Why should Mass Drug Administration for Scabies be combined with Albendazole in affected areas?

June 27, 2019

healthy soch

New Delhi, June 27, 2019:

When I was studying at MGIMS scabies was rampant in the society. Over 25% of the OPD cases were dur to scabies. Our standard treatment was escabiol ointment.

Scabies, an infestation with the mite Sarcoptes scabiei var. hominis, was added to the list of neglected tropical diseases by the World Health Organization in 2017.

Today Scabies is amenable to mass drug administration, as shown by the Skin Health Intervention Fiji Trial (SHIFT).

In this trial, the doctors randomly assigned three island communities in Fiji to one of three scabies intervention strategies: standard care involving the administration of topical permethrin to persons with scabies and their contacts (standard-care group), mass administration of topical permethrin (permethrin group), or mass administration of an oral ivermectin-based regimen (ivermectin group).

In the ivermectin group, a single dose of ivermectin-based treatment was provided to all participants, with a second treatment provided 7 days later to those with scabies. The participants ranged in age from infants to the elderly.

At 12 months, the ivermectin-based regimen was the most effective, with a 94% relative reduction from baseline in the prevalence of scabies (from 32.1% at baseline to 1.9%) and a 67% relative reduction in impetigo.

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The prevalence of scabies at 24 months was 3.6% in the ivermectin group, 13.5% in the permethrin group, and 15.2% in the standard-care group.

The prevalence of scabies was lower at 24 months than at 12 months in the permethrin and standard-care groups and slightly higher in the ivermectin group.

The prevalence of impetigo at 24 months was 2.6% in the ivermectin group, 8.9% in the permethrin group, and 13.0% in the standard-care group.

The relative reduction from baseline in the prevalence of impetigo was greatest in the ivermectin group at 90%.

In conclusion, we found that the mass administration of an ivermectin-based regimen reduced the prevalence of scabies 24 months after the intervention, with an additional effect on impetigo. Evaluation of effectiveness in larger, less isolated populations over a longer period is required to extend these findings.

In scabies affected areas, in addition to albendazole being given on 10thFebruary and August why not give ivermectin- albendazole combination ( is available in the country)

Dr K K Aggarwal

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