SUMMARY
Objective: The comparison of cost-efficiency of two scabies treatment modalities on mass scale in the low-resource clinical setting of a refugee camp.
Methods: Clinical data of diagnosed patients with scabies were analysed for the treatment failure at follow up on days 21, 42 and later. Treatment by ivermectin (IV) single dose and benzyl benzoate (BB) applied in two doses, dose 1 (BB1) applied on day 1 and dose 2 (BB2) applied on day 2, were compared for their efficacy based on patients re-presenting with scabies symptoms to the medical clinic. The cure ratios were then calculated for each modality of treatment.
Findings: Patients that were treated with ivermectin single dose (n= 127/663; 19.2%) remained symptomatic when reviewed three weeks after the treatment. This was a significantly higher number compared to patients who were treated with two doses of benzyl benzoate (n=10/576; 1.7%). Additionally, patients treated by IV single dose (n=70/663; 10.6%) presented with re-infection after a 6 week period, versus only 9 patients who were initially treated with BB two doses (n=9/576, 1.6%). Overall, throughout the testing period, the estimated cure rate of the infected was 88.9% (n= 1102/1239) treated by either with IV1 or BB2, while 96,7% (n=557/556) when prescribed BB2 and 70.3% (n=446/663) IV1.
Conclusion: Benzyl Benzoate lotion prescribed for two applications on two consecutive days is significantly more effective for mass treatment of scabies than ivermectin tablets administered in a single dose.
Key words: refugees, migrants, scabies, ivermectin, benzyl benzoate.
Lek Obz, 2021, 70(12): 469-473
Tomas SIMONEK 2, Helen ZAHOS 1,2, Kathryn MEGAN HUGHES 3, Christian HARKENSEE 4, Siyana MAHROOF-SHAFFI 5
1 School of Nursing and Midwifery, Griffith University, Queensland, Australia
2 Refugee and migrant joint programme St. Elizabeth University, Bratislava, Slovakia and UNHCR Lesbos, Greece
3 The London School of Hygiene and Tropical Medicine, London, UK
4 Paediatric Infectious Diseases at Gateshead Health NHS Foundation Trust, UK
5 King's College London, Faculty of Life Science & Medicine, UK
Cite:
SIMONEK T., ZAHOS H., MEGAN HUGHES K., HARKENSEE Ch., MAHROOF-SHAFFI S.: Ivermectin single dose versus Benzyl benzoate two application for scabies mass treatment in UNHCR refugee camp of Lesvos island. A retrospective cohort study. Lek Obz, 2021, 70(12): 469-473
