Scabies is one of the neglected health problems in developing countries including Iran . Scabies has non-uniform geographical distribution in Iran and prevalence of this infestation is nearly high and different in various provinces owing to different climates [13, 15]. For example, compared to other areas, the prevalence of scabies is higher in the northern parts of Iran, as a result of climatic conditions and higher population density [13, 15,16].
In this study the prevalence of scabies was 3.1% in primary schoolchildren of Bashagard County. Previous studies have reported the prevalence of scabies infestation in primary schoolchildren from 2.09% to 7.22 % in different parts of Iran [13, 17, 18]. In other studies, conducted in schoolchildren of Egypt, Nigeria, Turkey, and, Kuwait, the prevalence of scabies was 4.4%, 4.8%, 2.16%, and 3%, respectively [19-22]. In addition, studies from India and Cameron have reported high infestation rate of scabies among schoolchildren with the prevalence of 39.42% and 17.8%, respectively [23, 24]. The variation of scabies infestation rate may be due to different factors such as family size, personal hygiene, and economic conditions [25-26]. Prevalence of scabies infestation in the study area may be attributed to factors such as use of shared articles, low parents’ educational level, large family size, low frequency of bathing per week, and poor health facilities. Obviously, many of these factors are due to the extreme poverty.
In this study, the most common location of scabies lesions was found on the web spaces between the fingers and wrists. A similar study in the north of Iran also reported the highest number of scabies infestation on the web spaces between the fingers . Scabies infections are usually localized in specific parts of the body and elbows, wrists, and hands are the most commonly infected sites . Hand and wrist infections may occur due to handling mite-contaminated materials and touching infected persons. However, the distribution patterns suggest that the mites select special locations of the body and these locations may be preferred partly because of the lipid composition [27, 28].
In this study the highest prevalence of scabies infestation was observes in children aged more than 10 years. This finding is in accordance with the results of previous studies in Brazil, Nigeria, Pakistan, and Sri Lanka [7, 29-31]. This can be explained by more direct physical contact with friends at this students age group. In this regards, other studies also have reported the important role of physical contacts in transmission of scabies .
According to the results, scabies was more prevalent among schoolchildren with low educated parents. Similar findings have been reported from Iran [17, 18, 21, 32-35]. Parental education seems to have a major role in prevention of contagious diseases. Many studies have reported that parents with higher levels of education are more capable to apply healthcare and prevention measures for their children [21, 34, 37]. Since educational-based interventions have been reported to be efficient in reduction of insect-borne diseases in low socioeconomic areas , it is essential to provide appropriate educational programs for teachers, parents, and students to increase their awareness about scabies infestation risk factors and related prevention measures .
The results of the present study have confirmed the positive relationship between scabies infestation and the family size. This finding is supported by previous studies in Iran, Saudi Arabia, Cameroon, Ethiopia, Fiji, Mali, Malawi, and Cambodia [16-18, 24, 33, 38-40]. Larger family size leads to overcrowding. In the overcrowded homes, close contact between family members and use of shared beds and cloths, increases the risk of scabies transmission. In addition, having more children may result in higher scabies infestation rates, because parents with more children pay less time per child to perform laundry and other personal hygiene activities.
According to the results of this study, use of shared articles such as towel, combs, and cloth affects the scabies prevalence. In a similar study conducted by Karim et al in Bangladesh , children who had shared beds on the floor, contracted more severe scabies infections and became re-infected more frequently. It was attributed to the use of shared beds which facilitates skin-to-skin contact and transmission of scabies from infested children to healthy ones. Similar findings have been reported from Egypt, Pakistan, Brazil, Ethiopia, Argentina, and Taiwan [21, 30, 34, 41-43]. In the crowded conditions, use of shared beds, cloths, and other materials may transmit the scabies infestation .
The present study revealed that the prevalence of scabies was higher among schoolchildren without bathroom in their home and it had relationship with frequency of bathing. This finding is similar to the results of Wochebo et al, in Ethiopia who reported the risk of scabies is significantly associated with personal hygiene and children who took bath less than two times a week were five times more likely to be infected by scabies . Likewise, in previous studies conducted in Ethiopia, Nigeria, Saudi Arabia, Bangladesh, and Cameroon association between scabies infestation and frequency of bathing was reported [11, 29, 33, 35, 37]. This might be because primary school students have less control over their personal hygiene. In addition, since schoolchildren spend much of their time with their friends, they have a higher chance of physical contact which facilitates scabies transmission. Other studies also have confirmed that the prevalence of human scabies is linked with poor personal hygiene [44, 45]. Hence, the prevalence of scabies infestation in primary school children may be, to some extent, due to low awareness and practice regarding the personal hygiene.