Abstract
INTRODUCTION: The prevalence of scabies and impetigo is high in several Pacific Island countries and has led to the implementation of mass drug administration control strategies. Anecdotal clinical reports have suggested similarly high burdens of scabies and bacterial skin infection in French Polynesia, but formal prevalence data have been lacking. We aimed to determine the prevalence of scabies and bacterial skin infection in French Polynesia's two most populated islands: Tahiti and Mo'orea. METHODS: We conducted a community-based cross-sectional survey. Our study was pragmatically restricted to the main islands of Tahiti and Mo'orea, where we selected households using two-stage randomisation from 20 first-stage neighbourhoods. All individuals present in the home were invited to participate. Four nurses and one doctor conducted skin examinations using validated simplified diagnostic criteria to diagnose scabies, informed by the International Alliance for the Control of Scabies 2020 diagnostic criteria. RESULTS: Among 1770 participants, scabies prevalence was 11.9% and was highest among children aged <5 years (31.8%, RR 5.7, 95% CI 3.8 - 8.6, compared to ≥55 years). The overall bacterial skin infection prevalence was 5.5%. Participants with scabies had a 10-fold higher risk of bacterial skin infection compared to those without (26.8% vs 2.7%, RR 10.2, 95% CI 7.5-13.8). Written consent was obtained for all 1770 participants. CONCLUSIONS: The prevalence of scabies in this study exceeds 10%, the threshold above which evidence-based public health strategies including mass drug administration (treatment of the entire community, regardless of whether they show evidence of the disease) may be considered.