Field trial of community-based intervention to control scabies in the tribal communities of Gadchiroli, Maharshtra

This study is a cluster randomized, parallel group, two arm controlled trial to assess the effectiveness of community-based intervention to control scabies in the tribal communities of Gadchiroli, Maharashtra. The study will be conducted in the selected 12 villages of Dhanora block of Gadchiroli district.  The community-based intervention package will target all people of the intervention villages. During community survey if the prevalence of scabies  is found to be less than 10%, then the intervention will include i) Treatment of cases of scabies with two doses of ivermectin  (200 microgram per kg) with a gap of 14 days, along with single dose ivermectin (200 microgram per kg) administration to household members unless contraindicated (weight less than 15 kg, pregnant and breastfeeding women, individual with neurologic disease such as parkinson’s disease or cerebral palsy and individual taking medication that is metabolised by the cytochrome p450 pathway eg. warfarin, anticonvulsants). ii) Ivermectin will be replaced by topical permethrin 5% lotion in the above “ivermectin contra-indication†groups. iii) In addition to scabies treatment, the identified infected scabies or impetigo cases will be treated with 0.5% gentian violet paint by health workers. The severe infected scabies and impetigo cases (fever above 101 0F, toxic and delirious, severe protein energy malnutrition children with infected scabies or impetigo, patients with more than 40 lesions, no response to health worker treatment) will be referred to the tribal friendly hospital of SEARCH for further management. iv) If the prevalence of scabies is more than 10% in the community, then all the villagers in place of household members of scabies patient in the intervention villages will be treated with a single dose of Ivermectin (200 microgram per kg) unless contraindicated. The primary outcome will be reduction of prevalence of scabies among people of intervention villages as compared to the control villages at the end of 2 months of community-based intervention. The secondary outcome will be reduction of prevalence of impetigo among people of intervention villages as compared to the control villages after 2 months of community-based intervention. Other secondary outcomes will be reduction of prevalence of scabies and impetigo among people of intervention villages as compared to the control villages after 12 months of community-based intervention.