Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality.

Morrison, E J, Middleton, J, Lanza, S, Cowen, J E, Hewitt, K, Walker, S L, Nicholls, M, Rajan-Iyer, J, Fletcher, J and Cassell, J (2019) Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality. Epidemiology & Infection, 147 (e250). ISSN 0950-2688

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Abstract

Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks.

While high quality randomized controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literatures. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.

Item Type: Article
Keywords: Scabies, care homes, systematic review, outbreak management
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Primary Care and Public Health
School of Life Sciences > Biology and Environmental Science
Subjects: Q Science > QL Zoology > QL0360 Invertebrates > QL0434 Arthropoda
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0645.3 Home health care services
R Medicine > RL Dermatology > RL0760 Diseases due to parasites
Depositing User: Jo Middleton
Date Deposited: 04 Jul 2019 08:31
Last Modified: 08 Aug 2019 15:30
URI: http://sro.sussex.ac.uk/id/eprint/84734

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