Increasing trend of scabies in Belgium, 2000-2023

Several European countries have reported an increasing trend of human scabies in the past twenty years. In Belgium, scabies' clusters hinted at a similar trend despite individual cases not being notifiable. We aimed to describe scabies' trends between 2000 and 2023 in Belgium.

We described the evolution of scabies during 2000-2023 in Belgium using a variety of available data sources. Using generalized linear models, we analysed yearly trends and seasonality of scabies diagnoses at general practitioners (GPs) in Flanders, occupational health services in Belgium, nationwide asylum seekers' shelters and consultations for people with precarious housing, and student medical facilities in Flanders. Additionally, we analysed national reimbursement and sales data for first-line scabies treatments in Belgium.

Scabies diagnoses significantly increased at all investigated levels (p-value < 0.001): primary care (15% yearly increase, 2011-2023), occupational health services (16% yearly increase, 2011-2022, temporary decrease in 2020-2021), asylum seekers' shelters (41% yearly increase, 2016-2022), consultations for people in precarious living situations (41% yearly increase, 2019-2022), and pharmaceutical sales (15% yearly increase in permethrin sales, 2012-2022). In primary care, those 15-24 years-old were most affected (13.2/1,000 compared to 4.1/1,000 for all ages in 2023), as were urban areas (6.7/1,000 compared to 2.7/1,000 in rural areas in 2022). Incidence was overall higher in males (p-value 0.016).

Our study shows a strong increasing trend of scabies in Belgium since 2011, with higher incidences in younger age groups, urban areas and during colder months. We recommend further studies to better quantify the increase and investigate the underlying drivers.