National control programs for scabies: Experiences from Fiji and Solomon Islands.

Area of Science:

• Global health
• Neglected tropical diseases
• Public health interventions

Background:

• The World Health Organization (WHO) recommends mass drug administration (MDA) for scabies control in endemic areas (≥10% prevalence) using oral ivermectin and topical scabicides.
• Fiji and Solomon Islands were the first nations to implement national ivermectin-based MDA for scabies.
• This report details their experiences and lessons learned to inform global scabies control efforts.

Purpose of the Study:

• To document the implementation experiences and challenges of national ivermectin-based MDA for scabies in Fiji and Solomon Islands.
• To identify key lessons learned to inform future global scabies control strategies.
• To contribute to achieving WHO targets for neglected tropical diseases.

Main Methods:

• The World Scabies Program, a collaboration between research institutions and Ministries of Health, facilitated the translation of research into national programs.
• Implementation involved national-level mass drug administration campaigns in highly endemic settings.
• Programmatic adaptations were made in response to challenges, including the COVID-19 pandemic.

Main Results:

• The program adapted to challenges such as travel restrictions due to COVID-19, requiring increased local autonomy.
• Addressing local misconceptions about scabies was crucial for improving treatment uptake and health worker engagement.
• Integration with other neglected tropical disease programs enhanced the affordability and acceptability of scabies MDA.

Conclusions:

• National scabies MDA in highly endemic areas shows potential for significant health improvements if widespread coverage is achieved.
• Lessons learned emphasize the need for adaptable strategies, community engagement, and integration with existing health programs.
• Future efforts require strategies to reach urban populations and pragmatic dosing for broader feasibility.