Prevalence and Determinants of Scabies Infection among Male Inmates at Kiambu Main Prison, Kenya: A Mixed-Methods Cross-Sectional Study

Background Scabies remains a major neglected tropical disease in correctional facilities due to overcrowding and limited hygiene resources. However, evidence regarding the determinants of scabies infection among inmates in Kenyan prisons remains limited. This study assessed the prevalence and determinants of scabies infection among male inmates at Kiambu Main Prison, Kiambu County, Kenya. Methodology A mixed-methods analytical cross-sectional study was conducted among 188 male inmates recruited using a ward-stratified pragmatic sampling approach between May and June, 2026. Quantitative data were collected using questionnaires and clinical examinations based on the International Alliance for the Control of Scabies (IACS) diagnostic criteria. Qualitative data were obtained through focus group discussions and key informant interviews. Quantitative data were analysed using descriptive statistics, chi-square tests, and logistic regression, whereas qualitative data were analysed thematically. Results The prevalence of scabies was 54.8%, with a weighted prevalence of 54.0% (95% CI: 46.5-61.6%). Daily bathing (AOR = 0.07, 95% CI: 0.01-0.31), bathing 2-3 times per week (AOR = 0.09, 95% CI: 0.01-0.44), and daily clothes washing (AOR = 0.21, 95% CI: 0.06-0.65) were independently associated with lower odds of scabies infection. Remandees had higher odds of infection than convicted prisoners (AOR = 1.97, 95% CI: 1.00-3.91). Qualitative findings identified overcrowding, inadequate hygiene resources, limited health education, medication shortage, and delays in treatment as key contributors to scabies transmission. Conclusion Scabies remains highly prevalent among inmates at Kiambu Main Prison. Both individual hygiene practices and institutional conditions contribute to disease transmission. Strengthening prison health services through routine screening, structured health education, improved access to hygiene resources, and timely diagnosis and treatment may help reduce transmission. These findings provide evidence to inform prison health policies and targeted scabies control programmes in Kenya and other resource-limited correctional settings.