Prevalence and Associated Risk Factors of Scabies and Impetigo: A Cross-Sectional Study in the Nata Catchment Areas of Tutume District, Botswana

BackgroundScabies is a poorly understood disease in the developing world, particularly in regions with high disease burden. Lack of epidemiological data, especially in sub-Saharan Africa, hampers our understanding of the diseases occurrence and impact. This study aimed to estimate the prevalence and associated risk factors of scabies and impetigo in the Nata catchment areas of Tutume district. MethodologyA cross-sectional study was conducted in the Nata catchment area, targeting the settlements of Manxhotae, Malelejwe, Ndutshaa, and Tshwaane. Participants were randomly selected from randomly selected households. Data were collected using questionnaires, and scabies was confirmed by skin examination using the International Alliance for the Control of Scabies (IACS) consensus criteria. Statistical significance was set at p<0.05, with a 95% confidence interval for precision. ResultsA total of 429 participants were enrolled across the four settlements. The highest prevalence of scabies was in Manxhotae at 27.1% (21.2-34.0) and Ndutshaa at 23.4% (13.4-37.3). Malelejwe and Tshwaane had lower prevalence of 10.4% (6.2-16.8) and 3.4% (0.8-12.7), respectively. Only five(5) cases of impetigo were identified. Multivariable logistic regression analysis using the IACS criteria revealed that younger age and a household member with an itch were strongly associated with scabies, with adjusted odds ratios (AOR) of 5.69 [3.16-10.26] and 5.31 [2.76-10.21], respectively, however, a less sensitive criterion also included less frequent bathing as a significant exposure, AOR of 3.3 [1.9-5.8] ConclusionThe prevalence of scabies in the Nata catchment area was unexpectedly high. The risk factors included younger age, a household member with an itch, and less frequent bathing. Prospective studies are needed to explore household disease transmission dynamics and risk factors specific to the youth. Author SummaryThis study was carried out in the Nata catchment area in Tutume district, Botswana. It aimed to assess the burden, risk factors informing effective disease control programs. The survey involved interviews and skin examination by a health worker. Findings revealed a higher incidence of scabies cases, while impetigo cases were less prevalent. These results highlight the need for community-wide interventions to mitigate the diseases impact. Identified risk factors include younger age, residing with an individual experiencing itchiness, and infrequent bathing. Overall, this study supports advocating for scabies as a neglected tropical disease.