Community-based digital surveillance for scabies-compatible presentations in Nyasa District, Tanzania: A cross-sectional household screening study
4 affiliations
- 1Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
- 2SACIDS Foundation for One Health (SACIDS), Sokoine University of Agriculture, Morogoro, Tanzania
- 3National Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanzania
- 4Ministry of Health, Zanzibar; Dermatology Unit, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Abstract
Introduction: Scabies is under-detected in rural Tanzania because routine surveillance primarily captures people presenting to health facilities. After a community scabies event in Nyasa District in September 2022, community-based digital surveillance using AfyaData was implemented in selected villages in 2024. This study described household-level scabies-compatible presentations detected through the approach. Methods: Eight community health workers screened households in eight villages across four wards from July to October 2024 using a structured Kiswahili questionnaire on AfyaData. Households reporting compatible presentations provided information on symptoms, affected persons, household size, recent treatment, and livestock keeping. We assessed associations using chi-square or Fisher’s exact tests with Benjamini-Hochberg adjustment. Generalised estimating equations with village as the clustering unit estimated adjusted odds ratios for within-household clustering. Results: Of 665 submissions, 663 were analysed; 309 households (46.6%) reported a compatible presentation, but village proportions ranged from 13.1% to 100%, and one village supplied 40.3% of all records; excluding it raised the overall figure to 69.2%. Because one worker covered one village, these differences cannot be separated from worker practice. Household size predicted clustering (adjusted odds ratio 1.35 per additional member, 95%CI: 1.06 – 1.71, p = 0.016) and held across every sensitivity analysis. The crude association with livestock keeping did not survive adjustment. A recently treated member was present in 152 affected households (49.2%). Conclusion: These findings do not support estimation of district-level scabies prevalence because screening coverage and reporting varied between villages. Household size was associated with within-household clustering. Recently treated members in approximately half of affected households highlight the need to assess and manage household contacts. Further studies should evaluate household-based approaches to scabies detection and treatment.
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BibTeX
@article{kilagwa2026communitybased,
title = {{Community-based digital surveillance for scabies-compatible presentations in Nyasa District, Tanzania: A cross-sectional household screening study}},
author = {Ibrahim Twahir Kilagwa and Renfrid Ngolongolo Wiliam and Mpoki Mwabukusi and Victor Saturnus Mwingira and Hafidh Sheha Hassan and Athumani Msalale Lupindu and Sharadhuli Iddi Kimera},
journal = {Journal of Interventional Epidemiology and Public Health},
year = {2026},
month = sep,
doi = {10.37432/jieph-d-26-00041},
url = {https://doi.org/10.37432/jieph-d-26-00041},
note = {CC BY},
}
RIS
TY - JOUR
TI - Community-based digital surveillance for scabies-compatible presentations in Nyasa District, Tanzania: A cross-sectional household screening study
AU - Ibrahim Twahir Kilagwa
AU - Renfrid Ngolongolo Wiliam
AU - Mpoki Mwabukusi
AU - Victor Saturnus Mwingira
AU - Hafidh Sheha Hassan
AU - Athumani Msalale Lupindu
AU - Sharadhuli Iddi Kimera
PY - 2026
DA - 2026/09/01
JO - Journal of Interventional Epidemiology and Public Health
DO - 10.37432/jieph-d-26-00041
UR - https://doi.org/10.37432/jieph-d-26-00041
AB - Introduction: Scabies is under-detected in rural Tanzania because routine surveillance primarily captures people presenting to health facilities. After a community scabies event in Nyasa District in September 2022, community-based digital surveillance using AfyaData was implemented in selected villages in 2024. This study described household-level scabies-compatible presentations detected through the approach. Methods: Eight community health workers screened households in eight villages across four wards from July to October 2024 using a structured Kiswahili questionnaire on AfyaData. Households reporting compatible presentations provided information on symptoms, affected persons, household size, recent treatment, and livestock keeping. We assessed associations using chi-square or Fisher’s exact tests with Benjamini-Hochberg adjustment. Generalised estimating equations with village as the clustering unit estimated adjusted odds ratios for within-household clustering. Results: Of 665 submissions, 663 were analysed; 309 households (46.6%) reported a compatible presentation, but village proportions ranged from 13.1% to 100%, and one village supplied 40.3% of all records; excluding it raised the overall figure to 69.2%. Because one worker covered one village, these differences cannot be separated from worker practice. Household size predicted clustering (adjusted odds ratio 1.35 per additional member, 95%CI: 1.06 – 1.71, p = 0.016) and held across every sensitivity analysis. The crude association with livestock keeping did not survive adjustment. A recently treated member was present in 152 affected households (49.2%). Conclusion: These findings do not support estimation of district-level scabies prevalence because screening coverage and reporting varied between villages. Household size was associated with within-household clustering. Recently treated members in approximately half of affected households highlight the need to assess and manage household contacts. Further studies should evaluate household-based approaches to scabies detection and treatment.
SN - 2664-2824
ER -