Miller L , Eisenberg D , Liu H , Chang C , Wang Y , Luthra R , Wallace A , Fang C , Singer J , Suaya J , 2015. Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005–2010. BMC Infect Dis 15: 362.
Sharma JK , Miller R , Murray S , 2000. Chronic urticaria: a Canadian perspective on patterns and practical management strategies. J Cutan Med Surg 4: 89–93.
Kaye KS , Petty LA , Shorr AF , Zilberberg MD , 2019. Current epidemiology, etiology, and burden of acute skin infections in the United States. Clin Infect Dis 68: S193–S199.
Schofield J , Sherlock J , Lusignan S , 2020. Trends in attendance of patients with skin conditions in English general practice 2006 to 2016: Sentinel Network Database study. Dermatol Nurs (Lond) 19: 30–40.
Romani L , Koroivueta J , Steer AC , Kama M , Kaldor JM , Wand H , Hamid M , Whitfeld MJ , 2015. Scabies and impetigo prevalence and risk factors in Fiji: a national survey. PLoS Negl Trop Dis 9: e0003452.
Carapetis JR , Connors C , Yarmirr D , Krause V , Currie BJ , 1997. Success of a scabies control program in an Australian aboriginal community. Pediatr Infect Dis J 16: 494–499.
Carapetis JR , Steer AC , Mulholland EK , Weber M , 2005. The global burden of group A streptococcal diseases. Lancet Infect Dis 5: 685–694.
Steer AC , Jenney AW , Kado J , Batzloff MR , La Vincente S , Waqatakirewa L , Mulholland EK , Carapetis JR , 2009. High burden of impetigo and scabies in a tropical country. PLoS Negl Trop Dis 3: e467.
Tong SYC , Davis JS , Eichenberger E , Holland TL , Fowler VG , 2015. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev 28: 603–661.
Swe PM , Fischer K , 2014. A scabies mite serpin interferes with complement-mediated neutrophil functions and promotes staphylococcal growth. PLoS Negl Trop Dis 8: e2928.
Karimkhani C et al. 2017. Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol 153: 406–412.
Bowen AC , Mahé A , Hay RJ , Andrews RM , Steer AC , Tong SYC , Carapetis JR , 2015. The global epidemiology of impetigo: a systematic review of the population prevalence of impetigo and pyoderma. PLoS One 10: e0136789.
Romani L , Steer AC , Whitfeld MJ , Kaldor JM , 2015. Prevalence of scabies and impetigo worldwide: a systematic review. Lancet Infect Dis 15: 960–967.
Mason DS , Marks M , Sokana O , Solomon AW , Mabey DC , Romani L , Kaldor J , Steer AC , Engelman D , 2016. The prevalence of scabies and impetigo in the Solomon Islands: a population-based survey. PLoS Negl Trop Dis 10: e0004803.
Finley CR , Chan DS , Garrison S , Korownyk C , Kolber MR , Campbell S , Eurich DT , Lindblad AJ , Vandermeer B , Allan GM , 2018. What are the most common conditions in primary care? Systematic review. Can Fam Physician 64: 832–840.
Hendrickx D , Bowen AC , Marsh JA , Carapetis JR , Walker R , 2018. Ascertaining infectious disease burden through primary care clinic attendance among young Aboriginal children living in four remote communities in Western Australia. PLoS One 13: e0203684.
Thomas L , Bowen AC , Ly M , Connors C , Andrews R , Tong SYC , 2019. Burden of skin disease in two remote primary healthcare centres in northern and central Australia. Intern Med J 49: 396–399.
Fiji Islands Bureau of Statistics , 2018. 2017 Population and Housing Census Release 1. Fiji Bureau of Statistics. Available at: www.statsfiji.gov.fj.
Fiji Meteorological Service , Australian Bureau of Meteorology, Commonwealth Scientific and Industrial Research Organisation, 2011. Current and Future Climate of the Fiji Islands. Pacific Climate Change Science Program Partners, Australian Government.
