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Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019

Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in...

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Autores principales: Thean, Li Jun, Jenney, Adam, Engelman, Daniel, Romani, Lucia, Wand, Handan, Mudaliar, Jyotishna, Paka, Jessica, Cua, Tuliana, Taole, Sera, Sahukhan, Aalisha, Kama, Mike, Tuicakau, Meciusela, Kado, Joseph, Carvalho, Natalie, Whitfeld, Margot, Kaldor, John, Steer, Andrew C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752096/
https://www.ncbi.nlm.nih.gov/pubmed/33296378
http://dx.doi.org/10.1371/journal.pntd.0008887
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author Thean, Li Jun
Jenney, Adam
Engelman, Daniel
Romani, Lucia
Wand, Handan
Mudaliar, Jyotishna
Paka, Jessica
Cua, Tuliana
Taole, Sera
Sahukhan, Aalisha
Kama, Mike
Tuicakau, Meciusela
Kado, Joseph
Carvalho, Natalie
Whitfeld, Margot
Kaldor, John
Steer, Andrew C.
author_facet Thean, Li Jun
Jenney, Adam
Engelman, Daniel
Romani, Lucia
Wand, Handan
Mudaliar, Jyotishna
Paka, Jessica
Cua, Tuliana
Taole, Sera
Sahukhan, Aalisha
Kama, Mike
Tuicakau, Meciusela
Kado, Joseph
Carvalho, Natalie
Whitfeld, Margot
Kaldor, John
Steer, Andrew C.
author_sort Thean, Li Jun
collection PubMed
description Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division’s referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571–660). Incidence was highest at the extremes of age with peak incidence in children aged <5 years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children <5 years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings.
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spelling pubmed-77520962021-01-05 Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019 Thean, Li Jun Jenney, Adam Engelman, Daniel Romani, Lucia Wand, Handan Mudaliar, Jyotishna Paka, Jessica Cua, Tuliana Taole, Sera Sahukhan, Aalisha Kama, Mike Tuicakau, Meciusela Kado, Joseph Carvalho, Natalie Whitfeld, Margot Kaldor, John Steer, Andrew C. PLoS Negl Trop Dis Research Article Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division’s referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571–660). Incidence was highest at the extremes of age with peak incidence in children aged <5 years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children <5 years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings. Public Library of Science 2020-12-09 /pmc/articles/PMC7752096/ /pubmed/33296378 http://dx.doi.org/10.1371/journal.pntd.0008887 Text en © 2020 Thean et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Thean, Li Jun
Jenney, Adam
Engelman, Daniel
Romani, Lucia
Wand, Handan
Mudaliar, Jyotishna
Paka, Jessica
Cua, Tuliana
Taole, Sera
Sahukhan, Aalisha
Kama, Mike
Tuicakau, Meciusela
Kado, Joseph
Carvalho, Natalie
Whitfeld, Margot
Kaldor, John
Steer, Andrew C.
Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title_full Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title_fullStr Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title_full_unstemmed Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title_short Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019
title_sort hospital admissions for skin and soft tissue infections in a population with endemic scabies: a prospective study in fiji, 2018–2019
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752096/
https://www.ncbi.nlm.nih.gov/pubmed/33296378
http://dx.doi.org/10.1371/journal.pntd.0008887
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