Prevalence of scabies in long-term care hospitals in South Korea

Background: Scabies is a common contagious skin disease. With the economic growth in South Korea, the incidence of scabies has decreased. However, with the recent advancements in medical facilities, mainly the establishment of long-term care hospitals (LTCHs), scabies is now considered an emerging public health problem. Methodology/Principal findings: To examine the prevalence and management of scabies in LTCHs in South Korea, we contacted all 1,336 LTCHs registered at the Health Insurance Review and Assessment Service in South Korea in 2018. A total of 110 LTCHs completed a questionnaire, and we analyzed their responses. In the last 5 years, 71.8% (79/110) of LTCHs had a high incidence of scabies (suspected/confirmed cases). Usually, patients aged older than 80 years (45.5%) were diagnosed with the disease, with more women being affected than men. Only 30.0% of the patients were transferred to scabies-restricted rooms, and very few LTCHs (7.0%) had special departments for scabies. Fifty-five (61.1%) of 90 LTCHs reported contact between scabies patients and nurses, nurse aides, caregivers, and other employees (hereinafter, referred to as primary exposure), with 29 (32.2%) LTCHs reporting infections due to primary exposure. The most common challenges in managing scabies were patient isolation (47.8%), diagnosis (31.1%), management of individuals exposed to an individual with scabies (17.8%), lack of staff for managing the patients (16.7%), and treatment (11.1%). Conclusions: The incidence rate of scabies in LTCHs in South Korea has increased. Regular and enhanced staff training is needed, considering that most hospitals rarely focused on the handling of equipment and furniture used by scabies patients and on educating their healthcare staff. These findings can be used to develop various strategies to reduce the prevalence of scabies. Author summary: This study aimed to present a plan for scabies control by investigating the current status of scabies and management in long-term care hospitals (LTCHs) and by identifying the general characteristics of nursing staff managing scabies patients at nursing homes. To determine the incidence of scabies in LTCHs, we contacted all the 1,336 LTCHs registered at the Health Insurance Review and Assessment Service in South Korea in 2018. Among them, 256 LTCHs agreed to participate in the present study, but only 110 LTCHs completed the survey questionnaire. Studies have shown that scabies is common in LTCHs, and secondary bacterial infection is also common in patients with scabies. Moreover, the incidence rate of scabies has increased in the last 5 years even in LTCHs with highly educated healthcare staff, manuals on the prevention and management of scabies, and infection reporting systems. Regular and enhanced staff training is needed, considering that most hospitals have rarely focused on the handling of equipment and furniture used by scabies patients and on educating their healthcare staff. These findings can be used to develop various strategies to reduce the prevalence of scabies.