Steer AC , Tikoduadua LV , Manalac EM , Colquhoun S , Carapetis JR , Maclennan C , 2009. Validation of an integrated management of childhood illness algorithm for managing common skin conditions in Fiji. Bull World Health Organ 87: 173–179.
World Health Organization , Regional Office for the Western Pacific, Asia Pacific Observatory on Health Systems and Policies, 2011. The Fiji Islands Health System Review. Manila, Philippines: WHO Regional Office for the Western Pacific.
National Drug and Therapeutic Committee , 2006. Fiji Essential Medicines Formulary.
World Health Organization , 2014. IMCI Module 1, General Danger Sings for the Sick Child. Geneva, Switzerland: WHO Publications.
Harris PA et al. 2019. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95: 103208.
Harris PA , Taylor R , Thielke R , Payne J , Gonzalez N , Conde JG , 2009. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377–381.
Fiji Islands Bureau of Statistics , 2007. 03_Relationship-Ethnicity-and-Religion-by_Province-of-Enumeration_Fiji-2007. Census 2007 General Tables.
Tun K , Shurko JF , Ryan L , Lee GC , 2018. Age-based health and economic burden of skin and soft tissue infections in the United States, 2000 and 2012. PLoS One 13: e0206893.
Fritz SA , Shapiro DJ , Hersh AL , 2020. National trends in incidence of purulent skin and soft tissue infections in patients presenting to ambulatory and emergency department settings, 2000–2015. Clin Infect Dis 70: 2715–2718.
Loadsman MEN , Verheij TJM , van der Velden AW , 2019. Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data. Fam Pract 36: 410–416.
Shallcross LJ , Hayward AC , Johnson AM , Petersen I , 2015. Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care. Br J Gen Pract 65: e668–e676.
Engelman D et al. 2020. The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. Br J Dermatol 183: 808–820.
Magree HC , Russell FM , Sa’aga R , Greenwood P , Tikoduadua L , Pryor J , Waqatakirewa L , Carapetis JR , Mulholland EK , 2005. Chest X-ray-confirmed pneumonia in children in Fiji. Bull World Health Organ 83: 427–433.
Jenney A , Holt D , Ritika R , Southwell P , Pravin S , Buadromo E , Carapetis J , Tong S , Steer A , 2014. The clinical and molecular epidemiology of Staphylococcus aureus infections in Fiji. BMC Infect Dis 14: 160.
Steer AC , Jenney A , Kado J , Good MF , Batzloff M , Waqatakirewa L , Mullholland EK , Carapetis JR , 2009. Prospective surveillance of invasive group a streptococcal disease, Fiji, 2005–2007. Emerg Infect Dis 15: 216–222.
Steer AC , Kado J , Jenney AW , Batzloff M , Waqatakirewa L , Mulholland EK , Carapetis JR , 2009. Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005–2007. Med J Aust 190: 133–135.
May PJ , Tong SYC , Steer AC , Currie BJ , Andrews RM , Carapetis JR , Bowen AC , 2019. Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health 24: 280–293.
Yeoh DK , Anderson A , Cleland G , Bowen AC , 2017. Are scabies and impetigo “normalised”? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections. PLoS Negl Trop Dis 11: e0005726.
World Health Organization , 2001. Traditional Medicine. Regional Office for the Western Pacific. Brunei, Darulssalam: World Health Organization.
Wagenaar BH , Augusto O , Beste J , Toomay SJ , Wickett E , Dunbar N , Bawo L , Wesseh CS , 2018. The 2014–2015 Ebola virus disease outbreak and primary healthcare delivery in Liberia: Time-series analyses for 2010–2016. PLoS Med 15: e1002508.
Pont SJ , Grijalva CG , Griffin MR , Scott TA , Cooper WO , 2009. National rates of diarrhea-associated ambulatory visits in children. J Pediatr 155: 56–61.
Romani L et al. 2019. Efficacy of mass drug administration with ivermectin for control of scabies and impetigo, with coadministration of azithromycin: a single-arm community intervention trial. Lancet Infect Dis 19: 510–518.
Romani L et al. 2015. Mass drug administration for scabies control in a population with endemic disease. N Engl J Med 373: 2305–2313.
