Estimation of scabies prevalence using simplified criteria and mapping procedures in three Pacific and southeast Asian countries

Background Scabies causes considerable morbidity in disadvantaged populations. The International Alliance for the Control of Scabies (IACS) published consensus criteria in 2020 to standardize scabies diagnosis. However, these criteria are complex, and a WHO informal consultation proposed simplified criteria for mapping, to identify regions of high prevalence as targets for mass drug administration. We aimed to investigate the accuracy of simplified criteria in determining scabies prevalence, compared to the 2020 IACS criteria. Methods We obtained data relating to demographics, relevant history and skin lesions from all-age prevalence surveys from Fiji (n = 3365) and Solomon Islands (n = 5239), as well as school-aged children in Timor-Leste (n = 1043). We calculated prevalence using the 2020 IACS criteria and simplified criteria and compared these disease estimates. Results There was no significant difference in the pooled prevalence using the two methods (2020 IACS criteria: 16.6%; simplified criteria: 15.6%; difference = 0.9, [95% CI -0.1, 2.0]). In Timor-Leste, the prevalence using simplified criteria was lower (26.5% vs 33.8%). Simplified criteria had a sensitivity of 82.3% (95% CI 80.2, 84.2) and specificity of 97.6% (95% CI 97.2, 97.9) compared to the 2020 IACS criteria. Conclusions The scabies prevalence estimation using simplified criteria was similar to using the 2020 IACS criteria in high prevalence, tropical countries. The prevalence estimation was lower in the school-based survey in Timor-Leste. Mapping using simplified criteria may be a feasible and effective public health tool to identify priority regions for scabies control. Further work assessing use of simplified criteria for mapping in a field setting should be conducted.

Insights from mathematical modelling on the proposed WHO 2030 goals for scabies

Scabies was adopted by the World Health Organization (WHO) as a Neglected Tropical Disease in 2017. There is currently no formal global scabies control programmes or existing WHO guidelines on scabies control although at least two countries, Fiji and Ethiopia, have adopted national approaches to scabies control. In February 2019 WHO held a first Informal Consultation on a Framework for Scabies Control, in part as a response to multiple national requests for guidance on public health management in high disease burden areas. Below we outline control strategies proposed at this meeting and summarise the role that modelling can play in supporting the development of evidence to translate these proposals into formal WHO recommendations and national and global control programmes. Provisional proposals discussed at the WHO Informal Consultation for a scabies control programme include the use of mass drug administration when the community prevalence of scabies is ≥ 10% (generally considered to reflect a childhood prevalence of at least 20%) and the use of intensified case management when the prevalence is below 10%.

Academic Dental Librarianship in Canada: Taking Stock, Planning the Future

The Oral Health Interest Group/Groupe d’intérêt en santé buccale of CHLA/ABSC, established in 2016, aims to act as a source of networking for dental librarians in Canada, conduct research, and advocate for the specialty. In the present article, the first produced by OHIG, the authors describe the current landscape of academic dental librarianship in Canada using data resulting from an informal consultation of all OHIG members. Examples of distinctive practice are highlighted through a series of vignettes, and the overview is set in context through a literature review of dental librarianship, focussing on Canadian contributions to the speciality. The article concludes with the authors’ reflections into possible directions the specialty may take over the next few years, noting the importance of increased embedded collaboration with faculty and the need to develop new skills, for example, to support research data management and new trends in scholarly communications.

La Unión Europea, Cataluña y Escocia (Cuestiones jurídicas sobre las recientes tendencias secesionistas en los Estados Miembros de la UE)

Este estudio surge de los acontecimientos producidos en 2014 y 2015 en Escocia (referéndum sobre la independencia) y en Cataluña («consulta informal» y elecciones autonómicas). En ambos casos, los movimientos secesionistas deseaban que un nuevo Estado nacido de la secesión llegara a ser (según ellos, «siguiera siendo») parte de la UE. Esta convicción les fortalece, ya que la UE es vista como un «refugio seguro », que permite la independencia sin la amenaza de quedar aislado. Los Tratados de la UE ni prevén ni prohiben la división de un Estado miembro. No obstante, para llegar a ser parte de la UE, la región secesionista debería primero ser reconocida como Estado por la comunidad internacional, y específicamente por los 28 Estados miembros de la UE (incluyendo España y el Reino Unido). Esto sería legalmente posible si el nuevo Estado naciera respetando completamente el Estado de Derecho, pero en cambio excluiría un «Estado» que hubiera declarado unilateralmente su independencia violando la Constitución nacional. Así, un nuevo Estado reconocido podría ser candidato a incorporarse a la UE. El autor muestra que debería seguirse el procedimiento del artículo 49 del Tratado de la UE y no el del artículo 48 (enmiendas a los Tratados). Tomando Escocia como ejemplo, el autor describe los pasos legales necesarios que deben darse después de la secesión. Señala que la división de un Estado de la UE ya no debería verse como un asunto estrictamente nacional; dadas sus consecuencias sobre la UE en conjunto y sobre otros Estados miembros, es un asunto que no puede ser ignorado por la UE.This study starts from the 2014-2015 events in Scotland (referendum on independence) and in Catalonia («informal consultation» and regional elections). Secessionists movements in both cases wished that a new State born from the secession would become (according to them «continues to be») part of the EU. That conviction strengthens them, as the EU is seen as a «safe haven», allowing independence without the threat of being isolated. The EU Treaties neither provide for, nor prohibit the partition of a Member State. However, in order to become part of the EU, the secessionist region should first be recognized as a State by the international community, and specifically by the 28 EU Member States (including Spain and the UK). This would be legally possible if the new State was born in full respect of the Rule of Law, but would exclude a «State» having unilaterally declared its independence in violation of the national Constitution. Then, a new State recognised could be a candidate to the EU. The author shows that the procedure of article 49 of the Treaty on EU woud have to be followed (accession of a new State) and not that of article 48 (amendments to the Treaties). Taking Scotland as an example, the author describes the necessary legal steps to be accomplished after the secession. He stresses that the partition of an EU State should not anymore being regarded as a strictly national matter. Given its consequences on the EU as a whole and on other Member States, it is a matter that cannot be ignored by the EU.