of universal health coverage and control of neglected diseases proposed in the World Health Organization's 2030 roadmap. Focusing on five ectoparasitoses (scabies, pediculosis, tungiasis, cutaneous myiasis and cutaneous larva migrans), we highlight their key epidemiological, diagnostic and treatment data supported by the current scientific literature, as well as the knowledge gaps that jeopardize their control. This review highlights the need to expand our knowledge; promote research into diagnostic tools, treatment and control; implement elimination programmes in the areas where these diseases are most prevalent; and develop holistic solutions to tackle these diseases. Clinical care must be combined with measures to address the social and economic determinants of health and universal health coverage. For ectoparasitoses that are not species-specific or complete part of their life cycle outside humans, such as tungiasis, cutaneous myiasis, and cutaneous larva migrans, the environment and other animal species must also be considered.