Investigation of a Scabies Outbreak at Sandwe Primary School, Lusangazi District, Zambia, 2022

Abstract

<jats:p>Scabies is a neglected tropical disease caused by Sarcoptes scabiei var. hominis and remains a significant concern in overcrowded, resource-limited settings. On 30 March 2022, Sandwe Rural Health Centre reported an unusual cluster of suspected scabies cases among learners at Sandwe Primary School in Lusangazi District. An investigation was conducted to determine the magnitude of the outbreak, describe its epidemiological characteristics, and identify contributors to transmission and institute control measures. The investigation took place between 30 March and 5 April 2022 and used a descriptive approach. A case was defined as any learner presenting with an intensely pruritic rash at one or more typical anatomical sites, with or without visible burrows, or with a positive skin scraping during the outbreak period. Data collection methods included outpatient register reviews, clinical examinations, active case finding, skin scraping for laboratory confirmation, and environmental assessment of the school premises. Twenty-six cases were identified, representing an attack rate of 4.5 percent. The majority of cases were male adolescents, and boarders were disproportionately affected. Six of eleven skin scrapings tested positive for Sarcoptes scabiei ova. Environmental assessment revealed overcrowding, shared sleeping arrangements, shared bathing materials, insufficient ventilation, and inadequate hygiene practices. The outbreak was confirmed to be propagated, driven by overcrowding and poor hygiene conditions. Interventions included mass treatment, improved hygiene education, and surveillance strengthening. Sustainable prevention will require structural improvements to boarding facilities, reductions in crowding, and improved access to essential hygiene materials.</jats:p>