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<div><p>Background</p><p>Scabies is a common but neglected skin disease caused by the parasitic mite <i>Sarcoptes scabiei var</i>. <i>hominis</i>. Globally, the disease affects more than 400 million people. Although Ethiopia is a high-burden country for scabies, its epidemiology has not been well assessed. Therefore, this study aimed to determine the prevalence of scabies, clinical features, and associated risk factors in the communities of the Hawassa Zuria District of the Sidama Region, southern Ethiopia.</p><p>Methods</p><p>A community-based cross-sectional study was conducted from September through November 2023 in the Hawassa Zuria District. A multistage random sampling technique was applied to enrol 511 participants. The International Alliance for Control of Scabies Diagnostic Criteria was used for examination. The data were collected electronically using the Open Data Kit application through a pretested interviewer-administered questionnaire. Analysis was performed using STATA software. The binary logistic regression analyses model was used to assess the association between each independent variable and scabies prevalence. During the bivariate logistic regression analyses a variable with a p-value of < 0.25 was a candidate for multivariable logistic regression analyses. In multivariable logistic regression analyses the odds ratios with a 95% confidence interval and a p-value less than 0.05 were used to describe the strength of the association and statistical significance.</p><p>Results</p><p>The median age of the study participants was 19 years (interquartile range: 11–32 years), and 52.6% of the participants were females. The overall prevalence of scabies was 6.3% (95% CI 4.3–8.7%). The majority of individuals with scabies had a moderate degree of severity. The most frequent lesions were intensely itchy papules, vesicles, and pustules that appeared in the interdigital space, flexor wrist surfaces, and elbow. Males were more likely to have scabies [adjusted odds ratio (AOR) = 2.57; 95% CI: 1.10–6.00] than females were and it was not influenced by age. The risk of scabies was higher for households with low (AOR = 3.88; 95% CI: 1.01–14.91) and middle-class wealth index (AOR = 4.43; 95% CI: 1.13–17.33), as well as for individuals residing in households with an overcrowding index >1.5 (AOR = 2.64; 95% CI: 1.13–6.18), in those individuals who washed their hands with water only (AOR = 2.98; 95% CI: 1.23–7.24), in those who used an unimproved water source (AOR = 2.98; 95% CI: 1.25–7.06) and in those who slept on the floor (AOR = 2.70; 95% CI: 1.17–6.18).</p><p>Conclusion</p><p>The observed moderate presence of scabies in the study area stresses the need to strengthen disease management efforts, improve wealth, reduce overcrowding, ensure clean water access, and promote better hygiene practices to reduce the spread of scabies.</p></div>