Association between nutritional status and scabies infestation in a boarding school in Indonesia: a crosssectional study

Background: Scabies is an infestation caused by Sarcoptes scabiei var. hominies, prevalent in children with poor nutritional status and hygiene, particularly in overcrowded communities. Indonesia has 14.5% cases of the double burden of malnutrition among school-aged children. As there has been no study establishing the role of nutritional status in the occurrence of scabies, this study aims to investigate the association between body mass index (BMI) and height with scabies infestation in an Islamic boarding school in Indonesia. Methods: This was a cross-sectional study conducted in an Islamic boarding school in Indonesia with children aged 11-17 years old as participants. Physicians performed anthropometry measurements, and a dermatologist confirmed the diagnosis of scabies through history taking and physical examination. Logistic regression was used to analyze the association between BMI and height and the prevalence of scabies. Results: Of 287 subjects, 135 (47%) were diagnosed with scabies, with a male predominance (66.1%). Most of the subjects had normal weight (76.7%) while 20 (7%) were underweight, and 153 subjects (53.3%) had short stature. Male subjects were four times more likely to be infested by scabies (P < 0.001). Obese and short subjects were 4 and 1.67 times more likely to develop scabies, respectively. Conclusion: Poor nutritional status represented by BMI and height cannot be regarded as an independent risk factor for scabies, while environmental factors might be the most crucial factors in the development of scabies. A holistic approach addressing these factors should be implemented to eradicate scabies in addition to appropriate pharmacological management.