Factors associated with scabies severity and reinfection: A cross-sectional study during recent surges in the Chattogram Division, Bangladesh

Objectives: This study aimed to assess the severity level, reinfection pattern, and associated factors of scabies in the Chattogram Division of Bangladesh. Methods: This is a cross-sectional household-based study conducted among 349 scabies-affected participants using multi-stage cluster sampling. Data were collected through face-to-face interviews using a structured questionnaire. The study considered two primary outcome variables, namely, severity and reinfection rate. Descriptive analyses were conducted to show frequency and percentage, heatmapping for geographical variation, and chi-square tests for bivariate association; to identify the associated factors, multinomial logistic regression was performed. Results: Of the participants, 44.3% experienced severe scabies, whereas 34.1% of the participants faced reinfection three or more times in the last 12 months. Chattogram district showed the highest hotspot burden for severity and reinfection. Children and older adults had significantly higher odds of severe scabies problems. Low educational attainment, infrequent bathing habits, pus discharge, poor hygiene, excessive dust, sharing bed or cloth items, and family history of scabies or skin disease were strongly associated with increasing severity and reinfection. In addition, combined treatments are found to be more effective than traditional methods or single treatments. Conclusion: This study reveals a significant burden of scabies severity and reinfection that emphasizes household-focused and community-based treatments.