Past two years | Past Year | Past 30 Days | |
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Abstract Views | 747 | 121 | 31 |
Full Text Views | 347 | 142 | 0 |
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Scabies, impetigo, and other skin and soft tissue infections (SSTIs) are highly prevalent in many tropical, low-middle income settings, but information regarding their burden of disease is scarce. We conducted surveillance of presentations of scabies and SSTIs, including impetigo, abscesses, cellulitis, and severe SSTI, to primary health facilities in Fiji. We established a monthly reporting system over the course of 50 weeks (July 2018–June 2019) for scabies and SSTIs at all 42 public primary health facilities in the Northern Division of Fiji (population, ≈131,914). For each case, information was collected regarding demographics, diagnosis, and treatment. There were 13,736 individual primary healthcare presentations with scabies, SSTI, or both (108.3 presentations per 1000 person-years; 95% confidence interval [CI], 106.6–110 presentations). The incidence was higher for males than for females (incidence rate ratio [IRR], 1.15; 95% CI, 1.11–1.19). Children younger than 5 years had the highest incidence among all age groups (339.1 per 1000 person-years). The incidence was higher among the iTaukei (indigenous) population (159.9 per 1000 person-years) compared with Fijians of Indian descent (30.1 per 1000 person-years; IRR, 5.32; 95% CI, 5.03–5.61). Abscess was the condition with the highest incidence (63.5 per 1,000 person-years), followed by scabies (28.7 per 1,000 person-years) and impetigo (21.6 per 1,000 person-years). Scabies and SSTIs impose a substantial burden in Fiji and represent a high incidence of primary health presentations in this population. The incidence in low-middle income settings is up to 10-times higher than that in high-income settings. New public health strategies and further research are needed to address these conditions.
Authors’ addresses: Li Jun Thean, Daniel Engelman, and Andrew C. Steer, Murdoch Children’s Research Institute and University of Melbourne, Royal Children’s Hospital, Parkville, Victoria, Australia, E-mails: lijun.thean@mcri.edu.au, daniel.engelman@rch.org.au, and andrew.steer@rch.org.au. Lucia Romani, Handan Wand, and John Kaldor, Kirby Institute, University of New South Wales, Wallace Wurth Building, Kensington, New South Wales, Australia, E-mails: lromani@kirby.unsw.edu.au, hwand@kirby.unsw.edu.au, and jkaldor@kirby.unsw.edu.au. Adam Jenney, Fiji National University and The Alfred Hospital, Melbourne, Victoria, E-mail: jenneya@unimelb.edu.au. Jyotishna Mani and Jessica Paka, Murdoch Children’s Research Institute, Labasa, Fiji, E-mails: jyotishna.mudaliar@gmail.com and macabresatara@yahoo.com. Rachel Devi, Aalisha Sahukhan, Mike Kama, and Meciusela Tuicakau, Ministry of Health and Medical Services, Fiji, Dinem House, Suva, Fiji, E-mails: rachel.devi@govnet.gov.fj, aalisha@gmail.com, mnkama02@gmail.com, and meciutui2015@gmail.com. Joseph Kado, Telethon Kids Institute, University of Western Australia and Ministry of Health and Medical Services Fiji, Northern Entrance, Perth Children’s Hospital, Nedlands, Western Australia, Australia, E-mail: joseph_kado@yahoo.co.uk. Natalie Carvalho, University of Melbourne, Carlton, Victoria, Australia, E-mail: natalie.carvalho@unimelb.edu.au. Margot Whitfeld, St. Vincent’s Hospital and School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia, E-mail: mwhitfeld@stlderm.com.au.
Financial support: Funding for this study was provided by the National Health and Medical Research Council (NHMRC) of Australia, awarded as a project grant (grant number: APP1127300) to Andrew Steer (principal investigator), Margot Whitfeld, Handan Wand, Mike Kama, Joseph Kado, Lucia Romani, and Natalie Carvalho. The NHMRC had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Miller L , Eisenberg D , Liu H , Chang C , Wang Y , Luthra R , Wallace A , Fang C , Singer J , Suaya J , 2015. Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005–2010. BMC Infect Dis 15: 362.
