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Is Scabies the Key to Rheumatic Heart Disease Prevention? A Systematic Review of the Evidence
Saptorshi Gupta1, Simon Thornley2, Arthur Morris3
1Section of Biostatistics and Epidemiology, Faculty of Medical and Health Sciences, The University of Auckland, M&HD Building 507, 28 Park Ave, Grafton, Auckland, New Zealand.
The Australasian Journal of Dermatology
|November 15, 2025
Summary
Scabies infections significantly increase the risk of Group A streptococcal (GAS) infections, which are linked to acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Improved scabies treatment could reduce ARF/RHD incidence.
Area of Science:
- Public Health
- Infectious Diseases
- Dermatology
Background:
- Scabies, acute rheumatic fever (ARF), and rheumatic heart disease (RHD) are highly prevalent in regions like Oceania.
- The causal link between scabies and ARF/RHD remains under-investigated.
- Group A streptococcal (GAS) skin infections are a known precursor to ARF/RHD.
Purpose of the Study:
- To evaluate the relationship between scabies, GAS infections, and the subsequent development of ARF and RHD.
- To explore scabies as a potential modifiable risk factor for ARF/RHD prevention.
Main Methods:
- A systematic review of studies investigating the association between scabies, GAS, ARF, and RHD.
- Databases searched include PubMed, Web of Science, and Scopus.
- Inclusion of 73 articles, primarily from Australasia.
Main Results:
- Epidemiological and microbiological evidence supports scabies increasing the risk of GAS infections.
- A strong association and shared risk factors were identified between scabies and ARF/RHD.
- The review indicates a role for scabies and GAS skin infections in the pathogenesis of ARF/RHD.
Conclusions:
- Available evidence suggests scabies and GAS skin infections contribute to ARF/RHD development.
- Further large-scale observational studies are needed to confirm the relationship.
- Improving scabies diagnosis and treatment is a potential strategy to reduce ARF/RHD incidence.
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