Article Text

Mass drug administration campaigns for scabies and impetigo: protocol for a systematic review and meta-analysis
  1. Pousali Ghosh1,
  2. Wubshet Tesfaye2,
  3. Avilasha Manandhar1,
  4. Thomas Calma1,
  5. Mary Bushell1,
  6. Victor M Oguoma2,
  7. Sam Kosari1,
  8. Faye McMillan3,
  9. Greg Peterson1,4,
  10. Jackson Thomas1
  1. 1Health, University of Canberra, Canberra, Australian Capital Territory, Australia
  2. 2Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
  3. 3School of Public Health and Community Medicine, The University of New South Wales, Kensington, New South Wales, Australia
  4. 4School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
  1. Correspondence to Dr Jackson Thomas; Jackson.Thomas{at}


Introduction Scabies is recognised as a neglected tropical disease, disproportionately affecting the most vulnerable populations around the world. Impetigo often occurs secondarily to scabies. Several studies have explored mass drug administration (MDA) programmes, with some showing positive outcomes—but a systematic evaluation of such studies is yet to be reported. The main aim of this systematic review is to generate comprehensive evidence on the effect and feasibility of MDA programmes in reducing the burden of scabies and impetigo.

Methods and analysis A systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Electronic databases to be searched will include CINAHL EBSCOhost, Medline Ovid, ProQuest, Science Direct, PubMed and SCOPUS. In addition, grey literature will be explored via the Australian Institute of Health and Welfare, Australian Indigenous HealthInfoNet, Informit, OaIster database and WHO. No language restrictions will be applied. All treatment studies following an MDA protocol, including randomised/quasi-controlled trials, and prospective before–after interventional studies, will be considered. The main outcome is the change in prevalence of scabies and impetigo The Cochrane collaboration risk of bias assessment tool will be used for assessing the methodological quality of studies. A random-effect restricted maximum likelihood meta-analysis will be performed to generate pooled effect (OR) using STATA V.16. Appropriate statistical tests will be carried out to quantify heterogeneity between studies and publication bias.

Ethics and dissemination Ethical approval is not required since data will be extracted from published works. The findings will be communicated to the scientific community through a peer-reviewed journal publication. This systematic review will present an evidence on the effect of MDA interventions on scabies and impetigo, which is instrumental to obtain a clear understanding of the treatments widely used in these programmes.

PROSPERO registration number CRD42020169544,

  • scabies
  • crusted scabies
  • norwegian scabies
  • skin sores
  • school sores
  • impetigo
  • MDA
  • permethrin
  • ivermectin
  • azithromycin

Data availability statement

No data are available. This is a systematic review protocol, hence not applicable.

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Data availability statement

No data are available. This is a systematic review protocol, hence not applicable.

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  • Contributors PG, WT, AM and JT conceived the study. PG, AM, WT and JT involved in developing the first draft. All authors contributed intellectually to the manuscript development.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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