Sharma JK , Miller R , Murray S , 2000. Chronic urticaria: a Canadian perspective on patterns and practical management strategies. J Cutan Med Surg 4: 89–93.
Kaye KS , Petty LA , Shorr AF , Zilberberg MD , 2019. Current epidemiology, etiology, and burden of acute skin infections in the United States. Clin Infect Dis 68: S193–S199.
Schofield J , Sherlock J , Lusignan S , 2020. Trends in attendance of patients with skin conditions in English general practice 2006 to 2016: Sentinel Network Database study. Dermatol Nurs (Lond) 19: 30–40.
Romani L , Koroivueta J , Steer AC , Kama M , Kaldor JM , Wand H , Hamid M , Whitfeld MJ , 2015. Scabies and impetigo prevalence and risk factors in Fiji: a national survey. PLoS Negl Trop Dis 9: e0003452.
Carapetis JR , Connors C , Yarmirr D , Krause V , Currie BJ , 1997. Success of a scabies control program in an Australian aboriginal community. Pediatr Infect Dis J 16: 494–499.
Carapetis JR , Steer AC , Mulholland EK , Weber M , 2005. The global burden of group A streptococcal diseases. Lancet Infect Dis 5: 685–694.
Steer AC , Jenney AW , Kado J , Batzloff MR , La Vincente S , Waqatakirewa L , Mulholland EK , Carapetis JR , 2009. High burden of impetigo and scabies in a tropical country. PLoS Negl Trop Dis 3: e467.
Tong SYC , Davis JS , Eichenberger E , Holland TL , Fowler VG , 2015. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev 28: 603–661.
Swe PM , Fischer K , 2014. A scabies mite serpin interferes with complement-mediated neutrophil functions and promotes staphylococcal growth. PLoS Negl Trop Dis 8: e2928.
Karimkhani C et al. 2017. Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol 153: 406–412.
Bowen AC , Mahé A , Hay RJ , Andrews RM , Steer AC , Tong SYC , Carapetis JR , 2015. The global epidemiology of impetigo: a systematic review of the population prevalence of impetigo and pyoderma. PLoS One 10: e0136789.
Romani L , Steer AC , Whitfeld MJ , Kaldor JM , 2015. Prevalence of scabies and impetigo worldwide: a systematic review. Lancet Infect Dis 15: 960–967.
Mason DS , Marks M , Sokana O , Solomon AW , Mabey DC , Romani L , Kaldor J , Steer AC , Engelman D , 2016. The prevalence of scabies and impetigo in the Solomon Islands: a population-based survey. PLoS Negl Trop Dis 10: e0004803.
Finley CR , Chan DS , Garrison S , Korownyk C , Kolber MR , Campbell S , Eurich DT , Lindblad AJ , Vandermeer B , Allan GM , 2018. What are the most common conditions in primary care? Systematic review. Can Fam Physician 64: 832–840.
Hendrickx D , Bowen AC , Marsh JA , Carapetis JR , Walker R , 2018. Ascertaining infectious disease burden through primary care clinic attendance among young Aboriginal children living in four remote communities in Western Australia. PLoS One 13: e0203684.
Thomas L , Bowen AC , Ly M , Connors C , Andrews R , Tong SYC , 2019. Burden of skin disease in two remote primary healthcare centres in northern and central Australia. Intern Med J 49: 396–399.
Fiji Islands Bureau of Statistics , 2018. 2017 Population and Housing Census Release 1. Fiji Bureau of Statistics. Available at: www.statsfiji.gov.fj.
Fiji Meteorological Service , Australian Bureau of Meteorology, Commonwealth Scientific and Industrial Research Organisation, 2011. Current and Future Climate of the Fiji Islands. Pacific Climate Change Science Program Partners, Australian Government.
Steer AC , Tikoduadua LV , Manalac EM , Colquhoun S , Carapetis JR , Maclennan C , 2009. Validation of an integrated management of childhood illness algorithm for managing common skin conditions in Fiji. Bull World Health Organ 87: 173–179.
