Table 1. Priority research issues for scabies control.
| Medications and safety |
| Effectiveness of single-dose ivermectin-based MDA strategy (compared to current 2-dose recommendation) |
| Safety of ivermectin in currently contraindicated groups (pregnant and breastfeeding women and children weighing <15 kg or <90 cm in height) |
| Safety of permethrin in infants aged <2 months |
| Safety of coadministration of ivermectin with medications used in other MDA programs |
| Efficacy of moxidectin for the treatment and community control of scabies |
| Interventions |
| Prevalence thresholds for starting and stopping MDA |
| Optimal number of MDA rounds to achieve sustainable control |
| Effectiveness of MDA in diverse settings including non-island and urban settings |
| Effectiveness of control strategies when scabies prevalence is <10% (including targeted MDA, screen and treat, and IDM); comparisons of effectiveness, cost, and feasibility should be made with community MDA |
| Integration of MDA regimens that use ivermectin for other NTDs to maximize the impact on scabies. |
| Effect of stopping ivermectin MDA for other NTDs on scabies transmission |
| Effectiveness of MDA for scabies outbreaks in various settings |
| Mapping, monitoring, and evaluation |
| Further validate the 2020 IACS criteria, rapid mapping criteria, and training programs for field assessment |
| Develop monitoring and evaluation methodologies, including sampling, diagnostic tools or needs, and frequency of assessment |
| Define the relationship between scabies prevalence in schools and in communities |
| Define the relationship between scabies and impetigo in various settings, including the extent to which MDA for scabies reduces the burden of impetigo |
| Evaluate different sampling strategies for scabies mapping, including cluster and geospatial sampling designs |
| Integration of monitoring and evaluation for scabies into existing systems for other diseases |
| Develop new diagnostic tools (e.g., point of care or rapid diagnostic tests) aligned with programmatic thresholds |
| Develop strategies to detect recurrence of scabies transmission after cessation of MDA |
| Monitor for development of resistance of mites to ivermectin and permethrin |
| Morbidity and costs |
| Determine the impact of scabies MDA on the complications of scabies, including skin and soft tissue infections, invasive bacterial disease, glomerulonephritis, and rheumatic heart disease |
| Measure impact of scabies and associated impetigo on quality of life, including absenteeism from school and work and broader social costs |
| Compare cost of scabies control program activities and health-related cost savings and cost-effectiveness of control strategies |
IACS, International Alliance for the Control of Scabies; IDM, intensified disease management; MDA, mass drug administration; NTD, neglected tropical disease.