In the late 60s, during the Nigeria-Biafra civil war, most children had scabies in both divide. The name in Pidgi is craw-craw. The Igbos call it – akpukpa, ikpa or ogbu abua. The Yoruba call it ogbun-ogbun or itun-tun. The Hausa call it kare koki or kwari afata. Meaning skin parasite. Immediately after the war the epidemic reduced and it was seen more in secondary school dormitories.
In the 80s and 90s scabies almost disappeared and was diagnosed far and in between. Last year when Gregory University through the Prof. Gregory Foundation, embarked on free medical outreach programm in Abia State, most children and students in primary and secondary schools who consulted the medical team had scabies. After we had seen more than 12 cases in one centre, we became alarmed. We asked ourselves rhetorically: “Are we having a resurgence of scabies just like we had during the Nigeria – Biafra civil war and if so, why?” We immediately referred these findings to our University Medical Research Team. They immediately commenced documentation. I shall keep us updated on their findings.
What I am doing now is to raise national awareness about it. Is scabies, as an infection, returning to Nigeria as an epidemic? I shall update us more after our research, but today everybody should read this write-up carefully and become your own detective and preventive doctor, for sake of your children. Not only for our children, but also for the sake of adults.
Let us note these facts made known by the World Health Organisation (WHO).
• Human scabies is a parasitic infestation caused by Sarcoptes scabiei ver hominis.
• At least 200 million people worldwide suffer from scabies at any one time.
•.An estimated 5-50% of children in resource poor areas are affected by scabies.
• Scabies occurs worldwide but is most common in hot tropical countries and in areas of high population.
We know that scabies is an itchy skin condition caused by a tiny burrowing mite called sarcoptes scabies. It leads to intense itching along the burrows. The urge to scratch may be especially strong at night.
Scabies is contagious and can spread quickly through close physical contact in a family, childcare group, boarding houses, school classes, nursing homes or prison.
Scabies has been observed in humans since ancient times. Archeological evidence from Egypt and the Middle East, suggests scabies was present as early as 494 BC. The first recorded reference to scabies is believed to be from the Bible. It may be a type of leprosy “mentioned in Leviticus about 1200 BC or mentioned among the curses in Deuteronomy 28.
In the 4th century BC, Aristotle reported on “lice” that “escape from little pimples if they are pricked”, a description consistent with scabies.
The Roman encyclopedist and medical writer, Aulus Cornelius Celsius (25 BC – 50AD) is credited with naming the disease “scabies” and describing its characteristic features. The parasitic aetiology of scabies was documented by the Italian physician, Giovanni Cosimo Bonomo (1663-1696), in his 1687 letter, “Observations Concerning the Flesh worms of the Human Body.» Bonomo’s description established scabies as one of the first human diseases with well-understood cause.
In Europe in the late 19th through 20th centuries, a sulfur bearing ointment called by the medical eponym of Wilkinson’s Ointment was widely used for topical treatment of scabies.
Approximately, 300 million cases of scabies are reported worldwide each year. Natural disasters, war and poverty lead to overcrowding and increased rate of transmission. Africa is responsible for more than one half of the 300 million infestation and Nigeria has the highest number of infestation of scabies than any other country in Africa.
Of the 200 dermatology outpatients in University of Jos in 1986 with scabies the following distribution was found. Females 59 percent, children 37.5 percent and males 18 percent. It was later discovered that most of the females came from the boarding house of a secondary school.
Scabies is clearly an endemic disease in many tropical and subtropical regions, being among six major epidermal parasitic skin diseases (EPSD), that are prevalent in resource poor populations, as reported in the Bulletin of the World Health Organization in February 2009.
Scabies can infest any human who comes in contact with the mites, including people in good health. The only known risk factor is direct skin contact with someone who is infested. Good hygiene and health practices cannot prevent transmission, if there is close contact with an infected person. The contact one experiences in social settings, is not likely to be sufficient to transmit the mites.
Settings in school dormitories, sexual or other close contact such as hugging is required to spread the condition. The condition does appear in clusters, so outbreaks may occur within university hostels, boarding houses, camps or communities that sleep together.
Scabies is highly contagious and spread via direct skin-to skin contact or by using a towel, beddings or furniture infested with the mites. As such, some of the most likely people to become infested with mites include:
• Students in dormitories or hostels.
• Parents of young children .
• Sexually active young adults and people with multiple sexual partners
• Residents of extended camp facilities.
• Older adults.
• People who are immuno-compromised, including those with HIV/AIDS, transplant recipients and others on immunosuppressant medications.
The main symptoms observed in scabies include: itching, mite tunnel borrows, itching along the tunnels, rashes, scratching and aggravation of pre-existing skin conditions.
Vigorous scratching can break your skin and allow a secondary bacterial infection, such as impetigo to occur. Impetigo is a superficial infection of the skin that is caused most often by staph (staphylococcal) bacteria, or occasionally by strep (streptococcal) bacteria.
A more severe form of scabies called “crusted scabies” may affect certain high-risk groups including people with chronic health conditions that weaken the immune system, such as HIV or chronic leukaemia.
Scabies treatment involves eliminating the infestation with medication. Several creams and lotions are available which your doctor will prescribe. A second treatment is needed if new burrows appear.
Because scabies spreads so easily, your doctor will likely recommend treatment for all household or all dormitory or hostel members.
To prevent re-infestation, and to prevent the mites spreading to other people, clean all clothes, beddings and linens with disinfectant and iron them thereafter.
Starve the mites by placing all clothes you can’t wash immediately, in a sealed plastic or jute bags, and leave them out of the way places, such as your garage for a couple of weeks. Mites die after a few days without food. Always be medically guided. Please follow me on [email protected]