Prevalence and risk factors of scabies among orphans: A cross-sectional study in Bangladesh

Introduction: Scabies is one of the most common neglected tropical diseases predominantly affecting children from low socio-economic background. This study was conducted to determine the prevalence and associated factors of scabies among the children living in the orphanages of Bangladesh. Methods: This was a cross-sectional study among children in selected orphanages in Dhaka city of Bangladesh from May to December 2023. The participants were screened for scabies according to the diagnosis criteria of the International Alliance for the Control of Scabies guideline (IACS, 2020). A logistic regression model was used to determine the factors associated with scabies among the children. Results: A total of 471 children living in five selected orphanages of Dhaka city of Bangladesh were screened for scabies. Majority of the children living in orphanages were female with a mean age of 11.9 (SD 3.24) years. The overall prevalence of scabies among the children was 31.6% (mild 60.4%, moderate 28.2% and severe 11.4%). Male gender (aOR 2.76, 95% CI 1.14, 7.45, p-value 0.032), increased number of children per room (aOR 1.07, 95% CI 1.03, 1.12, p-value 0.001), and history of pruritus in the close contacts or peers (aOR 1.89, 95% CI 1.04, 3.46, p-value 0.038) were associated with a higher odds of being infected by scabies. Conclusion: One-third of the children living in the orphanages were suffering from scabies. Male children and those who live in crowded facilities and had close contact with infected peers were at higher risk of scabies. Author summary: Scabies is a common but often overlooked skin disease that affects children, particularly those from disadvantaged backgrounds. This study investigated how widespread scabies is among children living in orphanages in Dhaka, Bangladesh, and identified the factors that contribute to its spread. We screened 471 children across five orphanages and found that nearly one-third (31.6%) were affected. Boys, children living in crowded rooms, and those who had close contact with others experiencing itching were more likely to have scabies. By addressing overcrowding and improving awareness about scabies transmission, policymakers and healthcare providers can help protect vulnerable children from this highly contagious disease.