World Health Organization , Regional Office for the Western Pacific, Asia Pacific Observatory on Health Systems and Policies, 2011. The Fiji Islands Health System Review. Manila, Philippines: WHO Regional Office for the Western Pacific.
National Drug and Therapeutic Committee , 2006. Fiji Essential Medicines Formulary.
World Health Organization , 2014. IMCI Module 1, General Danger Sings for the Sick Child. Geneva, Switzerland: WHO Publications.
Harris PA et al. 2019. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95: 103208.
Harris PA , Taylor R , Thielke R , Payne J , Gonzalez N , Conde JG , 2009. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377–381.
Fiji Islands Bureau of Statistics , 2007. 03_Relationship-Ethnicity-and-Religion-by_Province-of-Enumeration_Fiji-2007. Census 2007 General Tables.
Tun K , Shurko JF , Ryan L , Lee GC , 2018. Age-based health and economic burden of skin and soft tissue infections in the United States, 2000 and 2012. PLoS One 13: e0206893.
Fritz SA , Shapiro DJ , Hersh AL , 2020. National trends in incidence of purulent skin and soft tissue infections in patients presenting to ambulatory and emergency department settings, 2000–2015. Clin Infect Dis 70: 2715–2718.
Loadsman MEN , Verheij TJM , van der Velden AW , 2019. Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data. Fam Pract 36: 410–416.
Shallcross LJ , Hayward AC , Johnson AM , Petersen I , 2015. Incidence and recurrence of boils and abscesses within the first year: a cohort study in UK primary care. Br J Gen Pract 65: e668–e676.
Engelman D et al. 2020. The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. Br J Dermatol 183: 808–820.
Magree HC , Russell FM , Sa’aga R , Greenwood P , Tikoduadua L , Pryor J , Waqatakirewa L , Carapetis JR , Mulholland EK , 2005. Chest X-ray-confirmed pneumonia in children in Fiji. Bull World Health Organ 83: 427–433.
Jenney A , Holt D , Ritika R , Southwell P , Pravin S , Buadromo E , Carapetis J , Tong S , Steer A , 2014. The clinical and molecular epidemiology of Staphylococcus aureus infections in Fiji. BMC Infect Dis 14: 160.
Steer AC , Jenney A , Kado J , Good MF , Batzloff M , Waqatakirewa L , Mullholland EK , Carapetis JR , 2009. Prospective surveillance of invasive group a streptococcal disease, Fiji, 2005–2007. Emerg Infect Dis 15: 216–222.
Steer AC , Kado J , Jenney AW , Batzloff M , Waqatakirewa L , Mulholland EK , Carapetis JR , 2009. Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005–2007. Med J Aust 190: 133–135.
May PJ , Tong SYC , Steer AC , Currie BJ , Andrews RM , Carapetis JR , Bowen AC , 2019. Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health 24: 280–293.
Yeoh DK , Anderson A , Cleland G , Bowen AC , 2017. Are scabies and impetigo “normalised”? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections. PLoS Negl Trop Dis 11: e0005726.
World Health Organization , 2001. Traditional Medicine. Regional Office for the Western Pacific. Brunei, Darulssalam: World Health Organization.
Wagenaar BH , Augusto O , Beste J , Toomay SJ , Wickett E , Dunbar N , Bawo L , Wesseh CS , 2018. The 2014–2015 Ebola virus disease outbreak and primary healthcare delivery in Liberia: Time-series analyses for 2010–2016. PLoS Med 15: e1002508.
Pont SJ , Grijalva CG , Griffin MR , Scott TA , Cooper WO , 2009. National rates of diarrhea-associated ambulatory visits in children. J Pediatr 155: 56–61.
Romani L et al. 2019. Efficacy of mass drug administration with ivermectin for control of scabies and impetigo, with coadministration of azithromycin: a single-arm community intervention trial. Lancet Infect Dis 19: 510–518.
Romani L et al. 2015. Mass drug administration for scabies control in a population with endemic disease. N Engl J Med 373: 2305–2313.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 747 | 121 | 31 |
Full Text Views | 347 | 142 | 0 |
PDF Downloads | 209 | 64 | 0 |