National survey in Switzerland calls for improved diagnosis and treatment in children with scabies
Issued Date
2023-01-01
Resource Type
ISSN
14247860
eISSN
14243997
Scopus ID
2-s2.0-85180346701
Journal Title
Swiss Medical Weekly
Volume
153
Issue
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
Swiss Medical Weekly Vol.153 No.11 (2023)
Suggested Citation
Buettcher M., Stebler A.K., Theiler M., Kobylinski K., Pfister M. National survey in Switzerland calls for improved diagnosis and treatment in children with scabies. Swiss Medical Weekly Vol.153 No.11 (2023). doi:10.57187/SMW.2023.40129 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95938
Title
National survey in Switzerland calls for improved diagnosis and treatment in children with scabies
Corresponding Author(s)
Other Contributor(s)
Abstract
AIM OF THE STUDY: The global prevalence of scabies is estimated to be up to 200 million cases annually, with young children particularly affected. In Europe, most cases are thought to originate in migrant populations. Scabies management is challenging in children. To identify knowledge gaps and research needs, we aimed to descriptively evaluate the management of children with scabies by different Swiss healthcare providers. METHODS: An invitation for an anonymous online survey (36 questions) was sent to members of Swiss societies of dermatologists, general practitioners, paediatricians, paediatric dermatologists, paediatric infectious diseases specialists, and tropical medicine specialists, inviting clinicians to participate from 25th May to 8th August 2020. One reminder invitation was sent. Hospital pharmacies and the distributor of permethrin were contacted to report consumption trends of scabicides in 2018 and 2019. RESULTS: The survey was completed by 248 clinicians: 146 (59%) paediatricians, 47 (19%) dermatologists, 28 (11%) general practitioners, 6 (2%) paediatric dermatologists, 13 (5%) paediatric infectious diseases specialists, and 8 (3%) tropical medicine specialists. Most consulted up to 10 scabies cases within a 16-month period, with similar numbers in migrant and Swiss children. Dermoscopy was used by 24% of non-dermatologists. Non-dermatologists did not consider co-treatment of close contacts in up to 59% of cases. While permethrin was the first-line treatment, treatment failures were frequently reported in children aged <5 years. Up to 67% of paediatric dermatologists regularly used oral ivermectin off-label in children weighing <15 kg. None of the paediatric dermatologists, 15% of the dermatologists, and 9% of the non-dermatologists used only one treatment cycle.Scabicide consumption increased. Treatment studies on ivermectin use in children weighing <15 kg had the highest research priority. CONCLUSION: In Switzerland, scabies is a frequent dermatosis in migrant and Swiss children. While accessible, optimal diagnostics are underutilised, and treatment is suboptimal. Permethrin resistance appears to be an increasing problem. Dermatologists regularly use ivermectin off-label in children weighing <15 kg. Treatment studies on ivermectin use in children weighing <15 kg, user-friendly diagnostic tools, new treatment protocols, and child-friendly dosage forms are needed to improve the diagnosis and treatment of children with scabies.