Behavioral and Healthcare Determinants of Self-Reported Scabies in Chiwanda Ward, Nyasa District, Tanzania

Abstract

Scabies, caused by Sarcoptes scabiei, is a neglected tropical disease that disproportionately affects underserved rural communities, where transmission is commonly sustained through prolonged close contact and sharing of personal items.This study assessed household scabies experience and associated factors during a past outbreak in Nyasa District. A retrospective community based cross sectional study was conducted among 198 households from four villages. Data were collected using an AfyaData digitized, expert validated questionnaire aligned with the International Alliance for the Control of Scabies criteria to improve syndromic specificity. Quantitative data were analyzed using univariable and multivariable logistic regression. Open ended responses were analyzed thematically and triangulated with regression findings. Overall, 60.6% of households reported scabies experience during the outbreak period. In multivariable analysis, higher odds of household scabies experience were associated with sharing personal items (Rarely AOR = 4.059; Frequent AOR = 4.688) and receiving treatment during the outbreak (AOR = 4.705). Non collaboration with healthcare personnel showed increased odds but was not statistically significant (AOR = 2.035; p = 0.098). Households reporting unsure answers for previous scabies history (AOR = 0.235) and treatment (AOR = 0.249) had lower odds, indicating misclassification due to uncertainty. The following determinants were linked to qualitative themes: sharing items related to laundry, bedding, and clothing hygiene practices; treatment related to concerns about effectiveness and barriers to access; collaboration related to requests for education, outreach, and follow up; and unsure responses related to misunderstandings and uncertainty. In addition to highlighting the need for coordinated outbreak responses that prioritize household level prevention, reducing the sharing of personal items, improving access to effective treatment, and strengthening health system community engagement, the study shows a significant household burden of scabies. Triangulation of regression results with community narratives supports AfyaData value for standardized, criteria-informed investigation and targeted public health action in Tanzania.