Sexually transmitted scabies in resource-limited settings: a facility-based cross-sectional study

Objective: Recent surges in scabies incidence in some countries have been attributed to increased transmission through sexual contact. Few data are available on the burden of sexually transmitted scabies in Sub-Saharan Africa. We aim to determine the incidence and sociodemographic variables associated with sexually transmitted scabies in Ile-Ife, Nigeria. Patients and Methods: Three thousand three hundred nineteen medical records from a dermatology and genitourinary clinic in Ile-Ife, Nigeria, covering new patients treated between 2017-2023, were reviewed. Statistical tests were performed to determine the incidence of genital scabies, associated sociodemographic characteristics, and the relationship between sexually transmitted scabies and traditional non-HIV sexually transmitted infections (STIs). The level of statistical significance was set at p<0.05. Results: Sexually acquired scabies were the third most frequent STI, constituting 25.84% (54/209) of all STI consultations and 18.18% (54/297) of newly confirmed scabies cases. It was diagnosed nearly exclusively in males (92.59%, p<0.001, OR: 12.025, 95% CI: 4.141-34.919) within the 20-29 age group (p<0.001). Sociodemographic and behavioral characteristics associated with genital scabies aligned with traditional STI risk factors (p>0.05). 61.1% of genital scabies cases exhibited concurrent STIs, notably anogenital warts (46.3%). Multiple STI diagnoses were four times more prevalent in scabies patients (p<0.001, OR: 4.369, 95% CI: 2.274-8.397). Regression analysis highlighted male sex, lower education, and socioeconomic status as pivotal factors for genital scabies. Additionally, male sex and a genital scabies diagnosis were predictive of multiple comorbid STIs. Conclusions: Sexual transmission of scabies is common among young adult males and has a significant association with other STIs not fully preventable by condoms. There is a need for public health programs to raise awareness of non-condom preventable STIs among sexually active young adults.