The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines

Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection...

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Bibliographic Details
Published in:	Epidemiology and infection 2016-11, Vol.144 (15), p.3121-3130
Main Authors:	WHITE, L. C. J., LANZA, S., MIDDLETON, J., HEWITT, K., FREIRE-MORAN, L., EDGE, C., NICHOLLS, M., RAJAN-IYER, J., CASSELL, J. A.
Format:	Article
Language:	eng
Subjects:	Acaricides Acquired immune deficiency syndrome Aged Aged, 80 and over AIDS Antigens Bacteria Bacterial infections Benzoic acid Cognitive ability Communities Complications Content analysis Cream Cross Infection - epidemiology Cross Infection - parasitology Cross Infection - prevention & control Data processing Decontamination Dementia disorders Dermatology Disease control Disease Outbreaks - prevention & control Disease transmission Documents England - epidemiology Epidemics Epidemiology Epidermis Fomites Government procurement Guidelines Health care Health services HIV Hospitals Human immunodeficiency virus Humans Hypersensitivity Hypersensitivity (delayed) Income Infections Infectious diseases Infestation Institutions Itching Legislation Lesions Lindane Local government Long-term care Malathion Older people Original Papers Parasites Population density Practice Guidelines as Topic Prisons Public health Residential Facilities Risk Scabies Scabies - epidemiology Scabies - parasitology Scabies - prevention & control Scaling Skin Washing World Wide Web Wrist
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Summary:	Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.
ISSN:	0950-2688 1469-4409