Factors associated with scabies outbreak among prisoners in Trang Provincial Prison

Abstract

Crowded environment and hygiene of patients affect the outbreak of scabies, which is a major public health problem, especially in the prison context, which is a place where many people gather and share things. This cross-sectional descriptive study aimed to identify epidemiological characteristics and factors related to the outbreak of scabies among prisoners in Trang Prison.
Method: The sample consisted of all prisoners in Trang Prison who received telemedicine for skin diseases from October till November 2023. The medical records were reviewed, interviewed, and screened for scabies and risk factors by professional nurses. Scabies were diagnosed by sending skin scrapings from patients with lesions to examine for scabies under a microscope, as well as surveying the prison environment. Data were analyzed using descriptive statistics, chi-square test and Fisher’s exact test to identify the relationship between risk factors and  the occurrence of scabies. At the statistical significance level 0.05
Results: Of 272 screened inmates 262 (96.7%) were male, with a mean age of 37.6 (±10.75) years, and slightly more than half lived in Zone 1 (52.2%). Scabies were found among156 (57.4%) of the inmates. The most common symptoms were itching and red rash (52.6%), followed by itching at night and red rash (26.9%). The most common lesions were on the finger web (47.4%), followed by the genitals (39.7%). The most important risk behaviors were contact and sharing clothing with a person with scabies (63.5%), followed by sleeping next to a person with scabies (26.1%). From the correlation analysis to find the chance of scabies among prisoners in prison, It was found that contact and sharing clothes with scabies patients were significantly associated with the development of scabies (COR = 1.58, 95% CI: 1.10 - 2.27). Having a history of sleeping next to a scabies patient was significantly associated with the development of scabies (COR = 1.36, 95% CI: 1.14 - 1.62). The duration of staying in prison less than 12 months was not significantly associated with the development of scabies (COR = 0.98 95%CI 0.94 – 1.02). A survey of prison environments found that dormitories were overcrowded, with an average area of ​​only 1.2 square meters per person and limited access to clean water for cleaning the body.