An Immunodiagnostic Assay for Scabies

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Scabies is a global disease and a major health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia prevalences of up to 50% in children have been described, despite the availability of effective chemotherapy. Scabies is caused by a tiny mite burrowing under the skin and symptoms include intensely itching lesions that can be very distressing, and often become secondarily infected with Group A Streptococcus. These skin sores can result in serious complications, including blood poisoning and kidney damage. Control of scabies is hindered by difficulties with diagnosis, the cost of treatment, evidence for emerging resistance, and lack of effective vaccines. The symptoms of scabies infestations can mimic many other skin diseases such as dermatitis, eczema, impetigo, and allergic reactions, and traditional tests to diagnose scabies are often less than 50% accurate. Control measures in endemic regions include community-based scabies intervention programs and although successful at reducing levels of scabies in the short term, have proved difficult to sustain due to low levels of scabies persisting within communities. Recent developments leading to expression and purification of scabies mite recombinant antigens have identified a number of molecules with diagnostic potential and this study aims to investigate the accuracy of these recombinant proteins to identify scabies specific antibodies in people with active scabies. An effective simple, cheap, rapid, sensitive and specific diagnostic test for scabies will aid in the early identification of disease and thus treatment. Furthermore it will enable the selective treatment of affected children and their families, reducing the requirement for mass treatment and associated costs, decrease the potential for escalating mite resistance, and provide another means of controlling scabies in highly affected areas.