NTA Level 4 • Semester 1 • PST04102

Identification of Patients with Scabies

Disease Control and Prevention • Source Session/Topic 25

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Session 25: Identification of Patients with Scabies

Total Session Time: 120 minutes + 2 hours Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• Describe Cause(s) of Scabies

• Describe Mode of Transmission of Scabies

• Describe Major Signs and Symptoms of Scabies

• Explain Treatment of Scabies

• Explain Prevention and Control of Scabies

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board, chalk and whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

SESSION CONTENTS

STEP1: Presentation of Session Titles and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Causes of Scabies(10 minutes)

|Activity: Buzzing (10 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What causes scabies? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• Scabies: A parasitic infection of the skin characterised by an intense

itching with typical distribution caused by the mite Sarcoptes scabies

• Prevalence is high in areas with shortage of water

• Common in people who do not take bath regularly

• Low socio-economic conditions favour the spread of the disease

STEP 3: Mode of Transmission of Scabies (10 minutes)

• Transmission is by direct close body contact from infected person and

indirectly through bed clothes and sharing clothing

• The female mite enters the skin and makes a small tunnel or burrow

• The burrow is always superficial

• The skin selected for burrow is always thin and wrinkled giving

scabies rash a typical distribution

• In the burrows, eggs and faeces are produced

• The eggs hatch in 4-5 days

• The larvae leave the parent tunnel and bury in the skin in other

places, but do not make tunnels

STEP 4: Signs and Symptoms of Scabies (30 minutes)

|Activity: Brainstorming (10 minutes) |

| |

|Ask students to brainstorm on the following question: |

| |

|What are the signs and symptoms of scabies? |

| |

|ALLOW few students to respond |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

• Intensive itching, especially at night

• Eczema-like signs

o The itching leading to scratching

o Secondary bacterial infection

• In case of immune suppression such as HIV and AIDS, infestation can be

extensive

• Typical distribution of severe itch and rash are:

o Anterior axillary fold

o Nipples, lower abdomen in women

o Belt line (umbilicus)

o Front side of wrist and elbows

o External genitalia

o Thighs and buttocks

o Sides of fingers and toes

o Sides and webs of fingers

o Scalp and feet (infants under 1 year)

• Patients with leprosy or other diseases which interfere with normal

sensation may not feel the itching caused by scabies. In these cases,

scabies can be very extensive and thick crusts can form

[pic]

STEP 5: Treatment of Scabies (30 minutes)

• The drug of choice is 10% Benzyl benzoate emulsion (BBE)

• Administration information

o After the patient has taken a warm bath, the drug is applied over the

whole body except the face

o After 24 hours of first treatment, the patient should bath again and

put on clean clothes

o The drug has no effect on the eggs, therefore repeat BBE after 4 – 7

days to kill larvae which have hatched after the first treatment

• Other drugs which can be used in the absence of BBE include:

o Tetmosol solution or soap

o Permethrin cream 5% (applied to areas of the body from neck downward

and washed off after 8-14 hours)

o Ivermectin 200µg/kg orally and repeated after 2 weeks or Lindane (1%)

lotion or cream

o Antibiotics are used only when there is a secondary infection

(preferably Penicillin)

STEP 6: Prevention and Control of Scabies (30 minutes)

|Activity: Small Group Discussion ( 15 minutes) |

| |

|DIVIDE students into small manageable groups |

| |

|ASK students to discuss on the following question |

|What are the measures of preventing scabies? |

| |

|ALLOW students to discuss for 10 minutes |

| |

|ALLOW few groups to present and the rest to add points not mentioned |

| |

|CLARIFY and SUMMARIZE by using the contents below |

Prevention and control of scabies

• Regular bathing with soap

• Washing clothes regularly

• Give health education to stress the use of soap and personal hygiene

• Treat the whole family

• Decontamination of bedding materials and clothing

• Improve water supply

STEP 7: Key Points (5 minutes)

• Scabies is characterized by severe itching

• It is treated with BBE, Tetmosol, Ivermectin or Lindane.

• Treatment of scabies should include all family members

• Control is by regular bathing using water and soap

STEP 8: Evaluation (5 minutes)

• What is the cause of scabies?

• What is the mode of transmission of scabies?

• What are signs and symptoms of scabies?

• What is the treatment of scabies?

• What are control measures for scabies?

STEP 9: Assignment (5 minutes)

|Activity: Take Home Assignment (10 minutes) |

| |

|DIVIDEstudents into small groups assignment |

| |

|ASK the students to work individually on the following Assignment |

|Prepare a presentation on how to control scabies at home. |

| |

|ALLOCATE time for students to do the assignments and submit |

| |

|REFER students to recommended references |

References

Cook, G. & Zumla, A. (2003).Manson’s Tropical Diseases. (21sted.). London:

Saunders Ltd

Denyer, S. P. Hodges, N. A. & Gorman, S. P (2011) Ed.Hugo & Russell’s

Pharmaceutical Microbiology (8thed). Oxford: Willey-Blackwell publishing

Eshuis,J, & Manschot,P (1992). Communicable diseases,(1st ed). Nairobi:

AMREF

GoT (2004): National Infection Prevention and Control (IPC) Guidelines for

Healthcare Workers. Dar es Salaam: MOHSW

GoT (2013) Standard Treatment Guidelines & National Essential Medicines

List (4thed). Dar es Salaam: MOHSW

Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in

Sub-Saharan Africa, Nairobi: AMREF

Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable

Diseases. (4thed.). Nairobi: AMREF

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