Prevalence and Associated Risk Factors of Scabies and Impetigo: A Cross-Sectional Study in the Nata Catchment Areas of Tutume District, Botswana

Background Scabies is a poorly understood disease in the developing world, particularly in regions with high disease burden. Lack of epidemiological data, especially in sub-Saharan Africa, hampers our understanding of the disease’s occurrence and impact. This study aimed to estimate the prevalence and associated risk factors of scabies and impetigo in the Nata catchment areas of Tutume district. Methodology A cross-sectional study was conducted in the Nata catchment area, targeting the settlements of Manxhotae, Malelejwe, Ndutshaa, and Tshwaane. Participants were randomly selected from randomly selected households. Data were collected using questionnaires, and scabies was confirmed by skin examination using the International Alliance for the Control of Scabies (IACS) consensus criteria. Statistical significance was set at p<0.05, with a 95% confidence interval for precision. Results A total of 429 participants were enrolled across the four settlements. The highest prevalence of scabies was in Manxhotae at 27.1% (21.2-34.0) and Ndutshaa at 23.4% (13.4-37.3). Malelejwe and Tshwaane had lower prevalence of 10.4% (6.2-16.8) and 3.4% (0.8-12.7), respectively. Only five([5][1]) cases of impetigo were identified. Multivariable logistic regression analysis using the IACS criteria revealed that younger age and a household member with an itch were strongly associated with scabies, with adjusted odds ratios (AOR) of 5.69 [3.16-10.26] and 5.31 [2.76-10.21], respectively, however, a less sensitive criterion also included less frequent bathing as a significant exposure, AOR of 3.3 [1.9-5.8] Conclusion The prevalence of scabies in the Nata catchment area was unexpectedly high. The risk factors included younger age, a household member with an itch, and less frequent bathing. Prospective studies are needed to explore household disease transmission dynamics and risk factors specific to the youth. Author Summary This study was carried out in the Nata catchment area in Tutume district, Botswana. It aimed to assess the burden, risk factors informing effective disease control programs. The survey involved interviews and skin examination by a health worker. Findings revealed a higher incidence of scabies cases, while impetigo cases were less prevalent. These results highlight the need for community-wide interventions to mitigate the disease’s impact. Identified risk factors include younger age, residing with an individual experiencing itchiness, and infrequent bathing. Overall, this study supports advocating for scabies as a neglected tropical disease. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics committee of Republic of Botswana Ministry of Health under Health research division office gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data can be availed on request from the corresponding Author [1]: #ref-5